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HomeMy WebLinkAboutBUSINESS PLAN 8/1/2007FLOWER STREET MINI-MART ~' { 928 FLOWER STREE ~ ~: T ,, ~ ,. . ~-=_ ~, i ,- `~ ~3~d~ ~ ~~ ~~ ~~ ~~ ~t .i. -~ ~ _ ~~ ~~~ ,j 1~~ _. I r~ ,- ~.. ~ E ., ., 7I ~ Rm =-~ SiteID: 015-021-001244 Manager HUSSEIN ~ ~ ~-U;v~OQ.1~ BusPhone: (661) 328-0732 Location: 928 FLOWER ST Map 103 CommHaz Moderate City BAKERSFIELD Grid: 20D FacUnits: 1 AOV: CommCode: BFD STA 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title HUSSEIN % MANAGER 328a~ HUSSEIN A HUSSEIN / OWNER Business Phone: (661) 3~fi-°~~ Business Phone: (661) 322-1521x 24-Hour Phone (661) x g~~scj 24-Hour Phone (661) 872-6544x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact Phone: (661) 328-0732x MailAddr: 928 FLOWER ST State: CA City BAKERSFIELD Zip 93305 Owner HUSSEIN A HUSSEIN Phone: (661) 328-0673x Address 1200 FLOWER ST State: CA City BAKERSFIELD Zip 93305 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG U - UST EIVT~~ ~~~ f1 1 C~`1 2~~~ ~~~€~~ ~rj rrty inquiry of those individuals resp~h;~i~ti~a r~~r ~~rtaining the information, I certify under p~t~aity of faw that I have personally examir~p~ €~r~~i am familiar with the infiormation submitted and bQli9ve the information is true, accurate, and eomplete. g D - 1 ~ (~~ Signature Date -1- 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: EXPRESS MINI MART Cross Street Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper PROPERTY OWNER INFORMATION ICC Nbr: Name HUSSEIN A HUSSEIN Phone: (661) 322-1521x Address: City State: Zip: Type INDIVIDUAL TANK OWNER INFORMATION Name HUSSEIN A HUSSEIN Phone: (661) 322-1521x Address: City State: Zip: Type INDIVIDUAL BOE UST Fee# UNKNOWN Financ'1 Resp: STATE FUND Legal Notif Tank Owner Mailing Address Date:10/31/2000 Phone: (166) 115-21 x Name:HUSSEIN A HUSSEIN Ttl:OWNER State UST # 1998 Upg Cert#: 00829 -2- 05/21/2007 '' F EXPRESS MINI MART = ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-001244 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP REGULAR UNLEADED F IH DH L 9000.00 GAL Mod PREMIUM UNLEADED F IH DH L 8000.00 GAL Mod CARBON DIOXIDE G 50.00 FT3 Min -3- 05/21/2007 -4- 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: UNDERGROUND TANK CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 9000.00 GAL 9000.00 GAL _._ _ __ •ta nar~r~~r~~ r~wwr~r.~.Trt~.~rm~ ___- L1EiGL-1RLVUA lrVl"lYV1V P.~1V 1J - - --- %Wt. RS CAS# 100.00 Gasoline No 8006619 t11~G1jtCL 1~.7 J L' J A1~1L" 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: UNDERGROUND CAS# 8006-61-9 Liquid TMixture T Ambient~E ~ AmbientT~E ~ UNDEROGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 8000.00 GAL 8000.00 GAL 8000.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Gasoline No 8006619 nt~~rucL r~aJr~Jarir,lV 1 a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: SODA FOUNTAIN CAS# STATE - TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas PureAbove Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 FT3 50.00 FT3 50.00 FT3 - HAZARDOUS COMPONENTS $Wt. RS CAS# 100.00 Carbon Dioxide No 124389 !lL-]GtiRL HA iJ L' JJl°1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min -6- ~ 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/30/2000 ~ CALL 911 - WE SELL ONLY GASOLINE. Employee Notif./Evacuation 10/30/2000 TELEPHONE AND IN PERSON TO SURROUNDING NEIGHBORHOOD. Public Notif./Evacuation ALL THE CUSTOMERS WOULD BE INFORMED VERBALLY BY THE EMPLOYEES. 