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HomeMy WebLinkAboutBUSINESS PLAN 7/28/2007 yr, 0 %~ a ~' VONS #420 r ~ i~W~ 9000 MING AVE. ~~~ - l ~~c `~-; r -. _ ~-~ µ- -.' ~ !4 I... to '" -,.. ~. ... .. t BAKERSFIELD FIRE DEPT. ~~0 Prevention Services ~ Q FIRE PREVENTION INSPECTION >I EFiRE I L D 900 Tnzxtun Ave., Ste. 210 ARTM T Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) -2171 DISTRICT BLOCK NO. DATE / ~ 1 ~r ~ EE ~ {''~ `$ ( -'J FACILITY ADDRESS ~ ~ ~ CITY, STATE, ZIP~j y t ~ / ~ ~ c... ~ ~ `v i ` ~ 4' t ~ (. FACILITY NAME ~ ~ ~ MANAGER'S NAME Q ~, PHONE NO. FACILITY f~ BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP WNER'S PHONE NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STA1E, ZIP, BILLING PHONE NO. OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL V{OLATIONS vw~~noN REQUIREMENTS CHECKED BELOW No. Y 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) COMBUSTIBLE WASTE /DR 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 m{r~l~l't~s in height over each required exit (doorlwindow) to SIGNS fire escape. (U.F.C.) ~ ((f~ g Provide and maintain appropriate numbers on a contrasting backgroun d s~®D 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) ______________________________________. Plastering FIREDOORSI FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (U.B.C.) 10 Remove/repair (item & 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 andlor 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.) oUTDOORBURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49.040 f the B akersfield Munici al Code B.M.C. re ardin fireworks. OTHER ( 18 /~ T--~~^ G].cy~ . `j ,.~ N d 1.~ c .1 G ~ ~ () a ~ ~ Ci \j.' ~ i I ~-~ ~ . ~ o ~ ca 6 ! CUSTOMER: r1J~ r?L.?~ f ^ ~ ND~ _ C F.C CALIFORNIA FIRE CODE (Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE [ 1 INSPECTOR: ~ G~.-•~~-- < AP NO~~1~ 'f B.M.C. BAKERSFIELD MUNICIPAL CODE 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) - \l T ~~ VONS 2420 SiteID: 015-021-001821 Manager DALE OKAMOTTO Location: 9000 MING AVE City BAKERSFIELD CommCode: BFD STA 09 EPA Numb: BusPhone: (661) 663-0595 Map 123 CommHaz High Grid: 05C FacUnits: 1 AOV: SIC Code:5411 DunnBrad: Emergency Contact / Title Emergency Contact / Title DALE OKAMOTTO / STORE MANAGER AL BLACK / ASST MANAGER Business Phone: (661) 663-0595x Business Phone: (661) 663-0595x 24-Hour Phone (661) 834-9368x 24-Hour Phone (661) 900-4033x Pager Phone (818) 499-4390x Pager Phone (818) 499-4390x Hazmat Hazards: Contact.: MIKE CLIATT MailAddr: PO BOX 513338 City LOS ANGELES Fire Press ImmHlth Phone: (626) 821-6192x State: CA Zip 90051-1338 Owner GILBARCO INC - CMS Phone: (303) 986-8011x Address PO BOX 22087 MAIL STOP F76 State: NC City GREENSBORO Zip 27420 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD TotalASTs: _ TotalUSTs: _ RSs: No ~~ ~~ ~ ,~ ~ }3ased on my inquiry of those individua.is ~~~ responsible for obtaining the information, I certify under penalty of lav,~ that ( have personally examined and am farnifiar with the information submitted and believe the infGrmatiori is true, accurate, and complete. ~~ ~~ Sig nature ~ Date Gal Gal -1- 07/16/2007 a f ~ T' F VONS 2420 SiteID: 015-021-001821 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP BLEACH HELIUM IH F P IH L G 200.00 291.00 GAL FT3 Hi Min -2- 07/16/2007 a, ; , -3- 07/16/2007 ;; ~4. ~ F VONS 2420 SiteID: 015-021-001821 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE AISLE 11 CAS# ~iquid Mixture ~mbient~E ~ AmbientT~E ~ PLASTIOCTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 200.00 GAL ._150.00 GAL tiH~Htwvu~ ~vlnr~iv~ly 1 %Wt. RS CAS# 100.00 Bleach No 7681529 nH~HxL H~S~aal~i~lv15 TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit Days On Site 365 Map: Grid: CAS# 7440-59-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATIONI Largest Co291100rFT3 Daily 291100m FT3 ` Daily 291r00e FT3 nH~Htu~vu~ ~urirvivr~ivta %Wt. RS CAS# 100.00 Helium No 7440597 ril-~GHKL H. 7AL" .7~71~1L" 1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min Facility Unit: Fixed Containers at Site ~ -4- 07/16/2007 T ~, ~ F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/26/1999 ~ PROCEDURE MANUAL IN OFFICE. POCKET GUIDES ON PERSON. CALL 911. Employee Notif./Evacuation PA SYSTEM OR VERBAL, AS PER SITUATION. 03/24/2006 Public Notif./Evacuation AS PART OF PROCEDURE MANUAL. 10/27/1997 Emergency Medical Plan MERCY SOUTHWEST OR BAKERSFIELD OCCUPATIONAL MEDICAL GROUP. 10/27/1997 -5- 07/16/2007 ~~ ,~ , F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/26/1999 ~ RETAIL GROCERY ITEMS AND CHEMICALS ARE MERCHANDISED ON SHELVES IN SUCH A MANNER AS TO PRECLUDE DAMAGE, BREAKAGE, OR SPILLAGE OF THE PRODUCT. INCOMPATIBLE CHEMICALS ARE SEPARATED BY DISTANCE AND/OR PARTITION TO AVOID ACCIDENTAL MIXTURE. Release Containment 03/24/2006 PROPER STORAGE AND SEPARATION OF INCOMPATIBLES. Clean Up 03/24/2006 SELF-CONTAINED SPILL KITS AND PERSONAL PROTECTIVE EQUIPMENT. v~.aaca. accavua.~,c Y~l:l.1VQL1Val -6- 0~/16/200~ r ~, F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Site Emergency Factors .Overall Site ~ _, J1.JG 1.10.1 R0.G 0.11.L~7 Utility Shut-Offs 04/27/2007 GAS - W SIDE OF BLDG ELECTRICAL - NW CRNR OF BLDG WATER - NW CRNR OF BLDG Fire Protec./Avail. Water 03/24/2006 PRIVATE FIRE PROTECTION - SPRINKLERS. NEAREST FIRE HYDRANT - NE CRNR OF LOADING DOCK IN BACK. Building Occupancy Level 03/10/2006 85 EMPLOYEES -7- 07/16/2007 ~1~ k, ,R F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/17/2007 ~ MSDS SHEETS ON FILE IN OFFICE. BRIEF SUNIlKARY OF TRAINING PROGRAM: ORIENTATION FOR NEW ASSOCIATES. RECORDS ARE AVAILABLE ON REQUEST BY FAX. rayc c. Held for Future Use Held for Future Use -8- 07/16/2007 ~. , .; + . _ ~- _ a ,FIRE PREVENTION INSPECTION ~_ _ _ _ _ .~_ . - - :f:_ .:r .. ~~ BAKERSFIELD FIRE DEPT. ~~ >3 E R S P I D Prevention Services FARE 900 Truxtun Ave., Ste. 210 ~i~~ ~~ Alt 1M T Bakersfield, CA 93301 ry _ Tel.: (661) 326-3979 ^ Fax: (66 52-2171 DISTRICT BLOCK NO. DATE E / FACILITY ADDRESS i ~ ~ 1,~ CITY, STATE, ZIP ~ ~ f A ~ L//` 5'. p / ~ JF ! / FACILITY NAME lG•c~ MANAGER'S NAME FACILITY PHONE NO. ~fl/ ~ ~~ - BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP OWNER'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 DAT ^ YES ^ NO CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS CHECKED BELOW No. STIBLE WASTE /DRY CO 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) MBU 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 clear a u r~s b~c~~7door (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 & 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, ` l~ 1 by a person having a valid license or certificate. (U.F.C.) ~ A 2 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) ______________________________________. Plastering FIRE DOORS/ - FIRE SEPARATIONS Shall return the surface to its original fire resistive condition. (U.B.C.) 10 Remove/repair (item & 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.) oUTDOORBURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 / ..~Q ~ _~ I U QG (J ~ ~ - J ~1 ,7 CIJST~MER: LEGEND: C.F.C. CALIFORNIA FIRE CODE (SlgnatUf (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE ~ B.M.C. BAKERSFIELD MUNICIPAL CODE jL'7~- AP NO.: ~ INSPECTOR: ~~f/ 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) ~H ~~d„c ., ~. - UNIFIED PROGRAM INSPECTION CHECKLIST .~-.'