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Home My WebLink AboutBUSINESS PLAN (3)___ MIDAS MUFFLER __ - - ~~ ; 2919 CHESTER AVENUE , - --- -- --- - -- -- - - - -- I UNIFIED PROGRAM INSPECTION CHECKLIST ~ SECTION 1: Business Plan and Inventory Program i~ Prevention Services R a r. x s r l D 900 Truxtun Ave., Suite 210 F/RE Bakersfield, CA 93301 a R rui Tel.: (661) 326-3979 Fax: ~"(661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIIy1E ~ ~ ~ 2Z ~ r-.-, f .S v , ADDRESS P NE N NO OF ~PLOYEES FACILITY CONT ' ~ BUSINESS ID NUMBER ~~~ 15-021- ~ I, f _ __~~~ Section 1: Business Plan and. {nventory Program i ~~ L7 ROUTINE - _ ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance -OPERATION V=Violation COMMENTS L ~ ^ APPROPRIATE PERMIT ON HAND ,_ / L°~ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ~,,, ^ VISIBLE ADDRESS ~ E~ 0-'~^ CORRECT OCCUPANCY Ig'~^ VERIFICATION OF INVENTORY MATERIALS 0'~^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~~^ PROPER SEGREGATION OF MATERIAL LR'~~^ VERIFICATION OF MSDS AVAILABILITY ~^ VERIFICATION OF HAZ MAT TRAINING CJ'~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ~^ CONTAINERS PROPERLY LABELED C~^^ F-IOUSEKEEPING C3'~^ FIRE PROTECTION C4~^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUSW.A~STE ON SI~T'/E?n EXPLAIN: ~~' ~ !~f / 4' ! /M~~ ^ NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT-(661) 326-3979 L ~ " ~ Business Site / Res onsible Pa Please Print Inspector (PI se Print) Fire Prevention / 1" In /Shift of Site/Station # P rtY ( ) White -Prevention Services Yellow -Station Copy ~ Pink -Business Copy FD 2155 (Rev. 09/05 MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 Manager STEVE RUCKMAN Location: 2919 CHESTER AVE City BAKERSFIELD BusPhone: (661) 325-5779 Map 103 CommHaz High Grid: 19C FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:7533 DunnBrad: Emergency Contactf ~ Title ~~~ ~''4'~~ ~ Emergency Contact / Title ~ ' d eCrt~,Ct KEN JACHIM / PARTNER/OWNER Business Phone: (661) 325-5779x Business Phone: (661) 837-8371x 24-Hour Phone (661) 428-0492x 24-Hour Phone (661) 204-7774x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact STEVE RUCKMAN Phone: (661) 325-5779x MailAddr: 2919 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Owner VINCENT MILLER BAKERSFIELD LLC Phone: (661) 837-8969x Address 6919 WHITE LN State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT E ENT's 0 ~~ 1 Zoo? PROG T - ABOVEGROUND STORAGE TANK Da;,ed on my inquiry of those individuals resF'on•sible for obtaining the inf ormation, l certify undor penalty of law that I h e ave personally xamined and am familiar with th sub i t e me nformation ted and believe the information is true accurate, and com l t , p e e, ~~ Date -1- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~. Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETYLENE - E F P IH G 1200.00 FT3 Hi OXYGEN F P IH G 1685.00 FT3 Low WASTE .OIL F DH L 500.00 GAL Low WASTE OIL F DH L 110'.00 GAL Low TRANSMISSION FLUID F DH L 85.00 GAL Low ANTIFREEZE L 55.00 GAL Low WASTE ANTIFREEZE F DH L 55.00 GAL Low WASTE ANTIFREEZE L 55.00 GAL Low ARGON/CARBON DIOXIDE F P IH G 715.00 FT3 Min MOTOR OIL F DH L 110.00 GAL Min ~l -2- 07/12/2007 -3- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: N EXT PORTABLE CAS# 74-86-2 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 300.00 FT3 1200.00 