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Home My WebLink AboutBUSINESS PLAN (2)~.. r~ 0 ~~'~~ f~ i ~. VOWS FUEL CTR BKFD #2512 2100 WHITE LANE ,~ I` i~) '"r '.'t' ,J ~a ,@ ;~ i' :a ,~ FEB-15-2007 13:26 VONS NON PERISHRBL(r s ~E ,~ i 9 ~) 1 r 6268217984 P.O2t91 Owner Statemeats a~'Desiggated Undound Storage Tat~~k {UST} C?perator aoci Undezstanding of ~d Compliance with USA' Xi,etluiremeats Faa`liryName~ SAPEWAYlV4NS #ZSIa F~ailiryID#k 152858 Facility Addteaa: 210Q wi~'~ LADS HATS,ERSFLFLD, CA 933Q8 ltrasoa for $ub~titLiug 9~ia Form (C16eck One!? ®Chsflge of Operator Feicili{Y Fhcae (k b6139f~0161 7L-1219 n Update iCir # aadlor a bnto ~J_r~. 19M1r(w..w71 l)e~i,~ated___,_UST (?t>e]r~tc~r(s~ 1 far t~ut® Phcil~ty Desi~tsbxi 4pexamr'a Name: 7oha RWa'kat Rrldivn ~ U32' Faali~y {CT~c Om~ Bn6inasp NeamEO ~d{',~e~e franc abm~rf: I~ oatadr ~ ^ ~ployea Desig}~ateri Upes~sF'hont#~:818-997{981 inegnational Code Lbuual CmtiSceliom #: Sz7AZ88•UC O Savic:a~'oC~oici~ I$i '17~ird ~~ty won Detx 03%09/z008 ALTirrRbiAT~ x t~ 1?aei~tad Cis Hama Tom Mascots Dt~aigatttadOpere2as's Pbpae#: 81$-992-8981 Iataaatioasl Colo Ccon~ Ce-~lf"icetion fk 5Z6919f~UC a~+~,T~ a (~ 11G$ ik~i~afied Qperetm'a 339mC: Sealdss 7~ttarelgn Bttsiaeas Name (~{d~*e~ffromadotrd: l7cttgaatcd Oparetor'sPbaaa#: B18 992-B981 Taternafioaal Cado Ctnme~ Ctrtificatiafl ~_ 5238439-j1C Relatiaa m LT6T Feallty { orb o owatr o opeaanor a Etnglayee o Setvietz Taa'ttndciaa ®T~d-Pmfy ExplrAtion Data 11J17R007 ' Rdffiicnto UST Facility {~+~ Dne} ~ Owner ~ Qpeasrar d Employee D Service Te~nicaaa -~ "ffiu,d PtteRy >~tpirattozr Date: OTl09lL0a8 Z testify that, for the faciZit~ zadicated at the tog of tYuis page, the iadividv~al(s3 listed ' above will s~-e3 as DesigQatexl UST Op~.ator(s). 'The indivxdtlal.(s) will conduct at~ci docamaeot aaont~ily facility iuspectioxas a~ armual fari]ity e~ployae tceiniag, in li accordaace ^ Caiiforaia Code ofRetticras, title 2~, sectiau 2715(c) - (fj. ~'urthelnonore, I tratkerstsnd aad axa 3n conap~eae with the re~ex€x'emenfis ($tatute9, ~, t`egalal~on8, anal local ordhtanoes) $ppIlcable to motdergrol~ad stArage tanks. 1~~ a>z ~rAxx awrr~ (p'leare P oN$ - SCOxT L1~R SIC~IA,TU~ aF TANK OWNER: nA'~o 211,5/200'7 o~svlv~x~s ~sarr~ ~: (62~ Z55-684A `~ ; r' ~,;~ > , ,.. ,S,~~s `.':~', ~l Y1 ,,"'7, ~~~~~ak ,~~~~;~ ,f`~Y`,N~r ~~,I a~ y L, ',Y.1 ~ `~+f "~; . } ~~~ ,,~r~ `;'i;"~ ~4;y ~,~ r; ~, . r.,,,;~ ~~ ~-,~: hdwy~ ND'v~mbar 2004 '~fj :, ; TOTAL P.01 .,~- c Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements -continued ALTERNATE 3 (Optional) Designated Operator's Name: Kevin Watermolen Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 916-212-7973 ^ Service Technician x^ Third-Party International Code Council Certification #: 5250470-UC Expiration Date: 12-21-2008 ALTERNATE 4 (Ootionall Designated Operator's Name: Jessica Tuttle Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 831-537-7663 ^ Service Technician ~ Third-Party International Code Council Certification #: 5286530-UC Expiration Date: 07-03-2008 ALTERNATE 5 (Optional) Designated Operator's Name: Jim Palmer Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 831-840-5235 ^ Service Technician x^ Third-Party International Code Council Certification #: 5254109-UC Expiration Date: 2-21-2007 ALTERNATE 6 (Optional) Designated Operator's Name: Brian Ellsworth Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 707-815-2511 ^ Service Technician ^D Third-Party International Code Council Certification #: 