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Home My WebLink AboutBUSINESS PLAN 7/13/2007 [e tt' C---~ -"> ,'-~> -. II. l iI- , ~ !) 1)/ /j - I . . : COMPLETE AUTOMOTIVE REPAIR~ :! 7001 WHITE LANE #115 . . - . - . - -- - . - - -.,....--- ---' -- -----'- --. -'-- rr-rE 3Lf { (:2- ;LtC(3 -b .3 COMPLETE AUTOMOTIVE REPAIR SiteID: 015-021-002193 Manager : KIRK LOWE Location: 7001 WHITE LN 115 City BAKERSFIELD BusPhone: Map : 123 Grid: 16D (661) 834-4899 CommHaz : Low FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: CAL000223885 SIC Code:7538 DunnBrad: Emergency Contact / Title Emergency Contact / Title KIRK LOWE / OWNER YONNA LOWE / OWNER Business Phone: (661) 832-8280x Business Phone: (661) 837-6060x 24-Hour Phone : (661) 834-4899x 24-Hour Phone : (661) 834-4899x Pager Phone : ( ) - x Pager Phone : (661) 203-1025x Hazmat Hazards: Fire DelHlth Period : Preparer: Certif'd: ParcelNo: to Phone: (661) 834-4899x State: CA Zip : 93307 Phone: (661) 834-4899x State: CA Zip : 93307 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Contact : KIRK LOWE MailAddr: 8828 CLYDESDALE ST City : BAKERSFIELD Owner Address : City KIRK LOWE 8828 CLYDESDALE ST : BAKERSFIELD Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK c . uir ot thOse individ~~I'D J U L 2 3 Za07 Based .o~ m~ tnq . Y the information, I certify responsible fot Ob!a:ntn9that.' have person~lIy ur1de~ penal~ o~ f~%iliar with the informatIOn examined an a \' e the information is true, submitted and be lev . ,accura,e, and c~Plete. -: /1 ib 1 ()( ~ ~ :;I!;nature -1- 07/10/2007 s F COMPLETE AUTOMOTIVE REPAIR p= Hazmat Inventory f== MCP+DailyMax Order SiteID: 015-021-002193 9 By Facility Unit 9 Fixed Containers at Site 9 \specHazlEPA Hazards I Frm I DailyMax IUnitlMCP Hazmat Common Name... ANTIFREEZE WASTE OIL MOTOR OIL F F DH DH L L L 55.00 GAL 55.00 GAL 55.00 GAL Low Low Min -2- 07/10/2007 -; -3- 07/10/2007 1': ~ F COMPLETE AUTOMOTIVE REPAIR f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME ANTIFREEZE SiteID: 015-021-002193 1 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-NONMETAL Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 1. 00 GAL Z %Wt. RS CAS # 100.00 Ethylene Glycol No 107211 HA ARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low HAZARD ASSESSMENTS p= Inventory Item 0003 F= COMMON NAME / CHEMICAL NAME WASTE OIL Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55.00 GAL %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS N TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSME TS -4- 07/10/2007 F COMPLETE AUTOMOTIVE REPAIR f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME MOTOR OIL SiteID: 015-021-002193 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # 8020835 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 2.00 GAL %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESSMENTS -5- 07/10/2007 F COMPLETE AUTOMOTIVE REPAIR I f= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-002193 9 Fast Format 9 Overall Site 9 10/24/2006 CHECKED VISUALLY AND BY CRANES WASTE OIL WHEN THEY PUMP THE TANKS MONTHLY. Employee Notif./Evacuation 10/24/2006 EMPLOYEE WOULD CONTACT OWNERS/EMPLOYEES, KIRK AND YONNA