HomeMy WebLinkAboutBUSINESS PLAN:~~
JEWELRY +-
- Valley Plaza
WEDDIlVC SET 2701 Ming Ave. Suite #301
PE~~LIST Bakersfield, CA 93304
_ S (661)834-6920
. - Matthew R. Crew
www.rogersjewelryonline.com Manager
UNIFI~$ PROGRAM INSPECTION CHECKLIST
. ,~
SECTION 1 Business ,Plan and Inventory Program: o~
ADDRESS
~-`~ d ~ P'VI [ ef~y ~ 30 (
FACIUTVCONTACT
Bakersfield Fire D~F lS
Environmental Services ~~/I.
900 Truxtun Ave., Suite 210 >,
Bakersfield, CA 93301
Tel: (661)-326-3979
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INSPECTION TE INSPECTION TIME
- __ 4~_0 ~-.-- ------. _ _ _ _- _
PHONE No. No. of Employees
Vurnber -- --- -- - -
15-0 - i.1i%`L t
Section 1: Business Plan and Inventory Program J~ ' `
^ Routine ^ Combined O Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection
C V \V=VioaplonnCel OPERATION COMMENTS O`
~ /
^ ^ APPROPRIATE PERMIT ON HAND
^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
^ ^ VISIBLE ADDRESS
^ ^ CORRECT OCCUPANCY
^ ^ ~ VERIFICATION OF INVENTORY MATERIALS ~ ~~21 Um
^ ^ VERIFICATION OF QUANTITIES Zj"'t
^ ^ .VERIFICATION OF LOCATION ) ~ScOE ~,~f~LdYt-~. RL•~S i~pU~
^ ^ PROPER SEGREGATION OF MATERIAL
~ __- . __.__--
~
^ ^ VERIFICATION OF MSDS AVAILABIUTYE I ~ ~
^
^ ....._-__----._.._....-_
VERIFICATION OF HAT MAT TRAINING _r-..._._...__...........
! _.-.._.......-..__.~a~,~......__ -------_---------__...
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^
.---- ^
-- - VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
----- -.:.._..------. ...-------- ----...__ ___ -..._ _.. l Pi.r~~c
I . _. _. _..._.. _. _ ~~,~ i~L.tii J~ ~`~~~
_ .-..___..._ ...._ .. _. -....._..
^ ^ EMERGENCY PROCEDURES ADEQUATE ~
^ ^ CONTAINERS PROPERLY LABELED
^ ^ HOUSEKEEPING
^ ^• FIRE PROTECTION ~ PL~.~ ~-S~~.i1.1~ ~~~i~ltSl~~-
^ ^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: ^ YES
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT tiss~ ~ 326-3979
~ f,.,r-S w~~ _ ___
Inspector (Please Print) Fire Prevention 1st-INShift of Site
While -Environmental Services Velbw - Staten Copy
Busine Site Responsible Party (Please rint)
Pink • Business Copy
,~'~~~ CITY OF I~AI{ERSFIELD
B EF~~~ '. OFFICE OF ENVIRONMENTAL SERVICES ~
ARTM T 1715 Chester Ave., CA 93301 (661) 326-3979
/ '~~~~~' HAZARDOUS MATERIALS INVENTORY' ~
CHEMICAL DESCRIPTION
(one form permaterial per building orareaJ
NEW ^ ADD ^ DELETE ^ REVISE 200 Page _ of
~ . ;; ~. ~;',, `~ 1 FACILITY IR~FORMATION _._._.. _ __ . ___t~
BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 '
_~~-
j -~.-s ~~...~
CHEMICAL LOCATION 201, CHEtAICAL LOCATION '
//JStp~ ~,~L~C-C >a~-S~Y?~/I/~ CONFIDENTIAL(EPCRA) ^Yes ^No 202 ~
FI- AGILITY ID # -~ - 1 ^---~ ~ ~ i 1~ MAP # (opbonaQ 203 GRID # (ophonan - 20a ~
~- ----1---------__ ___ . - --- - ----_ __ -- -- -- -- -- --- -
II. CHEMICAL LVFORMATION
. . .
__. ._..._... _ __.__.._ ._ _ _ .----.. _ _... __ 205 TRADE SECRET '
^ Yes ^ No 206
CHEMICAL NAME
j J f,~ ~~ (J~ ~i If Subject to EPCRA, refer to instructions
~-- --i-~-~----- -- .-.. _ . _ -- ----- - - - - - 207 i -... ----- ------~
COMMON NAME ~ EHS'
i ^ Yes ^ No 208
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CAS # - - _ 209 !` •If EHS is'Yes,' a8 amounts,below must be in lbs.
j i ~..
- ---- ----------_ -- - --- ~ -- --- - --- --- - - - I
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
; 210
TYPE , -. ..- -- - -- ----------------- -- ------- ~ - -- ^ Yes ^ No-- -- - -- 212 i CURIES 213 !
C!><1..~ PURE ^ m MIXTURE ^ w WASTE ~ R~~OIOACTIVc
I PHYSICAL STATE LARGEST CONTAINER ~ - 215 '
^ s SOLID ^ I LIOUID GAS 214
Zt
L _ ..________.._ .__-_..-._ - -_.. __. - ._.___-- ._.__._ ~
FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTIVE ~ PRESSURE FiEL6;SE ^ 4 .4:UTE HEALTH ^ 5 CHRONIC HEALTH 216
(Check all that apply)
ANNUAL WASTE 217 ~~1.4XIMUM 218 AVERAGE ~ ~ 219 , STATE WASTE CODE 220
AMOUNT _ DAILY AMOUNT -_ Z ~ ~ DAILY AMOUNT Z (~ I
I DAYS ON SITE 222
UNITS' ^ ga GAL ~~ CU FT ^ Ib LBS ^ to TONS 221
i
i ' If EHS, amount must be in lbs. j
STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223
(Check all that apply)
^ b UNDERGROUND TANK ^ f CAN ~ j BAG ^ n PLASTIC BOTTLE ^ r OTHER ;
~' ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN '
^ d STEEL DRUM ^ h SILO ~I CYLINDER ^ p TANK WAGON I
STORAGE PRESSURE ^ a AMBIENT r~a ABOVE AMBIENT ^ ba BELOW AMBIENT 224 I
STORAGETEMPERATURE AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225
%WT HAZARDOUS COMPONENT
1 ~ zzs
2 ~ 230
I -- ----- -- _ __ -
3 i 23~
4 ~ 238
5 242
EHS f
227 ~ ^ Yes ^ No 228
III. SIGNATURE
SIGNATURE
231 ^ Yes ^ No 232
I
235 ; ^ Yes ^ No 236
.._.-i.--- ---~----~------
239 i ^ Yes ^ No 240
243 ^ Yes ^ No 244
__. _. ~ --
t5 # :;
z2s
I
233
_ __ I
i
237
I
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241 i
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245
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DATE 246
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