10/30/2000 Emergency Medical Plan 10/30/2000 KERN MEDICAL CENTER, 1830 FLOWER ST, 326-2000. -7- 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/03/2006 ~ WE HAVE EMERGENCY SHUT-OFF SWITCH; ALL THE DISPENSERS ARE ALSO EQUIPPED WITH AUTOMATIC SHUT-OFF DEVICES. Release Containment 04/03/2006 WE HAVE EMERGENCY SHUT-OFF SWITCH. ,., - - ~_ Other Resource Activation 04/03/2006 WILL CONTACT THE LEGITMATE CLEAN-UP FIRM IN CASE IT IS REQUIRED. -8- 05/21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~1C 1L1c11 nac~ai u.5 Utility Shut-Offs 01/30/2007 A) GAS - BACK OF BLDG B) ELECTRICAL - INSIDE BLDG C) WATER - BACK OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. 01/30/2007 FIRE HYDRANT - 900 BLOCK OF FLOWER ST S SIDE; OWENS ST ACROSS FROM STORE ENTR OF HWY 58. Building Occupancy Level 04/03/2006 2 EMPLOYEES -9- 05j21/2007 F EXPRESS MINI MART SiteID: 015-021-001244 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/30/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: ALL THE EMPLOYEES HAVE BEEN TOLD TO LEAVE THE BLDG AND BE ON THE FLOWER AND BEALE CORNER NEAR THE TUNEUP MASTER. ALL THE EMPLOYEES HAVE BEEN SHOWN THE SAFETY SWITCH AND THEY KNOW HOW TO TURN IT OFF. FIRE EXTINGUISHER IS AVAILABLE FOR EMERGENCY. CITY FIRE HYDRANT IS ACROSS THE ST FROM THE STORE ON OWENS. rc~yC G ric.iu ivi ru~.ui.c vac ncit.t ivi r u~uic v~C -10- 05/21/2007 .r ~jn ~,: I- ~4 FL04JER ST ~~t°(I fV I t°IART ' 528 FLOUJER ST BAKERSFIELD L'A 53305 661-328-0673 AUG 1 r 2007 1:51 Pt"1 S`lSTEM STATUS REPORT ALL FUPJCTIOPdS PJ0Rh1AL I NVE(VTORY REPORT T 1:UNLEADED VOLUME = 11038 %AL~a ULLAGE = 585 GALS 50`4 ULLAi;E= 0 i.,ALS ' TC VOLUME = 10759 GALS HEIGHT = 56.65 I tVCHES ~ WATER VOL = 0 GALS WATER = 0.00 INCHES ' TEMP = 56.1 LiEG F T 2:PREMIUM VOLUtHE = 3216 GALS ULLAGE = 4573 i;ALS 50% ULLAGE= 4154 GAL~a TC V0LUh1E = 3146 GALS HEIGHT = 46.5 ItVCHES WATER t.10L = 0 GALS WATER = 0,00 INCHES TEMP = 90.8 DEG F END ~ ~ * ~ ~ ~r Prevention Services 1~'~UNIFIED PROGRAM INSPECTION CHECKLIST ` A E R s e ~ . n 900 Truxtun Ave., Suite 210 Fine ' Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ;., ~ ARrM Tel.: (66i) 326-3979 _ >~ ~ Fax: (661) 872-2171. - r FACILITY NAM INSPEC 10 AT~ INSPECTION TIME '/fir, w 1 'V~ ADDRESS PHO N ~~3 ~ ~ NO OFEMPL YEES `~ ~ ( ~ g o~ FACILITY CONTACT BUSINESS ID NUMBER 15-021- y~(.f Section 1: Business,Plan and Inventory Program ,. __ _ _ _ ^ ROUTINE MBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~~ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~ o- ~.l/L~ 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 ANY HAZARDOUS WASTE ON SITE? EXPLAI N ^ YES ^~O ~~ THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Please Print) Fire Pr~tion / 1~` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy ~'~--~ usiness Site / Re ponsible Party (Please Print) Pink -Business Copy FD 2155 (Rev. 09/05 ~, - INSPECTIONS H E R S F I L D BUSINESS PLAN & ~ rM r INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~pre~ ~,,~~ 6U~fi Section 2: Underground Storage Tanks Program INSPECTION DATE: ~~~~ ^ Routine Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank t(~G}~S Number of Tanks ~' _ Type of Monitoring ~Gli~, Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current ~IUt. Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ^ No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No 1 Inspector: ~ Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Aggregate Capacity Number of Tanks usiness Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) -. ~~~ ~ - - CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES DIVISION 1600 TRUXTUN AVENUE, SUITE 401 (661) 326-3979 001561 Location: ~c~1~ ~IOt~C~ S~, Yo are hereby required to take the following action at the above location; CORRECT & CALL FOR REINSPECTION ^ CORRECT & PROCEED I 1 ~{'C,rahte't~~h~fDr, I~~'~jptr Qc.Oe ~C`t SSt hM1M ~ 6?T ~iPt~~ G\c\J1 ~ CI~ 4 lr' ACT l'S Completion Date for Corrections: ~ /~_ /~ Received by: Inspector: teve Underwood Initial Date: ~_ /_~ /~ Desk Phone: (661) 326-3190 (from B:OOam to 8:30am) KBF-9229 '~ ~ ' ~ + €`h6W~R SST Nfi-idi M~3' _____________________________ SitelD: 015-021-001244 + Manager Location: 928 FLOWER ST City BAKERSFIELD BusPhone: (661) 328-0732 Map 103 CommHaz Moderate Grid: 20D FacUnits: 1 AOV: CommCode: BFD STA 04 SIC Code: l EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title HUSSEIN / MANAGER HUSSEIN A HUSSEIN / OWNER Business Phone: (661) 328-0675x Business Phone: (661) 322-1521x 24-Hour Phone (661) 328-0958x 24-Hour Phone (661) 872-6544x Pager Phone ( ) - x ~ Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact Phone: (661) 328-0732x MailAddr: 928 FLOWER ST State: CA City BAKERSFIELD Zip 93305 Owner HUSSEIN A HUSSEIN Phone: (661) 328-0673x Address 1200 FLOWER ST State: CA City BAKERSFIELD Zip 93305 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG U - UST based 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, accur e, and complete. S' nature Date -1- 04/03/2006 - ~ -~;~; UNIFIED PROGRAM INSPECTION CHECKLIST B e_R.S F__, _ - D SECTION 1: Business Plan and Inventory Program ~` ~RrM r ~; Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE ~ ~~ INSPECTION TIME J6 `1 S ~~ rE~S r~--H; gat z a~ ,' ADDRESS ~~ \©~~~ s~ P~N~ A 0~~~ NO OF~pQPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021- ` ~- Section 1: Easiness Phan and inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance OPERATION V=Violation COMMENTS -$' ^ APPROPRIATE PERMIT ON HAND ^ BUSIt1eSS PLAN CONTACT INFORMATION ACCURATE .~ ^ VISIBLE ADDRESS ~ ) ^ CORRECT OCCUPANCY O6 p p IL] ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ ~ VERIFICATION OF MSDS AVAILABILITY ~ w~ ~ce,,. ~~, ~ i.~ 1 ^ ^ VERIFICATION OF HAZ MAT TRAINING ^ ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ '~~ ~ ~, ~ ~ dam-- ~ b P ^ EMERGENCY PROCEDURES ADEQUATE /1• / (/ ~$ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ~( ^ FIRE PROTECTION ~ )C, ^ "® SITE DIAGRAM ADEQUATE & ON HAND i ,~ ANY HAZARDOUS WASTE ON SITE? ^ YES_~ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy C? i Site / Re ponsible Party (Please Print) Pink -Business Copy FD 2155 (Rev. 09/05 /~ I='I_S-I,.IE:k ::`1' f'1 I ('~i 1 ("Ir~ik`I Br-i};Ek:=1F I EL.C! i_'r' 9~:~ ii E' G I --:;'~' ~ -- 0 t''r ~- .~,•~ I'EP~1 ~"I'r;'1'IJS RE1=5:'+1:'.I. ~~. _.. s z n - - - -- - - -- - T I : UP~JLEr;L~Ef~ '.!L+I ULLrt4:1;= c,~y'~' 4ir-;L:_, "L~?. ~='LI_If'9E = 41 ? 1 r;F;Lt= Hirl GHT - ~'~' .•4 I P4~_ HE, 4~Jri TEk 1h,~1. - U GAL: ~,~1~;TEk = u . Cuj I P•U_'HE._~ TEh'1F' _ X4.9 LiEG F f° . ~ i; .r = 1604 ~=NLS i t,} 1 „!i = tea. _'~_ ' INCHES \ -~'.IP-i i Ll< \75:'1_ - l l l;,;l_:~ ' r•~~~rTEk = u . ~ to I rJ~_:I-IE:_] ~ TEh9F' _ OD . ~l L~Et:~ F ' A ~, '- .