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HomeMy WebLinkAboutBUSINESS PLAN 7/26/20071i i~ !' 'LENGTHWISE BREWING COMPANY ~~` L ~ II 6720 SCHIRRA COURT, BLD A --- - -----L__ _- ----- ,y ~~ LENGTHWISE BREWING CO Manager JEFF WILLIAMS Location: 6720 SCHIRRA CT City BAKERSFIELD CommCode: BFD STA 09 EPA Numb: BusPhone: Map 123 Grid: 16D SIC Code: DunnBrad: SiteID: 015-021-003494 (661) 836-2537 CommHaz Low FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title JEFF WILLIAMS / DARIN SCHWICKER / Business Phone: (661) 836-2537x Business Phone: (661) 836-2537x 24-Hour Phone (661) 549-9848x 24-Hour Phone (661) 549-9850x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact JEFF WILLIAMS Phone: (661) 836-2537x MailAddr: 6720 SCHIRRA CT State: CA City BAKERSFIELD Zip 93313 Owner JEFF WILLIAMS Phone: (661) 836-2537x Address 6720 SCHIRRA CT State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD 8~a.sad on my inquiry of those individual; res~,onsib;e f,~r obtaining the information, ! ~artifY d un er penalty of iatti~ that ! have per,r~naily ex i am .r,ed anr~ am familiar with the information submitted and believe th i e nformation is true, accurate, and complete. !~ Z G~9~% 7 '~~'~ T ~ Signature Date ENT JUL ~ 0 2007 -1- 07/12/2007 F LENGTHWISE BREWING CO SitelD: 015-021-003494 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP CARBON DIOXIDE F P IH G 200.00 FT3 Min -2- 07/12/2007 -3- o~/ia/aoo~ r; F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 124-38-9 ~GasATE T TYPE T PRESSURE TEMPERATURE ~~ CONTAINER TYPE I Pure I Above Ambient Ambient I PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 FT3 200.00 FT3 200.00 FT3 ru-~GtitcLVU~ ~vrirvlv~lyl~ %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 riSiGHKL H~~~AA1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 07/12/2007 ~; F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 02/28/2007 ~ CALL 911, FIRE DEPT 326-3979. Employee Notif./Evacuation 02/28/2007 CONTACT MANAGEMENT IN CASE OF PROBLEM. KNOW WHAT TO LOOK FOR AND HOW TO RESPOND. USE RULE & PASS PROCEDURES IN THE EVENT OF FIRE. Public Notif./Evacuation 02/28/2007 CALL 911. IN THE EVENT OF AN EMERGENCY, PULL FIRE ALARM, CLEAR BLDG, EVACUAT TO A SAFE DISTANCE. Emergency Medical Plan MING & ASHE MEDICAL CENTER, 100 OLD RIVER RD o2/2s/2oo7 -5- 07/12/2007 ., F LENGTHWISE BREWING CO SitelD: 015-021-003494 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 02/28/2007 ~ KEEP ALL AIR TANKS SAFELY FASTENED ACCORDING TO FIRE DEPT REGS. EDUCATE EMPLOYEES ON PROPER HANDLING OF TANKS. Release Containment 02/28/2007 IN THE EVENT OF A CO2 LEAK, OPEN ALL DOORS AND ALLOW CO2 TO ESCAPE. Clean Up 02/28/2007 CONTACT LOCAL PREVAILING AUTHORITY AND FOLLOW THEIR APPROVED GUIDELINES. v~..itci ncovul~.c ril.l~lVQl~1V11 -6- 07/12/2007 ,, ,s~ F LENGTHWISE BREWING CO SitelD: 015-021-003494 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ especial riazaras Utility Shut-Offs 02/28/2007 GAS - S SIDE OF BLDG OUTSIDE ELECTRICAL - NE CRNR OF BLDG OUTSIDE Fire Protec./Avail. Water 02/28/2007 SMOKE ALARM, STROBES, PULL STATION, EXTINGUISHERS, SPRINKLERS, AND WATER. Building Occupancy Level 02/28/2007 SEATING 130, CAPACITY 180 -7- 07/12/2007 i! ~~ • ~ F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/28j2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: ONGOING SAFE HANDLING OF CO2 TANKS, EVACUATION PLAN, RAZE - FIRE EMERGENCY RESPONSE, AND PASS - FIRE EXTINGUISHER DRILL. ruyC ~ aiciu Lvi r u~.,uic vac ricl.u ivi r u~..utc