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.UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
•
Prevention Services .
A F R s F _, , „ 900 Truxtun Ave.,. Suite 210
-FIRE Bakersfield, CA 93301
ARTM r Tel.: (661) 326-3979
-Fax: (661) 872-2171 '
FACILITY NAME ~
S ~- ~ C ~ ~v C . INSPECTION DATE
~ - /5' -~G INSPECTION TIME
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ADDRESS -
~(r 1 ur z-uc~ - ~ PHONE NO.
3 ZZ-?®3 NO OF EMPL YEES
FACILITY CONTACT ~,~ /~ BUSINESS ID NUM615'O21 ~ ~DO 2 Z
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Section 1: Business Plan and Inventory Program ~~j~V
t!S ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
(~ ^ APPROPRIATE PERMIT ON HAND
Ia ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ~~. ~
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY ~~
^ VERIFICATION OF INVENTORY MATERIALS ~ ~
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^ VERIFICATION OF QUANTITIES -~ ~~ ~ ~ u ~/dY
^ VERIFICATION OF LOCATION ~Q ~/ ~ us
^ PROPER SEGREGATION OF MATERIAL V~
^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
(~ ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
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^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? hd'YES ^ NO
EXPLAIN: ~~ S ~ ~l
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station #
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05
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+ B S & E CO INC =________----___________________________ SiteID: 015-021-000227 +
Manager
Location: 417 KENTUCKY ST'
City BAKERSFIELD
BusPhone: (661) 322-7035
Map 103 CommHaz High
Grid: 29A FacUnits:, 1 AOV:
CommCode: BFD STA 02
EPA Numb:
SIC Code:7359
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
TIM BANDY / MAN~tGER BOBBY JACKSON / SALES
Business Phone: (661) 32'2'-7035x Business Phone: (661) 322-7035x
24-Hour Phone (661) 39'9-2550x 24-Hour Phone (661) 366-8137x
}er Phone (661) Pager Phone ( ) x
+---~~' ----------------~'-r_~eeY----- --+------------------ --------------------+
Hazmat Hazards: Fire Press Reac t ImmHlth DelHlth
Contact Phone: (661) 834-2700x
MailAddr: 6319 DISTRICT E~LVD State: CA
City BAKERSFIELD Zip 93313
Owner BOB PHARES Phone: (661) 834-2700x
Address 6319 DISTRICT BLVD State: CA
City BAKERSFIELD Zip : 93313
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ABOVEGROUND STORAGE TANK
THIS IS AN SPCC SITE AND EtEQUIRES A JOINT INSPECTION. PLEASE CALL ENV SVGS
TO SCHEDULE THIS INSPECTION.
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,
accurate, and complete.
J f ~J ~D
ure Date
ENT°ppp~~~,
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02/28/2006
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
•
Bakersfield Fire- Dept.
'; Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel: (661) -326-3979
FACILITY NAME WSPECTION DATE INSPECTION TI E
Lei S ~- ~ , C %~ - Z ~ - S f 3 ?o ~Sn
o. ~~ ~.___ __ .___ __. _ __ ___-_ _... _- .---_ _ _ ..- --- ~---------~ - ----___ _ _- _-
--~-- --------- ------------ --------- ---- --- -- ------ PHONE No. No. of Empfoyses
ADDRESS
5l / ? GC~~:vT~IG~ ~ .32 2 ~ 7d 3
FACILITYCONT~I GT Business 10 Number
- t c i~ `t~ p,.t~fy,,t 15-021- ~ Z2 ~
Section 1: Business Plan and Inventory Program
Routine ~ Combined ~ Joint Agency ~ Multi-Agency O Complaint O Re-inspection
ANY HAZARDOUS WASTE ON SITE?: L1~ TES ^ NO
EXPLAIN: ~~s 1 i L of L
•
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~6G'I ~ 326-3979
- . - ---
spector (Please Print) Fire Prevention 1st-INShift of Site
White • Environmental Services Yellow -Station Copy
a,
Pink -Business Copy