Loading...
HomeMy WebLinkAboutBUSINESS PLAN 11/2/2006- ---- - - FOODS CO STORE #304 ~' :°~ 2505 HALEY STREET ~~ FOODS CO°3€~"~------_______- ___________________________ ~,~., b~~ Manage BusPhone: Locatio 2505 HALEY ST Map 103 City B Grid: 25B SiteID: 015-021-000124 + (661) 873-2052 CommHaz High FacUnits: 1 AOV: CommCode: BFD STA 08 STC Code:5411 // ~i~ EPA Numb : ~ DunnBrad : 19 - 3 2 8 - 2 5 71 ~~ ~~`L' ~" --------- ---------------- mergency ontact Title Emergency Contact / Title NANCY ~'iOP~m/i TORE DIRECTOR ALARM CENTER / RALPH SECURITY iness Phone: 873'-2052x Business Phone: (310) 900-3700x 24-Hour Phone (310) 900-3700x 24-Hour Phone (310) 900-3700x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact GAYLANN DENHAM Phone: (310) 884-4085x MailAddr: 2201 S WILMINGTON AVE State: CA City COMPTON Zip 90220 Owner RALPHS GROCERY CO Phone: (310) 884-4085x Address 2201 S WILMINGTON AVE State: CA City : COMPTON Zip 90220 Period to Preparers Certif'd: ParcelNo: TotalASTs: _ TotalUSTs: _ RSs: No Gal Gal Emergency Directives': ~,~ ~®v ®~ zoo6 ~N ~ FE ~ N~ ~ N%~t° /~~y r ----------- --------- ------------------- -1- 01/13/2006 - .~ ,.l UNIFIED PF20GRi4M INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program • Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees __ ZS~S ~~ S~ --~ --~ ----- x'73-z~s2 --- ~------- FACILITYCONTACT Business ID Number o~z~ ~ Is-o21- oo '~ ; Section 1 Business Plan and Inventory Program ~ ~~ ~~ ~ (o Routine, ^ Combined t] Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection ~J C V C=Compliance OPERATION V=Violation COMMENTS n ~ / ' , ^ APPROPRIATE PERMIT ON HAND j " l / Q ~ ~®~ ® ~ ~OO ^ 4e9 USINESS PLAN CONTACT INFORMATION ACCURATE U ISIBLE ADDRESS ,d 50 ^ CORRECT OCCUPANCY ^ ~ VERIFICATION OF fNVENTORY MATERIALS bp ^ VERIFICATION OF QUANTITIES s~~ '1 I L~`'`TCY 1 -- J~J ^ - ---------------------------------- VERIFICATION OF LOCATION -------------------.._...--------------------------___...----_ -------- ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE - - -- ------------ ------ - ----------- - i - - -- ^ --- VERIFICATION OF HAT MAT TRAINING - - --------- --------_ ~ vvv ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE -,~~J l~! ^ ---------- -------- ---- CONTAINERS PROPERLY LABELED ----------- __------------------ ---------------_-- _ _ -- ^ HOUSEKEEPING I~ ^ FIRE PROTECTION l~ ^ SITE DIAGRAM ADEQUATE & ON HAND G ANY HAZARDOUS WASTE ON SITE: ^ YES ~ NO EXPLAIN: QUESTIONS REGARDING HIS INSPECTION? PLEASE CALL US AT (661 ~ 326-3979 ~"s~ _- In ctor-_------_,_..---_- Badge No_---_-. Business Site Responsible Party White -Environmental Services Yellow -Station Copy - Pink -Business Copy ~. t FOODS CO 384 Manager JIM BAKER Location: 2505 HALEY ST City BAKERSFIELD SiteID: 015-021-000124 ~g~ BusPhone: (661) 873-2052 Map 103 CommHaz Extreme Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code:5411 DunnBrad:19-328-2571 Emergency Contact; / Title Emergency Contact / Title "T""~"" """`_rT"T..°_ `~t ~~,~(STORE DIRECTOR ALARM CENTER / RALPH SECURITY ~ Business Phone: 661) 873-2052x Business Phone: (310) 900-3700x 24-Hour Phone (310) 900-3700x 24-Hour Phone (310) 900-3700x Pager Phone ~ ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire -Press React ImmHlth DelHlth Contact ~,A7 DENHAM Phone : ( 310 ) MailAddr: PO BOX 54143 - State: CA 9~-3~,`~N City LOS ANGELES Zip 90054 Owner RALPHS GROCERY CO ~ Phone: A-~~e ~ (310) °°" ="".x Address t ~ ~G y tA% ~ ' 8\v~. te ~~+~~$~ City COMPTON Zip : 0220 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~~~~~ an my inpulry nt thaS~ inclividt~sl& tN+a lnfar!'n~tti4 ~rsan~lly rmapa~~i~9~ #ar ra~telnlr~~ a~ !