5263224-UC Expiration Date: 7-7-2007 ALTERNATE 7 (Optional) Designated Operator's Name: Aaron Celaya Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: S10-364-0385 ^ Service Technician O Third-Party International Code Council Certification #: 5246905-UC Expiration Date: 01-20-2007 ALTERNATE 8 (Optional) Designated Operator's Name: Darrell Riley Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 619-206-8379 ^ Service Technician ~ Third-Party International Code Council Certification #: 5248975-UC Expiration Date: 11-29-2008 ALTERNATE 9 (Optional) Designated Operator's Name: Darren Austin Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 858-699-2751 ^ Service Technician O Third-Party International Code Council Certification #: 5250436-UC Expiration Date: 11-11-2008 ALTERNATE 10 (Optional) Designated Operator's Name: Eric Banghart Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 310-467-2529 ^ Service Technician ^D Third-Party International Code Council Certification #: 5250118-UC Expiration Date: 11-9-2008 ALTL:KNA'1'E 11 (Optionap Designated Operator's Name: Blake Herness Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 951-288-1519 ^ Service Technician D Third-Party International Code Council Certification #: 5249180-UC Expiration Date: 12-12-2008 ~~~sa-R~a .~,~ VEEDER-RCIOT January 19, 2007 BAKERSFIELD FIRE DEPARTMENT -PREVENTION SERVICES 900 TRUXTUN AVENUE SUITE 210 BAKERSFIELD CA 93301 Re: Gilbarco Veeder-Root Address Change - --_ - _ - _ }~Y _ -_ __ To Whom It May Concern: Gilbarco Inc. Attn: CMS Mailstop F-76 7300 West Friendly Ave. PO Box 22087 Greensboro, NC. 27420-2087 www.gilbarco.com www.veeder.com Please note that Gilbarco Veeder-Root Compliance Management Services will be relocating operations from Lakewood, CO to Greensboro, NC effective February 1, 2007. Update your records with the following new contact information: Mailing Address: Gilbarco Inc. Attn: CMS Mailstop F-76 7300 West Friendly Ave. PO Box 22087 Greensboro, NC. 27420-2087 Phone Number: 800-253-8054 -- ~- - - =- --- ---~ - -~ -- - -- -- -- ---. _. .. ~ 4 -- ---- .___ . ~~- ~ ~~Fax~Num -er: 336-547-3384 Again, the above contact information is effective February 1, 2007. Thank you for taking the time to update your records with this information. Do not hesitate to contact me with any questions. Sincerely,, Kristopher A. Kohrt, Director Gilbarco Veeder-Root Regulatory Administration, UST Compliance Services, USTMAN® SIR ,~. COfi BAKERSFIELD FIRE DEPARTMENT -PREVENTION SERVICES 2512 Safeway -Vons 2100 White Lane Bakersfield CA ' 2512 Safeway -Vons 2100 White Lane Bakersfield CA 2512 Safeway -Vons 2100 White Lane Bakersfield CA Page 1 - . --'___-- - - - -._ _._ .~ -__ -~__ ~. - _r- - - - ~ - .. r- BAKERSFIELD FIRE DEPT. ~~ Prevention Services / ~~ FIRE PREVENTION INSPECTION a ~F~RE I D 90o Truxtun Ave., ste. 210 ARfiN T Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT BLOCK NO. DATE / ~ f]; t^ EE FACILITY ADDRESS y^ti Q ~ ~ s\ " } 1, ~ CITY, STATE, ZIP '-----~ tom V~. V ~ ~ ~ ~JCJ FACILITY NAME } ~ ~~ 4 ~ ' ` MANAGER'S NA E , ~ FA-C~I ~ ~~PHONE)NOr ) dd BUSINESS OWNER'S NAME AND ADDRES CITY, STATE, ZIP ~ O. OWNER'S PHONE N BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO. OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS ~n CHECKED BELOW No. a C MBUSTIB ASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) O LE W VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (U.F.C.) COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse boxlfire door (N.E.C.) (U.