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Home My WebLink AboutBUSINESS PLAN 10/2007:1 I ) ~. ~~ i., "~,.~ r ~ ."/ . ~' iy [9 ~f P~ i \,\ ~h ~~~ ~~? .i __. .. _ ~... _._ ._ _~ 1. ~z ~~ ~~- ,- -~~ ~~ ~- , , ,~ ~~ ~~ ~~ ~ ,, ~~ ~.:- 4 BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 Manager MICHAEL W BRAND Location: 101 TRUXTUN AVE City BAKERSFIELD BusPhone: (661) 322-6001 Map 103 CommHaz High Grid: 30D FacUnits: 1 AOV: CommCode: BFD STA 02 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title MICHAEL W BRAND / PRESIDENT / Business Phone: (661) 322-6001x Business Phone: 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 428-0900x Pager Phone Hazmat Hazards: Fire Press ImmHlth Contact MICHAEL W BRAND Phone: (661) 322-6001x MailAddr: PO BOX 1631 State: CA City BAKERSFIELD Zip 93302-1631 Owner MICHAEL W BRAND Phone: (661) 322-6001x Address 1601 SPRUCEHAVEN State: CA City BAKERSFIELD Zip 93312 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT Dt ^sd or my irCUirv of these indi~~ici~;-' ; ~ , respc?n~iLie gar oh'~~inin~ the infarrr~aion, 2 r_„~-i;ty under penalt ey ic tiN that I h ~~ ® C ~'° y 9007 L y . ove person fly . L examined and am familiar v~rith the information submitted and balieve the information is true, accurate. and completes. ~~ ~"~~ - ~ ~ ~ ignature Date -1- 10/01/2007 T F BRAND DRY ICE INC DBA BRANDCO ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-000047 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETYLENE E F P IH G 250.00 FT3 Hi ABC FIRE FIGHTING DRY CHEMICAL F S 6000.00 LBS Low OXYGEN F P IH G 440.00 FT3 Low CARBON DIOXIDE F P IH G 70500.00 LBS Min BC FIRE FIGHTING DRY CHEMICAL S 6000.00 LBS Min PURPLE FIRE FIGHTING DRY CHEMIC S 6000.00 LBS Min HELIUM F P IH G 3500.00 FT3 Min NITROGEN F P IH G 2500.00 FT3 Min HALON 1211 F P IH G 635.00 FT3 Min AFFF/F FIRE L 6000.00 GAL UnR -2- 10/01/2007 -3- 10/01/2007 ,T , F BRAND DRY ICE INC DBA BRANDCO ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME ACETYLENE Location within this Facility Unit W SIDE OF BLDG 1 SiteID: 015-021-000047 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 74-86-2 ~GasATE TPureE ~-AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 250.00 FT3 250.00 FT3 250.00 FT3 ru~atitcLVUJ w~~lrulv~ly 15 oWt. RS CAS# 100.00 Acetylene Yes 74862 -- i1tiGKttL H. 7.7P~.7~71"1P~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ABC FIRE FIGHTING DRY CHEMICAL Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE BLDG 1 CAS# 7631-86-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~mbient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 LBS 6000.00 LBS I 3000.00 LBS ritaututLVU~7 L.VPlt'V1V L'1V 1~J %Wt• RS CAS# Silica, Crystalline No 7631869 Monoammonium Phosphate No 7722761 Ammonium Sulfate No 7783202 r1tiL~tiLCL ti J~7.G.7.71~1P~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Low -4- 10/01/2007 F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ ~ 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: W SIDE OF BLDG 1 CAS# 7782-44-7 STATE TYPE T PRESSURE TEMPERATURE CONTAINER TYPE ~GaS Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THI5 LOCATION Largest Container Daily Maximum Daily Average 440.00 FT3 440.00 FT3 440.00 FT3 t11jG1jtCLVUS l.V1YlYV1VL'i1V 15 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 t1HG1~tCL 1-~J 5~5A1~1~1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Location within this Facility Unit INSIDE S SIDE BLDG 1 Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 128-38-9 ~GasATE TPureE ~-AboveSAmbient AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 48000.00 LBS 70500.00 LBS- 60500.00 LBS ntic~ti.t[LVU~ 1.V1~lYV1Vi',1V 1.7 oWt. RS CAS# 100.00 Carbon Dioxide No 124389 nsic~.ytcL