~.:' r.'?... ': C$R~'.:z.9;~~ . . „- *.c;..:~ :'$.~ a x x,.i 1~.. . n~ ' -..,T., a- , :...~,: :. :e.i'- . ; . 5 .,...r. v+. ~ ... k t SECTION 1: Business Plan and Inventory Program ~~ BAKERSFIELD FIRE DEPT B apt D Prevention Services f/RI 900 Truxtun Ave., Suite 210 ARTM >r Bakersfield, CA 93301 ~'' Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ~o~s ~5 ,~ a~ os' aster ~~ S ADDRESS G1000 /1/I ,~.s c~ ~ v ~ • HONE NO. b ~ - oS9S• O OF EMPLOYEES C~ FACILITY CONTACT USINESS ID NUMBER 1 s-o2~ - c~ ~ r g z b ~ E ©~' Q Nn OY a 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 ^ ^ BUSIf18SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS Q ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL / fd" ^ 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 8 ON HAND ANY HAZARDO S WASTE ON SITE]?~ ^ YES Ld~NO ~ / EXPLAIN: T) tti A '7~_ f~OndlL ~~ '~E2 __ __I_. .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1b~ In /Shift of Site/Station # siness Site/School Responsible Party (PI ase Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2048 (Rav. 02/05) ~~ t` VONS 2420 io3g~ Manager ~ Q~~ ~ IC~-m 0~ Location: 9000 MING AVE City BAKERSFIELD CommCode: BFD STA 09 EPA Numb: SiteID: 015-021-001821 BusPhone: (661) 663-0595 Map 123 CommHaz High Grid: 05C FacUnits: 1 AOV: STC Code:5411 DunnBrad: Emergency Contact / Title Emergency Contact / Title JOE OBRIEN / STORE MANAGER AL BLACK / ASST MANAGER Business Phone: (661) 663-0595x Business Phone: (661) 663-0595x 24-Hour Phone (661) 834-9368x 24-Hour Phone (661) 900-4033x Pager Phone (818) 499-4390x Pager Phone (818) 499-4390x Hazmat Hazards: Fire Press ImmHlth Contact MIKE CLIATT ~ Phone: (626) 821-6192x MailAddr: PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Owner GILBARCO INC - CMS Phone: (303) 986-8011x Address PO BOX 22087 MAIL STOP F76 State: NC City GREENSBORO Zip ~: 27420 Period to TotalASTs: = Gal Preparers. TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD ENTD ARR 2 ~ ~~;,~ t3ased on my inquiry of those individuals responsible far 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, accurat comp) , e. ~ ~~ ~ i nature Date -1- 04/23/2007 ~ ... ,. .C '. .' _~ F VONS 2420 SiteID: 015-021-001821 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name.. BLEACH HELIUM SpecHazIEPA Hazards) Frm IH F P IH L G DailyMax Unit MCP 200.00 GAL Hi 291.00 FT3 Min -2- 04/23/2007 -3- 04/23/2007 F VONS 2420 SiteID: 015-021-001821 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE AISLE 11 CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 200.00 GAL 150.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Bleach No 7681529 riE~GE~J.[L ASJL•~5~1~11"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 7440-59-7 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas TPure ~-Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 291.00 FT3 291.00 FT3 291.00 FT3 nrj~rucLUU~ ~.vinrulvr,lyl~ °sWt. RS CAS# 100.00 Helium No 7440597 ru-~~HtcL .y~ ~~~ai~i~iv1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 04/23/2007 F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/26/1999 ~ PROCEDURE MANUAL IN OFFICE. POCKET GUIDES ON PERSON. CALL 911. Employee Notif./Evacuation 03/24/2006 PA SYSTEM OR VERBAL, AS PER SITUATION. Public Notif./Evacuation 10/27/1997 AS PART OF PROCEDURE MANUAL. Emergency Medical Plan 10/27/1997 MERCY SOUTHWEST OR BAKERSFIELD OCCUPATIONAL MEDICAL GROUP. -5- 04/23/2007 ,: F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/26/1999 ~ RETAIL GROCERY ITEMS AND CHEMICALS ARE MERCHANDISED ON SHELVES IN SUCH A MANNER AS TO PRECLUDE DAMAGE, BREAKAGE, OR SPILLAGE OF THE PRODUCT. INCOMPATIBLE CHEMICALS ARE SEPARATED BY DISTANCE AND/OR PARTITION TO AVOID ACCIDENTAL