FT3 1200.00 FT3 HAGAKllUUS C:UMYUN~N'1'S oWt. RS CAS# 100.00 Acetylene Yes 74862 tia'~GI~.L'CL F~J~L' J.71~1L' 1V 1.7 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 N EXT PORTABLE Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 SATE ~pureE -~AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 300.00 FT3 1685.00 FT3 1685.00 FT3 i1LiGL-1tCLVUJ 1.U1~lYUlVl:,1V 1.7 oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 t1L-~GKKL L-~w7 ~ L' .7 ~71~1J~,1V 1 b TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -4- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: w WALL s cRNR cAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 500.00 GAL 110.00 GAL - nt~~x~cLUU~ ~uinrulvr,iv 1 ~ %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 t1AGHxL A7~J~771~1L'1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH j / / Low ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: 40FT NW OF BLDG CAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid. Waste Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Con55100rGAL Daily MlOl00m GAL I Daily 110r00e GAL ~ZARDOUS COMPONENTS oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 llti[~tiiCL HJ .7 LSiJ .71"1P~1V'1 .7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -5- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE ~ Inventory Item 0010 COMMON NAME / CHEMICAL NAME TRANSMISSION FLUID Location within this Facility Unit W WALL S CRNR SiteID: 015-021-000436 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map. Grid: CAS# 0 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixtur~mbient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 85.00 GAL 85.00 GAL tYHGHKL V U w7 1.U1~lYU1V 1;1V 7 5 %Wt. RS CAS# 100.00 Transmission Fluid (Petroleum-Based) No 0 t1HGHtCL H~7 .71~,J.71~1J;1V-1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: W WALL S CRNR CAS# Liquid TMixtur~ 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 iu~auru~LV~~ ~.va•arvivr,ivi5 %Wt• RS CAS# 100.00 Ethylene Glycol No 107211 ru-iutu~L ria ~r~~~!•1~1v1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -6- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: W WALL S CRNR CAS# 107-21-1 Liquid TWaste ~mbient~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 55.00 GAL 55.00 GAL tu-~~HttLUU~ ~.~~~irvlv~lyl~ %Wt. RS CAS# 30.00 Ethylene Glycol No 107211 riEiGEjJ.tL 1~55~Ja1~1L"1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0009 COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE Location within this Facility Unit W WALL S CRNR Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 107-21-1 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 55.00 GAL 55.00 GAL nt~c~tittLV~~ 1.V1~lYV1Vl~1V l.S oWt. RS CAS# 30.00 Ethylene Glycol No ' 107211 I1HGHIZL 1-~.7 .7iS~7.71~1~1V-1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -7- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME ARGON/CARBON DIOXIDE Location within this Facility Unit N EXT PORTABLE STATE TYPE PRESSURE _ Gas TMixtur~Above Ambient SiteID: 015-021-000436 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7440-37-1 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I- Daily Average 300.00 FT3 715.00 FT3 1 715.00 FT3 11HGKCCLVUJ l..Vl°lYV1VP~IVTS %Wt. RS CAS# 25.00 Argon No 7440371 75.00 Carbon Dioxide No 124389 11HG1iiCL HJ .7P~A~J1°1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Uriit Map: Grid: W WALL S CRNR CAS# 8020835 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily. Maximum Daily Average 110.00 GAL 110.00 GAL I 110.00 GAL HAZARDOUS COMPONENTS oWt. 100.00 Motor Oil, Petroleum Based RSI CAS# No 8020835 1~ZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -8- 07/12/2007 y F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/16/2000 ~ CALL 911. Employee Notif./Evacuation 11/01/2006 THE SHOP MANAGER HAS FULL RESPONSIBILITY FOR EVACUATION AND PROPER NOTIFICATIONS. IF THE SHOP MANAGER IS INJURED OR UNAVAILABLE, THE ASSISTANT SHOP MANAGER WILL BE IN CHARGE. CALL 911. Public Notif./Evacuation 05/07/1990 VERBAL COMMUNICATION OVER INTERCOM SYSTEM TO THE NEAREST EXIT. Emergency Medical Plan 11/01/2006 MINOR, FIRST AID THEN DRIVE TO NEAREST FACILITY. MAJOR, CALL FOR AMBULANCE. -9- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/26/1995 ~ WE HAVE INITIATED A HAZARD COMMUNICATION PROGRAM AT OUR PLACE OF BUSINESS. THIS INCLUDES CONTAINER LABELING, MATERIAL SAFETY DATA SHEETS, EMPLOYEE INFORMATION AND TRAINING, AND A LIST OF HAZARDOUS SUBSTANCES. Release Containment 11/01/2006 SHUT-OFF VALVES OF OXYGEN AND ACETYLENE TO STOP FLOW OF GASSES. IF VALVE IS BROKEN, FILL HOLE ONCE AND PRESSURE IS RELEASED. SPREAD FLOOR SWEEP (ABSORBENT) OVER AREA WEARING PROTECTIVE GLOVES AND EYE WEAR. Clean Up 01/26/1995 MOP/SPONGES WRING OUT IN CONTAINMENT BARRELS. Other Resource Activation -10- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ o~c~.iai nac~at~.ao Utility Shut-Offs 04/02/2007 GAS - NW CRNR OUTSIDE BLDG IN ALLEY ELECTRICAL - OUTSIDE W WALL NEXT TO GAS WATER - 24FT E OF CTR OF W WALL ___ Fire Protec./Avail. Water 11/01/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - NW CRNR (ADJ PROP). Building Occupancy Level 11/29/2006 3 EMPLOYEES -Il- 07/12/2007 F MIDAS MUFFLER-2919 CHESTER AVE SiteID: 015-021-000436 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/01/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING'PROGRAM: SAFETY MEETING MONTHLY TO COVER ALL SAFETY HAZARDS AND HAZARDOUS MATERIALS THAT ARE IN SHOP. rayc c. nciu LvL ru~.uLC vac IlC1u LVL L'ul. ILLC UDC -12- 07/12/2007 Y + MIDAS MUFFLER =________~='_'___________________________ Manager ~ BusPhone: Location: 2919. CHESTER AVE~ Map 103 City BAKERSFIELD ~,3 ~ ~ l Grid: 19C SiteID: 015-021-000436 + (661) 325-5779 CommHaz High FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:7533 ~~ ~~~ EPA Numb: __________________DunnBrad: Emergency Contact / Title Emergency Contact / Title TOM MOSER / MANAGER KEN JACHIM / OPERATIONS MGR Business Phone: (661) 32'S~-5779x Business Phone: (661) ~2.~~ex~'7- 24-Hour Phone (661) -8.1 ~-~~'~~ 24-Hour Phone (661) 204-7774x Pager Phone ( ) - x ~S+-{~~- Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : c~'P `~,~,r~~ P~~r-~ Phone: (661) 325-5779x MailAddr: 2919 CHESTER AVE. State: CA City BAKERSFIELD Zip 93301 Owner VINCENT MILLER BAKERSFIELD LLC Phone: (661) 837-8969x Address 6919 WHITE LN State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ( II PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK Based on my inquiry of those individuals responsible for obta+ning 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, and complete. Signature ~~~ ~~ o I~~~o~~ ~~` o` ~5~ ~N~ ~~ ~ ®1 2pps ~ p~~~ lN' ~~~' -1- 02/27/2006 -~ ~~~ MIDAS MUFFLER-2919 CHESTER AVE ~ SiteID: 015-021-000436 Manager ~~''~~~ T~~L~'M"eN BusPlione: (661) 325-5779 Location: 2919 CHESTER AVE Map 103 CommHaz High City BAKERSFIELD Grid: 19C FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:7533 DunnBrad: Emergency Contact / Title Emergency Contact / Title ~,,,,~,~, , TOM MOSER / MANAGER KEN JACHIM / OPS~~Ora. Business Phone: (661) 325-5779x Business Phone: (661) 837-8371x 24-Hour Phone (661) 428-0492x 24-Hour Phone (661) 204-7774x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ~.~c~<. ~~< Cw~ct~.~ Phone: (661) 325-5779x MailAddr: 2919 CHESTER AVE State: CA City BAKERSFIELD Zip 93301 Owner VINCENT MILLER BAKERSFIELD,LLC Phone: (661) 837=8969x Address 6919 WHITE LN State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ D~ PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK Based on my inquiry o4 thta~e Iw~$i~sMeiu~ils torn~atie~ ~ ~ ~ n responsible for obta~nina thv r~a~ally t 1 havt~ p under penalty of ia~w tha d am familiar with the intnpmation e , examined an e~e the information is tru submitted and beli ENT A ~~ ~ l and comp urate ,~~~ ~ , acc ~ ~~ ~ Signature -1- 02/05/2007 Bakersfield Fire Dept. UNIFIE® PROGI~AIVI INSPECTION CHECKLIST Enironmental services :: - . , : .~ ~ - .. ~ 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECT~IO/N DATE INSPECTION TIME _ F'1-td_c~1_~l_1~------------------------------- ----._.._.__ --~~Z~-~~ ----- ICJ-~°- - -- - ADDRESS PHONE No. No. of Employ~^ FACILITYCONTACT Business ID Number [~~j/ Section 1: Business Plan and Inventory Program ^ Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C ~ \V=Vioationnce~ OPERATION COMMENTS L7 ^ APPROPRIATE PERMIT ON HAND w, CtY ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE i~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY Cpl ^ VERIFICATION OF INVENTORY MATERIALS ~/ LJ ^ VERIFICATION OF QUANTITIES - I~'' ^ VERIFICATION OF LOCATION l~ ^ PROPER SEGREGATION OF MATERIAL (i~' ^ VERIFICATION OF MSDS AVAILABILITYE ^ L3~ __ VERIFICATION OF FIAT MAT TRAINING _-- _._ ~ . -- -- -- ~ rlo ik.'t'w,c-t -ttts~..~•~~ o~-, ~.,d LrJ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ^ EMERGENCY PROCEDURES ADEQUATE LZY ^ CONTAINERS PROPERLY LABELED -- . --- r L~ ^ FIOUSEKEEPING '~r>a t~c~+ ~~ c~-a. ~ c. I t A c c r.~ 1.~., r ~-~11 ~ ~ ^ i~' FIRE PROTECTION ~ ` l~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979 Inspector (PI se Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy an,~s Business ite Responsible Party (Please rint) rn 8 N Pink -Business Copy 0~~ 6 2~p3 4~~~` '~~' CITY OF BAKERSFIEI,D FIRE DEPARTMENT ~~ b OFFICE OF ENVIRUNMF,NTAL SERVICES ~' ~~ UNIFIED PROGRAM INSPECTION CHECKLIST "w ~~,i~ 1715 Chester Ave., 3'" Tloor, Bakersfield, CA 93301 FACILITY NAME I~ ~. ~5 INSPECTION DATE ~ - ~ J"- 03 PHONE NO. bL t - 3~~'-S-I`t 5 ADDRESS ~ ~ t ~ ~ DES rea A>>c~ FACILITY CONTACT}~~nrNt~v gvv\~\\~,_ BUSINESS ID NO. 15-210- Ot7b~-1.30 INSPECTION T1ME~/~' Mew NIJMBER OF EMPLOYEES LI Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^MuIti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address ~~ n fi ~ ~ -~--> ~~,,..; ~:-.~, Correct occupancy ~ 1 G- ~~,?~ /.~ ~~~ s! 0 Verification of inventory materials 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 `~ Explain: Questions regarding this inspection'! Please call us at (661) 326-3979 Whirr - Fm•. Svcs. Yellow -Station Copy Pink - Husiness Copy ustn a Responsible Party Inspecto~~~~ l~