~ f INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITYNAME~f~~'~~~-i r^~etb B D E R S F I L D F/RE ~RrM r Section 2: Underground Storage Tanks Program INSPECTION DATE: ~~ .2 d ^ Routine ~ Combined ^ Joint Agency ^ Multi-Agency Co plaint ^ Re-Inspection Type of Tank ~Dw Number of Tanks Type of Monitoring l~.Q-a d7E2 ~~- Type of Piping E ~..7 OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file ~ Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations H-~j~--~r ~ ~~ .-~.'( ~, s~_y ~ .~ ,S J Has there been an unauthorized release? ^ Yes ~jNo Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: G~ ~ ~e Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Business Site Responsible Party Pink -Business Copy BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 KBF-7335 FD 2156 (Rev. 09/05) UNIFIED PROGRAM INSPECTiONI CHECKLIST ~~; ~~~s 'S~+x'. ';;,:1". e4: =14V7i Y^~i..b R ~:'" Al .... ;.. ,f..-, ^' .'.>:-: .. '.. ... ...•Lt: .. ,.. _y ...... .~ .. :.. sRrN .SECTION 1: Business Plan and Inventory Program ~'' BAKERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME ~ 7 ~l ~''~°~ ~-31 ~ ;~d w ADDRESS HONE NO. O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER 15-021- Section 1: Business Plan and Inventory Program ^ ROUTINE ~ S'.OMBINED ^ JOINT AGENCY ^ MULTI•AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance` OPERATION J COMMENTS V_Violation ^ ^ APPROPRIATE PERMIT ON HAND V ^ V BUSIf18SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS S ~~ C~/ ^ ^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~" ^ VERIFICATION OF LOCATION ~~ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY UU) """~~~' ^ VERIFICATION OF HAZ MAT TRAINING ^ ERIFICATION OF ABATEMENT SUPPLIES AND Q! ~PROCE DURES ~}/^ EMERGENCY PROCEDURES ADEQUATE ~--. ^ CONTAINERS PROPERLY LABELED G A -, ~'' /~ f d v^~ ~i~GC ~t~ ~`L I S 7 ~!'Q-- ~C/~'S~i~~,~ ~bd5 ^ ~WOUSEKEEPING let/ < 7 ^- '~-- FIRE PROTECTION A~s~ ~I,~ ~ ~z~. ~~~C~ 1~~~ ^ ^ SITE DIAGRAM ADEQUATE & ON HAND I$R/~~~ %~y'4,, , ~~ ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO -/+ , ~/~ EXPLAIN: ~~2~1~~ufLA! ~'f E~~~yE .r, ._._~,/_L~~'_(p-~-`-~-~ yL--~L.54'~i~,~r2 Q ESTIONS REGARDING THIS INSPECTION? PLEASE CALL U9 AT (881) 828-3979 N ~~ Inspector (Please Print) Fire Prevention ! 1" In ! Shitt of Site/Station q White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rmr. 02105) ~ T ~V~~` '~~~~ C[TY OF BAKERSFiELD FIRE DEPARTMENT i~ ~ ~ M~~ OFFICE OF ENVIRONJ~IEN'I'AL fiERVICES ``° ~ _y~`` UNIFIED PROGRAM INSPECTION CHECKLIST \~ew ~R%,/I'p 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 ~.~~i FACILITY NAME~IBKs£ ,~71L£~7 /r1K7 INSPECTION DATE ~ s'f ofo Section 2: Underground Storage 'Tanks Program ^ Routine lc~-eombined ^ Joint Agency ^Muhi-Agency ^ Complaint ^ Re-inspection Type of Tank ~,fla~~~~ u~.Al~ ~~.~ Number of Tanks ~ Type of Monitoring L'o.vz;.vv~ss "type of Piping ~~ ~` _TL~.S `vww.-~r~~t~~-h- OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) _ Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on the with OF,S Adequate secondary protection Proper tank placarding/labeling [s tank used to dispense MVF? If yes, Does tank have overtilVoverspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: ~!t/!'