vac -8- 07/12/2007 ,..._ ~ - LENGTHWISE BREWING CO Manager ~tF~ W ~ ~~id4~5 Location: 6720 SCHIRRA CT City BAKERSFIELD BusPhone: Map 123 Grid: 16D SiteID: 015-021-003494 CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: (661) 836-2537 CommHaz Low FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title .Business Phone: (G~i) `63~ -a~3~x Business Phone: (LoI) 83~ -aS3~x 2 4 -Hour Phone ((y(~ ~) 5y 9 - 98~f8" x 2 4 -Hour Phone ( (f /) 5`~ Y - p~SDx Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact JEFF WILLIAMS Phone: (661) 836-2537x MailAddr: 6720 SCHIRRA CT State: CA City BAKERSFIELD Zip 93313 Owner ~~-~ ~i~ f i /~i /~'~j~ Phone :( 6 61) 8 3 6- 2 5 3 7 x Address 6720 SCHIRRA CT State: CA City BAKERSFIELD Zip :93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD ~N~~ ~ ~' dividuals i 9 ~5,~~~ n Based on my inquiry of those btaining the information, I certify f or o responsible under penalty of lavr that 1 have personally examined and am familiar with the information submitted and believe the information is true , accurate, and complete. ~~S ~~~ Signature Date -1- 02j02/2007 F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP CARBON DIOXIDE F P IH G 200.00 FT3 Min -2- 02/02/2007 -3- 02j02/2007 ~ ., ~i P LENGTHWISE BREWING CO ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE I Ili Location within this Facility Unit STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient SiteID: 015-021-003494 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 124-38-9 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 FT3 200.00 FT3 200.00 FT3 rif~GAtCLVUS LVi~lYV1V.C;1V1~ oWt. RS CAS# 100.00 Carbon Dioxide No 124389 tli',G1',K1J A551"~SJ1~11'~1V"1~5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 02/02/2007 i ,~ F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency_Notification ' i i ~~ qrl ~~ ~ ~~~ -- LdIl~J1V~/CC 1VV 1.11 ~ 8VC1l:Udl.1V11 _,_, ,~ rUlJ11.V. 1VV 1~11~. ~,~VQU LLCLL1Vll cai~ 1~~._ r~ T~~ ~vr~+ o-F ~~ ~~ERgew~y p~1,Q~ f,~~ ~~~.n. c~E~r~ g~,.~D,G.~, ~`~"~ ~v ~~u a ~~ To ~ S~ FE p l5 ~~o Gl4~i f 9 i I . r,ulCl.yC11U~/ 1.1CC11C:d1 Y1dI1 -5- 02/02/2007 F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention ~~~p ~~( ~k~R T-~~5 S~-~~~~ ~rr~~e~~ A-CCo/L/~~ivlr jo ~~,¢ D~~~ RCGvL~~~ 1~.G l.C Q~7G l.:Vll ~.Q 111111C11L =rv T~~ GVe~~- a ~ ~- Gv 2 L~-~i b~e~ ~ t l ~flo~ s ~ ~~ ~-~/aw ~~ ~ rv Escr,~ ~~ .crlean. -uLp ~/ f ~ '` (,Dy~~4fiT ~DLvi-L PREU~~C,;v(r /~U/N.o/Li~y ~ f0~/©w jh`Er2 ~~P-~U~/c ~ ~ivsO~~.~~ S vLner xesource t~cLlvaLion -6- 02/02/2007 ,. F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCl:1d1 Ild'G dl US • .V 1..1111.y- -O11U 1.-V11.7- ~ (~VtS S©~~'~ S;Ar GX-~..c,~.~.e~L o ~ ~v~ Lv~NU ~ ~Lcc,t2rcr~L Na271~ ~as~ Ca~Nr~e o~ ~~;G~~N6 [=X~~-~- ,_ 1'-11G C1Vl..CI~/HV d11 Wdl.Cl. 1 SmoK~ ~L~a-,~.~ 5~2o13e5~ Pull S~r~r~on/~ CX~~~w v~ 2'1~,~ /~ ~~-r ~ r~ D LL11lAllly Vl: I.: U~Jd11C,.y LCVC1 5~~~~;Nc~ X30 ~.4-~,~,~~y ~8~ -7- 02/02/2007 I' ~.~ 'mss F LENGTHWISE BREWING CO SiteID: 015-021-003494 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training; - ~ ,~ rte- 6 ~~~c ~~4L;N~. o~ Cn ~ T,~ks, tv~c~~1;n.,~ PL~n/ P. ~ . s. s. - t-~~~ rx~;~~~~S~E~ ~,~~1. rayc c. nciu iv.L ru~uic u~c rielQ LOr .N'ULUre USe -8- 02/02/2007 + LENGTHWISE BREWING CO _______________________________ SiteID: 015-021-002441 + Manager JEFF WILLIAMS Location: 6720 SCHIRRA CT City BAKERSFIELD BusPhone: (661) 836-2537 Map 123 CommHaz Low Grid: 16D FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title JEFF WILLIAMS / PRESIDENT DARIN SCHWICKER / VICE PRESIDENT Business Phone: (661) 836-2537x Business Phone: (661) 836-2537x 24-Hour Phone (661) 549-9848x 24-Hour Phone (661) 549-9849x Pager Phone (661) 549-9848x Pager Phone (661) 549-9849x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact JEFF WILLIAMS - Phone: -(661) 836-2537x MailAddr: 6720 SCHIRRA CT State: CA City BAKERSFIELD ~ Zip 93313 Owner JEFF WILLIAMS Phone: (661) 663-7269x Address 10917 RICONADA PL State: CA City BAKERSFIELD Zip 93311 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No' ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD c~~ ~~N ~~ ZQ ~6' C~t~~ed an my inquiry df thb&e indfvidu~ls P~~pufl~lblt~ frtr dbtt~ining the Informetlet~, I oprtify ~hd~r ~~r~a±ty ®f law 4h~t ! have pp~rpa~ally eXr~mined ~n am famlllar with the fr+tePmation submitted and believe the lnformatlon !s 4rue, ac~ur~te, and eopnpfete. gnature date -7-- 03/23/2006 UNIFIED PROGRAM INSPECTION CHECKLIST .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT s p Prevention Services ~itRS 900 Truxtun Ave., Suite 210 ~wrr ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ r ~ INSPECTION DATE ~` C,i J~ ~ INSPECTION TIME 1 ~-lA~t ~ l/ll l s e t ~ ~' . ©- ~1 ~(;l. ADDRESS ~ G 7 ~.a S ~. +~ i t r-4 Lj HONE NO. O OF EMPLOYEES ~ 'Z FACILITY CONTACT USINESS ID NUMBER 15-021- ~,~ ~ ~ ~ Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C J C V ~ C=Compliance OPERATION V=Violation COMMENTS _ ___ ____ _ ^ ~ APPROPRIATE PERMIT ON HAND /~hd ~ ~~~ ~~ e~~ ~ _ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY l~ ^ 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 ROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION /~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~10 EXPLAIN: __ _ .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~` ~ -- ~ Jt~ V!/tl ~~- s Inspector (Please Print) Fi Prevention / 1 In /Shift of Site/Station # Business Site/School Site Responsible Party (Please Print) While -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) Darin Schwicker 6000 Schirra Ct. Building A Bakersfield, CA 93313 661.836.2537 www.lengthwise,com CITY OF BAKERSFIEL~I~ OFFICE OF ENVIRONMENTAL ~;ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION TRADE SECRET [] Yes [] No 206 If Subject to EPCRA, refer to instructions CHEMICAL NAME COMMO_N NAM~ FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210 TYPE PURE [] m MIXTURE [] w WASTE 211 ! RADIOACTIVE DYes ~i~No 212 CURIES 213 PHYSICAL STATE [] s SOLID ~1 LIQUID [] g GAS 214 LARGEST CONTAINER 215 FED HAZARD CATEGORIES [] I FIRE (Chec~ all that apply) · [] 2 REACTIVE ~ 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 AMOUNT DALLY AMOUNT DALLY AMOUNT UNITS* [] ga GAL ~ cl' CU FT [] lb LBS [] tn TONS * If EHS. amount must'be in lbs. 219 I STATE WASTE CODE 220 I ,,v/,~, 221 ! DAYS ON SITE 222 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 ~[~1 CYLINDER [] p TANK WAGON STORAGE PRESSURE 1~ a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~ a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [] c CRYOGENIC 225 ,: %WT ...... ;~,~ , ~,~ HAZARDOUS,COMPONENT 226 230 227 [] Yes [] No 228 231 []Yes []No232 235 [] Yes [] No 236 239 [] Yes [] No 240 243 [] Yes [] No 244 229 233 234 237 238 241 242 I 245 ·. ,~, . , IlL SIGNATURE ~ PRINTNAME&TITLEOFAUTHoRIZEDCOMPANYREPRESENTATIVE SIGNATURE~,/ ~~,,~ DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd HAZARDOUS MATERIALS MANAGEMENT PLAN Section II1.1 - FACILITY AND LOCALITY INFORMATION LOCATION