ti~ar.a~rlr.ivl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 10/01/2007 F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ ~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME BC FIRE FIGHTING DRY CHEMICAL Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE BLDG 1 CAS# 1337-76-4 ~SolidE I Mixture I AmbRe~~URE TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 LBS 6000.00 LBS 1000.00 LBS HAZARDOUS COMPONENTS %Wt. RS CAS# Magnesium Aluminum Silicate No 0 Sodium Bicarbonate No 144558 I1HGH1<LJ 1~J ~~~~1~i~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min ~ Inventory Item 0010 COMMON NAME / CHEMICAL NAME PURPLE FIRE FIGHTING DRY CHEMICAL Location within this Facility Unit INSIDE BLDG 1 STATE TYPE PRESSURE Solid TMixture ~ Ambient Facility Unit: Fixed Containers on Site ~ Days on Site 365 Map. Grid: CAS# 1337-76-4 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Con55100rLBS Daily6000100m LBS I Dailyl000r00e LBS nxGxtcLV V a ~.vi~irvi~ my t ~ %Wt. RS CAS# Magnesium Aluminum Silicate No 0 Potassium Bicarbonate No 298146 lYHGHtCL E~.7 .'~~.751~1L' 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min -6- 10/01/2007 T. 7 F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 a Location within this Facility Unit Map: Grid: W SIDE OF BLDG 1 CAS# 7440-59-7 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3500.00 FT3 3500.00 FT3 3500.00 FT3 t1HGAt'ClJ V U .7 lL V 1~1Y V1V I;1V l ~ °sWt. RS CAS# 100.00 Helium No 7440597 tit~~KrcL t~a~~~ari~ivla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME NITROGEN Location within this Facility Unit W SIDE OF BLDG 1 STATE T TYPE PRESSURE _ Gas I Pure Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7727-37-9 TEMPERATURE ~~ CONTAINER TYPE ~ Ambient I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 2500.00 FT3 2500.00 FT3 2500.00 FT3 1zr~c,tucLVU~ ~.vlYlrvivl,ivt~ oWt. RS CAS# 100.00 Nitrogen No 7727379 I1HGL-11tL 1i.7 .71;.7.71~11;1V -1 .7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -7- 10/01/2007 F BRAND DRY ICE INC DBA BRANDCO ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME HALON 1211 Location within this Facility Unit INSIDE BLDG 1 S END SiteID: 015-021-000047 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 353-59-3 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Gas TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 635.00 FT3 635.00 FT3 635.00 FT3 nriG.ytcLVUS ~vi~irvlvnivi~ %Wt. RS CAS# 100.00 Bromochlorodifluoromethane No 353593 t~~t~tcli r~a 5~55in~iv i a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME AFFF/F FIRE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE BLDG 1 S SIDE OF YARD CAS# 107-41-5 Liquid TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 250.00 GAL 6000.00 GAL 250.00 GAL %Wt. HAZARDOUS COMPONENTS RSA CAS# 11HGHKL H. 7.7 A.7.71~1L" 1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -8- 10/01/2007 r~ ~ F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 01/31/2000 ~ CALL 911. Employee Notif./Evacuation 10/13/2006 CALL 911. EVACUATE FACILITY TO AREAS NOTED ON MAP. PROVIDE VENTILATION. CLEAN-UP PERSONNEL NEED PROTECTION AGAINST CONTACT WITH VERY COLD MATERIALS OR EXCESSIVE INHALATION OF GASES. Public Notif./Evacuation CONTACT 911/USE POSTED EVACUATION MAPS AT SITE. 03/15/2007 Emergency Medical Plan 01/31/2000 CALL 911. -9- 10/01/2007 ~~ F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ Fast Format ~ -Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/31/2000 ~ ALL CONTAINERS ARE SET TO VENT AT SAFETY TO AIR CYLINDERS ARE CHAINED AND CAPPED WHILE ON OUR DOCK. Release Containment 06/26/1992 ALL GASES AT SIGHT ARE INERT AND ARE RELEASED TO ATMOSPHERE. ALL FOSSIL FUELS AND OILS ARE CONTAINED IN AUTOMOTIVE EQUIPMENT. IF A SPILL SHOULD OCCUR THE SPILL