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UNIFIED `PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
BARER8FlELD FIRE DEPT
Prevention Services
I/RI 900 TYuxtun Ave., Suite 210
~~ir Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME n
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CA
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~ NSPECTION DATE
" NSPECTION TIME
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ADDRESS ~
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FACILITY CONTACT ~ USINESS ID NUMBER
15-021- ~-~~
Section 1: Business Plan and Inventory Program ~ 5 `~
~"` OUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
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C V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND ~, ~~ ~ ~ 1
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O ^ BUSIt1t3SS PLAN CONTACT INFORMATION ACCURATE - ,
~/^ VISIBLE ADDRESS
~,~`^ CORRECT OCCUPANCY
^ ' ^ VERIFICATION OF INVENTORY MATERIALS
^-'~ ^ VERIFICATION OF QUANTITIES
~Q.~`~^ VERIFICATION OF LOCATION
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^° ^ PROPER SEGREGATION OF MATERIAL
VERIFICATION OF MSDS AVAILABILITY
-- -- _ __------ --- -- -- --- -------- 2{~~6 ------_ -----_
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,.-^ VERIFICATION OF HAZ MAT TRAINING
~,. ^ VERIFICATION OF ABATEMENT SUPPLIES AND
PROCEDURES
~.-- ^ EMERGENCY PROCEDURES ADEQUATE
~,,.^ CONTAINERS PROPERLY LABELED
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t/ HOUSEKEEPING
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~,,. FIRE PROTECTION 9
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^r ^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITES
EXPLAIN: ! .~ ~ ,~~ ~~_.~_L
QUESTIONS REGARDING THIS INSPECTION? PLEA8E CALL US AT (6t31) 92a-3979
Inspector (Please Print) ~ Fire Prevention / 1" In / Shitt of Site/Stetion Y / usurer's Site/ choo~t`Sitti Resptmst le PaAy (Please Print)
White -Prevention Services Yellow -Station Copy Pink - Business Copy FD2M8 (Rw. OZ/08)
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~i~4~` T~ ~ CI'T'Y OF BAKERSF[ELD FIRE DEPARTMENT
elm ~ OFFICE OF ENVIRONMENTAL SERVICES
p~ ~ ~~ UNIFIED PROGRAM INSPECTION CHECKLIST
~-~~~tii~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
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FACILITY NAME 'I~o I k5 ~ ~~ c; -t C>J~ ~-. ~~ ~ INSPECTION DATE /2 - Z v - y r
ADDRESS 220 _ PHONE NO.
FACILITY CONTACT 'J,- c.,- ~. ' ~ BUSINESS ID NO. 15-21U- l"~OJ~1~4
INSPECTION TIME` /b ~ ~ Nt1MBER OF EMPLOYEES I'
Section 1:
Routine
Business Plan and Inventory Program
^ 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
Fire Protection
Site Diagram Adequate & On Hand
C-Compliance V=Violation -
Any hazardous waste on site?: Yes ^ No
Explain: C.l Ss~.., o:~.
Questions regarding this inspection'! Please call us at (661) 326-3979
White -Env. Svcs. Yellow -Station Copy Pink -Business Copy
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Business Site Responsible Party
Inspector:~~3~~ ..~Z?
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Q~Qt.n F~~~ ClTY OF BAKERSFIEI.D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
~~ UNIFIED PROGRAM INSPECTION CHECKLIST
s
_w ~ati~,d 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301
FACILITY NAME V ~ ~~~hfir'• [iVSPECTION DATE 6'~ z - ~ 3 _
ADDRESS % ZLD ~ 7rkXfiuv. PHONE NO. 3 z 6 - 8~ 9 Z
FACILITY CONTACT 1t1~ MCP l74i l y BUSINESS ID NO. l 5-21 U- zz 1 y
INSPECTION TiME1o/S' NUMBER OF EMPLOYEES I -
Section 1: Business Plan and Inventory Program
Routine ^ Combined ^ Joint Agency ^Muhi-Agency
^ Complaint
1 _ .
~:.. ~:
^ 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 / P
Proper segregation of material /
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate 1~
Containers properly labeled /
Eiousekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
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Any hazardous waste on site?: Yes ^ No
Explain: Wef1~c d~ I
Questions regarding this inspection? Please call us at (661) 326-3979
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usiness Site Responsible Party
White -Env. Svcs. Yellow - Station Copy Pink -Business Copy Inspector: N . 4 1
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+ VOLKSWAGEN COUNTRY __________________________________ SiteID: 015-021-002214 +
Manager
Location: 1220 E TRUXTUN AVE
City BAKERSFIELD
BusPhone: (661) 326-8092
Map 103 CommHaz High
Grid: 28C FacUnits: 1 AOV:
CommCode: BFD STA 02
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
MIKE DAILEY / /
Business Phone: (661) 326-8092x Business Phone: ( ) - x
24-Hour Phone ( ) - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact Phone: (661) 326-8092x
MailAddr: 1220 E TRUXTUN AVE State: CA
City BAKERSFIELD Zip 93305
Owner VOLKSWAGEN COUNTRY Phone: (661) 326-8092x
Address 1220 E TRUXTUN AVE State: CA
City BAKERSFIELD Zip 93305
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
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used on my inquiry of those Individuals
responsible for obtaining the information, 1 oertify
under penalty of law that I have personally
exam(ned and am familiar with the Information
submitted and believe the Information is true,
accurate, and complete.
Signature Date
-1- 08/09/2006