~w tha: !have R' a~lt " ' E~ y a~d~r p~~ exSi~;h~ad end ~m {~~m111ar with tha i~t~r~~t~tilon IS1fgrPTlr~tlCsrl iS trUe~ 1" ~ © ~ ~ ~~~~ ~ ~ D !~3 5ubmltteri Flrtt~ h~IiAVO t ~ accu-. „ atld ra~plete. ~~~ ~/~ ~ 7 __---/ Date `5ignmture -1- 01/31/2007 7 F FOODS CO 384 ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-000124 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common, Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP BLEACH IH L 700.00 GAL Hi PROPANE E F P IH G 150.00 GAL Hi AEROSOL CLEANERS E F P IH DH L 125.00 GAL Hi POOL ACID E R IH L 36.00 GAL Hi HOUSEHOLD GLASS CLEANERS R IH DH L 200.00 GAL Mod INSECTICIDES F P IH L 80.00 GAL Mod AMMONIA CLEANER E F IH L 50.00 GAL Mod CHARCOAL LIGHTER FLUID F IH DH L 45.00 GAL Mod FREON 22 F P R IH G 14015.31 FT3 Low AUTOMOTIVE PRODUCTS DH L 55.00 GAL Low MOTOR OIL F DH L 225.00 GAL Min AEROSOLS F P IH ' L 65.00 GAL UnR -2- 01/31/2007 -3- 01/31/2007 7 r F FOODS CO 384 SiteID: 015-021-000124 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 12 CAS# 7681529 Liquid TMixture ~AmbRent~E ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 700.00 GAL 500.00 GAL t1HGHKLVU~J lrV1~lYV1VJ;IVT~ °sWt . RS CAS# 7.00 Sodium Hypochlorite No 7681529 t11'~GXKiJ 1~~ 5L' .7.71~1L' 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0011 COMMON NAME / CHEMICAL NAME PROPANE Location within this Facility Unit STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 74-98-6 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest.Container Daily Maximum Daily Average 150.00 GAL - 150._00 GAL 150.00 GAL l1HGEiCCLV U.7 1.V1~lYV1V ~1V 1.7 %Wt. RS CAS# 100.00 Propane Yes 74986 tll-~GKKL H5 w7L5~`1~J1~1L"1V1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -4- 01/31/2007 'I` F FOODS CO 384 ~ Inventory Item 0010 COMMON NAME / CHEMICAL NAME AEROSOL CLEANERS Location within this Facility Unit AISLE 13 SiteID: 015-021-000124 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Above Ambient Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 125.00 GAL 90.00 GAL nt~~titcl~VUS ~V1nrVlvrlvl~ sWt. RS CAS# 0.50 Sodium Hydroxide No 1310732 10.00 n-Butane Or Butane Mixture _ Yes 106978 nx~tilcl~ ~~ar~a~ln~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH DH / / / Hi ~ Inventory Item 0012 COMMON NAME / CHEMICAL NAME POOL ACID Location within this Facility Unit Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Contiin0e0rG~ Daily M36100m GAL I Daily A36r00e GAL riAGt1KLVU~ l:Vl°lYV1Vt',1V1J °sWt. RS CAS# 100.00 Muriatic Acid Yes 7647010 riHG1iKL L-~J ~I;JJ1~1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi Facility Unit: Fixed Containers on Site ~ -5- O1j31/2007 F FOODS CO 384 SiteID: 015-021-000124 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME HOUSEHOLD GLASS CLEANERS Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 13 CAS# Liquid TMixture ~Ambient~E ~ AmbientT~E I GLASSOCONTAINERYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 200.00 GAL 140.00 GAL L11'iGKRLV V w7 l.Vl"lYV1V L' 1V 1 S ~Wt. RS CAS# 5.00 Isopropanol No 67630 5.00 2-Butoxyethanol No 111762 6.00 Isopropyl Alcohol No 67630 17.h~GHiCL H. 7 JI'+J .71~1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH DH / / / Mod ~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDES Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 12 CAS# 52645531 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~-Above Ambient Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum Daily Average GAL 80.00 GAL 45.00 GAL HAZARDOUS COMPONENTS %Wt• RS CAS# 0.20 Permethrin No 52645531 0.20 Pyrethrin No 80003347 0.50 Piperonyl Butoxide No 51036 i7-C~[~riRL tiJ JP~J Jl•1LilV 1 iJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Mod -6- 01/31/2007 F FOODS CO 384 SiteID: 015-021-000124 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME AMMONIA CLEANER Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 13 CAS# 7664-41-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~mbient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 50.00 GAL 35.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 30.00 Ammonia, Conc. 20% or Greater Yes 7664417 LIHGHKL H J~J~.7.71"1~a1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / Mod ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CHARCOAL LIGHTER FLUID Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 14 CAS# 800-66-42 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 45.00 GAL 33.00 GAL iJ.l7L~t'll,C.LIl V w7 l.Vl•lr V1V L'1V1J -- %Wt. RS CAS# 100.00 Petroleum Naphtha No 8030306 rLCiL~tiiC1J tia ~J r+J w71.1LilV 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -7- 01/31/2007 F FOODS CO 384 SiteID: 015-021-000124 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME FREON 22 Days On Site 365 Location within this Facility Unit Map: Grid: REF MACH RM MEZZ CAS# 75-45-6 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 14015.31 FT3 14015.31 FT3 14015.31 FT3 tYl-jGEitt11VU~ 1.V1~lYV1VL"1V15 %Wt. RS CAS# 100.00 Chlorodifluoromethane No 75456 tu~GlittL .ya~~aal~ir~ly 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P R IH / / / Low ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME AUTOMOTIVE PRODUCTS Location within this Facility Unit AISLE 12 STATE TYPE PRESSURE _ Liquid Mixture TAbove Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 107-21-1 TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~I Daily Average GAL 55.00 GAL 30.00 GAL IlEiGKCCLV U~7 1:V1~lYV1V~1V 1 b oWt. RS CAS# 90.00 Ethylene Glycol No 107211 IIHGKKL H.7 .7P~JJ1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Low -8- 01/31/2007 F FOODS CO 384 SiteID: 015-021-000124 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 12 CAS# 8020835 Liquid TMixtur~ Ambient~E ~ AmbientT~E METAL CONTAINRTNONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 225.00 GAL 180.00 GAL riHGH.tCLVU~ 1,V1~lYV1VJ;1V 1.7 %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 tiHGH.ttL tia JJ;JalnrJivla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME AEROSOLS Days On Site 365 Location within this Facility Unit Map: Grid: AISLES 15 & 16 CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~-Above Ambient. Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 65.00 GAL 40.00 GAL HAZARDOUS COMPONENTS ~Wt. RSA CAS# ti1~GL~iCL H~51;~~1~1L'1V1~J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / UnR -9- 01/31/2007' F FOODS CO 384 SiteID: 015-021-000124 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/02/2006 ~ IN THE EVENT OF A MAJOR HAZARDOUS MATERIAL RELEASE/SPILL, THE STORE DIRECTOR OR PERSON IN CHARGE SHALL IMMEDIATELY CONTACT THE FIRE DEPT 911. DURING OFFICE HOURS, CONTACT ENVIRONMENTAL AFFAIRS 310-884-4082. AFTER HOURS, CONTACT RALPHS 