HomeMy WebLinkAboutBUSINESS PLAN (2)~,.
.~
~:
"~
3
o
O M ~ ~ '-
~ ~ O~
o,
UNDERGROUND STORAGE TANKS .~`"..~- - BAKERSFIELD FIRE DEPT.
$ g ~ ~ ~ ; n Prevention Services
FIRS
,IKEA/ f 900 Truxtun Ave., Ste. 210
APPLICATION .~. Bakersfield, CA 93301
TO PERFORM ELD /LINE TESTING Tel.: (661) 326-3979
/ SB989 SECONDARY CONTAINMENT TESTING Fax: (661) 852-2171
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION Page 1 of 1
PERMIT NO. ~ D ~ `O
^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING
^ TANK TIGHTNESS TEST ~ TO PERFORM FUEL MONITORING CERTIFICATION ^ Cathodic Protection Testing
SITE INFORMATION
FACILITY READY GO MARKET NAME ~ FHONE NUMBER OF CONTACT PERSON
I
I ADDRESS 1600 VALHALLA DR I
OWNERS NAME Same
OPERATORS NAME Same PERMIT TO OPERATE N0.
I
NUMBER OF TANKS TO BE TESTED ~ IS PIPING GOING TO BE TESTED ^ YES ^ NO
TANK # VOLUME CONTENTS I
1 87 UL
2 I 91 UL I
I
~ I
TANK TESTING COMPANY
NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341
MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308
Bruce W. Hinsley 661-327-9341 CERTIFICATION #: 223613761
I
i DATE 8 TIME TEST TO BE CONDUCTED NOVemI)er 2O, 2007 08:00: ICC #:
//~~ q~~~ ~p ~ 106447- T
SIGNATURE OF APPLICANT A~~ZI~- w ~tTh~1 DATE OCt 16, 2007
APPROVED BY ~_ i .- ~// ~~ / c.~-,/ DATE I
FD 2095 (Rev. 09/05)
+ READY GO MARKET _______________________ ______________ SiteID: 015-021-001394 +
Manager BusPhone: (661) 835-8518
Location: 1600 VALHALLA DR Map 123 CommHaz Moderate
City BAKERSFIELD Grid: 02C FacUnits: 1 AOV:
CommCode: BFD STA 07 SIC Code:5541
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
HAN MO CHUNG / DENNY /
Business Phone: (661) 835-8518x Business Phone: ~~x
2 4 -Hour Phone ( 6 61) x 3~3-~~~ 2 4 -Hour Phone (d~Gl ) 3'13 - ~~~~ x
Pager Phone (661) 373-6877x Pager Phone ( ) - x
Hazmat Hazards:
Contact Phone: (661) 835-8518x
MailAddr: 1600 VALHALLA DR State: CA
City BAKERSFIELD Zip 93309
Owner HAN MO CHUNG Phone: (661)
Address _ 133~~ ~r~ t,:,~e~Ce ~L State: CA ~ ~3"'~tg'~+f
City BAKERSFIELD Zip ~ ~~~
Period to
Preparers
Certif'd:
ParcelNo:
TotalASTs: _
TotalUSTs: _
RSs: No
Gal
Gal
Emergency Directives:
PROG A - HAZMAT.
PROG U - UST
ENT'D JUN ~ ~ 206
6
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 complete. _
Signature Date
-1- 05/26/2006
i-
c
't
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY ME
o ~~-- INS CT ON DATE I INSPECTION TIME
N
f E
l
P
N
ADDRESS ~
~~--- --- -- -- --- ~ mp
oyees
o. o
oo.(7a ~
H11 N
~ bJ ~ tl ~ -~ --------
FACILITYCONTACT Business ID Number
15-~ZI-
Section 1: Business Plan and Inventory Program
^ Routine ~mbined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection
C V (C=Compliance) OPERATION COMMENTS
`V=Violation
~^ A
PPROPRIATE PERMIT ON HAND
(
Y
^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
~
f
LJ ^ VISIBLE ADDRESS
t~/ ^ CORRECT OCCUPANCY ~
~^ V
ERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
[~^ PROPER SEGREGATION OF MATERIAL
~
(
^ VERIFICATION OF MSDS AVAILABILITYE
T VERIFICATION OF HAT MAT TRAINING
-
-
-
^ --------------- ---
------
- - ---------------------r------------- -------
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~^ EMERGENCY PROCEDURES ADEQUATE
L~J ^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING ~
----- ------- --------- ----- - -
~/
LJ ^ FIRE PROTECTION -- -----------
A
O
H
l~ U AND
SITE DIAGRAM
DEQUATE 8c
N
ANY HAZARDOUS WASTE ON SITE: ^ YES ~NO
EXPLAIN:
QUESTION REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66~~ 326-3979
Inspector Badge No Business Site Responsible Party
White -Environmental Services Yeltow - Slatbn Copy Pink -Business Copy
ff
L
Y
,~'~~,~,. .~~~\ CITY" OF BAKERSFIEI.U FIRE DEPARTMENT
~~ ~ / M~ OFFICE OF ENVIRONI~~iENTAL SERVICES
~ y~` UNIFIED PROGRAM INSPECTION CI~ECKLIST
\'__•t~ ~Rti,,~'~+ 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301
,.,~~
FACILITY NAME ca~,~ O INSPECTION DATE
Section 2: Underground Storage Tanks Program
^ Routine ~ombined _ ^ Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection
Type of Tank ~~~5 Number of f1'anks ~ _
Type of Monitoring _~`/_ f.Bti Type of Piping bU1('
OPERATION C V COMMENTS
Proper tank data on file
Proper ownerloperatar data on file
Permit fees current
Certification ot~ Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes _ No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S)
Tvne ~f Tank
AGGREGATE CAPACITY
Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding!labeling
[s tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection'?