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on_brackets with the top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) EXTINGUISHERS 5 Provide and install (amount) ~.__ approved (type 8 size) ___ _ ____~/!_s < portable fire tinguisher to be I ~ ~ immediately accessible for use in (area) _____________________________ (U.F.C.) ) ~„~ . ~ ~~ - g 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.) 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in h ht over each required exit (door/window) to SIGNS fire escape. (U.F.C.) g Provide and maintain appropriate numbers on a contrasting background and visible fro tr ndicate the correct address of the building. (B.M.C.) (U.F.C.) g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering FIRE DOORSI FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (U.B.C.) 10 Remove/repair (item & location) _ .. ________________. Self-closing ---------------------------------------- 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.) ) EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.) 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 permanent approved wiring. Install additional approved electrical outlets ELECTRICAL APPLIANCES g' where needed. (N.E.C.) (U.F.C.) 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 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 ~ ~ 6 ~ ~ r/ ~ J ~. !' ~ ~ _x~ >n C,. ~ O °° _ ~ -~ ~ Z~ a ~ ~ tk~- ~ ~- r,1~ - yy~ : ^~,.,./e ~, / ' ~ Q ;y~.--- CUSTOMER:` ~' LEGEND: , ~ ; ... (Signature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE U.B.C. UNIFORM BUILDING CODE J INSPECTOR: -~ ~~~-ld----.___ AP NO:~'~ V ~''/ ~~~~~ ~ B.M.C. BAKERSFIELD MUNICIPAL CODE N.F.P.A. NATIONAL FIRE PROTECTION ~'• ~ za u~:~,, (Signature) ASSOCIATION {: , ~ N.E.C. NATIONAL ELECTRIC CODE Ktlh-7310 !+ White`- Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05) • ~j. .... ~ .. . BAKERSFIELD FIRE DEPT. FIRE PREVENTION INSPECTION • e EF~RE' D Prevention Services ,13~ ~RSM t 900 Truxtun Ave., Ste. 210 ,/~( Bakersfield, CA 93301 {' y Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT BLOCK NO. DA d ( EE E+°/ FACILITY ADDRESS \~ ~ ~ ~~ C~ ~. cITY, STATE, ZIP~~k ~ ` L ~ W C ~ FACILITY NAME ' MANAGER'S NAME / FA~L~~ P ~ONE~N' . Uv ~ (~ ~ ~. S .. (i BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP OWNER'S PHONE NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO. OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS wo~~riox REQUIREMENTS CHECKED BELOW xo. MBUS STE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) CO TIBLE WA VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (U.F.C.) COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the 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.) g 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.) 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to SIGNS fire escape. (U.F.C.) g Provide and maintain appropriate numbers on a contrastin b ~ kgr n vigibl~ ~p~the street to indicate the correct address of the building. (B.M.C.) (U.F.C.) ~ ~~oo g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering FIRE DOORS/ FIRE SEPARATIONS Shall return the surface to its original fire resistive condition. (U.B'C.) 10 Remove/repair (item 8 location) _________________________________________________________. Self-closing 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.) EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.) 