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Home My WebLink AboutBUSINESS PLAN 6/14/2006+ WATERFALL CLEANERS _________________ _________________ SiteID:, 015-021-002876 + Manager GEORGE MASUD BusPhone: (661) 836-3399 _Location: 3031 WILSON RD Map 123 CommHaz Low 'City BAKERSFIELD Grid: 12A FacUnits: i AOV: CommCode: BFD STA 07 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title / / Business Phone: ( ) - x Business-Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: __ _ _ __ :React -- - - - Contact GEORGE MASUD Phone: (661) 836-3399x MailAddr: 3031 WILSON RD State: CA City BAKERSFIELD Zip 93304 Owner GEORGE MASUD Phone: (661) 836-3399x Address 3031 WILSON RD State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ ~ ~'~ PROG H - HAZ WASTE GEN ~ ~,~ ~ E ~~ ~~C _ ~ 4 2~~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 ~~( l~ submitted and believe the information is true, [ ' . 1 ~` accurate, and complete. i ature Date ~~ -1- 06/07/2006 ~~~~~ UNII°IED PROGFt~-f~lll 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 NAME I INSPECT ON DATE :INSPECTION TIME t~~TC,2,~-~ LL CUC-~nIC~2S ~ Z u~slo 4 ADDRESS ~ PHON No. ' No. of Employees ~a"51 w t r`.SuN fLt> ~ ----- --------------------------------- ------ -------- -- ----- ---------~------- -- I --- --------- - -- FACILITYCONTACT Business ID Number ~-~R+G-~ vv~/~Svt~ ~ 15-021- /~~.~/ Section 1: Business Plan and Inventory Program Routine Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection C V \V=Voatioinncel OPERATION COMMENTS ^ ^ APPROPRIATE JPERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE --------------------------- -------- -- .----t---------... - --------- -- . _ ..-- - ------ --...--- -------- I ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ~~L~~~~y~„~ trj+k ~Z Diu -- ---- r -- --- --- -- -- -- -- -- -- -- - ---- - ^ ^ VERIFICATION OF QUANTITIES ~ ~ ~~ --- --- - --- l4S Vic. ~~% cx~.P~_ mss' ~~.- -,'3./ksTtc ------ - - ^ ^ VERIFICATION OF LOCATION S ~ CSR C~ 5~ CjLA~.. Orr S -------------- ^ ^ PROPER SEGREGATION OF MATERIAL (~, ^ ^ VERIFICATION OF MSDS AVAILABILITYE I~ ~ ~ lJ - - I ~ C ~ _ _ ^ ^ VERIFICATION OF HAT MAT TRAINING , ` -------------------------------- _-- ----t _____.. ---i-i~ -- -_ _ .----. .- --- ----- ~.~~--_--- ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I ` ~~ ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ------------------------- -------------------------- --------- ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ~ YES ^ NO EXPLAIN: I/J'~S t ~ ~~ZL QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661 ~ 326-3979 - -- --~t~c_s__ ___ ____ _ ___ _~___ ____ _ _ _ _ Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy ss Site Responsible- arty (Please Print) Pink -Business Copy rn g N 0 :n ~ _ "a ~--~~ UNIFIED PROGRAM INSPECTION CHECKLIST SECT90N 1 Business- Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 --- FACILITY NAME I INSPECT ON D TE INSPECTION TIME t^//~-rC"2~A~ lL ~,~-,/ANC-2,S Z Ct~SfU 4 ADDRESS PHONE No. No. of Employees 3 03 ~ w r ~ 5~N ~ ~ -- --- -- ~ ----- ------ --- ---- FACILITYCONTACT - ~ Business ID Number ~s~`~RC.-a` rtn l~ 5v n ~ 15-021- /~=W Section 1: Business Plan and Inventory Program Routine ~ 'Combined ^ Joint Agency ^Mult~-Agency ^ Complaint ^ Re-inspection ~, C V \V=Vioatoinnce~ OPERATION COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ -- VISIBLE ADDRESS ------------------ - -- ------ ^ ^ ------ - .._ CORRECT OCCUPANCY _ I __ - --- ----- ----- -- - - _ - -- - ------- - --- - -- - ^ ^ VERIFICATION OF INVENTORY MATERIALS ---- ---- ~L.~LF~WZ~ ~ g,~ t~L~-.~~ W~h ZZ. P~~ ^ ^ VERIFICATION OF QUANTITIES -_ ~ -_ - -- ~ ~~ --- --- - ^ ^ ---- VERIFICATION OF LOCATION ------ ---- ----- I 5~...3 C2N2 -cam t --- ~~nwE2S St~J CJLNR o>r STti(1c~ - -- - - - - - -- - - - ^ - ^ - - PROPER SEGREGATION OF MATERIAL --- --- -- -- - I . ^ ^ VERIFICATION OF MSDS AVAILABILITYE _ _ { ~~' L -' f ' ~~ ^ ^ VERIFICATION OF HAT MAT TRAINING ~ ~ ~ ~ \ ~ •~ ~'~ ` t~ ~Y /' ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES i ~ i~~ sz I~ ^ ^ EMERGENCY PROCEDURES ADEQUATE _.^ . %~~ i ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ~ ^ ^ FIRE PROTECTION I I ^ ^ SITE DIAGRAM ADEQUATE & ON HAND j I - ANY HAZARDOUS WASTE ON SITE?: ~. YES ^ NO EXPLAIN: t/J~S i ~ T ~~~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy ss Site Responsible Party (Please Print) rn 8 N Pink -Business Copy g `~; ~y~`' `~'c~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~ ~ OFFICE OF ENVIRONMENTAL SERVICES ~' •y UNIFIED PROGRAM INSPECTION CHECKLIST = k~,'~gti ~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME w~~~~=~'-~- C'-C~~ INSPECTION DATE t i ~~~o ~- Section 4: Hazardous Waste Generator Program EPA ID # LPL ~28p4~S ^ Routine ^ Combined ^ Joint Agency ^Multf-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made / ~t.L e TC--v-S O K.. EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storage i~ Reported release, fire, or explosion within 15 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 ~GcsC-f~ ';~(tVnn - OK Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters 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 C=Compliance/ -,v=vtolatton Inspector: `'_ C~L~ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink -Business Copy Business Site Responsible Party *~ 5°~~ WATERFALL CLEANERS SiteID: 015-021-002876 Manager GEORGE MASUD Location: 3031 WILSON RD City BAKERSFIELD BusPhone: (661) 836-3399 Map 123 CommHaz Moderate Grid: 12A FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: SIC Code: DunnBrad: Emergency Contact /-- -Title Emergency Contact / Title GEORGE MASUD / Dur^i~ / - Business Phone: (661) 836-3399x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact GEORGE MASUD - Phone: (661) 836-3399x MailAddr: 3031 WILSON RD State: CA City BAKERSFIELD Zip 93304 Owner GEORGE MASUD Phone: (661) 836-3399x Address 3031 WILSON RD State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT I~ ~~ PROG H - HAZ WASTE GEN ~N~`~ ~ ~ R 18 2007 of those individuals ui - ry Based on my inq on<<ib!e for ob'•-a~rin3 the infcrmatio~,rsonally resp under penalty of la.f~ that I have p r with the information ili a examined and am fam itted and believe the information is true, subm and complete. ccurate , a Date Si nature -1- 02/20/2007 ;. :, F WATERFALL CLEANERS SiteID: 015-021-00.2876 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common~Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PERCHLOROETHYLENE R L 145.00 GAL Low WASTE PERCHLOROETHYLENE R L 30.00 GAL Low -2- 02/20/2007 -3- 02/20/2007 i~ ~ 8 t F WATERFALL CLEANERS SiteID: 015-021-002876 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PERCHLOROETHYLENE Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF CLEANERS CAS# 127-18-4 STATE TYPE PRESSURE TEMPERATURE '~~ CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient I IN MACHINE/EQUIP AMOUNTS AT.THIS LOCATION Largest Container Daily Maximum Daily Average 145.00 GAL 145.00 GAL I 145.00 GAL HAZARDOUS COMPONENTS °sWt . 100.00 Perchloroethvlene RSI CAS# No 127184 HAZARD A SS~~~i~ir,lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE PERCHLOROETHYLENE Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF STOREROOM CAS# STATE TYPE Liquid Twaste = PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 30.00 -GAL 30.00 GAL HAZARDOUS COMPONENTS °sWt. RS CAS# 100.00 Perchloroethylene No 127184 HAZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Low -4- 02/20/2007 r F WATERFALL CLEANERS SiteID: 015-021-002876 Fast Format ~ Notif./Evacuation/Med-ical Overall Site Agency Notification. ~ ,. - Employee Notif./Evacuation YlLLJ11G 1VV1.11~~VdC:Udl.1V11 = Emergency Medical Plan -5- 02/20/2007 F WATERFALL CLEANERS SiteID: 015-021-002876 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention ;_ _ ~:Rel"ease Containment caean up vzner xesource ticLivaLioii -6- 02/20/2007 ~~ - F WATERFALL CLEANERS SiteID: 015-021-002876 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, .~Nc~.ial nac~ai.u~ Utility Shut-Offs Fire Protec./Avail. Water Building Occupancy LeveI~ -7- 02/20/2007 f' ~ F WATERFALL CLEANERS SiteID: 015-021-002876 ~ Fast Format ~ ~ Training _ Overall Site ~ _~ , .uu~1/ivycc 110.111111y rayc ~ iaciu ivi 1-u~.utc vac ncl~,a tvl, r u~uic v~C -8- 02/20/2007 Es iq~91 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION ~ ~/ _ ~ BUSINESS OWNER/OPERATOR IDENTIFICATION l0 Pa e 2 of 2 I. IDENTIFICATION FACILITY ID # I BEGINNING DATE loo. ENDING DATE 'oI (Agency UseOn[y) - - 02/01/2007 02/01/2008 BUSINESS NAME (satt~ ~ FACIUrY IJAME) 3 BUSINESS PHONE Ioz. ATBT Mobility -WILSON ROAD (14232) (425) 580-4902 BUSINESS SITE ADDRESS Ios. 3121 WILSON RD "] 104 CITY ZIP CODE Ios. ~j ~~~ BAKERSFIELD ~ ~,~ H ~ I 93304 DUN & BRADSTREET 106 SIC CODE (4 digit #) toz 10-202-6754 4812 COUNTY 108. Kern BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE I Io. AT8~T Mobility 425 580-49 02 ext. . II. BUSINESS OWNER OWNER NAME ~ I I OWNER PHONE 112 New Cingular Wireless PCS, LLC 425 580-4902 ext. OWNER MAILING ADDRESS IIS. P O Box 97061 CITY IIa. STATE CIS. ZIP CODE MI6. Redmond WA 98073-9761 III. ENVIRONMENTAL CONTACT CONTACT NAME t Iz CONTACT PHONE 118 Debra Okano 562 468 - 6495 ext. CONTACT MAILING ADDRESS i I9. 12900 Park Place Drive, 3rd Floor CITY 120 STATE I27 ZIP CODE Izz. Cerritos CA 90703 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME tzs. Debra Okano Wireless Network Control Center TITLE 124 TITLE ~''-9 Network Manager, Compliance Control Center BUSINESS PHONE I'-s. BUSINESS PHONE 130 562 468 - 6495 ext. 800 832-6662 ext. 24-HOUR PHONE* 126 24-HOUR PHONE* psi. 949 338 - 8434 ext. 800 832-6662 ext. PAGER # 127 PAGER # I3'-- N/A NIA ADDITIONAL LOCALLY COLLECTED INFORMATION: I3a. Billing Address: P O Box 97061, Redmond, WA 98073-9761 Property Owner: New Cingular Wireless PCS, LLC - DBA: AT8~T Mobility Phone No.: (425) 580-4902 Certification: 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 ~Wi ER/OPERATOR OR DESIG: REPRESENTATIVE D t3a. NAME OF DOCUMENT PREPARER ts5. g ~~ ~~ Steven Y Jin NrVVIE O GNER (print) X36. TITLE OF SIGNER 137. Sian Wiltshire Environmental Com liance S ecialist UV-020 - 4/17 www.unidocs.org Rev. 07/24/06 4 r BAKERSFIELD FIRE DEPT - ~ Prevention Services " UNIFIED PROGRAM INSPECTION CHECKLIST~~ H $~~t~' D 90oTnuctunAve., Suite 210 ,~.... _--. ~ ,r..~- u:.~ : ~-~ << ._ ~_ _<,:::- ..: . _ _.: : , ,~ .:•._ aRru~ r Bakersfield. CA 93301 SECTION 1: Business Plan and Inventory Program ~ Tel.: (661) 326-3979 • Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME it r \ ` ~h S ~ - ~ ~ Cf ADDRESS ~ ; 3o3i ~6t NsS34-33 OOF~P~YEES V FACILITY CONTACT USINESS ID NUMBER G ~.~ , 5-02, - ~ -~~ ~ ~ r Section 1: Business Plan and Inventory Program ~~~ ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT RE-INSPECTION C V ~ C=Compliance OPERATION V=violation ~ , C C DC~ ~ ~ 006 COMMENTS ~' ^ APPROPRIATE PERMIT ON HAND ~L / ^ Business PLAN CONTACT INFORMATION ACCURATE ~ ^ VISIBLE ADDRESS j ~I ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS l~, ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION (~ ~f ^ PROPER SEGREGATION OF MATERIAL ~ ^ VERIFICATION OF MSDS AVAILABILITY i --- ^ VERIFICATION OF HAZ MAT TRAINING i ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND ~ PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE - ^ CONTAINERS PROPERLY LABELED I~' ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZ~iDOU~SWASTE~ ON SITE? YES ^ NO EXPLAIN: .~1/~l5.~~~i~°_~~~ ~'e ~ ~ -.. .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ai i ~r.q rr~ ~ e Inspector (Please Print) Fire Prevenn on / 1s' In /Shift of Site/Station # usine s Site/School Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02!05) r BAKERSFIELD FIRE DEPT ., UNIFIED PROGRAM INSPECTION CHECKLIST-: H s P t D Prevention services ~~t~ 900 Truxtun Ave., Suite 210 Y ~ ~.-< ~_ _. , _,_. ,: _ _ : ~ .: - ~ --, ~Rr~r t Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~ ~ Tel.: (661) 326-3979 • Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS ~~ ~] ~~ ~~ HONE NO. (~~--5~6 -?3R`i O OF EMPLOYEES FACILITY CONTACT . USINESS ID NUMBER 15-021- 0 ~ ~~ ~ 0 $1(p Section 1: Business Plan and Inventory Program ~q `~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION v=violation COMMENTS ^ APPROPRIATE PERMIT ON HAND i I ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ~1 ^ VISIBLE ADDRESS f ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES °~ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~ ^ VERIFICATION OF HAZ MAT TRAINING ^ P CEDU VERIFICATION OF ABATEMENT SUPPLIES AND RES ^ ~ EMERGENCY PROCEDURES ADEQUATE ~~ ~7 ~~ t / l ~~ _ O ^ ~ CONTAINERS PROPERLY LABELED i ^ HOUSEKEEPING ^ '~ FIRE PROTECTION ~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZ``AR~~D--OUS WAS ON SITE? YES ^ NOJ EXPLAIN: V~iS~'L ~e.v~C`-. Y' C <~~"~.~1 Q,n j~ / --- ------- - .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1°' In /Shift of Site/Station ft m s Site/School Site Res nsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2048 (Rev. 02/05) . ,ii WATERFALL CLEANERS SiteID: 015-021-002876 Manager : GEORGE MASUD Location: 3031 WILSON RD City BAKERSFIELD BusPhone: Map : 123 Grid: 12A (661) 836-3399 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BFD STA 07 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergen~contact / Title GEORGE DAVID MASUD / OWNER Business Phone: BUS1ness Phone: 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : (661 ) 343-3385 CELL PH. Hazmat Hazards: React Owner Address City GEORGE MASUD : 3031 WILSON RD. : BAKERSFIELD Phone:(661) 398-3399 State: Zip : (661) 398-3399 CA 93309 (661) 836-3399x CA 93304 Contact : GEORGE MASUD MailAddr: 6631 MING AVE. City : BAKERSFIELD A-vc Phone: (661) 398 3399 State: Zip :93309 Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN [' or~ my inquiry of those indivif:i:J2!S ""/,-,<:',1" for ob'r::,ininCJ the informEl\jOn. I certify u penalty of jaw that I have per'3onally Ay'n:inet1 and am familiar with the information su::;mitted and b:'?liev8 the information is trUfJ, "<''''''''8, an;:;:;;; ~ ~~;1.-5-C/7~ -1- 10/12/2007 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program *(OQa9SI'7• itlCt-jnt, BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME /n} INSPE TI N DATE INSPECTION TIME ADD7S C t fur PHOrN O. j 3 -3366 NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER C v lu Consent to Inspect Name /Title POST INSPECTION INSTRUCTIONS: Refer to the back of this inspection report for regulatory citations and corrective actions • Correct the violations) noted above by • Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Y Signature hat all dol tions have been corrected as noted) Date' While — Business Copy yellow — Business Copy to he Sent in after return to Compliance Pink Prevention sarviees COpy FD2155(Re, 12/11) Lld Section 1: Business Plan and Inventory Program ._ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v ( C= Compliance OPERATION V= Violation COMMENTS 2 ❑ APPROPRIATE PERMIT ON HAND (BMC: 1.65.080) l9 ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) 1f ❑ CORRECT OCCUPANCY (CBC: 401) ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ,.,e_,/ LE9 VERIFICATION OF QUANTITIES (CCR: 2729.4) / ��77 /_0 / #zs )F ){i} 9 ,- (J V G�f ��- -' /❑ Ek ❑ VERIFICATION OF LOCATION (CCR: 2729.2) i(i �¢' C�U_;i� ciZ /K f�fltn � 2r- El ❑ PROPER SEGREGATION OF MATERIAL (CCR: 2704.1) - EJ'�+❑ VERIFICATION OF MSDS AVAILABILITY (CCR: 2729.2(3)(B)) ❑'r ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) Ir ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR: 2731)) ❑' ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) Rr ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34(F), CFC 2703.5) 17 ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) ANY HAZARDOUS WA TE,ON SITE? YES ❑ NO Si na eo£Recei t Explain: POST INSPECTION INSTRUCTIONS: Refer to the back of this inspection report for regulatory citations and corrective actions • Correct the violations) noted above by • Within 5 days of correcting all of the violations, sign and return a copy of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Y Signature hat all dol tions have been corrected as noted) Date' While — Business Copy yellow — Business Copy to he Sent in after return to Compliance Pink Prevention sarviees COpy FD2155(Re, 12/11) Lld