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Home My WebLink AboutBUSINESS PLAN~,r ~ ~ ELIZALDE JEVLRY 3201 F STREET __ I ,:, ELIZALDE JEWELRY SiteID: 015-021-002430 Manager NATALIA ELIZALDE Location: 3201 F ST 132 City BAKERSFIELD BusPhone: (661) 631-0885 Map 102 CommHaz Extreme Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ARMANDO ELIZALDE / OWNER NATALIA ELIZALDE / Business Phone: (661) 631-088 5x Business Phone: (661) 631-0925x 24-Hour Phone (661) 345-756 9x 24-Hour Phone (661) 345-0332x Pager Phone (661) 345-756 9x Pager Phone (661) 345-0332x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ARMANDO ELIZALDE Phone: (661) 631-0885x MailAddr: 3201 F ST 132 State: CA City BAKERSFIELD Zip 93301 Owner ARMANDO ELIZALDE Phone: (661) 631-0885x Address 3201 F ST 132 State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ENS D teased on my inquiry of those individuals responsib;e for obtaining the information, I certify under penalty of law that I have personally ermined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~ ~ 7 ' S na re Date -1- 07/11/2007 f 1 F ELIZALDE JEWELRY SitelD: 015-021-002430 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 180.00 FT3 Hi OXYGEN F IH DH G 249.00 FT3 Low HELIUM F P IH G 217.00 FT3 Min WASTE CYANIDE SOLUTION DH L 55.00 GAL Min -2- 07/11/2007 -3- 07/11/2007 ? ~ F ELIZALDE JEWELRY ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME PROPANE Location within this Facility Unit SHOP STATE TYPE PRESSURE _ Gas TPure Above Ambient SitelD: 015-021-002430 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 74-98-6 TEMPERATURE CONTAINER TYPE -- Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATIONI Largest Co180100rFT3 Daily M80100m FT3 4 Daily A80r00e FT3 t1tiG.~tc.u~ua wlnrvlv~lv_15 $Wt. RS CAS# 100.00 Propane Yes 74986 tiF~GAKL A~SL"~551~1L'1V"1_a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit SHOP STATE TYPE PRESSURE _ Gas TPure -Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 249.00 FT3 249.00 FT3 ruic,~rcLV V a ~.vlnrviv~ly 1 a %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 riEiGEiiCL H.7.7L' w7.`~1~11",1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/11/2007 r F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: SHOP CAS# 7440-59-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas _ TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 217.00 FT3 217.00 FT3 I 217__.00 FT3 nt~~t~ttLVU~ ~~inrvlv~ly l ~ %Wt. RS CAS# 100.00 Helium No 7440597 ts~,Gtitc.L tjaa~aai~i~iv 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE CYANIDE SOLUTION Days On Site 365 Location within this Facility Unit Map: Grid: REPAIR RM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 30.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# riHG!-itCL 1~~ 5~.7A1~1L"1V1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Min -5- 07/11/2007 r F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 02/26/2007 ~ MP ENVIRONMENTAL SERVICES, 3400 MANOR ST, 393-1151. Employee Notif./Evacuation 02/26/2007 IN CASE OF LIQUID FALLS WE HAVE AN OIL ABSORBANT TO USE TO CLEAN UP. Public Notif./Evacuation N/A 02/26/2007 Emergency Medical Plan 02/26/2007 CALL 911. -6- 07/11/2007 ,~ F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 02/26/2007 ~ ALL TANKS ARE CHAINED UP. Release Containment 02/26/2007 N/A Clean Up 02/26/2007 N/A Other Resource Activation -7- 07/11/2007 r~ F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCC1d1 rid'Gc1.LUS Utility Shut-Offs 02/26/2007 MANUAL SHUT-OFFS. Fire Protec./Avail. Water EXTINGUISHER 02/26/2007 Building Occupancy Level N/A 02/26/2007 -8- 07/11/2007 J ~ ~~ F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/26/2007 ~ BRIEF SUNIMARY OF TRAINING PROGRAM: TWO WEEKS TRAINING IN HOW TO USE ALL HAZARDOUS MATERIALS AND HOW TO PREVENT ACCIDENTS. rc~yc a nc.iu ivi ru~.uic vac Held for Future Use -9- 07/11/2007 + ELIZALDE JEWELRY ____________________________________ SiteID: 015-021-002430 + ~ k. ~ ~ Manager BusPhone: (661) 631-0885 Location: 3201 F ST 132 Map 102 CommHaz High City BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ARMANDO ELIZALDE / OWNER / Business Phone: (661) 631-0885x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ARMAND~ ELIZALDE"~ -Phone: (661) 631-0885x MailAddr: 3201 F ST 132 State: CA City BAKERSFIELD Zip 93301 Owner ARMAND~! ELIZALD'E~ Phone: (661) 631-0885x Address 3201 F ST 132 State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT PROG ~I - HAZ WASTE GEN ~N~°~ A ~ ~ ~ Z~~~ Sased on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, a plete. ~ ~~ ~' ~~ Signati(re Date -1- 02/27/2006 UNIFIED PROGRAM INSPECTIO SECTION 1: Business Plan and Inventory Program Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO. NO OF EM YEES Za ~' r 3 z. ,$K/~,~ -~: l~ cry s~ o ~ ~ -~ ~S ~ FACILITY CONTACT ~ BUSINESS ID NUMBER 15-021- ~„ ~~ ~ l v~ ~s.v Z~. ~ Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance OPERATION V=Violation COMMENTS / CI ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS l~^ CORRECT OCCUPANCY L'T ^ VERIFICATION OF INVENTORY MATERIALS ~~~IL~ ®~ ® QOr] L!~ f'~ y`~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES L'7 LJ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING L°T LJ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 / ~ ~~ Inspector (Please ~7PriTTnt) Fire Prevention 11s` In 1 Shift of SitelStation # - White -Prevention Services Yellow -Station Copy Pink -Business Copy ~~ ; ~ ~~ ,. N CHECKLISTS B E R S F t D ~.~-__~.. ~.~___ F/RE ARTM T FD 2155 (Rev. 09/05 ,,., ~ nor-ouw ANY HAZARDOUS WASTE ON SITE? L_ tJ ^ NO ~ ~~~ t "k ' in - - d ELIZALbE JEWELR11Y SiteID: 015-021-002430 Manager Nu.t~1`~ ~1'~"~ BusPhone: (661) 631-0885 Location: 3201 F ST 132 Map 102 CommHaz Low City BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 01 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ARMANDO ELIZALDE / OWNER / Business Phone: (661) 631-0885x Business Phone: (cwt, ) c.3t - a~ZSx 24-Hour Phone (~~,~) 3YS -'15'bgx 24-Hour Phone (~t;l ) 3~{S -a~x Pager Phone (~bt ) '~~{S - 1~6`lx Pager Phone (Gaol. ) 3`iS -O~3ax Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ARMANDO ELIZALDE Phone: (661) 631-0885x MailAddr: 3201 F ST 132 Stater CA City BAKERSFIELD Zip 93301 Owner ARMANDO ELIZALDE t Phone: (661) 631-0885x Address 3201 F ST 132 State: CA .. City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Based on my inquiry of those individuals ~~~~ responsible for obtaining the information, I certify under penalty of la~v that I have personally examined and am familiar with the information submitted and belie the information is true , accurate, an omp e. S gnature Date -1- 01/30/2007 ,~ i. ?, F ELIZALDE JEWELRY ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002430 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 180.00 FT3 Hi OXYGEN F IH DH G 249.00 FT3 Low HELIUM F P IH G 217.00 FT3 Min WASTE CYANIDE SOLUTION DH L 55.00 GAL Min -2- 01/30/2007 R --~ -3- 01/30/2007 ~ n `l ; _ r F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: SHOP CAS# 74-98-6 STATE T TYPE PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE ~GaS I Pure Above Ambient I Ambient I PnRT _ PRESS _ CYT,TNI~RR I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 180.00 FT3 180.00 FT3 180.00 FT3 HAZARDOUS COMPONENTS ~Wt• RS CAS# 100.00 Propane Yes 74986 I1tiGtitCL tiJ ~JL~.7J!