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 shaf~s. (Fire escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.) 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets ELECTRICAL APPLIANCES where needed. (N. E.C.) (U.F.C.) 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 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 ~. m~ Ste. pC mV ~ .. ~, ~ h S )< ~')"~ ,~ v. yc,~. ~ c ~ ,`y tk_, , ~~GV _ ~'~.t1 S-)-c\ ,.. _ ~ ~. Owl' a.,~~. ,-( ~ _,) . ~~. J d ~ fJ..- d Q 3a CUSTOMER: LEGEND: ____ C.F.C. CALIFORNIA FIRE CODE (Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE `~ INSPECTOR: L~~'_.2-~--' ~_~ AP NO.~~''~-'~V '~J B.M.C. BAKERSFIELD MUNICIPAL CODE N.F.P.A. NATIONAL FIRE PROTECTION (Signature) ~ ' ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE /, White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05) UI~FIED PROGRAM INSPECTION CHECKLIST ~' .SECTION 1. Business Plan and Inventory Program BASERSFIELD FIRE DEPT Prevention Services a p ~/t~ 900 Truxtun Ave., Suite 210 ~~>rr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NA/ME / ~ l ~ t NSPECC~TIO /D AT r ~ INSPECTION TIME ~ ~ 7 / f. S I Z ~ C.9v~5 g~~1~Oty Yd ~~ - to C~10 / ADDRESS 2, t,c90 W>±~-t r~ c~ HONE NO. O OF EMPLOYEES FACILITY CONTACT ' '' USINESS ID NUMBER 15-021- ~ Z 17 ~.t-(C~t-Y ~ ~d~ E Section 1: Business Plan and Inventory Program ___-~j5 ~~ °~~ ~ - ^ ROUTINE COtu~BINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND BUSIni3SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ~~ Q ~ ~11~~ f ~ ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ A~J ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~ ^ VERIFICATION OF HAZ MAT TRAINING / Q~J ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ~' ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ~ES ^ NO EXPLAIN: 1~37~ tn1Y1-Z-2 (~~0(,/°~/r=, f~'c.cyM _TiM!IC '-~~'Tir~r ------------ - QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL U8 AT (881) 328-3979 Inspector (Please Print) Fire Prevention / t" In / Shitt of Site/Station k ~~ ~-t. Business Site/Sch ' e esponsibte nY Pleas int) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2019 (Rev. 021051 ~, INSPECTIONS BUSINESS PLAN 8~ INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST B ~ R S F I L D F/RE ARTM T FACILITY NAME: ~C~~ 5 (9AS ~ 2SIZ Section 2: Underground Storage Tanks Program ^ Routine Combined ^ Joint Agency ^ Multi-Agency Type of Tank [~1AS2t-G-tr Number of Tanks Type of Monitoring '(a/S - 3Sp Type of Piping BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 INSPECTION DATE: `~ (~~orG ^ Complaint ^ Re-Inspection '~ W F OPERATION C V COMMENTS Proper tank data on file /u~~TClL~~1CY C ~~27, QI'/ Proper owner /operator data on file Permit fees current Certification of 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) Type of Tank Aggregate Capacity 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 overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: `~-~l~r"S Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Business Site Respo s le Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) ~:-. -« ~0~~`- -~~`~ CITY OF BAKERSFIELD FIRE DEPARTMENT e ~~ z~ cA4 FACILITY NAME ~O~S (SAS Sm~-no.J ~ ZSI Z INSPECTION DATE 9 ~~° (~ ~ Section 4: Hazardous Waste Generator Program EPA ID # ~~ ~- OOd 27z 1 ~ ~ ^ Routine ~ Combined ^ Joint Agency ^Multf-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made C~'ASJI.~~c ~ W/~S`rE ~ATC-~Z EPA ID Number Authorized for waste treatment and/or storage ~,-~ ~ ~~,~ ~~ p~~ ~,~ s Reported release, fire, or explosion within 15 days of occurrence ~ ~! ~. Established or maintains a contingency plan and training 7E~i~is,~rC~ ~Pl~rz,q~ P~j,hpGD Hazardous waste accumulation time frames ,/ ~ ,k~, ptC! v-+~rn A r~o:/ C~ ~ (0 06 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 ,C ~U ~~ ~~,,,,~ Conducts daily inspection of tanks /up t.~AS ; t: -t-n~„~ KS Used oil. not contaminated with other hazardous waste /~ A Proper management of lead acid batteries including labels ~ Proper management of used oil filters n/ ~ Transports hazardous waste with completed manifest ,/ Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~=~ompi~ance ~ wt=vtotat~on Inspector: Wl~~s Office of Environmental Services (661) 326-39'79 White -Env. Svcs. ~ OFFICE OF ENVIRONMENTAL SERVICES • P~ UNIFIED PROGRAM INSPECTION CHECKLIST '~ ti 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 Pink -Business Copy ~r Business Responsib arty n LJ T~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES . ~~ UNIFIED PROGRAM INSPECTION CHECKLIST w ~gti,~ 1715 Chester Ave., 3`d Floor, Bakersfield, CA 93301 FACILITY NAME ~~~s a 5~ ~ ADDRESS ?ate ~~ ~~ ~ FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program INSPECTION DATE - /~ ° c~ PHONE NO. 396 - ©i5/ _ BUSINESS ID NO. 15-210- l d'( ~ ! NUMBER OF EMPLOYEES ~~ - ~`/ X7371 Routine ^ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection • OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address ~ ~N ' Correct occupancy Verification of inventory materials Verification of quantities X Verification of location X Proper segregation of material X Verification of MSDS availability X Verification of Haz Mat training X Verification of abatement supplies and procedures ,X Emergency procedures adequate Containers properly labeled X Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~es No l~~i'dt Explain: l~ • Questions regarding this inspection? Please call us at (661) 326-39709 %~ Site Responsible Party c White -Env. Svcs. Yellow -Station Copy Pink -Business Copy Inspector: ~ 'J ~~/~ UNIFIED PROGRAM INSPECTION CHECKLIST; .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a Prevention Services ~I~a 900 TYuxtun Ave., Suite 210 ~Rrr s Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~. ~L~illS f~~l ~~' 2£~~- ~~~~ NSPECTION DATE ~~ Z-~ NSPECTION TIME ~~,IorS~ ADDRESS d(j HONE NO. O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER 15-021- / Section 1: Business Plan and Inventory Program ^ ROUTINE MBINED ^ JOINT AGENCY ^ MULTI-AGENCY , ^ COMPLAINT ^ RE-INSPECTION C V (~-~°"'Plia"~) OPERATION V=Violation COMMENTS O APPROPRIATE PERMIT ON HAND .~ . ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~! ^ CORRECT OCCUPANCY C~- ^ VERIFICATION OF INVENTORY MATERIALS / ~. ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION l~'1 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY -•~- ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ' ~" ^ EMERGENCY PROCEDURES ADEQUATE /Q~~ ^ CONTAINERS PROPERLY LABELED ' ^ HOUSEKEEPING ' ^ FIRE PROTECTION ~~/ " • ^ SITE DIAGRAM ADEQUATE & ON HAND ,~ ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: ._ DU STIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-3979 In pector (Please Print) Fire Prevention / 1" In / Shift of SNe/Station q Business Site/School ' e esponsible Party (Please Print) White -Prevention Services Yellow - 3letion Copy Pink - Buaineae Copy FD2048 (Rev. 02105) ~- +'~~` '~~ ~ CITY OF BAKERSFIEL.U FIRE DEPARTMENT 6 ~ ~ ro OFFICE OF ENVIRON1~~iEN1'AL SF,RVICES yp~ UNIFIED PROGRAM INSPECTION CHF,CKLIST _w ~ gti,,!'A 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME ~~G3liJS Fug( ~~iL/Z~/L` INSPECTION nATE~2 C>~j Section 2: Underground Storage Tanks Program ^ Routine ~.Gombined ^ Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection Type of Tank L~rU~I~ r~~~.4~ I Number of Tanks ~~ Type of Monitoring ~~ Type of Piping %kcs~l~ OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data un file Permit fees current Certification of 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 ~"--~•- Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/laheling Is tank used to dispense MVF? if yes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: ~/l.l <~-~/~-Z/¢ -~... Office of Environmental Services (661) 326-3979 Business Site es onstble Party white - fnv. Svcs. Pink -Business Copy .~ '!~t~ ~.. !'~ v 21UU b.1HLTE L.~I'dE Br}:EF' ;F I ELL? C ri . 6~.1- _9G-ii 191 FEB 2~. cGLir, 1 CI : Di ~ Fi("1 S'r:1 F t ;':kT hLl_ i 1r~;L I P~J'~.+'E P•JT S t T I:kEGUL~t' VCiLUt°lE - 6gh5 iShL~ IJLLr~i=~E i 4~]8G ~=~~L 1 9Q"£, ULL~i=F - 12Q1~SI] i;:hL: Z'i~ 1?~?LIIP'11= = 5'?61 ~=~~L:= HEIGHT = 4U.20 If'•Jt'.HEF_~ I,,Ir'iTEk 1?+L = Ci C~AL:~, l+Jr~TEk = Li . LII i 1 Ni'HEti TEI9P = ~~ 1 . i i L?E~'~ F T 2:F'LUS VULUJ°lE = 721 y GtiLS ULLr~:~E _ '~'~l o GrLE '~0`~ ULLi=ii ~E= l E 14 i;AL T~' ~?;JLUN1E = r l ~? i_ar~LE HE I%HT = 8u . ~? I Mi'HES WFiTEk +Ju~L = i i G~L^ I;,I~;TEF,' = u . Oil 1 "~~'HE T ;;:;~IIF'kEf'lE VULUh9E = 66 i 1 Gi~L ULLtiGE = 336i; t;HL yUvu ULLriE= '2:36'x' C;HLl3 HEIGHT = i'S.4? IIVCHE;3 L,IATEk 't? ~+I. = 0 GtiL 6JHTEk = r_i , uu I hJi SHE: TEJ°1F' _ br .v DEG F r' r//// / _ -° ~}~ ` ,~'w~' T~`~3 CITY OF BAKERSFIELD FIRE DEPARTMENT • Q6 ~ ~~ OFFICE OF ENVIRONMENTAL SERVICES ~`A ~ yp UNIFIED PROGRAM INSPECTION CHECKLIST °_;w ~gti p~~ 1715 Chester Ave., 3`d Floor, Bakersfield, CA 93301 ~~ ~~o~V FACILITY NAME ~/a~S INSPECTION DATE 7 ~~ 0 5 ADDRESS o~~ Gb wifi4~ LN. PHONE NO. 356 -ol si FACILITY CONTACT ~'`~/,~, 5~~~ BUSINESS ID NO. 15-210- INSPECTION TIME I /off NUMBER OF EMPLOYEES 30 • Section 1: Business Plan and Inventory Program I~Routine ^ Combined ^ Joint Agency ^Muiti-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 t 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: Questions regarding this inspection? Please call us at (805) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy I siness S' e onsible Party Inspector: L = c~vw~/ ~ /(~ ,~ + VONS 2512 ___________________________________________ SitelD: 015-021-001217 + Manager CHERYL FRYE BusPhone: (661) 396-2344 Location: 2100 WHITE LN Map 124 CommHaz Extreme City BAKERSFIELD Grid: 18C FacUnits: 1 AOV: CommCode: BFD STA 05 SIC Code:5541 EPA Numb: DunnBrad:009137209 +______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Title CHERYL FRYE / FAC MANAGER LOSS PREVENTION / LOSS PREY MGR Business Phone: (661) 396-2344x Business Phone: (626) 821-7545x 24-Hour Phone (626) 821-7545x 24-Hour Phone (626) 821-7545x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire. Press React ImmHlth DelHlth Contact SAFEWAY STORES INC Phone: (303) 986-8011x MailAddr: 12265 W BAYAUD AVE 300 State: CO city LAKEWOOD zip so228 Owner SAFEWAY STORES INC Phone: (303) 986-8011x Address 12265 W BAYAUD AVE 300 State: CO City LAKEWOOD Zip 80228 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG U - UST 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 nd complet ~. ~ 5 ~ S' nature Date ENTb A ~ R ~ ~ 20os -1- 04/03/2006