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HomeMy WebLinkAboutBUSINESS PLAN 8/4/2007i :WHITE LANE AUTOMOTIVE 4150 MEXICALI DRIVE ~>> ~;' :.`\ ~~. WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 Manager STEVEN HENDRIX Location: 4150 MEXICALI DR City BAKERSFIELD BusPhone: (661) 397-4406 Map 123 CommHaz High Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title STEVEN R HENDRIX / OWNER ROY HENDRIX / RELATIVE Business Phone: (661) 397-4406x Business Phone: (661) 665-8083x 24-Hour Phone (661) 978-9738x 24-Hour Phone ( ) - x Pager Phone (661) 663-7242x Pager Phone ( ) - x Hazmat Hazards: Fire Press. ImmHlth DelHlth Contact STEVEN HENDRIX Phone: (661) 397-4406x MailAddr: 4150 MEXICALI DR State: CA City BAKERSFIELD Zip 93313 Owner STEVEN R HENDRIX Phone: (661) 397-4406x Address 4150 MEXICALI DR 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 (C~(1pw~U,p~1,T, 0 ~ /(~±y~y ~~J`[ _...rr on my i,.quiry of those individuals resnan~:i~'e for ot~aining the information. I certify under ;:enalty of lave that i have personally examined and am familiar v~r;th the inbrmation submitted and b?lieve the information is true, accurate, and complete. Signature _ Date -1- 07/16/2007 .`-1`~: } F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ 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 300.00 FT3 Hi OXYGEN F IH DH G 300.00 FT3 Low WASTE OIL F DH L 55.00 GAL Low ARGON F P IH G 300.00 FT3 Min MOTOR OIL F DH L 55.00 GAL Min -2- 07/16/2007 ~t~~ .. ~. -3- 07/16/2007 s F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: S SIDE OF BAY 2 CAS# 74-86-2 ~GasATE ~PureE -~AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Co300100rFT3 Daily 300100m FT3 I Daily 300r00e FT3 17LiC~rilSLVIJJ 1.V1~lY V1V L~1V1J swt. Rs cAS# 100.00 Acetylene Yes 74862 r11iGL-iRL riJ JP~JJl•1P~1V1J TSecret RS BioHaz Radioactive/Amount EPA, Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: S SIDE OF BAY #2 CAS# 7782-44-7 ~GasATE TPureE ~-AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ( Daily Average 300.00 FT3 300.00 FT3 300.00 FT3 ru~uruu~vvo L.V1•lr V1V J;1V 1.7 owt. Rs cAS# 100.00 Oxygen, Compressed No 7782447 riL'i4riLCL riJ J1;A JP71J1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/16/2007 2t-1i F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: E END OF BLDG C'AS# 221 = STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste -~mbient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 40.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 riHG1~KL 1~5JL' S,`71~1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME ARGON Location within this Facility Unit S SIDE OF BAY 2 Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7440-37-1 ~GasATE ~PureE -~AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum -~ Daily Average 300.00 FT3 300.00 FT3 300.00 FT3 r1P9C.it1RLVl.1J ~..vrlrvivrJivlJ gWt• RS CAS# 100.00 Argon No 7440371 rlti[~tiRL tiJ J 1'.~ J J 1"1r.1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 07/16/2007 _..~•,. Y F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: E END OF BLDG CAS# 8020835 Liquid TMixture 1 AmbRent~E ~ AmbientT~E DRUM/BNARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 40.00 GAL tiHGtiKLVUa ~vinrvlv~lyl~ %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 t1AGHKL H~JJt;5~1~1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -6- 07/16/2007 ~~, 4 F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Notif./EvacuationjMedical Overall Site ~ ~ Agency Notification 05/10/1993 ~ IN THE EVENT OF EMERGENCY NOTIFY FIRE DEPT BY TELEPHONE. IF SITUATION EFFECTS ADJACENT BUSINESS NOTIFY OWNER/MANAGER IN PERSON. NOTIFY PROPERTY MANAGER IF THE COMPLEX IS EFFECTED. Employee Notif./Evacuation 01/23/2001 EMPLOYEES WOULD BE MADE AWARE OF PROBLEM AND THEN HELP CONTROL AND CORRECT THE PROBLEM. Public Notif./Evacuation 01/23/2001 SHOULD A CUSTOMER BE ON THE PREMISES AND AN EMERGENCY AROSE I WOULD ANNOUNCE IT AND REQUEST THEM TO MOVE OUT OF THE BLDG AND MOVE TO THE VACANT FIELD DIRECTLY ES OF THE SHOP. Emergency Medical Plan 01/23/2001 MOST MEDICAL EMERGENCIES CAN BE HANDLED BY THE MEDICENTER AT ASHE & MING OR THE MEDICENTER ON WHITE LN. IF THE NEED IS MORE SERIOUS THEN ER AT SAN JOAQUIN OR MERCY HOSPITAL ARE THE CLOSEST. -7- 07/16/2007 ~ ~~ F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/10/1993 ~ ALL MATERIALS (IE. MOTOR OIL, WASTE OIL, ETC.) ARE STORED IN APPROVED CONTAINERS. WASTE OIL IS PICKED UP AND REMOVED FROM THE PREMISES ON A REGULAR SCHEDULE. WASTE AND TRASH ARE PLACED IN METAL CONTAINERS WITH LIDS. Release Containment 05/10/1993 CONTAINERS ARE IN GOOD CONDITION & FREE OF RUPTURES. CONTAINERS ARE PROPERLY LABELED AND SITUATED AWAY FROM TRAFFIC AREAS. OVERSIZED FUNNELS TO PREVENT SPILLS. Clean Up 05/10/1993 STOP OR REROUTE TRAFFIC AWAY FROM SPILL. CAPTURE & CONTAIN SPILLS WITH ABSORBING MATERIAL & TRANSFER TO WASTE BARREL FOR DISPOSAL. VV11G1 iZG.7llUl l.C 1'il.: 1.1 VCL l.1 V11 -8- 07/16/2007 r y` ^~a F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNv~:lcal nac~ciiu~ Utility Shut-Offs ELECTRICAL - NE CRNR WALL NEXT TO RESTROOM WATER - S WALL OF BLDG E OF ROLL-UP DOOR 03/21/2007 Fire Protec./Avail. Water 03/21/2007 PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM. FIRE EXTINGUISHER MOUNTED ON SHOP WALL. NEAREST FIRE HYDRANT - 200FT N OF SHOP. Building Occupancy Level 12/11/2006 4 EMPLOYEES -9- 07/16/2007 ~* rt F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 03/21/2007 MSDS SHEETS ON FILE. BRIEF SUNIMARY OF TRAINING PROGRAM: I HAVE BEEN TRAINED IN THE HANDLING OF HAZARDOUS AND POTENTIALLY HAZARDOUS MATERIAL BY PRIOR EMPLOYERS. I AM SELF TRAINED THROUGH CONTINOUSLY REVIEWING MY HANDLING PROCEDURES. EMPLOYEES ARE AWARE OF ALL HAZARDOUS MATERIALS AND KNOW PROPER HANDLING PROCEDURES. HANDLING PROCEDURES ARE REVIEWED PERIODICALLY. rayc c. riC1U LV.C rULU=C USC riCLU LVL PUI. I.LLC U`.5C -10- 07/16/2007 UNIFIED PROGRAM INSPECTION CHECKLIS~~~ ~~ prevention Services e FRS,: , 0 900 Truxtun Ave., Suite 210 _ - : - FARE Bakersfield, CA.93301 SECTION. 1: Business Plan and-Inventory Program "RrM Tel.: (661) 326-3979- . ~ _ Fax: (661) 872-2171 FACILITY NAME ~ i ~ L ~~ t~~ ~~ I<~ INSPEC ION DATE `~ Z~ - a7 INSPECTION TIME ~v l D ADDRESS ~ `~lsa m ~a~, ~~. PHONE NO. 357~~1ye 6 NO OF E P YEES FACILITY CONTACT S! vii ~t/ i2 Ol. BUSINESS ID NUMBER 15-02 1- ~0(, - - _ _ - ___ Section 1: Business Plan and Inventory Program _- - IS ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION' C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ~,/ L'( ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY . . ,~ ~/ L''I ^ VERIFICATION OF HAZ MAT TRAINING ~ " LAY ^ 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? L'~YtS ^ NO EXPLAIN: .d r QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1'~ In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 T~ _.: 1 ~~~ WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 Manager ~~~e~ ~`~ir/c~~`/~ BusPhone: (661) 397-4406 Location: 4150 MEXICALI DR Map 123 CommHaz High City BAKERSFIELD Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact /, .Title- -- ~. STEVEN R HENDRIX / OWNER ROY HENDRIX / ~e~a ~`~C Business Phone: (661) 397-4406x Business Phone: (661) 665-8083x 24-Hour Phone (661) 978-9738x 24-Hour Phone ( ) - x Pager Phone (661) 663-7242x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ~ ~~~~ ~"'~-~''~ Phone: (661) 397-4406x MailAddr: 4150 MEXICALI DR State: CA City BARERSFIELD Zip 93313 Owner STEVEN R HENDRIX Phone: (661) 397-4406x Address 4150 MEXICALI DR 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 n DO [` k3r~&ed on my inquiry of those indivi~i~~rJ~ r~r~fnP+~.i{a;r--~ #f;r dbt?Inin~ thd~ infr?rrr~atipn, I ~e~rtiiy r~onally E~1'+n U A~^~ rv'rl ~ ® ~oo )rtri;-rity of 1~-rw that I have p~, undr r ~ , , eYan`iin~~r~ pni, tam fet~ili~r with thc> information submitted and boilevG the iniovmaiion is true, accurate, and complete. ~ ~ 7 'ignature Date -1- 02/20/2007 1, F WHITE LANE AUTOMOTIVE SitelD: 015-021-000406 ~ ~ 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 300.00 FT3 Hi OXYGEN F IH DH G 300.00 FT3 Low WASTE OIL F DH L 55.00 GAL Low ARGON F P IH G 300.00 FT3 Min MOTOR OIL F DH L 55.00 GAL Min -2- 02/20/2007 -3- 02/20/2007 S. F WHITE LANE AUTOMOTIVE ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME ACETYLENE Location within this Facility Unit S SIDE OF BAY 2 SiteID: 015-021-000406 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 74-86-2 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure ~-Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 300.00 FT3 300.00 FT3 300.00 FT3 tiAGiit[LVUJ 1=V1~1rV1vi51vla °sWt. RS CAS# 100.00 Acetylene Yes 74862 tiHG1~1CL 1~w 7.71",JJ1~1L" 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit S SIDE OF BAY #2 STATE TYPE PRESSURE = Gas TPure ~-Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 300.00 FT3_ 300.00 FT3 I 300.00 FT3 riEiGEitCLVUJ 1,V1~lYV1V~1V1J awt. Rs cAS# 100.00 Oxygen, Compressed No 7782447 tlL~l~tiKL H J.7L'.7AlY1L"1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 02/20/2007 f ~ F WHITE, LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid:. E END OF BLDG CAS# 221 STATE Liquid TYPE TWaste PRESSURE Ambient ~ TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 40.00 GAL t11~GE~tCL V U 5 lL V1~lY V1V L' 1V 1 ~ owt. Rs cAS# 100.00 Waste Oil, Petroleum Based No 0 t1E~GL~KL E~55t;5J1~1L'1V15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ARGON Days On Site 365 Location within this Facility Unit Map: Grid: S SIDE OF BAY 2 CAS# 7440-37-1 ~GaSATE TYPE ~f~'~ PRESSURE ~~ TEMPERATURE ~~ CONTAINER TYPE ~ TPure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 300.00 FT3 '300.00 FT3 I 300.00 FT3 nt~~tuc.uvua Lvl~lrvlv~lyl~ ~Wt. RS CAS# 100.00 Argon No 7440371 ri.HG1itCL I~J ~1;5J1~1r,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 02/20/2007 1 F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: E END OF BLDG ~ CAS# 8020835 Liquid TMixture ~mbient~E ~ AmbientT~E DRUM/BARRELEMETALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 40.00 GAL t1E~G.E1ttUVUa 1:V1~lYV1V~1V'1J oWt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 tir~~tittL r~~5~5,~i~i~lvta TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -6- 02/20/2007 F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/10/1993 ~ IN THE EVENT OF EMERGENCY NOTIFY FIRE DEPT BY TELEPHONE. IF SITUATION EFFECTS ADJACENT BUSINESS NOTIFY OWNER/MANAGER IN PERSON. NOTIFY PROPERTY MANAGER IF THE COMPLEX IS EFFECTED. Employee Notif./Evacuation 01/23/2001 EMPLOYEES WOULD BE MADE AWARE OF PROBLEM AND THEN HELP CONTROL AND CORRECT THE PROBLEM. Public Notif./Evacuation 01/23/2001 SHOULD A CUSTOMER BE ON THE PREMISES AND AN EMERGENCY AROSE I WOULD ANNOUNCE IT AND REQUEST THEM TO MOVE OUT OF THE BLDG AND MOVE TO THE VACANT FIELD DIRECTLY ES OF THE SHOP. Emergency Medical Plan 01/23/2001 MOST MEDICAL EMERGENCIES CAN BE HANDLED BY THE MEDICENTER AT ASHE & MING OR THE MEDICENTER ON WHITE LN. IF THE NEED IS MORE SERIOUS THEN ER AT SAN JOAQUIN OR MERCY HOSPITAL ARE THE CLOSEST. -7- 02/20/2007 F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/10/1993 ~ ALL MATERIALS (IE. MOTOR OIL, WASTE OIL, ETC.) ARE STORED IN APPROVED CONTAINERS. WASTE OIL IS PICKED UP AND REMOVED FROM THE PREMISES ON A REGULAR SCHEDULE. WASTE AND TRASH ARE PLACED IN METAL CONTAINERS WITH LIDS. Release Containment 05/10/1993 CONTAINERS ARE IN GOOD CONDITION & FREE OF RUPTURES. CONTAINERS ARE PROPERLY LABELED AND SITUATED AWAY FROM TRAFFIC AREAS. OVERSIZED FUNNELS TO PREVENT SPILLS. Clean Up 05/10/1993 STOP OR REROUTE TRAFFIC AWAY FROM SPILL. CAPTURE & CONTAIN SPILLS WITH ABSORBING MATERIAL & TRANSFER TO WASTE BARREL FOR DISPOSAL. V1.11CL 1CCSVULLC LiC.:l.1Vdl.lVil -8- 02/20/2007 e ~, , F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aj/c~ial nc«.aiu~ Utility Shut-Offs 12/11/2006 A) GAS - NONE B) ELECTRICAL - NE CRNR WALL NEXT TO RESTROOM C) WATER - S WALL OF BLDG E OF ROLL-UP DOOR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 12/11/2006 PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM. FIRE EXTINGUISHER MOUNTED ON SHOP WALL. NEAREST FIRE HYDRANT - APPROX 200FT N OF SHOP. Building Occupancy Level 12/11/2006 4 EMPLOYEES -9- 02/20/2007 ~, ~ £'_ F WHITE LANE AUTOMOTIVE SiteID: 015-021-000406 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 12/11/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: I HAVE BEEN TRAINED IN THE HANDLING OF HAZARDOUS AND POTENTIALLY HAZARDOUS MATERIAL BY PRIOR EMPLOYERS. I AM SELF TRAINED THROUGH CONTINOUSLY REVIEWING MY HANDLING PROCEDURES. ~ ,~'~ ~~1J4~,~/~F5 ~.L~C ~ccJi¢~C o j~` l1 /~ ./hW~c~ ~/4l~c /~aa~' Page 2 Held for Future Use nclu tvi ru~ul.c lJSc -10- 02/20/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services a E R S F r n 900 Truxtun Ave., Suite 210 __ _. FIRE Bakersfield, CA 93301 ARTM r Tel.: (661) 326-3979 Fax: (661) 872-2171 AGILITY NAME~I. * ~ ~ ~ ~ INSPECTION DATE// INSPECTION TIME i T(j i'VL®?