24-HR SECURITY 310-354-3700. THEY WILL CONTACT THE APPROPRIATE PERSON FROM THE AFTER-HOUR CALL LIST TO NOTIFY THE OES AND OTHER AGENCIES AS REQUIRED. Employee Notif./Evacuation 11/02/2006 UPON HEARING THE EVACUATION ALARM OR PA ANNOUNCEMENT, EMPLOYEES WILL EVACUATE AND REPORT TO DESIGNATED MEETING AREAS. THE STORE DIRECTOR OR PERSON IN CHARGE IS RESPONSIBLE FOR MAKING THE ANNOUNCEMENT AND TO ENSURE THAT ALL EMPLOYEES EXIT SAFELY. ,_ r.I.W L.LV 1VV 1.11 ~ L~VQI: UCL 1.1 V11 Emergency Medical Plan 11/02/2006 NEAREST HOSPITAL: INDUSTRIAL MEDICAL GROUP OF BAKERSFIELD, 2501 G ST, 327-2225. POISON CONTROL CENTER 800-876-4766. -10- 01/31/2007 o F FOODS CO 384 SiteID: 015-021-000124 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 03/01/2002 ~ ALL EMPLOYEES ARE TRAINED IN HAZARD COMMUNICATION THAT INCLUDES SAFE HANDLING PROCEDURES OF HAZARDOUS MATERIALS. IN SOME CASES EMPLOYEES DO NOT COME INTO DIRECT CONTACT WITH THE HAZARDOUS MATERIAL DUE TO SELF-CONTAINED UNITS OR CLOSED-LOOP SYSTEMS. Release Containment 11/02/2006 EMPLOYEES TO USE BARRIER GUARDS AND WARNINGS TO KEEP OTHERS AWAY FROM SPILL AREA. IF AN ABSORBENT IS NEEDED, WE WILL USE KITTY LITTER. IF THE SPILL IS OUTSIDE OUR PROPERTY (DIESEL FUEL) WE WILL USE ABSORBENT TO KEEP THE SPILL OUT OF THE STORM DRAIN AND WATER RECOURSE UNTIL HELP ARRIVES. Clean Up 11/02/2006 ANY HAZARDOUS MATERIAL LIQUID ABSORBED BY KITTY LITTER WILL BE PICKED UP AND PLACED IN A CONTAINER AND HELD FOR PROPER DISPOSAL BY A HAZARDOUS WASTE HAULER. THIS WILL BE COORDINATED THROUGH RALPHS ENVIRONMENTAL AFFAIRS DEPT. DESIGNATED CLEAN-UP CONTRACTOR: ADVANCED CLEAN-UP TECHNOLOGIES INC CACTI), 20928 LAMBERTON AVE, CARSON CA 90810, 800-334-2284 OR 310-763-1423. V1.11Ci iCC~VUl_UC HUl.1Vdl.1Ui1 -11- 01/31/2007 s F FOODS CO 384 SiteID: 015-021-000124 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs 11/02/2006 A) GAS - OUTSIDE SE CRNR B) ELECTRICAL - INSIDE NE CRNR C) WATER - OUTSIDE W FRONT DOOR AREA D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water FIRE HYDRANT - BOTH CRNRS FRONT OF STORE. 11/02/2006 Building Occupancy Level 87 EMPLOYEES 11/02/2006 -12- 01/31/2007 ,~ :~ ~~. F FOODS CO 384 SiteID: 015-021-000124 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/31/2007 ~ MSDS SHEETS ON FILE. BRIEF SUNINIARY OF TRAINING PROGRAM: TRAINING IS PROVIDED TO ALL MEMBERS VIA RALPHS FORMAL HAZARDOUS COMMUNICATION PROGRAM CONSISTING OF 3 PARTS: ORAL PRESENTATION; TRAINING VIDEO; AND EMPLOYEE HANDBOOK. EMPLOYEES ARE TRAINED IN PROCEDURES FOR USAGE OF FIRE EXTINGUISHERS, RESPONSIBILITY FOR FIRE, EMERGENCY AND EVACUATION PROCEDURES. rayv ~ Held for Future. Use nela rc~r ruzure use -13- 01/31/2007 Bakersfield Fire Dept. UNIFIE® PROGRAM INSPECTION CHECKLIST Enironmental services ,_ , ~a _ ;, ~ 1.715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 - Tel: (661)326-3979 • FACILITY NAME INSPECTION DATE INSPECT~jION TIME -------------------------------------- ---_ . - ------ _.-._. - -- - --- 'off-~-v,'- --`--------- -- `~ l.I~-~- - --- ADORESS PHONE No. No. of Employees ---- --- ----------- __----- --_-------- -?a?~z-- ----------- -- - FACILITYCONTACT Business ID Number N v fl 15-021- Ot~c~IZ~ Section 1: Business Play and Inventory Program ^ Routine Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection C V \V=Vioatonncel OPERATION COMMENTS ^ APPROPRIATE JPERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ,,f _---- - __---- -....._--- ._.-.... - __..- ._. -- -__. _....