C=Compliance '=Violation Y=Yes N=NO
0~
i
;'
c
Inspector:
Office of Environmental Services (661) 326- 9
\4'hitc - ~m~. Svcs.
B ss Site Res Bible Part
Pink -Business Ci~pv
.,- - ~. .:. .. f:
/ t. - ~..- ... . , .. .. - ~
... ` ~ Bakersfield Fire Dept.
UNIFIED PROGRAM INSPECTION CHECKLIST Enironmental services
1715 Chester Ave
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 9330
Tel: (661)326-3979
's
FACILITY ME I
~~--- --- ------ ---- ----~ INS~j CON DATE I INSPECTION TIME
--
'~ 1~ 2' -~---
of Em to ees
No
PH N N
ADDRESS p y
.
o.
~-~-- --
FACILITYCONTACT Business ID Number
~ 15-021- /~~
Section 1: Business Plan and InventoryProgram
^ Routine L~mtiried ~ ~ O Jo nt Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection
C V ncel OPERATION
t COMMENTS
on
\V=Vioa
- -
-~_-_
^ APPROPRIATE PERMIT ON HAND ____________
/
D/ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
,,.. /
LTV ^
CORRECT OCCUPANCY i
~
'~ ~ f
~^
TERIALS
V -~.+s~
u
ERIFICATION OF INVENTORY MA
^ VERIFICATION OF QUANTITIES
~-
---
- --- -- ----- - -------- ------
1 --
CJ
^ ------ ----------
VERIFICATION OF LOCATION ~
---
~
~
L~J L^. PROPER SEGREGATION OF MATERIAL
---
^ VERIFICATION OF MSDS AVAILABILITYE ~1~
-- ---
!a
/ ~p
~
~
~
U U
----------- -
VERIFICATION OF HAT MAT TRAINING
-----f--
~: -
,
-
-
-
-,
~84s ----- -
^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ;
---------- --
J
L~J ^ - - ---------
EMERGENCY PROCEDURES ADEQUATE ----
^ CONTAINERS PROPERLY LABELED
- - ------- ---F--- --- --------- --------..
^ HOUSEKEEPING
LI ^ FIRE PROTECTION
H
O
A
S
L~J U N
AND
DEQUATE
SITE DIAGRAM
~
ANY HAZARDOUS WASTE ON SITE: ^ YES ~NO
EXPLAIN:
.~
~:.
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979
,'
Inspector Badge No Business Site Responsible Party
White -Environmental Services Yellow -Station Copy Pink -Business Copy
_ _ _ ~ .__ R . ~~
4~~t~-
;.~ ~ ~ }.~
~i~4~tiLD pl~
~t'~~ i ~~~ CITY OF RAKERSFIELD FIRE DEPARTMENT / I
~~ 1 ~ ~~ OFFICE OF ENVIRONI\~IENTAL SERVICES
yr' UNIF[ED PROGRAM INSPECTION CHECKLIST
~ \'__•cir ~~j,//'~r 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301
~.~~i
FACILITY NAME ~ea~~ ~p0 n\~ ~'" INSPECTION DATE C ! •~
Section 2: Underground Storage Tanks Program `•
~.
^ Routine Combined _ ^ Joint Agency ^Mu1ti-Agency ^•~Complaint ^ Re-inspection
Type of Tank ~~ 5 Number of Tanks ~. _
Type of Monitoring ._C`LP~- Type of Piping ~~d9 ~'
OPERATION C V COMMENTS
Proper tank data on file
Proper owner;operator data on tilt
Permit tees current
Certification of Financial Responsibility
Moliitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S)
Tvne ~f Tank
AGGREGATE CAPACITl~'
Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding!labeling
Is tank used to dispense MVF?
If yes, Does tank have overtillioverspill protection'?
C=Compliance V=Violation Y=Yes N=NO
i % '
Inspector:
Office of Environmental Services (661) 326- 79
~'l'hitc - inv. Svcs.
Busin~t~s Site Resp nsible Party
Pink -Business Cody