~/~ W ~'~~~ L ~ ~ '~ '~!d ADDRESS ~ ~-r ~ PH NO. 7- ~`~0~ NO OF PLOYEES ( (sue ~ ~ ~c a- FACILITY NTACT ^ <- J\ BUSINESS ID NUMBER i 15-021- ~ p (P Section 1_:Business Plan and inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance .OPERATION V=Violation - COMMENTS ^ APPROPRIATE PERMIT ON HAND ~ ^ BUSInBSS PLAN CONTACT INFORMATION ACCURATE 1~ ^ VISIBLE ADDRESS EN1'~ [- ^ CORRECT OCCUPANCY IQ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION /~ (f' ^ PROPER SEGREGATION OF MATERIAL ~^ VERIFICATION OF MSDS AVAILABILITY B ~ ^ VERIFICATION OF HAZ MAT TRAINING ^ / 1~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ..tom ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZA/`RDOUS('W~ST{E~ONf~SIT ~ ~/1e~$ ^ NO EXPLAIN: /_ ~)~IS2~~Ji~~ ~ //!/~a~{~.- D/ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 2 ~/ ~ I ector (Please Print) Fire Pr ention / 1s` In /Shift of ite/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services rft~ 900 Truxtun Ave., Suite 210 ARTAI t gakers8eld, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME ADDRESS HONE NO. 35' -y OOF EMPLOYEES ~~ tso ~~.~x ~ 7 4oc~ FACILITY CONTACT USINESS ID NUMBER S` ~ 15-021- i{ D(Q C~ ~~~ rc i~.Z. Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS _ -/ l~l' ^ APPROPRIATE PERMIT ON HAND ^ BUSIIIQSS PLAN CONTACT INFORMATION ACCURATE l~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~/' L7 ^ 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 .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire revention / ts' In / Shift of Site/Station # Bust ss Site/School Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rav. tYllOS) UNIFIED PROGRAM 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 c? i-~.~i-~~urr~--------------_-_-_-_.-.-._~-._-_..- 4-~1 ~ ~< ~,l.J ~'--_-_~:_i. ~°`" ` ~-~ INSPECTION DATE i INSPECTION TIME ~~ "1_3___•_-L3 /Sm~K -- --------------- _ -- - .- - - - --- - ADDRESS , PHONE No. + No, of Employees ~ t ~ ~ ~~~~ ~ ~ ~ ~-~ 9 7 - ~Yo ~ 3 _ ------------ ---------- ----- __ FACILITYCONTACT ^O~ ,~ ~ {. ~ sT ---- ----- --- - Business ID 1 Sb~21 - ~~Q / C (o ~ U 4. M ~ t i~ Section 1: Business Plan and Inventory Program Routine ^ Combined O Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection C V \V-Vioatpiolnncel OPERATION ^ APPROPRfATE )PERMIT ON HAND - COMMENTS ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY / lid ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF pUANTITIES ~ ^ VERIFICATION OF LOCATION l~ ^ PROPER SEGREGATION OF MATERIAL l~ ^ VERIFICATION OF MSDS AVAILABILITYE - - L'7 ^ VERIFICATION OF HAT MAT TRAfN4NG - - L ` f ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES , . , / U ^ EMERGENCY PROCEDURES ADEQUATE ------- ~ -- l~ ^ CONTAINERS PROPERLY LABELED ----- - --- -------------------.`- -----------_. -- ^ HOUSEKEEPING ~---- ---- - 13 ^ FIRE PROTECTION -- -----`! ----- VT---- L7 ^ SITE DIAGRAM ADEQUATE H~ ON HAND - - - ANY HAZARDOUS WASTE ON SITE: ~ES ^ NO J EXPLAIN: ~ ~ ~ , C'91 ~ ''CV ~+G/S QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661 } 325-3979 --- ~~"~-~---------.___.------ b~ ------_ Inspector Badge No. White -Environmental Services Yellow - Statbn Copy _~ _ • Business Slte Responsible Party '' ~" Pink -Business Copy