Loading...
HomeMy WebLinkAboutBUSINESS PLAN 11/24/2004' , _ j ~ c O ~ ` O U ~~ C7 ~ ~ W: _ -p ~ z: i x ~' v z ~o F ~ z ~~ -° o N N P eJ .~ ' ((( 1 3• i ,~ L" + UNION TRUCK DRIVING SCHOOL __________________________ SiteID: 015-021-002903 + Manager SUKHI GHUMAN BusPhone: (661) 827-9010 Location: 2201 S UNION AVE Map 124 CommHaz Moderate City BAKERSFIELD Grid: 18B FacUnits: 1 AOV: CommCode: BFD STA 05 SIC Code: EPA Numb: DunnBrad: *______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Ti tl e / n ` / ~I~L ~d.~D~~-~ Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone :~~) / - ~3x ~F~SS 24-Hour Phone (Bel) ' -~~~ ~~ Pager Phone (~). - x? ~~ 38~ ~ Pager Phone ( ) - x +----------------------- --- ---------+ ------------------ --------------------+ Hazmat Hazards: Fire ImmHlth DelHlth Contact SUKHI GHUMAN Phone: (661) 827-9010x MailAddr: 2201 S UNION AVE State: CA City BAKERSFIELD Zip 93307 Owner SUKHI GHUMAN Phone: (661) 827-9010x Address 2201 S UNION AVE State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT ®~ ~ 1 ~ ZOQ6 ,1~~3 ~l C _ t 3~6o Ju ~/ 3 ~ -1- 06/07/2006 ./.-~- v~10 ~ Bakersfield Fire Dept. I~IVIFiE® PROGRAM IItiSPECTIOIV CHECKLIST Enironmental services «--_.~,- -~~ ~t~-~:y~~_~.. ~ ...:-~-~._ __ rw i .~.,~~a.~~~ ~,~ 1.715 Chester Ave SECTI®N 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME , ~J~-J~t(Ji~I 'ADDRESS FACILITYCONTACT R.~vr ~v ...--- - i - - - ~-•--- Bu is ness ID Number I5-021- ~~ t• 7 Section 1: Business Plan and Inventory Program ^ Routine Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection C V ~v=voaplonncel OPERATIO®~ ^ ^ APPROPRIATE )PERMIT ON HAND ~V ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL COMMEPITS ^ ^ VERIFICATION OF MSDS AVAILABILITYE ~^ ^ VERIFICATION OF HAT MAT TRAINING ~ I I ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES r ^ ----_-.,-- ----- - -- --- - -- -- ^ EMERGENCY PROCEDURES ADEQUATE - - --- - --- -- -- ----- -- - - - - -_ ------- - -- ----- - ~ ^ I ^ CONTAINERS PROPERLY LABELED _ ~ ~"1.~~~ ~3~L DiCS~~, TANKS ~ ~AS~ cso - ^ ^ HOUSEKEEPING ^ - _ ~ FIRE PROTECTION - -- _ ~ ___ _- -- --- ----- - - - ~_ i ~ 1 i i~C.C~hE ~NST1aiL ~T LL~"T cam'" ZA 40 13,G ^ ^ SITE DIAGRAM ADEQUATE & ON HAND I ANY HAZARDOUS WASTE ON SITE: ~ YES ^ NO EXPLAIN: ~~`~ ~ C Bl ~. ~ TV i3C 2C"m.O~K'7 QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661 ~ 326-3979 %/`~C.~ Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy usi~e R ponsr le Party (Please Pnnt) N Pink -Business Copy ... ~ ~ ~-'~\ ~~. Bakersfield Fire Dept. I~NIFIED PROGRAM INSPECTION CHECKLIST ~ Enironmental services .-;~-~~ -~ _ ~~:-~°;; ~~=r~ V °- 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAM~j _ , INSPECTION DATE I INSPECTION TIME tJ~"' ~^) JUG 2~uf ~.t(s $Cr-{cx~L t 1 21{. 