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GRAPEVINE OIL ii; 524 DOLORES STREET __ ___._.__ ___-__ ______-______-__. _.___ e t GRAPEVINE OIL SiteID: 015-021-001253 Manager LISA GUNTER Location: 524 DOLORES ST City BAKERSFIELD BusPhone: (661) 327-7611 Map 103 CommHaz Low Grid: 29C FacUnits: 1 AOV: CommCode: BFD STA 02 EPA Numb: SIC Code:5171 DunnBrad:00-823-7492 Emergency Contact / Title Emergency Contact / Title LISA GUNTER / MARKETER A CARR.ASCO / DISPATCHER Business Phone: (661) 327-7611x Business Phone: (661) 327-7611x 24-Hour Phone (661) 201-5020x 24-Hour Phone (661) 201-5024x Pager Phone ( ) - x Pager Phone (661) 872-5561x Hazmat Hazards: Fire ImmHlth DelHlth Contact LISA GUNTER Phone: (661) 327-7611x MailAddr: PO BOX 10075 State: CA City BAKERSFIELD Zip 93389-0075 Owner JOANNE STANLEY Phone: (661) 327-7611x Address PO BOX 10075 State: CA City BAKERSFIELD Zip 93389-0075 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN flfl ~~~rV ] 1e~ ~ ~ r~ ~ ~~~I <<^~~' on my inrG~iry of those individuals r~,~sponsihle for otutanin~ the information, I certify under penalty of law that I have personally eramined and am familiar with the information submitted and ha!'s~sve the information is true, accur + ,and t},o , fete, ~~ -~ iyn !~ Da e ~~ -1- 07/11/2007 r. . s `? ?. -.% F GRAPEVINE OIL SiteID: 015-021-001253 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ANTIFREEZE F IH DH L 220.00 GAL Low WASTE OIL F DH L 55.00 GAL Low MOTOR OIL F DH L 4500.00 GAL Min GREASE/GEAR LUBE F IH DH L 2000.00 GAL Min -2- 07/11/2007 cC ,G '1 -3- 07/11/2007 ~, ;. fi '~ F GRAPEVINE OIL ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME ANTIFREEZE Location within this Facility Unit WHSE STATE TYPE PRESSURE Liquid TMixture r Ambient SiteID: 015-021-001253 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 107-21-1 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 220.00 GAL 110.00 GAL nt~~tucLVUS wmrvivl;tvl5 %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 rlr~~r~tcl~ r~5a1,~~ln~lvlJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL L1tiGtiiCLVUJ 1.V1~lYV1V ~1V 1.7 %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 LSLiGrittL HJ J~.7~71~1L+1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -4- 07/11/2007 Liquid TWaste ~AmbRent~E ~ AmbientT~E DRUM/BNARRELEMETALLI~ ~ '' F GRAPEVINE OIL SiteID: 015-021-001253 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: NW LOT & WHSE CAS# 64742-65-0 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 4500.00 GAL 2000.00 GAL L1LiGKKLV U.7 1..U1~lYU1V L' 1V 1.7 °sWt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 riliGEitCL EiJ.71;.7.71~11:,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME GREASE/GEAR LUBE Location within this Facility Unit WHSE STATE TYPE PRESSURE Liquid TMixtur~ Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 64742-65-0 TEMPERATURE ~~ CONTAINER TYPE Amhi rent I TIRTTM/R~1?7?~!T._M~!T~T.T.T~ AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum I Daily Average 55.00 GAL 2000.00 GAL 1400.00 GAL iiraurucLVVa ~.v1•trvtvr.,lVtJ SWt. RS CAS# 100.00 Lubricating Oil (Petroleum-Based) No 8020835 L1tiL~tiiCL L'iJ .7 L'JJ1"1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Min -5- 07/11/2007 c ~ k' c5 F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 09/19/2000 ~ UNOCAL WILL NOTIFY THE APPROPRAITE STATE AND LOCAL AGENCIES UNLESS THE SITUATION REQUIRES URGENT IMMEDIATE RESPONSE BY THE AGENCIES, IN WHICH CASE THE DEALER SHOULD NOTIFY THESE AGENCIES: 1) LOCAL AGENCY: BAKERSFIELD FIRE DEPT PHONE NUMBER: 326-3979 2) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 (24 HRS) 3) CALL FOR HELP IN CASE OF AN EMERGENCY BY DIALING 911. Employee Notif./Evacuation 01/14/2002 NOTICE WILL BE VERBAL, EMPLOYEES WILL EVACUATE BLDG AND MEET AT EMERGENCY ASSEMBLY AREA. Public Notif./Evacuation 09/19/2000 IF THERE IS ANY IMMEDIATE DANGER, ANNOUNCE TO ALL PERSONS ON THE SITE: "THERE IS AN EMERGENCY, PLEASE TURN OFF YOU ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY." Emergency Medical Plan 09/19/2000 KERN MEDICAL CENTER - 1830 FLOWER STREET - 326-2000. -6- 07/11/2007 }. ,~ ,. i ,J F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/08/1995 ~ ABOVEGROUND AUTOMOTIVE PRODUCT ARE STORED IN UNBREAKABLE CONTAINERS AND IN MINIMUM QUANTITIES. ALL EMPLOYEES ARE TRAINED IN SAFE HANDLING OF HAZARDOUS MATERIALS. Release Containment 07/17/1998 STOP A RELEASE USING EITHER ABSORBENT MATERIAL OR A FIRE EXTINGUISHER AS NECESSARY. Clean Up 05/08/1995 CLEAN UP WITH ABSORBENT MATERIAL, BROOM AND SHOVEL, OR BY VACUUM TRUCK IF NECESSARY. Other Resource Activation 09/19/2000 GOGGLES, GLOVES, BROOM, SHOVEL, ABSORBENT, FIRSTAID KIT, FIRE EXTINGUISHERS, TELEPHONES. -7- 07/11/2007 F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs 01/31/2007 A) GAS - E SIDE OF SITE B) ELECTRICAL - N CTR OF SITE C) WATER - E SIDE OF SITE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water - __- 11/20/2006 PRIVATE FIRE PROTECTION - TWO FIGURE EIGHT FOG NOZZELS AND SEVERAL DRY POWDER ANSUL FIRE EXTINGUISHERS. FIRE HYDRANT - NW CRNR KERN & EUREKA. Building Occupancy Level 03/01/2006 9 EMPLOYEES -8- 07/11/2007 i .yl .~ • f~ F GRAPEVINE OIL SiteID: 015-021-001253 Fast Format ~ Training Overall Site ~ Employee Training 11/20/2006 MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES MUST BE GIVEN THIS TRAINING BEFORE STARTING WORK, AND REFRESHER COURSES MUST BE PROVIDED ANNUALLY. RECORDS MUST BE KEPT TO SHOW WHEN EACH STATION EMPLOYEE HAS BEEN GIVEN HIS/HER SAFETY TRAINING. 1) THE HAZARDOUS CHEMICALS AND WASTES KNOWN TO BE PRESENT AT THE FACILITY, EITHER FOR THE WHOLE FACILITY OR FOR INDIVIDUAL WORK AREAS. 2) THE HAZARDS ASSOCIATED WITH THE MATERIALS. 3) THE INFORMATION CONTAINED ON LABELS, FORMS, AND MSDS SHEETS. 4) METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS. 5) REPORTING OF ADVERSE HEALTH OR ENVIRONMENTAL EFFECTS (TSCA REPORTING). 6) LOCATION AND CAPABILITIES OF EMERGENCY EQUIPMENT. USE OF EMERGENCY RESPONSE EQUIPMENT AND SUPPLIES ON SITE. 7) A REVIEW OF THE FACILITY EMERGENCY RESPONSE PLAN AND THE PROCEDURES USED TO CONTROL RELEASES OF TOXIC AND HAZARDOUS MATERIALS. 8) REPORTING AND NOTIFICATION PROCEDURES, AND ROLES DETAILED IN THE EMERGENCY RESPONSE PLAN. 9) PROCEDURES FOR COORDINATION WITH LOCAL EMERGENCY RESPONSE ORGANIZATIONS. 10)A HISTORY OF SPILLS AND RELEASES, EQUIPMENT FAILURES OR MALFUNCTIONS AT THE FACILITY, AND THE RESULTING PRECAUTIONARY MEASURES. 11)REFRESHER TRAINING IS PROVIDED ON AN ANNUAL BASIS. rayc c. I1G1U 1V1 t Ul~U1.C 1.15C -9- 07/11/2007 F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Training Overall Site ~ ~ Held for Future Use -10- 07/11/2007 w. \ .f GRAPEVINE OIL SiteID: 015-021-001253 Manager ~, / ,5 A- C~ (J N ?'