HomeMy WebLinkAboutBUSINESS PLAN (2)i-
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' ~ ii COLDMEN OF CALIFORNIA 1
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~'' Prevention Services
.UNIFIED PROGRAM :INSPECTION CHECKLIST' >I F R S r , D 900Truxtun Ave., Suite 210,
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_ FiR>E Bakersfield, CA 93301 . _ -
SECTION 1:" Business-Plan and Inventory Program "RrM Tel.:, -(661) 326-3979
Fax: (661) 872-2171 '~
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FACILITY NAME . ~ - - ' - ~
L lY2 i`~ ~ .~ r9-L _ INSPECTION DATE
r-Z~ - INSPECTION TIME
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ADDRESS _ PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT - ..- - ~ ~
_ ~ ~--,---Q .-T-.~"m _ BUSINESS ID NUMBER
15-021- `
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Section 1: Business Plan and Inventory Program ~~-1
^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ . RE-INSPECTION
- ROUTINE
C" V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND
BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS ~ ~ ~ 7 `J(~O~`
+L V ~j
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL U
^ VERIFICATION OF MSDS AVAILABILITY '
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~~EMERGENCYPROCEDURESADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION 1~~~ ~ ~ !\re ~ ~ ~
v ~ i - e ~
^ SITE DIAGRAM ADEQUATE & ON HAND ,/'Y- ~ SSj ~f^O V I ~ ~ ~[~'~.. ~ ~p« Ii
ANY HAZARDOUS WASTE ON SITE? ^ YES ~NO
EXPLAIN:.
QUESTIONS~R~(E/G~rA^/JRDING TIiIS~I{/N/~Sy~PECTION? PLEASE CALL US AT (661) 326-3979
Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # sin ss
- White =Prevention Services - Yellow -Station Copy Pink -Business Copy
1
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FD 2155 (Rev._ 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
•
•
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., S_ uite 210
Bakersfield, CA 933,
Tel: (661)_326-3979 ? ~ ?005
FACILITY NAME WSPECTION DATE INSPECTION TIME
ADDRESS PHONE No. No. of Employees
~ -ne... ~c~ _ _ _ __- ------ - - Z~-~- ---__.5------- ..
FACILITYCONTACT Business 10 Number
~raC ~ ~'r'CmA ~ •- o~~l'c2 rY\oa, f 15-021- ~ r7 ~~
Section 1: Business Plan and Inventory Program ~ ~(J
Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection
ANY HAZARDOUS WASTE ON SITE?: ^ YES ~IO
EXPLAIN:
• QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~G6'I ~ 326-3979
~~~~_._~r_;-------------~ ~ ~--- ----_ - -
Inspector (Please Print) fire Prevention tst-In/Shift of Site
White -Environmental Services Vellow -Station Copy
B iness Site R o stble (P easePRtif)
Pink -Business Copy
+ COLDMEN OF CALIFORNIA _______________________________ SiteID: 015-021-001799 +
Manager TRACI STAMPS BusPhone: (661) 832-9516
Location: 4708 STINE RD Map 123 CommHaz High
City BAKERSFIELD Grid: 14C FacUnits: 1 AOV:
CommCode: BFD STA 13 SIC Code:
EPA Numb:. DunnBrad:94-224-2777
Emergency Contact / Title Emergency Contact / Title
TRACI STAMPS / BRANCH MANAGER PAUL JORDAN / OWNER
Business Phone: (661) 83,2-9516x Business Phone: (559) 275-1146x
24-Hour Phone ( ) - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire Press ImmHlth
Contact Phone: (661) 832-9516x
MailAddr: 4708 STINE RD State: CA
City BAKERSFIELD Zip 93313
Owner PAUL JORDAN Phone: (559) 275-1146x
Address 5623 W BARSTOW AVE State: CA
City FRESNO Zip 93722
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif ' d: RSs : No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of law that I have personally
exa d and am familiar with the information
su it d and believe the information is true,
a ~ur e, and.eamnlete_
ate
~N~''~ ~~~ ~ ~ ~~~06
-1- 03/15/2006
-"~' CITY OF BAKERSFIEI,D FIRE DEPARTMENT
OFFICE OF ENVIRONMF,NTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
~E ~`` 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NA E
ADDRESS ~
FACILITY CONTACT ~~
INSPECTION TIME I D ~ ~~
INSPECTION DATE ~ ~ " 1 ~~J ~ ~ _
PHONE NO. ~3 ~-- ~~~lo
BUSINESS ID NO. 15-210- 1 "--I~t~
NUMBER OF EMPLOYEES .S~
Section l: Business Ptan and Inventory Program
Routine ^ Combined ^ Joint Agency ^Muhi-Agency ^ Complaint ^ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand 3
Business plan contact information accurate 0~ ~'
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
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate 8 On Hand
C=Compliance V=Violation ,:~
J~ I ,
Any hazardous waste on site?: ^ Yes o i -".
Explain:
~! ~. ,~ c"
Questions regarding this inspection° Please call us at (661) 326-3979 usiness Site I
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White - Em-. Svcs. Yellow -Station Copy Pmk -Business Copy Inspector: ~%r
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