4 __ __ ____ ADDRESS 'PHONE No. ~No. of Employees FACILITYCONTACT Business ID Number ~ 15-021- /~~1 Section 1: Business Plan and Inventory Program ^ Routine Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection COMMENTS ^ - ^ --- BUSINESS PLAN CONTACT INFORMATION ACCURATE -- ---------------------------- ---r--- -- ^ ^ VISIBLE ADDRESS, ^ ^ CORRECT OCCUPANCY ^ -~.,®4 ^ ^ VERIFICATION OF INVENTORY MATERIALS. ~,<: ^ - ^ ---- VERIFICATION OF QUANTITIES J' ------- ----------------- - ------------------- --- ^ ^ I VERIFICATION OF LOCATION ^ ^ - - - PROPER SEGREGATION OF MATERIAL ------------------------------ -- --- --- - -- - - ^ ^ 1 VERIFICATION OF MSDS AVAILABILITYE ^ ^ VERIFICATION OF HAT MAT TRAINING i ^ ^ ' VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ ~ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED 1~LL~SE C,~3e~c.. 1~tEsF~, ~-pn+KS ~ WASTE c ^ ^ HOUSEKEEPING ~ ---- - --- -- --~-- ---fin-- ----- ^FIRE PROTECTION t~c.~~sE ~NSTA~t 14T !~-~ST c~C: ZAP 4O R,G ^ ^ SITE DIAGRAM ADEQUATE & ON HAND I ANY HAZARDOUS WASTE ON SITE: ~ YES ^ NO EXPLAIN: ~~STL Ol („ < TV 13C ~C-~'Ma~C'7 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~66~ ~ 326-3979 //`1C:S ------------- ----------------- Inspector (Please Print) Fire Prevention 1st-InlShift of Site -. - ~ While -Environmental Services Yellow - Station Copy -- Business Site R ponsible Party (Please Print) g Pink -Business Copy ~T~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~ OFFICE OF ENVIRONMENTAL SERVICES b Y UNIFIED PROGRAM INSPECTION CHECKLIST w ~gti~ 1715 C&ester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME ~^J`~`J T'~-vc~ ~~`~`''~~ S~~L- INSPECTION DATE ~~ / Z~(~' Section 4: hazardous Waste Generator Program EPA ID # ^ Routine ~ Combined ^ 3oint Agency ^Multf-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number G•~+LL nl~-O ~ orc- ~n,c~/ac,. Authorized for waste treatment and/or storage Reported release, fire, or explosion within IS days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks UNION TRUCK DRIVING SCHOOL~J Used oil not contaminated with other hazardous waste ~'~~ ~'-' Th Wh l Proper management of lead acid batteries including labels I e ee ~ = ~?_ O Proper management of used oil filters I _ 7~ Opportunity Transports hazardous waste with completed manifest I Ph. (661) 827-9010 ~~9h, Owner Sends manifest copies to DTSC I Fax (661) 396-9884 2201 South Union Ave. Cell (661)331-0786 Bakersfield, CA 93307 Retains manifests for 3 years ~ _ _ _ SuKN 1 ~ ~ V~tan/ - Retains hazardous waste anal sis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~=~.ompuance v=vtotanon Inspector: ~ r ~S Office of Environmental Services (661) 326-3979 White -Env. Svcs. Business Site sponsible Party Pink -Business Copy I I i ) i ~~ I. FACILITY IDENTIFICATION FAGUTY ID No . t Yey ~9mr?i^9 tap Year Ending ttn BUSINESS NAME (Barra sa FAGLITY NAME or OBA• Ooirp 8usinssa As) ~ BUSINESS PHONE to ~~lN~~N ~v~k ;pr-vr ~1Cr ~e~~L_ (o(~! ~2~--= ~`iC~~ ('C~ SITE ADDRESS ~ ~~ c~ i S Win, i o~v AYe CITY . to ZIP taa DUN b BRADSTREET tm SIC CODE ~--~ - ttv N ~ (4 ayt w) - --, -- 000NTY k ~~ ><~ ~ OPERATOR NAME taa OPERATOR PHONE tta ~p ~A~~1Gi.-J D~ dam A totoi °- ~~t~1 ~-3 Gn II. OWNER INFORMATION OWNER NAM a ttt ~~ O/WN~ER PHONE /P---q to 9`. 1 ~ `_ ~ .. t _ ~O `V . ONMER MAILING ADDR _ S'"l t ~ ~ ~ A _ r~T to CITY nn tt. ~A ~Q,~-~t ~ STATE rta ~~ ZIP ~ ~ na ' . ~ ~• .III. ENVIRONMENTALCONTACT CONTACT NAME - m CONTACT PHONE to CONTACT MAILING ADDRESS-. t>9 - a , S ~~ti©ti, ~v~. CITY f2o !~ STATE t2t ZIP L13~ o t72 -PRIMARY- ~• - IV. EMERGENCY CONTACTS ~ SECONDARY- NAME.- ~ 123 LODE FA- b- NAME k~~~) ~)-~ t29 71TLE 12S M• ~ ~e~, TITLE v w -.~ e.~ 130 BUSINESS PHONE )~ }~~ i28 W W' l.ol`?