WILL BE COVERED BY CLAY ABSORBENT. THIS CONTAMINATED ABSORBENT WILL BE CONTAINED IN HAZARD DRUMS AND DISPOSED OF IN ACCORDANCE WITH STATE AND FEDERAL CODES. Clean Up 06/26/1992 SPILLS WILL BE COVERED WITH CLAY ABSORBENT AND DISPOSED OF IN ACCORDANCE WITH STATE AND FEDERAL CODES. V1~11CL LCCSVUt C:C LiU I..LVdl.l Vil -10- 10/01/2007 :. F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ orc~.iai na~.a.LUa Utility Shut-Offs 03/15/2007 GAS - S REAR OF BLDG ELECTRICAL - W INSIDE WALL OF BLDG WATER - S REAR OF BLDG IN ALLEY PAVEMENT Fire Protec./Avail. Water 10/13/2006 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS IN BLDG/OFFICE. FIRE HYDRANT - UNION AVE N OF BLDG AND SHADY LN & V STS W OF BLDG AT CRNR. Building Occupancy Level 03/01/2006 13 EMPLOYEES -11- 10/01/2007 ~•J ~ 9 F BRAND DRY ICE INC DBA BRANDCO SiteID: 015-021-000047 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/13/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE AT 101 & 107 TRUXTUN AVE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY TRAINING IS CONDUCTED ON A MONTHLY BASIS IN ACCORDANCE WITH BRANDCO SAFETY MANUAL. CLASSES ARE BASED ON WRITTEN AND VIDEO PUBLICATIONS PROVIDED BY DIFFERENT SOURCES. rayc c aic_tu ivi L~ u~.uic ~.~c nc.+.u ivL ru~.uic ~5c -12- 10/01/2007 $-~ _~ ~~rwy' ~'~'~~ CITY OF BAKERSFIELD FIRE DEPARTMENT • ~ ~ ya OFFICE OF ENVIRONMENTAL SERVICES ~~ ~ p UNIFIED PROGRAM INSPECTION CHECKLIST =_~E~~~~i~~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~~ ~n ~ ~ _ INSPECTION DATE (6 ~ ~' ~ v ~ ADDRESS I D ~ ° ~ ~ a.; ~ " - ~ n - ~~ )2y~(vn/PHONE NO. (o(~ / ~3Z2^ p~ ~ FACILITY CONTACT i'Y) ~' ~.~I ~ L ~ ~Z,~vD BUSINESS ID NO. 15-210- ~~ QoSi 7 INSPECTION TIME l ,~ w~,t'n( NUMBER OF EMPLOYEES ~ .] Section 1: Business Plan and Inventory Program f~Routine ^ Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate 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 v Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ^ Yes ^'1~10 • Explain: Questions regarding this inspection? Please call us at (805) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy Business Site Responsible Party ..---. Inspector: r i ~~~- .~~~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES .y UNIFIED PROGRAM INSPECTION CHECKLIST ;w ~~~~~~~ 1715 Chester Ave., 3~" Floor, Bakersfield, CA 93301 FACILITY NAME~Ln~.rh ~~1 1C~~ ADDRES5 ~ ~~ j~~x` ~T ~ ~4~-l'~ FACILITY CONTACT,j~~=NAC-I-- __ gfLA~l~j INSPECTION TIME 1 ~ r'I r~~ Section 1: Business Plan and Inventory Program ~outine ^ Combined ^ Joint Agency ^Mulb.-Agency INSPECTION DATE ~ U ~~ ~I °3 _ PHONE NO. 3-Z~ ~ C~ 6 v l BUSINESS ID NO. I5-21 U- OQ6 d 7 NCJMBER OF EMPLOYEES `'`C ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate ~ Visible address Correct occupancy Verification of inventory materials ~ Verification of quantities / Verification of location / Proper segregation of material Verification of MSDS availability v Verification of Haz Mat training / Verification of abatement supplies and procedures t/ Emergency procedures adequate / Containers properly labeled ~ ~~~.- Housekeeping Fire Protection Q~. '' r~ Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ^ Yes No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink - t3usiness Copy Business Site Res nsible Party Inspector: -~ +~BRAND DRY ICE INC DBA BRANDCO _______________________ SitelD: 015-021-000047 + Manager Location: 101 TRUXTUN AVE City BAKERSFIELD BusPhone: (661) 322-6001 Map 103 CommHaz High Grid: 30D FacUnits: 1 AOV: CommCode: BF'D STA 02 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title MICHAEL W BRF~ND / PRESIDENT C A WOOD / FOREMAN Business Phone: (661) 322'-6001x Business Phone: (661) 322-6001x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone (661) 428-0900x Pager Phone (661) 428-0907x Hazmat Hazards: Fire Press ImmHlth Contact Phone: (661) 322-6001x MailAddr: PO l_OX 1631 State: CA City BAKERSFIELD Zip 93302-1631 Owner MICHAEL W BRAND Phone: (661) 322-6001x Address 1601 SPRUCEHAVEN State: CA City BAKERSFIELD Zip 93312 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Dire<:~tives PROG A - HAZMA~' .. - 1~1~~ V ~ ~O~Q 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 and believe the information is true, accurate, and gomplete. Signature Da e -1- 03/01/2006 ~._ +'BRAND DRY ICE INC DBA BRANDCO _______________________ SiteID: 015-021-000047 + += 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: +----------------+ W SIDE OF BLDG #1 I CAS# 7782-44-7 += STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ Gas ~ Pure ~ Above Ambient ~ Ambient ~ PORT. PRESS. CYLINDER --------- ---------- --------------- -------------- +__________________________+ AMOUNTS AT THIS LOCATION =_____________________=__+ Largest Container Daily Maximum Daily Average 440.00 FT3 I 440.00 FT3 I 440.00 FT3 +_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+ 100t00,Oxygen, Compressed INoSI CAS#77824471 +_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSNcoretlNoS(BN Haz~ RNod~oactive/Curies I FPP HalHrds I %F~A/ ~ USDOT# l LoCW +______=+===I+====__+____________________+_____________+_________+________+_____+ += Inventory Item 0003 _______________ Facility Unit: Fixed Containers on Site + +_= COMMON NAME / CHEMICAL NAME ______________________________+________________+ CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: +----------------+ S SIDE OF BLDG #1 INSIDE OF BLDG #1 I CAS# 128-38-9 += STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ Gas ~ Pure ~ Above Ambient ~ Below Ambient ~ PORT. PRESS. CYLINDER - --------------- --------------- ------ --------------- +__________________________+ AMOUNTS AT THIS LOCATION =_____________________--_+ Largest Container (IQs I' Daily Maximum L~ I Daily Average ~B rs L}$ ~b -- ~,~' 70500.00 ~ 60500.00 ~ -------- -------- ------ -------- ---------- ---------- +_______+______________ HAZARDOUS COMPONENTS =_____________+___+_____=_________+ ~Wt• RS CAS# 100.00`Carbon Dioxide INo I 1243891 +_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSecretl RSIBioHazl Radioactive/Amount I EPA Hazards I NFPA I USDOT# ~ MCP No `No No (` No/ Curies F P IH / / / Min -5- 03/01/2006 } ~~' ~ _ Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST e F >r s F . 0 900 Truxtun Ave.,'Suite 210 ~-_ ~~~.~~_,~~,. _ ,~_.~~~~.h _ `~_.~~. _~-,a_..~~_~ ~.~ __~._~~..__ ~ FiaF Bakersfield, CA 93301 SECTION 1 ; Bu$in@SS Plan 8110 Ilnv@ntOry P1'OgPBm '°a"" = Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ - ~ cZ,~ ~ ~~ ~ '~~ z ~ ~ INSPECTION DAT ~ 1 ~ Z3 v ~ INSPECTION TIME S ~ ADDRESS ^_ ~ PHONE NO. ~ Z2 ~~ ( NO OF EMPLOYEES 7 l JFL- FACILITY CONTACT ~ - ~ - , - BUSINESS ID NUMBER 15-021-Gb00 c/7 2 ~ ,fir ~ ~L l __ _ 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 • - f X , ~ / ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE C S ~ / ^ VISIBLE ADDRESS [ % f ~ ~ / L~J ^ CORRECT OCCUPANCY ®~ ^ VERIFICATION OF INVENTORY MATERIALS I~ ^ VERIFICATION OF QUANTITIES I~ ^ VERIFICATION OF LOCATION '0" ^ PROPER SEGREGATION OF MATERIAL ~^ VERIFICATION OF MSDS AVAILABILITY [~^ VERIFICATION OF HAZ MAT TRAINING I~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~^ EMERGENCY PROCEDURES ADEQUATE i~ ^ CONTAINERS PROPERLY LABELED ,~ yy ^ HOUSEKEEPING ~ ^ FIRE PROTECTION , Id' ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~J. i l- ~-DG ~- r~ -'~- Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # sin White -Prevention Services Yellow -Station Copy Pink -Business Copy ^ YES ~O n: FD 2155 (Rev. 09/05 ~_