---- ----------- __.._....-..----- AO ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES l - --- -------- - -..-~ - --- ----- ---- - __-I - -..-. _ __ ----. --_... - ---.._..- ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ ~ VERIFICATION OF MSDS AVAILABILITYE - - - -- ,,f -- __..-- --- -- - ~ ----.._ LEA VERIFICATION OF HAT MAT TRAINING 'l --- - - - --------- ------ ------ - --------- _ _ _ _ -- -I ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES w0 ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING _----..._r_ .. -------- --- - - __ ____.. - ._.-. ---_... _ __ __---------- ------- ^ FIRE PROTECTION I ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES t~NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~66 ~ ~ 326-3879 _---/IIdnk_~4n~~~a- -------------------~ ~------- ---- Inspector (Please Print) Fire Prevention 1st-1nlShift of Site White -Environmental Services Yellow -Station Copy sin s ite Responsi le Party (Please Print) g Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Pyre Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME l \ I ION TIME ` r, ~ ~ I N ~ ~ ~~ ~ ~~~ ~3 ~ ~ r ~~ S GDS/~/~~ ~~ ~ -~"''.~---------------- PHON ~ --------- ADDRESS E No. No. of Employees __________a_~o.~ ~~~ ~-~_-_.__. _____-________._______x.$73-Z~~~~_.___- _ FACILtTYCONTACT Business ID Number ~~a ~ ~i~~' ~ 15-021-~ /~ iz Section 1: Business Plan and Inventory Program ^Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint O Re-inspection C V \V=VioatonnCel OPERATION COMMENTS APPROPRIATE PERMIT ON HAND ^ - --- BUSINESS PLAN CONTACT INFORMATION ACCURATE - - -/ -/ / N~G6~ ~ y gtiT~~Y ^ -- VISIBLE ADDRESS - ----- ----------- • -- - _ Q - - ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES - - ^ - -VERIFICATION OF LOCATION -------------.~ f~~5 ~------~r°~~J~ ~J~ ~©q ----- -- --- ^ -- - PROPER SEGREGATION OF MATERIAL - ------------- ~It~_. ~ ~~ ~--- ~_~~ - -_ ~-1 ~~1.~------ ^ VERIFICATION OF MSDS AVAILABILITYE VERIFICATION OF HAT MAT TRAINING _ - ~ ,~ ~ - ^ -- -------------- VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES --- --------- -------VVV-- ____- ^ EMERGENCY PROCEDURES ADEQUATE --` `~ , A, - / ~ ~Q~- ~L~-rte' - --------------------..._-- ^ CONTAINERS PROPERLY LABELED --- ----- ~J~ ~ ~ a~ v ^ ------ HOUSEKEEPING --- --- -~p~~,..-------------- ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES NO EXPLAIN: QUESTIONS RE RD THIS INSPECTIONS PLEASE CALL US AT (iJs'I ~ 3X)-3979 - Ins for ~ Badge No. ~ Busin esponsible ~ /~ White -Environmental Services Yellow • Stalbn Copy Pink - Business Copy ~ l./ UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program ~; H E R S F l D F/RE ~Rrn- r Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ INSPECTION DATE ~ o INSPECTION TIME (-:~d ~w- 0o s ~ -Z - ~ ADDRESS Z~C)S ~-~1e b(0 PHONE NO. 8~3-~~ NO OF EMPLOYEES FACILITY CONTACT ~I G BUSINESS ID NUMBER 15-021- app (Z,~ Section 1: Business Plan-and #nventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE ^, VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION - / Cld' ^ 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? EXPLAIN: ^ YES ~NO rtar-ouio QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US A7 (661) 326-3979 S-~-Ur-c 1Mar I~ w ~~ S fog . 8 ~ i +ti. Inspector (Please Print) Fire Prevention / 1~' In /Shift of Site/Station # Business Si White -Prevention Services Yellow -Station Copy Pink -Business Copy /.~,/ FD 2155 (Rev. 09/05