MIXTURE. Release Containment 03/24/2006 PROPER STORAGE AND SEPARATION OF INCOMPATIBLES. Clean Up 03/24/2006 SELF-CONTAINED SPILL KITS AND PERSONAL PROTECTIVE EQUIPMENT. Other Resource Activation -6- 04/23/2007 :• „ , . F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 Ild'Gdl U5 Utility Shut-Offs 03/24/2006 A) GAS - W SIDE OF BLDG B) ELECTRICAL - NW CRNR OF BLDG C) WATER - NW CRNR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 03/24/2006 PRIVATE FIRE PROTECTION - SPRINKLERS. NEAREST FIRE HYDRANT - NE CRNR OF LOADING DOCK IN BACK. Building Occupancy Level 03/10/2006 85 EMPLOYEES -7- 04/23/2007 ~~ F VONS 2420 SiteID: 015-021-001821 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/17/2007 ~ MSDS SHEETS ON FILE IN OFFICE. BRIEF SUMMARY OF TRAINING PROGRAM: ORIENTATION FOR NEW ASSOCIATES. RECORDS ARE AVAILABLE ON REQUEST BY FAX. rciyC G rielQ LOr t''ULUre USe n~.LU tVi 1'uI,LLIC USA -8- 04/23/2007 UNIFIED PROGRAM INSPECTION CHECKLIST ~L,.,-ar°^;,,,Rc~+t%1-.w,~~....:w ...c:.~.4:.-...,>i~xY Uk ..-... :. n'f.:~lc ~5::....`.:. r«.R...:. i.... ;;:u::~_.. ," ~t'...:i :k,,. :. ._..~,,Z.;. :.. SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a p 1 Prevention Services w,>t~ 900 Truxtun Ave., Suite 210 ~Rnr s Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY N ME I/ icJ '1 ~~ NSPECTION DA E ~ o a~ 4'G INSPECTION TIME O •~.< < v~ ADDRESS HON NO. OOFEMPLOYEES 40©~ -•v~ ~~ ~ - os4.s FACILITY CONTACT ~,4 ~, e CJ•Cs91N o r'o USINESS ID NUMBER 15-021- o of ~-z- Section 1: Business Plan and Inventory Program ~S ~~~D b ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION 1I ,I u C V ~ C=Compliance OPERATION V=Violation COMMENTS __ // C~" ^^ APPROPRIATE PERMIT ON HAND _ / LSef BUSIf12SS PLAN CONTACT INFORMATION ACCURATE ^ t ME`'~ ~-`'S !S 7A~Z ~l~~vA~~.~yQ_ L 'r''`~~ ,/ tN ^ VISIBLE ADDRESS ~~/~ ~ L ~~ C-L4l~ry~~C ~O.t/~CC ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~ly~-uv C 1~ ~, G-?2.G- 4 S ~"2, ~ QO.~vc 'f `~'- '~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION Lg ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY - l ~o~ ^ VERIFICATION OF HAZ MAT TRAINING ~~ _/ LK ^ VERIFICATION OF ABATEMENT SUPPLIES AND CEDURES P RO - / l3 ' ^ EMERGENCY PROCEDURES ADEQUATE ry l~ T ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE A ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN. ^ YES lt3' NO .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Pre ntion / is' In / Shift of Site/Station # ~~: White -Prevention Services Yellow -Station Copy Pink - Business Copy FD2048 (Rev. 02/05) .~ + VONS 2420 =_______--_~ ______________ ~ ________________ SiteID: 015-021-001821 + ~L~ t`J'~~2/~iv Manager _~-_:~---y- .- . _ _- _ _ "4~°' ~ BusPhone: (661) 663-0595 Location: 9000 MING AVE Map 123 CommHaz High City BAKERSFIELD Grid: 05C FacUnits: 1 AOV: CommCode: BFD STA 09 SIC Code:5411 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ~Y~' ~ ~-'13JZc~ / STARE MANAGER ~~ ,Grf©~ ~~~~ - j ASST MANAGER Business Phone: (661) 663-0595x Business Phone: (661) 663-0595x 24 -Hour Phone ( 661) ~~~/~9:~ 24 -Hour Phone ( 661) -~~?~,~ ~~~: ~:~-= Pager Phone (818) 499-4390x Pager Phone (818) 499-4390x, Hazmat Hazards: _ - - - Fire Press _ ImmHlth DelHlth ~- - -_ - : Contact MARCELLA GELMAI~T Phone: (661) 663-0595x MailAddr: PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Owner VONS A SAFEWAY ~CO Phone: (661) 663-0595x Address PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT ENTD MAR 2 4 2006 Based on my inquiry of those lndlvi~uals responsible for obtaining the lnformatlan, t certify under penalty of law that I havA personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~ ~7 o!p i nature Date -1- 03/10/2006