~~~-- Location:~ 524 DOLORES ST - City BAKERSFIELD BusPhone: (661) 327-7611 Map 103 CommHaz Low Grid: 29C FacUnits: 1 AOV: CommCode: BFD STA 02 EPA Numb: SIC Code:5171 DunnBrad:00-823-7492 Emergency Contact / Title Emergency Contact / Title LISA GUNTER / MARKETER A CARRASCO / DISPATCHER Business Phone: (661) 327-7611x Business Phone: (661) 327-7611x 24-Hour Phone (661) 201-5020x 24-Hour Phone (661) 201-5024x Pager Phone ( ) - x Pager Phone :. (661) 872-5561x Hazmat Hazards: Fire ImmHlth DelHlth Contact : DTh7f~T/'~ ~(1C+TTL~O LlS~ ~UN7~3~~ phone: (661) 327-7611x MailAddr: PO BOX 10075 State: CA City BAKERSFIELD Zip 93389-0075 Owner ~OAN~(= ~TH~-N~-~=~ Phone: (661) 327-7611x Address PO BOX 10075 State: CA City BAKERSFIELD Zip : 93389-0075 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ~UC10 PJ ~ ~ D ~, e~ ~QiJJ 0"`~d on my inquiry of those individuals ~ an~,~i~ for obtaini un c ng the information, I certify penalty of law that I have examin personally ed and am fa iliar with the information s~~t?mitted and beliF ~ the information is true accur •e, and cc~?n , a ~ a u .~7 7 00~ Da -1- 01/31/2007 F GRAPEVINE OIL SiteID: 015-021-001253 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ANTIFREEZE F IH DH L 220.00 GAL Low WASTE OIL F DH L 55.00 GAL Low MOTOR OIL F DH L 4500.00 GAL Min GREASE/GEAR LUBE F IH DH L 2000.00 GAL Min -2- 01/31/2007 -3- 01/31/2007 4 ~ F GRAPEVINE OIL SitelD: 015-021-001253 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: WHSE CAS# 107-21-1 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 220.00 GAL 110'.00 GAL riAGAKLVU~ 1:V1~lYV1VL';1V 15 %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 t11~G1-1KL L~JJL' a~1~il;1V 1.7 TSecret' RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site' 365 Location within this Facility Unit Map: Grid: CAS# Liquid TWaste ~ AmbRent~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL riHGEitCLVU~ 1,V1~lYV1V1;1V1~ owt. Rs cAS# 100.00 Waste Oil, Petroleum Based No 0 ri1~GH.tCL 1-~~ a~a~l~tl;lvl~J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -4- 01/31/2007 F GRAPEVINE OIL SiteID: 015-021-001253 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: NW LOT & WHSE CAS# 64742-65-0 Liquid TMixtur~Ambient~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 4500.00 GAL I 2000.00 GAL nti~tuc~vua ~vriruivr,lvia %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 riAGHKL H~~t57~1~1~1V 17 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME GREASE/GEAR LUBE Location within this Facility Unit WHSE STATE TYPE PRESSURE Liquid TMixtur~mbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 64742-65-0 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container - Daily Maximum I Daily Average 55.00 GAL 2000.00 GAL 1400.00 GAL nx~xrc~uu~ ~uinrulv~iv t %Wt. RS •CAS# 100.00 Lubricating Oil (Petroleum-Based) No 8020835 ri1~GKK1J 1~,5~IS.7Jl~l~ly 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Min -5- 01/31/2007 ,~ F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 09/19/2000 ~ UNOCAL WILL NOTIFY THE APPROPRAITE STATE AND LOCAL AGENCIES UNLESS THE SITUATION REQUIRES URGENT IMMEDIATE RESPONSE BY THE AGENCIES, IN WHICH CASE THE DEALER SHOULD NOTIFY THESE AGENCIES: 1) LOCAL AGENCY: BAKERSFIELD FIRE DEPT PHONE NUMBER: 326-3979 2) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 (24 HRS) 3) CALL FOR HELP IN CASE OF AN EMERGENCY BY DIALING 911. Employee Notif./Evacuation 01/14/2002 NOTICE WILL BE VERBAL, EMPLOYEES WILL EVACUATE BLDG AND MEET AT EMERGENCY ASSEMBLY AREA. Public Notif./Evacuation 09/19/2000 IF THERE IS ANY IMMEDIATE DANGER, ANNOUNCE TO ALL PERSONS ON THE SITE: "THERE IS AN EMERGENCY, PLEASE TURN OFF YOU ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY." Emergency Medical Plan 09/19/2000 KERN MEDICAL CENTER - 1830 FLOWER STREET - 326-2000. -6- 01/31/2007 ;~ F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/08/1995 ~ ABOVEGROUND AUTOMOTIVE PRODUCT ARE STORED IN UNBREAKABLE CONTAINERS AND IN MINIMUM QUANTITIES. ALL EMPLOYEES ARE TRAINED IN SAFE HANDLING OF HAZARDOUS MATERIALS. Release.Containment 07/17/1998 STOP A RELEASE USING EITHER ABSORBENT MATERIAL OR A FIRE EXTINGUISHER AS NECESSARY. Clean Up 05/08/1995 CLEAN UP WITH ABSORBENT MATERIAL, BROOM AND SHOVEL, OR BY VACUUM TRUCK IF NECESSARY. Other Resource Activation 09/19/2000 GOGGLES, GLOVES, BROOM, SHOVEL, ABSORBENT, FIRSTAID KIT, FIRE EXTINGUISHERS, TELEPHONES. -7- 01/31/2007 •'? r~ F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~Nc~:iai na~aLU~ Utility Shut-Offs 01/31/2007 A) GAS - E SIDE OF SITE B) ELECTRICAL - N CTR OF SITE C) WATER - E SIDE OF SITE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/20/2006 PRIVATE FIRE PROTECTION - TWO FIGURE EIGHT FOG NOZZELS AND SEVERAL DRY POWDER ANSUL FIRE EXTINGUISHERS. FIRE HYDRANT - NW CRNR KERN & EUREKA. Building Occupancy Level 03/01/2006 9 EMPLOYEES -8- 01/31/2007 F GRAPEVINE OIL SiteID: 015-021-001253 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/20/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUNIlKARY OF TRAINING PROGRAM: EMPLOYEES MUST BE GIVEN THIS TRAINING BEFORE STARTING WORK, AND REFRESHER COURSES MUST BE PROVIDED ANNUALLY. RECORDS MUST BE KEPT TO SHOW WHEN EACH STATION EMPLOYEE HAS BEEN GIVEN HIS/HER SAFETY TRAINING. 1) THE HAZARDOUS. CHEMICALS AND WASTES KNOWN TO BE PRESENT AT THE FACILITY, EITHER FOR THE WHOLE FACILITY OR FOR INDIVIDUAL WORK AREAS. 2) THE HAZARDS ASSOCIATED WITH THE MATERIALS. 3.) THE INFORMATION CONTAINED ON LABELS, FORMS, AND MSDS SHEETS. 4) METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS. 5) REPORTING OF ADVERSE HEALTH OR ENVIRONMENTAL EFFECTS (TSCA REPORTING). 6) LOCATION AND CAPABILITIES OF EMERGENCY EQUIPMENT. USE OF EMERGENCY RESPONSE EQUIPMENT AND SUPPLIES ON SITE. 7) A REVIEW OF THE FACILITY EMERGENCY RESPONSE PLAN AND THE PROCEDURES USED TO CONTROL RELEASES OF TOXIC AND HAZARDOUS MATERIALS. 8) REPORTING AND NOTIFICATION PROCEDURES, AND ROLES DETAILED IN THE EMERGENCY RESPONSE PLAN. 9) PROCEDURES FOR COORDINATION WITH LOCAL EMERGENCY RESPONSE ORGANIZATIONS. 10)A HISTORY OF SPILLS AND RELEASES, EQUIPMENT FAILURES OR MALFUNCTIONS AT THE FACILITY, AND THE RESULTING PRECAUTIONARY MEASURES. 11)REFRESHER TRAINING IS PROVIDED ON AN ANNUAL BASIS. ruy~ a azciu tvt r u~.utc vac -9-' 01/31/2007 F GRAPEVINE OIL SiteID: 015-021-.001253 ~ Fast Format ~ ~ Training Overall Site ~ nclu ivi ru~utc ~~c -10- 01/31/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program • Section 1: Business Plan and Inventory Program ~ ~~L L1a' ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ~I Prevention Services R s e, ~ ,-„ A E 900 Truxtun Ave.,, Suite 210 , F/RE " Bakersfield, CA 93301 AR1•M T Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION.DATE INSPECTION. TIME G/L~~r v~tir orc- ~-~~°~ I3 ADDRESS s Zy OoLO~zs PHONE NO. 3 Z~ - ~~ 1/ NO OF EMPLOYEES - 3 F ITx CONTACT ~ ~ BUSINESS ID NUMBER 15-021- vlS l Z $~~ ~ - ~ `~ 1/ C V ~ C=Compliance OPERATION V=Violation COMMENTS ~J fd ^ APPROPRIATE PERMIT ON HAND CX ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE L~ ^ ~/ISIBLE ADDRESS V ~ ^ CORRECT OCCUPANCY / L~J' ^ ~/ERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL L~ ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING r, ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - ~ ~ ~On~``' 5+V ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ~~~ ~ ~_ (p ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WA/~S.T~E ON SITE? C''lYES NO EXPLAIN: ~~~ • '~~~~ DI QUESTIONS REGARDING THIS I NS PE CTION? PLEASE CALL US AT (661) 326-3979 i / ~ Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05