LOWE, AFTER PROPER AUTHORITEIS, SUCH AS, 911 AND/OR OFFICE OF EMERGENCY SERVICES 800-852-7550 FOR ALL SPILLS THAT ARE A THREAT TO LIFE, SAFETY, OR ENVIRONMENT. SPILLS NOT CLASSIFIED ABOVE ARE TO BE REPORTED TO LOCAL OFFICE 326-3979. Public Notif./Evacuation 10/24/2006 OWNER, KIRK LOWE, WILL DECIDE IF IT IS A HAZARDOUS SPILL. YONNA LOWE WILL NOTIFY AUTHORITIES AND CLEAN-UP COMPANIES. KIRK WILL MAKE SURE BUILDING IS EVACUATED IF NEEDED AND BE THERE FOR EMERGENCY RESPONSE TEAM. Emergency Medical Plan 10/24/2006 YONNA OR KIRK WILL CALL 911 IF EMEREGENCY INDICATES. FACILITY OF CHOICE WOULD BE KMC HOSPITAL. -6- 07/10/2007 .-. SiteID: 015-021-002193 9 Fast Format 9 Overall Site 1 01/03/2001 F COMPLETE AUTOMOTIVE REPAIR I f= Mitigation/Prevent/Abatemt Release Prevention WE WILL BE USING A STATE LICENSE HAZARDOUS COMPANY TO SUPPLY, MONITOR AND REMOVE CONTAINERS AND HAZARDOUS WASTE. Release Containment 01/03/2001 IF DRUMS LEAK THEY WILL BE REPLACED BY THE SERVICE WHICH PROVIDES THE DRUMS, CRANES WASTE OIL. Clean Up 10/24/2006 CLEAN UP MATERIAL WITH RAGS AND CONTACT CRANES WASTE OIL 800-272-6330. Other Resource Activation -7- 07/10/2007 ? F COMPLETE AUTOMOTIVE REPAIR I f= Site Emergency Factors Special Hazards SiteID: 015-021-002193 9 Fast Format 1 Overall Site 9 Utility Shut-Offs 01/29/2007 A) GAS - N/A B) ELECTRICAL - W WALL C) WATER - IN GROUND W WALL D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/29/2007 PRIVATE FIRE PROTECTION - FIRE EXGINGUISHERS. NEAREST FIRE HYDRANT - FRONT OF SITE. Building Occupancy Level 12/11/2006 2 EMPLOYEES -8- 07/10/2007 ""I: " ., , F/COMPLETE AUTOMOTIVE REPAIR I . ,p Training Employee Training SiteID: 015-021-002193 9 Fast Format 9 Overall Site 1 02/26/2007 / I BRIEF SUMMARY OF TRAINING PROGRAM: TRAINING IS SUPPLIED TWICE A YEAR AND AT HIRING OF EMPLOYEE. I Page 2 Held for Future Use Held for Future Use o -9- 07/10/2007 '.,:.~: '] COMPLETE AUTOMOTIVE REPAIR Manager : \<\'f~ ~ Location: 7001 WHITE LN 115 City BAKERSFIELD SiteID: 015-021-002193 BusPhone: Map : 123 Grid: 16D (661) 834-4899 CommHaz : Low FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: CAL000223885 SIC Code:7538 DunnBrad: Emergency Contact / Title Emergency Contact / Title KIRK LOWE / OWNER YONNA LOWE / OWNER Business Phone: . (661) 832-8280x Business Phone: (661) 837-6060x 24-Hour Phone : (661) 834-4899x 24-Hour Phone : (661) 834-4899x Pager Phone : ( ) - x Pager Phone : (661) 203-1025x Hazmat Hazards: Fire DelHlth Owner Address : City KIRK LOWE 8828 CLYDESDALE ST : BAKERSFIELD Phone: (661) 834-4899x State: CA Zip : 93307 Phone: (661) 834-4899x State: CA Zip : 93307 Contact : KIRK LOWE MailAddr: 8828 CLYDESDALE ST Ci ty : BAKERSFIELD Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ENTD FEB 23 Z007 . ir of those individua.