OF SHUT-OFFS AT YOUR FACILITY: ~PROPANE: ~/~OT~ ~'~"~'~ ELECTRICAL: WATER: : 5o~'T~ SPECIAL: LOCK BOX: YES /(~ IF YES, LOCATION: A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): A. NUMBER OF EMPLOYEES: // B. MATERIALS DATA SHEETS ON FILE: C. BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION Based m my In~ of those individuals responsible for obtaining the informaU0~, I ceftif~ under penalty of law that I heve pemonnaly examined and am familiar with the Infom~tlon submitted and believe the information la true, accurate, end co~e. SIGNATURE OF OWNER/~ DE__YE. DATE5- 1 ~ ~ ~'''~'' 477. NAME OF SIGNER (/x~lt) 478. TITLE OF ~IGNER 479. UPCF (7/~9) $:~RE MANUAU~faw HMMP fo~m.wpd HAZA~I~)OUS MATERIALS MANAGEME~I)PLAN Section 11.2 - RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND MITIGATION: FOLLOW-UP ACTIONS C. CLEAN-UP AND RECOVERY PROCEDURES: UPCE (7/99) S:~PROCEDURE MANUAt.~,Iew HMMP form.v43d CITY OF BAKERSFIELI~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN Section I1.1 - DISCOVERY AND NOTIFICATIONS ..'.~;;t ,~, ,., ' IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 AOORESS (For Iocat use oP, ty) 476. A. LEAK .DETECTION-AND MONITORING P-15,0C~:DURE,~: ~o''z} , B. EMERGENCY AND AGENCY NOTIFICATION PROCEDURES: C. SPECIFIC RESPONSIBILITIES OF EMPLOYEES: EMERGENCY MEDICAL PLAN D. CLOSEST LOCAL MEDICAL FACILITY: ]00 O L C:, 12 i V ~,r~.p_c,~ . UPCF (7/99) S:~PROCEDURE MANUAL~New HMMP fo~m.w~ O OF ENVIRONMENTAL S 2ES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION Page __ Of __ BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 BUSINESS PH E- 102 SITE ADDRESS ~o3 DUN & ~o~ S,CCO~E 105 107 108 ~ OPERATOR PHONE ~b]'-' ~'ff~ - ,~z~',~..~o 'OWNERNAME ~(~ W;il;.~f -, O~ERPHONE ~/'¢~3- ~ f 112 ADDRESS CITY [Z_.2 Fy ~,,Z,,~ f ~,-(¢'.'-[,~ ~i'4 STATE ~i~ ,,s ZIP CON*AC~ NAM. ~ff ~; il;~ ~ ., ~ CONTACT PHONE CONTACT ~ILING CITY 'NAME TITLE 123 NAME ~25 TITLE ~2o STATE ~2~ ZIP 122 BUSINESS PHONE 24-HOUR PHONE b61- ¢3/. ')~'3 7- .~ BUS,NESS PHONE ~b/ ' ~q~- qff~ ,27 24-HOURPHONE ~ 128 PAGER ~ PAGER # Certification: 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 in this inventory and believe the information is true. accurate, and complete. i DATE 134 NAME OF DOCUMENT PREPARER ,35 136 TITLE OF OWNER/OPERATOR 137 SIGNATUiE OWFN E:Noi E~~ ~qAMES O~ .... UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd i ,i 0 0 0 0 0 , o o ~ ~)Oo 0 0 0 0 . EI,,PL~:Tr't~E ! 0 0 0 0 0 0 0 0 0oo~,~,~. oooo oo,'1°°. 0 :-~x~o~ o_~. C C RE81~OOM IF-O" FLOOR PLAN LI ENGEL & COMPANY FLOOR PLAN LENGTHWISE BREWING 6720 SCHIRRA COURT BAKERSFIELD, CA FACILITY NAME ADDRESS' ~ FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES lq / UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 biS- 0 0 I Co, INSPECTION DATE '2. /t!/O~ PHONE NO. ~' ~ - ~ 5'"3'7 BUSINESS ID NO. 15-210- /x~'-'to NLIMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~j'--Routine [~ Combined I~ Joint Agency [~ Multi-Agency [,.] Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand /x/'~ ~ ,,r" ~t ~ Business plan contact information accurate Visible address Correct occupancy / Verification of inventory materials O~ :'ff-t~,,./ ~.-O.'r,_ Verification of quantities ~,~'~' I Z.~O c..g'/ 7../d-~ ~ 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 & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: Yes ~No Questions regarding this inspection? Please call us at (661 ) 326-3979 Whi~e - Env. Svcs. Yellow- Station Copy Pink - Business Copy Inspector: