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HomeMy WebLinkAboutBUSINESS PLANi ALL MY LOVE A 1603 S. H STREET 1 _~ -~ _ x.~, s..,~,~_-,P..-..,- .- - l1NIFIED PROCRARII INSPECTION CHECKLIST - .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT s Prevention Services ~Itr 900 Truxtun Ave., Suite 210 ~t>rr Bakersfteld, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME // NSPEC/TION// DATE INSPECTION TIME ~/ ADDRESS J ~ ~ ~ ~ ~ „~ f .. S f HONE NO. ~t 3 Z £~cjc>b O OF EMPLOYEES -~ FACILITY CONTACT "~ ~~ 7 ~.~~ USINESS ID NUMBER 15-021- v v ~ v Z. c/ Section 1: Business Plan nand Inventory Program -~~~ -- --- - ~ - ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION r • C V (c=Compliance OPERATION COMMENTS V=violation - - ^ .^ APPROPRIATE PERMIT ON HAND If, r~r3 ~ j~ •- lj A, ....- ~,. t.-; ;' . ~ ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ~ ,® ^ VISIBLE ADDRESS ' ~~ ^ CORRECT OCCUPANCY ,© ^ VERIFICATION OF INVENTORY MATERIALS ~~/ ~/ ,,^ ^ . VERIFICATION OF QUANTITIES ^ 'VERIFICATION OF LOCATION ,,u ^ PROPER SEGREGATION OF MATERIAL ~,®f ^ VERIFICATION OF MSDS AVAILABILITY ,~' ^ VERIFICATION OF HAZ MAT TRAINING ,!'J ^ VERIFICATION OF ABATEMENT SUPPLIES AND , PROCEDU RES t . .,^ ^ 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 INSPECTION? PLEASE CALL U8 AT (661) 926-3979 Inspector (Please Print) Fire Prevention / 1 `~ In / Shift of Site/Station # ~ ~., Business SNeI~~ ool SNe-Responsible PaAy (Please Print) ~ ~ ~~. ` ~ ~ NBfI~~ a ti ` rvices Yellow -Station Copy Pink - Buaineae Copy ~~t./// FD2048 . (Ra. 72105) BAKERSFIELD FIRE DEPT.~~ Prevention Services ~~ FIRE PREVENTION INSPECTION a EP~iRE I ~ 900 Truxtun Ave., ste. 210 ~j ARTM t Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT BLOCK NO. DATE ~ /~ ~ ! EE .i./ FACILITY ADDRESS ~~ ~ ~ ,~' ~ CITY, STATE, ZIP ~~'0 ~ ,~t I J Ct FACILITY NAME ~ t /~..~ V ~ /~ N 4 , f / ! MANAGER'S NAME sa err F, CILITY PH~ON~ENO. BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP NER'S PHONE NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO. OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS vio~wTioN REQUIREMENTS CHECKED BELOW xo. COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (U.F.C.) COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) ExTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) __________________ portable fire extinguisher to be immediately accessible for use in (area) _____________________________ (U.F.C.) g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use, by a person having a valid license or certificate. (U.F.C.) 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to SIGNS fire escape. (U.F.C.) g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the correct address of the building. (B. M.C.) (U. F.C.) g Repair all (cracks/holes/openings) in plaster in (location) ______________ _~_~ ~1ja~.._________. Plastering FIRE DOORS/ FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (U.B.C.) ~tJJ~~~~ 10 Remove/repair (item 8 location) _________________________________________________________. Self-closing doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the closing device. (U.F.C.) EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.) 12 Provide a contrasting colored and permanently installed electric light over or near required exit (location) ______________________________ to clearly indicate it as an exit. (U.F.C.) STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.) 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets ELECTRICAL APPLIANCES where needed. (N. E.C.) (U.F.C.) 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N.E.C.) (U.F.C.) OUTDOOR BURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREWORKS 17 Vi ol ations of Section 7802 U.F.C. or 8.49.0 40 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 ,( ~ J 1 I ! G? C S ~ 1 ~ C i, ~'s.. ~ (C.G"~'t t G 9~ ~ C~ n. ~i ~ ®(l -P '' _ ~ ti ~~ a CUSTOMER: o L~-~t/ 1 % Z w ` ND. CALIFORNIA FIRE CODE C.F.C (S i gnature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE ,~^~ t ~ '~ : ~ ~ '- B.M.C. BAKERSFIELD MUNICIPAL CODE INSPECTOR: C... /C % '-^~-~" AP NO.: N.F.P.A. NATIONAL FIRE PROTECTION (Signature) ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05) ~~~ ~ ;J~u ~ ~ ~ EN~'D ~ u ~ ~ ~ 2006 _ //S -.~;/ _F~' ~i// r7Nv~ssP,~~~(J'/~ ~Uri7 ~a-z(o-l~~O ~q.i. cr~ ~ fCr~' ~ ~/i Z olc~ GrG / ~ ~' ~~ `^/ O ~!~ ~U - - ~~ l~ U3 0 ~ ~~-C ~~d ~,Jri S'~iv~ -fvCa~~ --- S-~~~~ , `~ ; ~ S~ ~ ~dr~~ ~1', ~~9- 9 X 309 . OU ~ I f f ~/~y v~ ~~ ~JS r~GJ __ f~j~~' ~ ~ S`~ ZooG_ ~TGLen~G~e c~~ -f~ ~+~f~k~rs aS ~CCO rc~~ ~ 1 ~-~n ~eG[ Q•~ (~ S T'~'~~ G w ~r ~U ~a I go~f~ ~~ .s ~i~ ~y ~~ ~Fr~,~~~s ~~~fG~'~ W -e. i~ ~ ~~ ~L(~?" ~. ~G1 ~• «~ ~ G Z a c~u v.I ~q~rva I o v~ 5 ~~e ar f~ ~ re~4~,~s v w~e~ c(, d, a Gs o~9-1=0~, ~-NY Q ~~1' ~~~-~~ --~ - _ -- - - G ., ; G' a ~/.' -~ SSG qa3-o~33 _ (FIMMP) HAZARDdUS MATERIALS MANAGEMENT PLAN BAKERSFIELD FIRE DEPT. Prevention Services a cam, . ~:. , <<~. _. " : .. .. ~ .;> ~ r _~ : : B_ E R S_a...I. . D 900 Truxtun Ave., Suite 210 .; .. _ SITE ~ FACILITY DIAGRAM Pllt~ ~~rr T Bakersfield, CA 93301 ~ Tel.: (661) 326-3979 Page2of2 Fax: (661) 852-2171 _-_ _ _ _ _ . ' SITE DIAGRAM ~ z ~`" FACILITY DIAGRAM Business Name: __ - Business Address: __ __ - - __ S~s~~ ~~ i~~~ ENr~ ~~ ~ ~ ~ ... Zao~ c~~~~~ ~~~ ~~ rG'~ X (~ ~~~ ~~ ~a NORTH Please indicate direction of North r ~ FD 2170 (Rev. 09/05) HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN ~ "'-~(j~/~ _ _ ~0 >__._ ... y:_~ SITE & FACILITY DIAGRAM ~R r r Page 2 of 2 BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Suite 210 . Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 __~ SITE DIAGRAM Business ~ Business ~ ,~~t;~-i ~~,,,, Please indicate direction of North FACILITY DIAGRAM FD 2170 (Rev. 09/05) ~wuo ,. ;~ ~~ NORTH a, ~ -C- (HMMP) ;- BAKERSFIELD FIRE DEPT. HAZAR__. ~, _ . , ... ._ _.. _ _ DOUS MATERIALS MANAGEMENT PLAN $ $ R S' A 1 n Prey@IIt10II .Se1V1C@8 ~:~ _....~ ~~.. _ _ _ .._ - _ _,: _ p/RB 900 Truxtun Ave., Ste. 210 INSTRUCTIONS ~. '; ~RSr r sakersfield, CA 93301 SITE & FACILITY DIAGRAM ...._ ~ Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 2 These instructions explain the use of the site diagram and the facility diagram. Normally, small and medium size businesses will only have to submit a site diagram. If you have subdivided your business into smaller areas because of the complexity or size, then you will be completing and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business if it is in a remote location. All diagrams must be on 8'/z x 11"paper and drawn using a straight edge tool. ,. \ _ . ~ SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will, be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following information: , 1. Check the box on the top left corner of the form provided that indicated "Site Diagram". 2. Print the name of your business, as shown in your HIVIlVIP, on the top of the diagram. 3. Label the location of the hazardous materials and identify them by name and type of hazard (i.e., flammable liquid;-corrosive solid). 4. Label the location of utility shutoff points for gas, electric and water services. 5. Label the location of fire hydrants. 6. Label portions of the building protected by automatic sprinkler systems. 7. Label the direction representing north on the diagram. (The diagram form provided includes a north arrow). 8. All labeling and identification on the diagram must be legible and easily understandable at the scale submitted. Diagrams must be sufficiently legible to produce a legible copy. Try to avoid the use of abbreviations or symbols. If you must use them, provide a legend explaining your system. Maps may be returned for correction if you fail to follow these instructions. FACILITY DIAGRAM INSTRUCTIONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. 1. Check the box in the upper right hand corner of the form provided that indicated "Facility Diagram". 2. Print the name of your business as shown on your HMMIP. Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. 3. Indicate which area the diagram represents and the total number of facility diagrams that you are including. If a map represented the-first of four areas, it would be labeled # 1 of 4. 4. Follow instructions (3 -8)* for site diagrams regarding the specific details to be included on each facility diagram. UNDERGROUND STORAGE TANK FACILITIES PLEASE NOTE: * If you operate an Underground Storage Tank (LJST) facility, the facility diagram shall also specify the location(s) of the UST continuous leak monitoring system and/or the location(s) where the UST monitoring will be performed. FD 2170 (Rev. o9io5) UNIFIED PROGRAM INSPECTION CHECKLIST ;~ -~~au~ta ~s+mta~e~: SECTION 1 Business .Plan and Inventory Program FACILITY NAME~ /^~ -- - ---- ------.. _.~- --- - --i ---- . -- _-- _ ._ _ ADDRESS ~~ \ 103--------.5__.--_._-~=--- s.--....-- FACILITYCONTACT Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: X661)_326-3979 INSPEjTION D?}TE INSPECTION TIME / Z ~/U,~ 15-021- NC Section 1: Business Plan and Inventory Program ~~.Z~ ,~-FEeutine ^ Combined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-ins C V ncel OPERATION t COMMENTS on lV=~oa ^ ^ APPROPRIATE PERMIT ON HAND //~~ /~ (~`rt ' ~ /'< ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ --.-_ ^ ~ .._..- VERIFICATION OF INVENTORY MATERIALS _ - - - --------- .....- --- -------- --- -.__.. __ - -- ---- I r Q%~~J~ t~i- ^ ^ VERIFICATION OF QUANTITIES '~i~ G~ ^ ^ VERIFICATION OF LOCATION (NS r4C- S~ C2/~/'2 4i~ S~tG„ ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE I -_ ^ ---, ^ .-- -- -- - -- ---.. __ .. .___.... ---.._._ ...._ VERIFICATION OF I"IAT MAT TRAINING _ f -...._..__..... ' 1 ___--._..... _ _. ... ~~... T - ----._._.. ~~~ ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ ... _. ^ ^ EMERGENCY PROCEDURES ADEQUATE i l /' 1 yJ ~ 1 ~j --- ^ ----- ^ ---- ._.....__ ------ -.._..----- ------_.._....-------------- -_......__ -. CONTAINERS PROPERLY LABELED .. ~ _...-- --_ __. ........_ .-- ... . . _......_ .. ...._- ---_ ,/ ^ ^ HOUSEKEEPING ^ ^. FIRE PROTECTION ~ ^ ^ SITE DIAGRAM ADEQUATE ~ ON HAND r 2405 ~i ANY HAZARDOUS WASTE ON SITE?: ^ YES LrJ`WD EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~G6') ~ 326-3979 C.~ r .~-°~ P~3 Inspector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Yellow -Station Copy Business Site Responsible Party (Please Print) rn Pink -Business Copy ~~ r: -~ c.lu~~c~~ UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Invent i ne /1, /~ •~i i . D Bakersfield Fire Dept. ~ Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 ~ Tel: (661)326-3979 FACILITY NAME ~ ~ INSPECTION DATE INSPECTION TIME /' Q ~` ` ADDRESS ~4 O.J J~~ ~~ -- -fl'__---- ~f ~ H/ONE No, ? i l gJ~~ ~ No. of Employees ----- ~•------ FACILITYCONTACT 1 Busi s ID Number 1 s-021- Qd Z3 rri a,~.c. c> ~., r Section 1: Business Plan and Inventory Pn~gram Routine ^ Combined O Joint Agency ^Mu1ti-Agency O Complaint ^ Re-inspection C V n~/ OPERATION \V=Vi at COMMENTS on o ^ APPROPRIATE PERMIT ON HAND I~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE -------- -- ---- a ti-~ ----- --------- ----.--- ---------_.._. ------ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~I ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION - - - ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE l~ ^ VERIFICATION OF FIAT MAT TRAINING ~i ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE 'gyp ~.------ -------- ---- _._..----------°---- ^' - ^ W ^ CONTAINERS PROPERLY LABELED I~ ^ HOUSEKEEPING j -- - ^ --- FIRE PROTECTION ._ ~---'_-'` - ------------------ ~----- -.__- ^ SITE DIAGRAM ADEQUATE Ht ON HAND ~ ` _ ,----~ ANY HAZARDOUS WASTE ON SITE: EXPLAIN: ./~ Q f~CLZ~,(.~-, ~`_\ DnYES ~`~.~'No t~,.i,~,. J _ . _~ // . ~lF,~ QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~F6') ~ 326-3S7S Inspector ~ Badge No. Whtle -Environmental Services Yellow ~ Station Copy Business Site Responsibl arty Pink Business Copy ~ ~ ~~ ,; t~~ ~ PLEASE DETACH AND SEND THIS COFY WITH REMITTANCE N f~-@ ii (~'~ ~+.~ ~ ° '^i~ Y DATE: 1/01/0- UE DATE: 1/31/06 NAM ALL MY LOVE ~ ~, CUSTOMER N0: 62311 76725 P S - ENVI ONM TAL SE • REMIT AND MAKE CHECK PA E O uFORN~P CITY OF BAKERSFIELD ~ ° { PO BOX 2057 BAKERSFIELD 9 0 -2 57 ,' (661) 326-3678 TOT UE: $221.00 { ~~~J~ ~~ ~ ~~~~~~ ~ ~`~~