\s Based on my mqu. Y tM information. I certify responsible for obtatn~g tha"'t \ have person~\ly under penalty of \a Tar with the info~mat1On examined and am\" a~1 ~he information IS true, submitted and be lev accurate, and complete. C~ .dWai -1- 01/29/2007 S ,Ii F COMPLETE AUTOMOTIVE REPAIR p= Hazmat Inventory p== MCP+DailyMax Order SiteID: 015-021-002193 9 By Facility unit 9 Fixed Containers at site 9 IspecHazlEPA Hazards I Frm I DailyMax IUnitlMCP Hazmat Common Name... ANTIFREEZE WASTE OIL MOTOR OIL F F DH DH L L L 55.00 GAL 55.00 GAL 55.00 GAL L6w L6w Min -2- 01/29/:2007 ~ ;i -3- 01/29/~607 ;'" F COMPLETE AUTOMOTIVE REPAIR f= Inventory Item 0002 F= COMMON NAME / CHEMICAL NAME ANTIFREEZE SiteID: 015-021-002193 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-NONMETAL Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 1. 00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MG:!? No No No NO/ Curies / / / Low HAZARD ASSESSMENTS f= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME WASTE OIL Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # '- . - 100.00 Waste Oil, Petroleum Based No 0 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MGP No No No No/ Curies F DH / / / Lew -4- 01/29/2007 :" F COMPLETE AUTOMOTIVE REPAIR p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME MOTOR OIL SiteID: 015-021-002193 1 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SW CRNR IN BACK Map: Grid: CAS # 8020835 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 2.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # 100.00 Motor Oil, Petroleum Based No 8020835 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC:!? No No No No/ Curies F DH / / / Min -5- 01/29/2007 ~ M F COMPLETE AUTOMOTIVE REPAIR I p= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-002193 9 Fast Format 9 Overall Site 1 10/24/2006 CHECKED VISUALLY AND BY CRANES WASTE OIL WHEN THEY PUMP THE TANKS MONTHLY. Employee Notif./Evacuation 10/24/2006 EMPLOYEE WOULD CONTACT OWNERS/EMPLOYEES, KIRK AND YONNA LOWE, AFTER PROPER AUTHORITEIS, SUCH AS, 911 AND/OR OFFICE OF EMERGENCY SERVICES 800-852-7550 FOR ALL SPILLS THAT ARE A THREAT TO LIFE, SAFETY, OR ENVIRONMENT, SPILLS NOT CLASSIFIED ABOVE ARE TO BE REPORTED TO LOCAL OFFICE 326-3979. Public Notif./Evacuation 10/24/2006 OWNER, KIRK LOWE, WILL DECIDE IF IT IS A HAZARDOUS SPILL. YONNA LOWE WILL NOTIFY AUTHORITIES AND CLEAN-UP COMPANIES. KIRK WILL MAKE SURE BUILDING IS EVACUATED IF NEEDED AND BE THERE FOR EMERGENCY RESPONSE TEAM. Emergency Medical Plan 10/24/2006 YONNA OR KIRK WILL CALL 911 IF EMEREGENCY INDICATES. FACILITY OF CHOICE WOULD BE KMC HOSPITAL. -6- 01/29/2007 ;;, i< SiteID: 015-021-002193 9 Fast Format:. 9 Overall Site 1 01/03/2001 F COMPLETE AUTOMOTIVE REPAIR I p= Mitigation/Prevent/Abatemt Release Prevention WE WILL BE USING A STATE LICENSE HAZARDOUS COMPANY TO SUPPLY, MONITOR AND REMOVE CONTAINERS AND HAZARDOUS WASTE. Release Containment 01/03/2001 IF DRUMS LEAK THEY WILL BE REPLACED BY THE SERVICE WHICH PROVIDES THE DRUMS; CRANES WASTE OIL. Clean Up 10/24/2006 CLEAN UP MATERIAL WITH RAGS AND CONTACT CRANES WASTE OIL 800-272-6330. Other Resource Activation -7- 01/29/2007 i' F COMPLETE AUTOMOTIVE REPAIR I p= Site Emergency Factors Special Hazards SiteID: 015-021-002193 , Fast Format: 9 Overall Site 1 Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - W WALL C) WATER - IN GROUND W WALL D) SPECIAL - NONE E) LOCK BOX - NO 01/29/2007 Fire Protec./Avail. Water 01/29/2007 PRIVATE FIRE PROTECTION - FIRE EXGINGUISHERS. NEAREST FIRE HYDRANT - FRONT OF SITE. Building Occupancy Level 12/11/2006 2 EMPLOYEES -8- 01/29/2007 c \ \ '!l / r.,/ / \ F COMPLETE AUTOMOTIVE REPAIR f I 4 p= T:r;?!ining . . . 7EmPIoyee ~ral~lng / \~\~\~b \~ Su...()()L\~ \'-J\L'C.... ,4 ~ ~ / '{\, \A \{L\~ b ()~ G~\)~O~~L SiteID: 015-021-002193 9 Fas t Format 9 Overall Site 9 ~'-18P"(L ~ Page 2 Held for Future Use Held for Future Use -9- 01/29/2007 BAKERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield. CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 . UNIFIED PROGRAM INSPECTiON CHECKLIST . SECTION 1: Business Plan and Inventory Program FACILITY NAMEC Au"1O ~ Tl" ~ NSPECTION DATE INSPECTION TIME OM..P<" ':;..:r~ l2A P,/-I k.. 16 ". 1. '1- 6r 10 /I"t'; ADDRESS HONE NO. NO OF EMPLOYEES 700 I UJl04-11-At- Lf\l lIS- e 3~ ~ 4 a 9 Cj "Z:.. FACILITY CONTACT I3USINESS ID NUMBER k l'ik L fa ~ ,,~. 15-021- ZI~3 . Ill""" ROUTINE Section 1: Business Plan ~nd Inventory Program o COMBINED 0 JOINT AGENCY 0 MULTI-AGENCY 0 COMPLAINT ORE-INSPECTION . C V ( c=compliance) OPERATION COMMENTS V=Violation - .. [3"""0 ApPROPRIATE PERMIT ON HAND ~O Business PLAN CONTACT INFORMATION ACCURATE [U/o VISIBLE ADDRESS lM"""'0 CORRECT OCCUPANCY ~O VERIFICATION OF INVENTORY MATERIALS ~O VERIFICATION OF QUANTITIES uv'0 VERIFICATION OF LOCATION B"'o PROPER SEGREGATION OF MATERIAL - -- (D,.,r0 VERIFiCATION OF MSDS AVAILABILITY uv'0 VERIFICATION OF HAl MAT TRAINING ~O VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~O EMERGENCY PROCEDURES ADEQUATE ./ g'0 CONTAINERS PROPERLY LABELED ~ 0 HOUSEKEEPING !1V0 FIRE PROTECTION ./ [Q"'O SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN:~~>l~ OIL ~S o NO Inspector (Please Print) Fire Prevention /1 sI in / Shift of Site/Station # .QUESTIONS REGARDING THIS INSPECTION? PLEASE CAll US AT (661) 326-3979 S. 'b'/t"Tl' 9'c. White - Prevention Services Yellow - Station Copy Pink - Business Copy FD2049 (Rev. 02105) I + CO~LE~ AUTOMOTIVE REPAIR ========================== SiteID, 015-021-002193 + Manager : Location: 7001 WHITE LN 115 City BAKERSFIELD BusPhone: Map : 123 Grid: 16D (661) 834-4899 CommHaz : Low FacUnits: 1 AOV: CommCode: BFD STA 09 SIC Code:7538 EPA Numb: ~'f\LDOO ~~~'1)~ DunnBrad: , +==============================================================================~~ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title KIRK LOWE / OWNER YONNA LOWE / OWNER Business Phone: (661) 832-8280x Business Phone: (661) 837-6060x 24-Hour Phone : (661) 834-4899x 24-Hour Phone : (661) 834-4899x Pager Phone () x Pager Phone (661) 203-1025x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire DelHlth I +------------------------------------------------------------------------------+ Contact : KIRk LOWE - ---~-~ -- ~- -~ ---. - - -->-pJ:lorie:--=r6o-r)~8'3"i:1 4899)c MailAddr: 8828 CLYDESDALE ST State: CA City : BAKERSFIELD Zip : 93307 +--------------------------------------------------------~~--------------------+ Owner KIRK LOWE Phone: (661) 834-4899x Address : 8828 CLYDESDALE ST State: CA'~ City : BAKERSFIELD Zip : 93307' +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = "-, Gal Certif'd: RSs: No ParcelNo: +------------------------------------------------------------------------------+ Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ENrn MAl? 202006 - ~ ----.- --- -- -----,--------=-- - Based on my inquiry of those i,ndividua,ls responsible for obtaining the information. I certify under penalty of law,t,hat I, have person~lIy examined and am familiar With the ,Info~matlon submitted and believe the information IS true, accurate, and complete, ~ Ig ture d/\slo~ Date +=======================================================~======================+ -1- 03/13/2006 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 INSPECTION DATE INSPECTION TIME I()-"'O~, 15~1;'" p~~____h___ -Nci:-OfEmPloyees--- ~ 3~ . ~).. ~Q_L_~_ ___.____ Business 10 Number 15-021- 0 ICf3 FACiliTY NAME C Q..~ {J.lf-k-___J\v...\.U~.u_:h_V_.c-___. Le_\?_<L~_L_ '__ ____._____ _H ___.n__ ___ ____ ADDRESS . :fr C 1 2. <J lUUJ 700 \ l..) h \t.~_~t-J______l1S_'---___._______n ___U_______ ___ FAClLiTYCONTACT Section 1: Business Plan and Inventory Program ~utine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection c V ( C=Compliance ) V=Violation OPERATION COMMENTS ~ 0 ApPROPRIATE PERMIT ON HAND 'IJ 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE iii 0 VISIBLE ADDRESS _______.._ -_o- ra 0 CORRECT OCCUPANCY ~ 0 VERIFICATION OF INVENTORY MATERIALS ------------ ~ 0 VERIFICATION OF QUANTITIES aa 0 VERIFICATION OF LOCATION 151 0 PROPER SEGREGATION OF MATERIAL I?lJ 0 VERIFICATION OF MSDS AVAILABILlTYE ~ 0 VERIFICATION OF HAT MAT TRAINING ()1 0 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ 0 EMERGENCY PROCEDURES ADEQUATE lS3 0 CONTAINERS PROPERLY LABELED L9 CJ HOUSEKEEPING - -==~---f+ -=-~-=:=:=-===-=:=:: l)iI CJ FIRE PROTECTION - ----------------------- -------- ----- --------.------.----- --------- - ~---- ~ 0 SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: rp... YES CJ No ~ EXPLAIN: WAr'> TCc..- 01 L QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326- ~-2~LC-------.-..-...---~S-~_ Inspector Badge No. While . Environmenlal Services Yellow . Station Copy Pink . 8usiness Copy ~c~ ... Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 ! - UNIFIED PROG'RAM INS,PECTION CHECKLIST SECTION 1: Business Plan and Inventory Program . ~"'--~ "~":j~'" y-~;-- ',~ q;;;:: ;"':;~ '.rip'lliv~ntb.;y:e~. o COMPLAINT FACILITY NAME 7 c:s-c j FACILITY CONTACT ~ r; '-ill. TIi(. W b- 1Ft;; \. L?zt A-.A-o /)A..I.;:,. r(':"~ ADDRESS LJ<.A to L".)&, C v (c-cOmPlianCe) V=Violation OPERA TION COMMENTS ~ ~D ~D ,;a/' 0 ApPROPRIATE PERMIT ON HAND Business PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY o . VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION ~D PROPER SEGREGATION OF MATERIAL. ~. VERIFICATION OF MSDS AVAILABiliTY ~D VERIFICATION OF HAZ MAT TRAINING ..0/ 0 VERIFICATION OF ABATEMENT SUPPliES AND PROCEDURES ~D EMERGENCY PROCEDURES ADEQUATE ,.0...... 0 CONTAINERS PROPERLY LABELED ,- ,,~." ~ 0 HOUSEKEEPING f [d/D FIRE PROTECTION / '" )~... 0 SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? YES o NO EXPLAIN: ~~J QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 e' Clv I ntion /1" In / Shift of Site/Station # Print) White - Prevention Services Yellow - Station Copy Pink.- Business Copy FD 2155 (Rev. 09/05