-'3 BUSINESS PHONE ~' ~- ++ Q '-7 ~lL;''1 OZ C •~ 131 24•HOUR PHONE 127 to l~ ~ l~ ~ 7 - 3 (o ~ 24-HOUR PHONE _ Cv (p I 3 3 i ~- ©'7 ~ 132 PAGER No A t r~ 128 . /" !/ PAGER No - `~' 133 V. CERTIFICATION Ctatientbn: 8aaed on my irtgtairy d t-toae irWlviduala roaponaiDla for oDt@irtirtp fns Information, 1 certiry under penalty of law that 1 trove personally examined. and am familiar. with fns inforrnatlon.strDmitted In Wa Inventory and oeuew the irtfarmetlon is hw, accurate. artd complete.- SIGMA RE OWNER/pPER~,ITOR r GATE 134 NAME OF DOCUMENT PREPARER . . . 135 . ~ ~~3~ j . f p q' % NAMES F OWNERlOPERAT (pnnq ' ~: 138 TITLE OF OY4NER/OPERATOR 137 v fd2080 . . :,- - Bakersfield~~;Fires Dept: D Environmental..3ervices /~R~ `~ 1715 Chester Ave:: ~: -:-.~ . ~Rrr r ~ Bakersfield, CA:9330~1 ~- --~"~ -Tel: (661)326=3979 ~'~ (one loan per material per building or area) Paget of 1. FACILITY INFORMATION 1 BUSINESS NAME (Same a FACILITY NAME or DBA - Ooinq Buaness As) 3 CHEMICAL LOCATION 207 CHEMICAL LOCATION 202 ~ / ~~7 /J"- ~-2-~ /Vp c?T~j CONFIDENTUIL (EPCRA) ^ Yea ~ "° FACILITY ID No. t MAP No. (optlonaf) 203 GRID No. (ODtWnBQ 204 1V A ^/ A II. CHEMICAL INFORMATION CHEMICAL NAME 2~ ~ ~ kkkfff TRADE SECRET O Ya~NO / rN r w' b If S b t w EPC t - ~ n i C.~~ v~ R ~ u jec e ut b s COMMON NAME Z07 EMS' ^ Yes ^ No ~~ 208 CAS ~ 209 9f EHS is'Yss.' a0 amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete it roquested by kxel 8rs Utief) 270 TYPE 2tt D PURE ^ m MIXTURE ^ w WASTE 212 RADIOACTIVE ^ Yes No CURIES 273 PHYSICAL STATE 274 ^ s SOLID /~I uDUID ~ 9 GAS / , LARGEST CONTAINER ~i ~© (,y4L 275 FED HAZARD CATEGORIES ~t flRE ^ 2 REACTIVE ^ 3 PRESSURE RELEASE ^ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH 278 (CtNClc ~ ~ aPDl1) ANNUAL WASTE 217 MAXIMUM 278 AVERAGE 279 STATE WASTE 220 AMOUNT DAILY AMOUNT ~ DAILY AMOUNT CODE ~ A QQQ,,,~~~ l GAL ^ d CU FT ^ Ib LBS ^ fn TONS 221 UNITS" DAY i 222 ~ ~~ Aw 1f EHS. amaatt st bs in Ibs. S70RAGE CONTAINER ~a ABOVEGROUND TANK ^ t CAN ^ k BOX ^ D 7ANK WAGON 223 (CheGcatl~hatappy) ^ b UNDERGROUND TANK O q CARBOY ^ I CYLINDER ^ q RAIL CAR ^ e TANK INSIDE BUILDING ^ h SILO ^ m GLASS BOTTLE ^ r OTHER ^ d STEEL DRUM ^ i FIBER DRUM ^ n PLASTIC BOTTLE ^ • PIASTICMONMETALUC DRUM ^ j BAG ^ o TOTE BIN STORAGE PRESSURE ~a AMBIENT ~ as ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE a AM&ENT O as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS CAS.# 1 220 227 O Ya O No 228 - 229 2 230 231 ^ Yes ^ No 232 233 3 231 235 O Yes ~ No 238 237 4 238 Y!9 O Yes ^ No 240 241 3 242 243 ^ Yes O No 244 245 -... . . Iil. SIGNATURE - . .. '. PRINT NAME 8 TIT OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 248 - ~ ~ `---'~~~ D, c V 7 r _~~ _,''i-~......_.. CITY OI~ fic~I<ERSF[ELD - '~ ~-~-,*,~.rr, ti EP~R~ ` ° OFFICE OF ENVIROV~•IENT.~L SERVICES 17 `'~ _ . ARTM T 15 Chester f1ve., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form permatenal oerbuilding orarea) ~EW ^ ADD ^ DELETE L-7 REVISE 200 Page _ of ' ~ - I. FACILITY INFORMATION - . -- BUSINESS NAME (Same as FACILITY NAME or 08A -Doing Business As) - - ~~-- ~ ~ _ - - -~ ~ -- --- -- g CHEMICAL LOCATION 20 ~ CHEdICAL LOCATION CONFIDENTIAL (EPCRA) ^ Yes ^ No 202 FACILITY ID # ~ -'~ ----~- i - 1 MAP # (optionan 203- ~-GRID # (optional) - - - - 20a If. Ci1EM1CAL INFORMATION -_ -- - CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 j'1/(~) ~2 ~ t L 1` Subject to EPCRA. refer to instructions ' COMMON NAME --~ --_- ~ 207-----EHS' - ---- 3~'S•~~~ ~K~P ^ Yes ^ No 208 CAS # I 209 •If EHS is'Yes° ell amo°n[s below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 2~0 ---------------~-- - - ------ --- -----c _ _ TYPE ,PURE oo~00''m'' MIXTURE ^ w WA..-_ <~ : n-,UIOACTIVc ---~ ~ ^ Yes - ~NO-~----_-- 212 CURIES 213 PHYSICAL STATE ^ s SOLID ~rr•tIQUID ^ g GAS 214 t.ARGEST CONTAINER ~~ 215 FEO HAZARD CATEGORIES FIRE ^ 2 REACTIVE ^ 3 PRESSURE RELE.;SE _ c A lU-E HEALTH ^ S CHRONIC HEALTH 216 (Check alt that apply) ANNUAL WASTE 277 :d.4XIMUh•. 2i8 AVERAGE 219 ~ STATE WASTE CODE 220 ': AMOUNT DAILY AMOUNT S ~ DAILY AMOUNT 3C~ UNITS' ~qa GAL ^ d CU FT C Ib LBS LJ to TONS ~~ ~ DAYS ON`SITE 222 ' If EHS, amount must be in lbs. ~ 6S 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 STEEL DRUM Li h SILO ^ I CYLINDER ^ p TANK WAGON STORAGE PRESSURE ~a AMBIENT ^ as ABOVE AMBIENT ^ ba BELONJAMBIENT 224 STORAGE TEMPERATURE AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 .. ... ,. ,_.. ~- I °loWf HAZARDOUS COMPONENT EHS CAS # 1 226 227 229 ^ Yes ^ No 228 i 2 230 231 ^ Yes ^ No 232 233 3 234 235 ^ Yes ^ No 236 237 i -' 4- -------238"x=---~ _-=-..-'_-'-='--'--------=---'=---_-------------`-=--~9-. - ~ ---_..--..__. __241. ~..--. ^Yes "No 240-;-'--------~-" i I 5 242 243 ~ ^ Yes ^ No 24a 245 i ~ __ ;. _ ; . ,. ,_ III. SIGNATURE _ PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE _ _ - SIGNATURE ~- ~ ~ ~ - - ~~ - _ _ DATE 246 _' t - -- -- _ __. .- -- -_ -_- -- ~~~ - - =-~ ~ I-~~~i-==0 UPCF (7/99) _ S:\CUPAFORMS\OES2731.TV4.wpd ~~~ CITY OI~ t3AtiERSI~ [ELD .~-~- . M, . E R ' F ' ° OFFICE OF EN~'IROV~[E~TAL SERVICES 5 f~Re ~ 1715 Chester Ave - . ~RrM r ., CA 93301 (661) 326 3979 -••~ HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (ona form per material perGwlaing orarea_) ~EW V ADD ^ DELETE ^ REVISE 2CU Page _ of _ ffflff ______ I. FACILITY INFGRMATIQN _ _ ___ 9USINESS NAME (Same as FACILITY NAME or DBA - Darg Business As) ---- - 3 IN r ~ ~ "jrZ,JCfL {~ ~~ r/ t.JC~ JZ. CHEMICAL LOCATION ~ // 201 CHEtdICAL LOCATION f=~ 1 S r~` 5~ C,2•~1i2 ~ ~N` P ~ USG- ~ CONFIDENTIAL(EPCRA) ^ Yes ^ No 202 FACILITY 10 # ; ~ - - '~- , i -' - - i MAP tt (optionan 203 GRtD # (optrional) ------- - ----- _~-. ,.~. I 2(}a - I1. CHEMICAL INFORMATIGN 205 TRADE SECRET CHEMICAL NAME ~ ^ Yes ^ NO 206 j,,`f (ks ^~ O (~,- If Subject to EPCRA, refer to instructions ---- -- - --- - -.. - 207 .. _.. . ------------- --- ---- -- -- COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 'If EHS is'Yes,' all amomts below must be is lbs. _ _.. ( p equested Dy local fire chief) - - - -- - - ------ FIRE CODE HAZARO CLASSES Com lete if r 270 ---- ------------------ - - --- - TYPE -- - - _ -- -• ^ No 2t2 CURIES ^ p PURE ^ m MIXTURE ~.v WA£-= .. rZ-,C'IOACTIVc ^ Yes 2t3 PHYSICAL STATE ^ s SOLID ~IDUID ^ g GAS 2t4 LARGEST CONTAINER ~ t`~- 2?5 FED HAZARD CATEGORIESFIRE ^ 2 REACTIVE ^ 3 PRESS IRE RELEASE a :U-E HEALTH ^ 5 CHRONIC HEALTH (Check all that apply) 2t6 ANNUAL WASTE 2t7 :,A4XIMUM1' ~t8 P.VERA:,E ) r 2t9 STATE WASTE CODE ~G s O 220 DAILY AMOUNT / AMOUNT DAILY AMOUNT UNITS' .'~ga GAL ^ Li CU FT ^ 'b LBS LJ to TONS 221 DAYS ON SITE 222 ' If EHS, amount must be in lbs. STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIGNONMETALLIC 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 STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON STORAGE PRESSURE ~a .4MBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE Ali' a AMBIENT ^ as ABOVE AMBIENT L-I ba BELOW AMBIENT ^ c CRYOGENIC T ~ 225 HAZARDOUS COMPONENT EHS ~ CAS # %1Nr t 226 ; 227 ^ Yes ^ No 228 229 2 230 ~ 237 ~ ^ Yes ^ No 232 233 3 234 ~ 235 ^ Yes ^ No 236 i 237 . q ._T _ ...- _ -- --- 238 '- - - ---- ---__ ...-- ---- - -- 239. _ _ _. _ - - i i -- Yes No -~240~ ~--~-- - - i 241... i 5 242 i 243 ^ Yes ^ No 244 _~ -----_ _-----. _._ .__ _...____ ___ -_ __--- --- . . .... _......__-__ .. .... . . ... ..: _.. .---- --- ---- .._-..--------------- 245 -- III. SIGNATURE _ - _ __ _ ___ __ _-_ ~~Z_4_ _ ___ ______ __ ~ ~ ~ ` ~~ ~ ~ ` ~ t SIGNATURE PRINT NAME 8 TITLE OF AUTI-fORIZED COMPANY REPRESENTATIVE DATE 2a6 UPCF (7/99) S:ICUPAFORMS\OES2731.TV4.wpd . i - :1 Prevention Services UNIFIED PROGRAM.INSPECTION CHECKLIST a . r: R s >: , ~ 900 Truxtun Ave., -Suite 210 F~Re Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "RTM Tei.: (661) 3zs-3979 ' ~ Fax: (661) 872-2171 - FACILITY NAME INSPECTIOMDATE INSPECTION TIME I ADDRESS ,PHONE NO. - ~NO O MPLOYEES j 'L ~ X2'1 -OCOI o I. FACILITY CONTACT BUSINESS ID NUMBER - ~~ ~ ~ s S' , ~ 15-021- Qp2 ~~ i __ __ i Section 1: Business Plan and Inventory Program `~ ~ ~~~ ~ __ - - - '~f ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION c: C ~ C=Compliance OPERATION~N V=Violation ~t~ _ - ~ X006 COMMENTS i ^ APPROPRIATE PERMIT ON HAND i B It1@SS PLAN CONTACT INFORMATION ACCURATE' VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY ^ ,VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ ^ i VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL I VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ C ,A Q y' ~ ~~_ ~ ~~ EMERGENCY PROCEDURES ADEQUATE '' ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING FIRE PROTECTION \ ~ ©~ ( f I^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: v ~i QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 ~ ~ ?mss s~~- .~1 ~nr ~y Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) ^ YES C~YNO White -Prevention Services 'Yellow -Station Copy Pink -Business Copy FD 2155. (Rev-.09/05 d ~~ FIRE PREVENTION INSPECTION >I E R S F I L D F/RE ' ARTM ! BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 - Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT _ ~ ` t.~. .3 "~' ~~ ~, BLOCK NO. _, DATE ~ ~ -. ` t }3 ~~ 6u EE FACILITY ADDRESS- r,,. t CITY, STATE; ZIP ~ !. I ~ _ FACILITY NAME {g "'" ~ ~` _ MANAGER'S NAME ' FACILITY PHONE NO. ~` '+ R'S NAME AND ADDRESS E ~ ~ ,r° BUSINESS OSW~N ~ r' - ! ~ ~ ~ CITY, STATE, ZIP r OWNER ~ ~ NE NO . i{ ~~ S A ~ f ~ ~h t~?R' t' -~ J V f ~ t ~ ~ BILL TO: (IF DIFFERENT FROM ABOVE) NAME, iADDRESS,~+ I CITY, STATE, ZIP, BILLING PHONE NO. . OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG ~,~ fr `~~ RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS CHECKED BELOW No. COMBUSTIBLE WASTE I DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.,).~ ~ VEGETATION Provide non-combustible containers with tight fitting lids for the storage of combustible waste- and-~rubb )sh pending its 2 l ` safe disposal. (U.F.C.) i ~ (L',L~'( COMBUSTIBLE STORAGE 3 v: Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/Mire door (N.E.C.) (U.F.C.) ~~ `qa Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top'.;fq,the • i (;A extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) ' •. EXTINGUISHERS 5 Provide and install (amount) _____ approved (type & size) __________________ portable fire extinguisher to be' immediately accessible for use in (area) _____________________________ (U .F.C.) ~` ~ Re-charge all fire':extinguishers. Fire extinguishers shall be serviced at-least once each year, and/or after each use, by a person having a valid license or certificate. (U.F.C.) a 4 } ~,/ ~ I ~ 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in`tieight over each required eicit.(door/window) to SIGNS fire escape. (U.F.C.) ~~~~) ~ ~ ~' R ; Provide and maintain appropriate numbers on a contrasting background and visible from the street to 'indicate the '~ correct address of the building. (B. M.C.) (U.F.C.) f y /~~ ' g ' . __________________________. Plastering Repair all (cracks/holes/openings) in plaster in (location) __ ___ __'~_ FIRE DOORS/ S i _ ~ shall return the surface to its original fire resistive condition (U.B.C.) FIRE SEPARATION ~ - 10 ~ ______________. Self-closing Remove/repair (item 8 location) _________- _____ _ ______ ________ _ doors shall be designed to close by gravity. or by the action of a mechanical device or by an approved smoke and ~ heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the closing device. (U.F.C.) ~ Exlrs 1 11 i Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.) i ! ~ 12 Provide a contrasting colored and permanently installed electric light over or near required exit (location) ~ _________________ to clearly indicate it as an exit. (U.F.C.) STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire escapeslstair shafts are to be maintained free from obstructions at all times.) (U.F.C.) ~ 14 Extension cords shall not be used in lieu of pe`manent approved wiring. Install additional approved electrical outlets ELECTRICAL APPLIANCES where needed. (N.E.C.) (U.F.C.) ~n r 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N.E.C.) (U.F.C.) OUTDOOR BURNING 16 .Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREWORKS .-t7 ~ v Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Cade B.M.C. re ardin fireworks. OTHER 18 ~ ~.----- ~s..-,ti g .Ld-~- ~c~ ' ~ Ui ,rn-~%o n (~' O . ~P C~ f - (.~, ~ ~~ o .~,,.. ~,, o w ~ i vG(Gl mss,, ` T a v,,1`~,. ~~/ - ~~' fv A t P ~ ~A.J 't / u'3'~'~' 6 _ cr ~P 7W ~~t~ F iC'1"1 j s USTOMER: ~" ~'' " ~'" ; : ; j -~ )i"~ i~f r+l ~` ~~'-"-`T ~~ LEGEND: C.F.C. CALIFORNIA FIRE CODE .e,~(Signature) (Please Print Name Legibly, Tltle) U.B.C. UNIFORM BUILDING CODE ~~'~~ t! B.M.C. BAKERSFIELD MUNICIPAL CODE INSPECTOR ~'" '\il! ~ ~ AP NO.: N.F.P.A. NATIONAL FIRE PROTECTION (SlgflatUre) ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE KtlF-73GU White - CustomerlOriginal Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)