~~_CY/Q~~ T Office of Environmental Services (661) 326-3979 l~'hitc - Fnv. Svcs. usme Si sponsib e Party Pink -Business ('i~py :~ ~ F ~ }'L<>I• II.'[,' :-ri' f i [ P•! [ I t;;I;'T bHh;rh::~t'lE1I~ CH '~~„_Clr, t,bl -3~'I;--Llt~73 ~'Y;=~"rl:h1 :~Tr,1'I I: , kf?h t_'R"I. r-iL.L 1=iJl`!C'I'[ '~ I!~~k.Fh-;L. I Ids:?LPJ'1'!~?F'~` F'E'I •~, L;1 T 1 :IJf`lL.Lr;1~I:1~~ 1'~.: '~rr~LlJl°lE _ ~,;i.;;=~ i:;hLi_i FIEl~_~HT = 5r;.5'i Ihd~`IIE. I;,Ir`I'EI = I I, in"I i I'~l~:f G""_ T '_ : PkEi°i I i IP1 IIL.I_.rii'.:~I' - t,r~ll:=' i_;i-i1..:- T~_~ rriL,i Ih'lE' = 1 =?1- ~7riI_l= FiE I - I-li' _ ~-' ,- - -~ 1 ,_, [ I'd . Fi[~S I [,:iri 11;I: . '_iL - . l l_~~,L _~ I InlriTL:k: = I I . I II_c ! I`!r'I IE . ." ... Iran . . ~~~U'`J %~-- ~~ ~ - d 3 ~~ Bakersfield Fire Dept. G~~ ~~~ ~ UNIFIED PROGRAM INSPECTION CHECKLIST Enironmental Services 1715 Chester Ave 'SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ~~ C ~~ ~~ i INJYtI:I IVN UA1 t INJf'tGTIVN TIME -- -_ .._ _ __ __ - -~ --- - _ - -L--- ----- _---- -- - ADDRESS ~ PHONE No. No. at Employees - -- 1:~~---1=1o~c_~------~T ----- -----~---- .----- -- ------- - - ~ --~---~ "C 132. FACILITYCONTACT Business ID Number 15-021- Section 1: Business Plan and Inventory Program D Routine .Combined ^ Joint Agency OMulti-Agency O Complaint O Re-inspection C V \V=VioationnCe/ OPERATION COMMENTS ~^ APPROPRIATE PERMIT ON HAND L3' ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE G]/^ VISIBLE ADDRESS Q/~^ CORRECT OCCUPANCY I L9/ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES R ^ VERIFICATION OF LOCATION ... - L~!/ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE LI ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES W ^ EMERGENCY PROCEDURES ADEQUATE ----- ------.-..------------...-...----- __ --- _---------------.....--_..I ...._..--- --.__....-- --------...---_ _ -.........---.._.._-.-...- ---- ^ CONTAINERS PROPERLY LABELED ICJ/ ^ HOUSEKEEPING __^ (/FIRE PROTECTION _..____.._..-----.-.---------_._---•-.-- ` ------ -.~L~s~ _ ~~-SLS_~L~.t_- C~._~~ .. __r.. -~~1Q~1~~ _ .. _..~ ~ ~c.--~. ~'^ SITE DIAGRAM ADEQUATE $c ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTION$-'R CARDING 1S SPECTION~ PLEASE CALL US AT (66~) 326-3975 Inspector Badge No., Whsle -Environmental Services Yellow • Sletion Copy ~~ - ~~i Business Site Responsible Party Pink • Business Copy •' ~~ ~•-. . z; ;i'~~` •~F ~ CITY OF BAKERSFIEI,U FIRE DEPARTMENT ro OFFICE OF ENVIRONII~IENTAL SERVICES ~ y~' UNIFIED PROGRAM INSPECTION CHECKLIST _w>:"a~,~~= 1715 Chester Ave., 3'~`' Floor, Bakerstield, CA 93301 FAC[L["i'Y NAME FICt..I,~C~ S~ ~ Gk~ Section 2: Underground Storage Tanks Program ~~p~i INSPEC"TIUN DATE ~~ ~ e 3 ^ Routine ~] Combined ^ Joint Agency ^MuIti-Agency 3 ^ Complaint ^ Re-inspection Type of Tank SLJL (N . ~ ~ Number of yanks Type of Monitoring r1TC~ Type of Piping SGt.) 5 LC ~ E~ UPERATION C V COMMENTS Proper tank data on file Proper owner,'operator data on tilt Permit fees current ~/ Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations S H ~~ Has there been an unauthorized release? Yes NO ~./ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPAC[TY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? Ifyes, Does tank have overfill/overspill protection'? C=Compliance ~, V=Violation Y=Yes N=NO _ ~1 Inspector: Office of Environmental Services (661) 326-3979 R~hitc -Env. Svcs. Pink -Business Ci~~y /'tom Business Site Responsible Party