HomeMy WebLinkAboutBUSINESS PLAN 3/28/2008i -
~~ STRONG
B u BRONN ARM
~~' 4200 TRUXTUN AVE•,_SUITE 300
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UNIFIED PROGRAM -.INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
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Prevention Services
e F R s F , „ 900 Truxtun Ave., Suite 210
i/RE Bakersfield, CA 93301
ARTM r Tel.: (661) 326-3979
Fax: .(661) 872-2171
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ADDRES ~~ ~'~ ~ PHYONE NO. (,~ /y'
> ~~r 1 (~ NO OF EMPLOYEES
FACILITY CONTACT
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~ BUSINESS ID NUMBER
15-021-~ ~Z-
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= = Section '(: ~usiness_Plan and lnveniory Program
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ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation- COMMENTS
^ APPROPRIATE PERMIT ON HAND
'. ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE
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^ VISIBLE ADDRESS
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tLV ^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS ENT ~
^ VERIFICATION OF QUANTITIES
~ ~1 ^
\ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
° ^ VERIFICATION OF MSDS AVAILABILITY \
~` ^
` VERIFICATION OF HAZ MAT TRAINING
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^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
1QI' ^ EMERGENCY PROCEDURES ADEQUATE
'~" ^ CONTAINERS PROPERLY LABELED
J ^ HOUSEKEEPING
I~ ^
11 FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL us AT (661) 326-3 7~9
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Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station #
^ YES ^ NO
White -Prevention Services - Yellow -Station Copy Pink =Business Copy ~ FD 2155 (Rev. 09/05
+ BROWN ARMSTRONG CPA _________________________________ SiteID: 015-021-002921 +
Manager MADELINE PARKA
Location: 4200 TRUXTUN AV"E~ 300
City BAKERSFIELD
BusPhone: (661) 324-4971
Map 102 CommHaz Low
Grid: 26C FacUnits: 1 AOV:
CommCode: BFD STA O1
EPA Numb:
SIC Code:
DunnBrad:
+__________________________--_____________-____________________________-___=====t
Emergency Contact / Title Emergency Contact / Title
MADELINE PARKA / OFFICE MGR /
Business Phone: (661) 3291-4971x Business Phone: ( ) - x
24-Hour Phone ( } - x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards:
Contact MADELINE PARKA Phone: (661) 324-4971x
MailAddr: 4200 TRUXTUN AVE1300 State: CA
City BAKERSFIELD Zip 93309
Owner MADELINE PARKA Phone: (661) 324-4971x
Address 4200 TRUXTUN AVE~300 State: CA
City BAKERSFIELD Zip 93309
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
~ Emergency Directives: ~
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
ENT'D MAR 0 8 2006
Based on my inquiry of those individuals
responsible for obtaining the information, 1 certify
under penalty of law that I have personally
examined and am familiar with the information
submitte¢'~and believe the information is true,
accurate, nd complete.
~ 3,~,0~
g ature Date
-1- 02/28/2006
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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Te_l: (661) 326-3979
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FAC ITY NAME /~ INSPECTION DATE INSPECTION TIME
ADDRESS PHONE No. No. of Employees
FACILITYCONTACT ( Business ID Number
1~I J~ C.~e t,.. 2 (~ 15-021- GU Zg Z
Section 1: Business Plan and Inventory Program
Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection
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ANY HAZARDOUS WASTE ON SITE: ^ YES ~IO
EXPLAIN: 6/
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QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~FC'I ~ 326-3979
1
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Inspector (Please Print) Fire Prevention 1st-InlShift of Site
White -Environmental Services Yellow - Stalan Capy Pink -Business Copy
Party (Please Print)
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