°1ralV 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SHOP CAS# 7782-44-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 249.00 FT3 I 249.00 FT3 rirsutu~LVVa L.vP7r V1V L~1V1S %Wt• RS CAS# 100.00 Oxygen, Compressed No 7782447 i1tiL~tiLCL Yi J w7 L~J.71~1L~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 01/30/2007 ~; `` r _ ~~ F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: SHOP CAS# 7440-59-7 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 217.00 FT3 217.00 FT3 217.00 FT3 - HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Helium No 7440597 t1AL,Al[L A7Jt;5~1~i1"~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min, ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE CYANIDE SOLUTION Days On Site 365 Location within this Facility Unit Map: Grid: REPAIR RM CAS# Liquid TWaste ~ Ambient~E ~ AmbientT~E DRUM/BARRELENONMETAL~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 30.00 GAL HAZARDOUS COMPONENTS , °sWt . RS~ CAS# nt~~rseu~ tia ~1,~51~il,lvt5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Min -5- 01/30/2007 t n J F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ 1-~yclluy 1VV1.111C:d1.1V11 M P .~~ ~~ fay ~~.~~.~ ~~~ ~ r yes, ~y o0 1~.~, ro-- s-~. ~~ ~ ~~~°~ ~ k e.rs ~ i ~~ ~, C~~,~ 3g~-~rsl _, r ,~ uu~~ivycc ivvt,ii . / ~Vd~udt_1V11 ~ r~ G.c.-S e. ~ C' (' Cj c~ i G~. t Cl I ~ S ~A/ Q... ~ r;W Q ~ J'~ rl.LiJ11C: ivV1.11 / L' VdC:Udl.1V11 N~A LiutCLyCilC:y 1.1CU1C:d1 Y1d11 ~~.~1 ~~t .-~ -6- 01/30/2007 r 5 f F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention - (,~ \ ~ '~a,,,,,~5 cxr e ~-i F,lz `r~i ~~~ ~ ~-Yl Chu: i'i $ . i~C 1C0.C7C L.V111.Q 111ILIC1IV ~~ ~ ~ U ..~ VLGQ.11 Vt./ I P, ~~ iJ Other Resource Activation -7- 01/30/2007 ~. . _ _ , -- r F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~Nc1:1a1 na:c~al.u~ V 1.111. 1.Y iJllu 1.-V1L~ __ _. - __ _ _. __ ~N1,u nun( S ~Jf -v1~~s~ ,~ , i-~.1_c rl.v~.c~.. jrivail. r~al.cl. - 2. x ~' D U111Allly Vla. u~JQlll.y LG V C1 NSA -8- 01/30/2007 _ ~ ~- ~-t F ELIZALDE JEWELRY SiteID: 015-021-002430 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training Z ~w~elS k~~:~~~..~ 1~ 1 I ~o ~ .~ o uSe. ~~~ H ~ZaYO~oUS f`'~c~t~ /~ G. ~S ~- p r e v ev'l,~ G,GC ~ ~ e,~.~"S AvtiO~ ~•o w P rctyC G Held for Future Use n.ciu ivL ru~,uic vac -9- 01/30/2007 e `~ • ~y~~ ~'~~ CITY. OF BAKERSFIELD FIRE DEPARTMENT ~~ ~ OFFICE OF ENVIRONMENTAL SERVICES ~ ~ ~ UNIFIED PROGRAM INSPECTION CHECKLIST `w ~~,i~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME C/,'Z9/olL ~-e~.-~~I r'.. INSPECTION DATE ~ 3 -a ~ _ ADDRESS ~ Gi r s~. s'fe, ~' ~ 3?_ PHONE NO. ~3 !-a ~cS FACILITY CONTACT q .hQ BUSINESS ID NO.__ 15-210- INSPECTION TIME c? S : ~ n NLIMBER OF EMPLOYEES s _ J Section 1: Business Plan and Inventory Program ^ Routine ^ Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials 1 Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures ~ , .~ Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~ Yes ^ No • Explain: ~e ~(r., ~ . /~ a ,..~ , ~.. 9 Questions regarding this inspection? Please call us at (661) 326-3979 si e ' e Responsible Party Z~ White -Env. Svcs. Yellow -Station Copy Pink -business Copy Inspector: _. - ~... _ Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST ., Enironn><entai Services - 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 ~~ Tel: (661)326-3979 ~ • • -_ __ FACILITY NAMF~ INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees 3~c?1 F's-t. 132- ~~ ~ - v~~S ____ FACILITYCONTACT Business ID Number VU 1 ~°~ rx Idp ~a 15-021- Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V \V=Vioaplonnce~ OPERATION COMMENTS Lrl ^ /4PPROPRIATE PERMIT ON HAND lJ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE i~ ^ VISIBLE ADDRESS ~^ CORRECT OCCUPANCY L'J ^ VERIFICATION OF INVENTORY MATERIALS ~^ VERIFICATION OF QUANTITIES ~~/'^ VERIFICATION OF LOCATION D ^ PROPER SEGREGATION OF MATERIAL -r--------- ------------------------ ----__.._.-..------ -- _ ____---- -_....---_..---_.._.-..---- - _- -- __ __------ ------------ L~ ^ VERIFICATION OF MSDS AVAILABILITYE ~^ VERIFICATION OF HAT MAT TRAINING ~ LY ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^,. FIRE PROTECTION ~ - ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661 ~ 326-3979 __- -/--f~ ~~ rl~? - - -- -------------- -------- - --- - - Inspector (Please rint) Fire Prevention 1st-InlShift of Site s n s ite Resp si tnt) N White -Environmental Services Yellow -Station Copy Pink - Busine opy ~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER / OPERATOR IDENTIFICATION FACILITY INFORMATION Page __ Of __ · .. ,. ,: ; < ,..:i;;,;~,~;~,~,,~,~.z,~ , ,. ,,~ ,..~..,~;,~:. ~:~ . ~ . , . . . . ./.. . FACILI~ID · j j ~ ~ ~ ~ ~ ~ ~ Year Beginning ~ ~oo ~ Year Endin~~ BUSINESS NAME (Same as FACILI~ NAME 9r DBA- Doing Business ~) 3 BUSINESS PHONE ~02 SITE ADDRESS ~ L. ~ , .~ ~_ DUN & ~ SiC CODE B~DSTREET (4 Digit ~) COUN~,,~P~ ~ . r do -~ ........ ~, ;.~,~ ~:~,~'~ ~, ~, ~'~ ,',:.:~ ~, ~ ~ ~,~,,~,,~?~, .... ~' ~;~,~,~!~.: OWNER INFORMATION ~ ,,.~, ~. ~.~ ~, ~: ? ....... ~?,:: ~,:: ~:,,- O~ER ~ILING CONTACT NAME a~z ~ CONTACT PHONE ~ CONTACT ~ILING ~9 ~ ADDRESS TITLE ~~ ~25 TITLE ~ ~~ BUSINESS PHONE ~ BUSINESS PHONE ~3~ 24-HOUR PHONE 127 24-HOUR PHONE 132 PAGER ~ ~28 PAGER ~ 133 CeAiflcation: Based on my inqui~ of those individuals responsible for obtaining the info~ation, I ~ under penal~ of law ~at I have personally examined and am familiar ~t~e info~ation submiEed in this invento~ and believe the information is true, a~urate, and ~mplete. ~ ~s o~ o~o~ (p~nt)~ ~ ,~ ~ ~}~c[ o~ o~o~o~ UPCF (7~99) ' S:\CUPAFORMS\OES2730.TV4.wpd CORI[ECTION NO ICE BAKERSFIELD F. IRE. DEPARTMENT Location ~ 7_-o,. ~ </~ d', ~; Name ~t ~~ You ~e hereby required to m~e ~e co~ections at ~e above location: ~Or. RO. C~mpletion Date for Corrections .... " Inspe~or FD 1~ 326 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME., ff i! ~-~.l _Ac "5-~,y~L}r~ INSPECTION DATE ,.3/o~-? ADDRESS FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program ~Routine [~ Combined ~ Joint Agency [~ Multi-Agency ~l Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan conlact information accurate Visible address Correct occupancy i/ Verification of inventory materials i/ Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Explain: ' Questionsregardin§thisinspection?Ple,,,¢allu$,t(661,326-,979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy I CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 550O / FACILITY NAME ~d._t2.,a,t_c~6 ..3~,,~E-t.O,V INSPECTION DATE l/ l ADDRESS 3R. ot V 51- ~ l'">~ PHONE NO. 6'3 1 ~ o~6~s- INSPECTION TIME NUMBEROF EMPLOYEES ~ Section 1: Business Plan and Inventory Program /0,~ -~ ~.~ ~ Routine [~ Combined {~ Joint Agency {~J Multi-Agency ~,~ Complaint ~ Re-inspection OPERATION C V: COMMENTS Appr. opriate permit on,hand ~ ~°E.-~--~.¢ n: Busines~ plan contact information accurate Visible address Correct occupancy Verification of inventory materials ~ I, '141~c' °~"x ,,, Verification of quantities . . . ~dla~ 2. t Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures ~..~ Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection .... Site Diagram Adequate & On Hand C=Compliance V=Violation Questions regarding this inspection? Please call us at (661) 326-3979 B~ess Site Responsible i~a~t White - EnD. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: