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HomeMy WebLinkAboutInspections1 .~=` UNIFIED PROGRAM INSPECTION CHECKLIST ~' ~~~~ e _.. ,:.: .:, ... .SECTION 1: Business Plan and Inventory Program ~'' ~.,,~ BAKERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSP N T INSPECTION TIME ~ ~ ® ~ ADDRESS ~ HONE NO. O OF PLOYEES a CCr ~~ FACILITY CONTACT USINESS ID NUMBER ~ A 15-021- f' o Section 1: Business Plan and Inventory Program ---~i~ ~l.Y~ 1- -l- O ROUTINE C~-~MBINEO ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSP CTION C V (~=Compliance` OPERATION J COMMENTS V=Violation ^ APPROPRIATE PERMIT ON HAND ^ BUSIt1@SS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS CORRECT OCCUPANCY Q/f7 VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL '. ~Q ~, / 7 V ~~ ~ ~ L4 L ERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO DURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION c , ~ ~ f ~ ~ ~ ( ~ ~~( tS~-~o~€ccz-~S-tL-~ ~c~s ~= ~^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES l'C~KIO 10 EGARD IS INSPECTION? PLEASE CALL US AT (887) 328-3979 (Please Prin Fire Pre ntion / 1" In /Shift of SitelStation ~ B )~ White -Prevention Services Yellow -Station Copy Pink - Business Copy FD2048 (Rw. 02!05) ~' ~~ +~iw4~`~~Y ~~F ~~\ CITY OF BAKERSFIELD FIRE DEPAR'T'MENT ;~ ~ ~ M~ OFFICE OF F:NVIRONI~~IE;N'I'AL SERVICES y~i! UNIFIED PROGRAM INSPECTION CHF,CKLIST `_wE'~g~,,~'~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 P FACILITY NAME rt eg~t~ ~nt ~+rlr~rc~-S INSPECTION DATE S' 3 ®~O Section 2: Underground Storage Tanks Program ^ Routine (Combined Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection Type of Tank ,'. Number of "Tanks 3 Type of Monitoring _~} 1 ~ Type of Piping Stt) OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current d ~ ~ (© O 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: Office of Environmental Services (661) 326-3979 ~4'hitc - Pnv. Svcs. Busines Site esponsible Party Pink -Business Copy ~. } •~~ 4 UNIFIED PROGRAM INSPECTION CHECKLIST: APF°E'-''-:~M~ P"vy d{°n`.G~°i~r.n .. 1. (.._ .F C~'..',i'::. ... .i;. '. :. i-.... :': n.. ~.'~v '. -.;%.. -w :. •...., ~..:. x:... .. .._ .~. SECTION 1: Business Plan and Inventory Program ~,. BASERSFIELD FIRE DEPT s Prevention Services ~It~ 900 Truxtun Ave., Suite 210 ARrr Bakersfteld, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ` ' NSPECTION DATE ' NSPECTION TIME j~S7,q , f ~ / 3/d ~ ;ate ADDRESS HONE NO. O OF EMPLOYEES 7 /! ,~. ~ ~d° ~ ` FACILITY CONTA T ~ USINESS ID NUMBER 15-021- Section 1: Business Plan and Inventory Program ^ ROUTINE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT D RE-INSPECTION C V (c=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND . ^ BUSIftASS PLAN CONTACT INFORMATION ACCURATE -^ VISIBLE ADDRESS ^ -^ ^ 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 /~Ii.'1 ^ VERIFICATION OF ABATEMENT SUPPLIES AND R CEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING F~'~ ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN ^ YES ,~-N~- QUESTIONS REGARDING THIS iNSPECT10N4 PLEASE CALL US AT (881) 326-3979 Inspector (Please Print) Fire Prevention / 1u In / Shift of Sile/Stetion q BtuinE White - Prwention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rw. 02105) a - ;q- ,. - ~L - ~~~w4~' `~~ \ CITY OF BAKERSFIELU FIRE DEPAR'TMF.NT ~~ ~ ~ ~~ OFFICE OF ENVIRONMENTAL fiERVICES ~`~ yob UNIFIED PROC:RAM INSPECTION CHECKLIST \~w ~gti,,~'~~ 1715 Chester Ave., 3n`' Floor, Bakersfield, CA 93301 ,,~~ FACILITY NAME /- i fS7r¢ ~ i q~Qlls INSPEC"TION DATE ~~ 3/ ~_ Section 2: Underground Storage Tanks Program ^ Routine mbined ^ Joint Agency ^Multi-Agency ~ ^ Complaint ^ Re-inspection Type of Tank S. .,~~/1 ~./~w,T? ~f "~ Number of Tanks Type of Monitoring ~;ll~tcd Type of Piping L,= w~1 7~ OPERATION C V COMMENTS Proper tank data on file Pmper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current -7 ~ z %o atv .~ Maintenance records adequate and current r Failure to correct prior UST violations Has there been an unauthorized release? Yes NO r `~' ~~:~ 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? Ifyes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N-NO Inspector: ~ N ~~,2zA- Office of Environmental Services (661) 326-3979 white - inv. Svcs. Business Site Re ~ ~ ble Party Pink -Business Copy  Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enironmenta] Services an'an nvent°ry-P 0 l - =CTION 1. "' 'r 1715 Chester Ave siness PI d I Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME~. ~..~ ,~,.~._j.~, ___ INS~:~ON~,_ INSPECTION TIME ............................ FACILITYCONTACT Business ID Number 15-021- ,,,, ,:.,,~,:,~-, ~,,.. .. ? ,, · ~: .seBtion .l :'BUsineSs Plan and InVentoryProgram , ~ : ', ,?~,~;",.- .., ,. ,:':.:,~, ~,, ,. ~ . ,' .'~ · , . ' . I-! Routine J~ombined ~ Joint Agency ~1 Multi-Agency rl Complaint 3 Re-inspection C V /' C=Compliance '~ OPERATION COMMENTS \ v=Violation -~/'- ~ /~PPR0i"IATE pERM;T ._ON HAND' _ ................................................................................... I .~ ~] BUSINESS PLAN CONTACT INFORMATION ACCU~TE ~ ~ VISIBLE ADDRESS ~ ~ CORRECT OCCUPANCY  ~ VERIFICATION OF INVENTORY MATERIALS  ~ VERIFICATION OF QUANTITIES ~ ~ VERIFICATION OF LOCATION ~ ~ PROPER SEGREGATION OF MATERIAL ~ ~ VERIFICATION OF MSDS AVAILABILI~E ~ ~ VERIFICATION OF HAT MAT TRAINING  ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ EMERGENCY PROCEDURES ADEQUATE ~ ~ CONTAINERS PROPERLY ~BELED ~ ~ HOUSEKEEPING ~ ~ F~aE PROTECTION ~ ~ SITE DIAGRAM ADEQUATE & ON HAND ANY H~ARDOUS WASTE ON SITE?: ~ YES ~ No EXPLAIN: QUESTIONSo~,~/¢ ~[~ _x~ ~f~_. J/~GA~J;;~ING THIS INSPECTION? PLEASE CALL US AT (661)326-3979~ .~ White - Environmental Services Yellow - Station Copy Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CltECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program ~ Routine ,~ Combined ~ ~,int Agency [~1 Multi-Agency [~ Complaint I~1 Re-inspection Type of Tank ~ltx.ji...(._ 0,_.' ~ ) Number of Tanks ~3 Type of Monitoring -,4T'('~ Type of Piping L. '"~T" OPERATION C V COMMENTS Proper tank data on file Proper owner,loperator data on file Permit lees 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 t, nauthorized release.'? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Ad&quate 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 In spector: ~,'~fl'fl~]'~[/~~ '~ ,t~,~ Office o~ent~l ie'r{i~661)~26-3979 * Business~lSq~e"~esponsible Party White - Env. Svcs. Pink - Business Copy ~~° ~ f° 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 N tE ~SPECTION GATE INSPECTION 71ME - ~ ~S_«-- - _~1_ ~ lGtSJ.L.Y.~_ _._.... -- -- -- - - _ -__ --- - - PHONE No. ADDRESS No. of Employees -- -- - - ~-----~~!~~~__~_--- -----.---. ------------------ ---- ~.~__~~ 41--i-- 2. ---- -- fAC1UTY~NTACT _ Business ID Number 15-021- Section 1: Business Plan and Inventory Pn~gram ^ Routine l~ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection -C/V \V=Voatlonnce~ OPERAT{ON COMMENTS ~,1' ^ APPROPRIATE PERMIT ON HAND --y----------~-------------------------------------------....°---------_-------------....--- -...._..._._. _...._..._..__..-...--...... ..__.._ LV/ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE - IiY ^ VISIBLE ADDRESS O i T . ____ _..-------._ ..•_ - ....- -... _... _ _. . lam' ^ CORRECT OCCUPANCY I i~/^ VERIFICATION OF INVENTORY MATERIALS 0% ^ VERIFICATION OF QUANTITIES ~~^ VERIFICATION OF LOCATION O/~ ^ PROPER SEGREGATION OF MATERIAL a/^ VERIFICATION OF MSDS AVAILABILIrYE ^ VERIFICATION OF HAT MAT TRAINING ~' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES it ~ ^ EMERGENCY PROCEDURES ADEQUATE L3 ^ CONTAINERS PROPERLY LABELED ~ L;y ^ HOUSEKEEPING (,~ ~ ^ FIRE PROTECTION 4 '~ Q~ ^ S{TE DIAGRAM ADEQUATE 8t ON HAND - i ANY HAZARDOUS WASTE ON SITE: ^ YE5 ^ NO EXPLAIN: QUESTION EGARDIN S INSPECTIONS PLEASE CALL US AT ~t)t)~~ 326-3979 __ _-f ~ --~- ---._._....-_-. _.-...---__ _ --~ ----------- Inspector Badge No., White • Environmental Servieea Vellow • Sletlon Copy '~j-r ~~ // Business Site Re(/spohdible Party Pink • Business Copy Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enh-onmental Services , ,,,,, ,,,, ,,, ,,,,,~,,~, ,,,,, ,,,,,, , ,, ,,,,' ,, 1715Chester^ye SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 ~ Tel: (661)326-3979 t.FACII.ITY . I INSPECTION DATE I INSPECTION TIME ~i~?~~ -~~ ........................................................... ~ ............................ t~;?--~--I~-~-~ ...................... [Business ID Number / ~s-021- Section 1: Business Plan and Inventory Program ~ Routine '~. Combined UI Joint Agency U] Multi-Agency U] Complaint ~ Re-inspection t'C=C°n'P"anc~ ~ OPERATION COMMENTS ~. V=Violation APPROPRIATE PERMIT ON HAND VISIBLE ADDRESS --~ C OREE C-----C-------- '--~ TOCUPANCY ......................................................... VERIFICATIONOF INVENTORY MATERIALS VERIfiCaTIONOF OU~NTmES w.,.,~.,o, o. ~oc~.,o. PROPER SEGREGATION OF MATERIAL EMERGENCY PROCEDURES ADEOUAIE CONTAINERS PROPERLY ~BELED HOUSEKEEPING F~RE PROTECtiON S~TE D~AGRAM ADEOUATE & ON HAND .~aRDOUS WASTE O. S~TE?: D YES D NO QUiESTION~.EGARDI~IS INSPECTION? PLEASE CALL US AT (661 ) 326-3979 //_~ -!.~-~ ........................ ~ ................................ ~-s~-~ Inspector Badge No., White - Environmental Services Yellow - Station Copy Pink . Business Copy J~ • 1 iii. 1~~~~tiLD p~~ ~ O ~~w F ~\ CITY OF BAKERSFIE[,U FIRE DEPAR"I'MF,N"I' `< ~ ~°~~ OFFICE OF E:NVIRONMF.N"tAL SERVICES ~`~ y~` UNIFIED PROGRAM INSPECTION CHECKLIST \~ _w~''~R~,~~'~ 1715 Ci~ester Ave., 3r`' Floor, Bakersfield, CA 93301 FAC[L["I'Y NAME rtr 4~.c, Illtry~' tf5 Section 2: Underground Storage Tanks Program INSPECTION DATE; ~ (' ~ 3 ^ Routine ~ Combined ^ Joint Agency. ^MuIti-Agency ^ Complaint ^ Re-inspection Type of Tank ~}~_ C ~ • Q•~ Number of Tanks 3 Type of Monitoring ~TC~ ~ Type of Piping ti PT OPERATION C V COMMENTS Proper tank data un file 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 L/~ 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 Inspector Office of Environmental Services (G61) 326-3979 white N=NO ~~~~~ ~j~ Business Site Responsible Party tinv. Svcs. Pink -Business Cory CITY OF I~AKE'RSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM'INSPECTION CltECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~'1¢.~ ~t~OO¢'; INSPECTION DATE ~ Section 2: Underground Storage Tanks Program [221 Routine '~1 Combined [] Joint Agency [] Multi-Agency_ [] Complaint [] Re-inspection Type of Tank ~O,}L (. ~.,~,~ Number of Tanks Type of Monitoring ~T~ Type of Piping OPERATION C V COMMENTS / Proper tank data on file ~ /' / / 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) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS sPcc available SPCC on file with OES A'd~quate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=ComplJance // V=Violation Y=Yes N=NO Inspector:,l~._fl~,(~ ~)//.~ ~~5 Office of Environmental Services (661) 326-3979 Business Site Responsible Party While - Ear. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301 FACILITY NAME ~"~C~'&--]x,O~_~.6 INSPECTIONOATE 7~ ADD.SS 0~3 ~(t '- PHONENO. 3-qt q FACILITY CONTACT BUSINESS ID NO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~ Routine [~Combined 1~ Joint Agency [~ Multi-Agency ~.] Complaint [~ Re-inspection OPERATION C!V COMMENTS Appropriate permit on hand / Business plan contact information accurate Visible address L~//~t'~ 4tc) ~t;~)~ya~.-~ "~"'~ Correct occupancy Verification of inventory materials L. Verification of quantities / Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures L,,, Emergency procedures adequate Containers properly labeled / .//_ Housekeeping Fire Protection Site Diagram Adequate & On Hand C... C=Compliance V=Violation Any hazardous waste on site?: [~l Yes ffNo Explain: Questions regarding this inspection? Please call us at (661)326-3979 Business Site ~ffsponsjJale Party ,f/-- White - Env. Svcs. Yellow - Station Copy Pink - Business Copy I nspect°r: ,-- J~'/g~ ~/~~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ,~/¢.{"~,&_ .~t ~_10[',~ INSPECTION DATE '7~O~,~*~'-~ Section 2: Underground Storage Tanks Program ~l Routine [~ Combined [] Joint Agency [~l Multi-Agency_ [] Complaint [21 Re-inspection Type of Tank ,~/_OL. Number of Tanks .~ Type of Monitoring /~(3 Type of Piping .~p,F' OPERATION C V COMMENTS Proper tank data on file r~.~ Proper owner/operator data on file Permit tees 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) AGGREGATE CAPACITY' Type of Tank 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 z~V=Violation Y=Yes N=NO Inspector: .~1~., ~~/~ ~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ADD.SS ~Z' ~kcr ~T PHONENO. ~' FACILITY CONTACT BUSINESS IDNO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine ~ Combined I~ Joint Agency [~ Multi-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 L /' 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 i ~ · Fire Protection F Site Diagram Adequate & On Hand /' C=Compliance V=Violation Any hazardous waste on site?: [~] Yes [~] No ~St~ Explain: White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~'7~ c~'o,, /x, ~Oo .t.S INSPECTIONDATE'"'Ii/3!/fO/ Section 2: Underground Storage Tanks Program [] Routine [~[ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank ~l,Ol Number of Tanks ~ Type of Monitoring ./tT~ Type of Piping .L~ OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current 4~. / 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) AGGREGATE CAPACITY Type of Tank 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=C°mptialce~'V=Vi°lati°n'//d,~")~ Y=Yes N:NO ~c//~ ~ Inspector: ...?ffJX_] Office of Environment~al-~ervi~e~ (805) 326-3979 Bt~sil~ss Site ~esponsible Party White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~}e_~O.. ]x~tgOor~ INSPECTION DATE iO/o2S/O0 ADDRESS ,-00~3 O~_cv-'~T PHONENO. 3~3-qf~gt{ FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine ~/~ombined [] Joint Agency [~ Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate L, / / Visible address 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 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 dlIltl Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business nsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: _]~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME laTC3~c /xl~OOt~ INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank ,Sul_~ k(wee{ Number of Tanks 3 Type of Monitoring fi'TO Type of Piping /.4/" OPERATION C V COMMENTS Proper tank data on file L,,/ Proper owner/operator data on file Permit tees 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) AGGREGATE CAPACITY' Type of Tank 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 Office of Environmental Services (805) 326-3979 Busin ponsible Party I White - Env. Svcs. Pink - Business Copy ~ BAK~iSFIELD CITY FIRE DEPAI~ENT ~ HAZARDOUS. MATERIALS DIVISION INSPECTION RECORD POST CARD AT JOBSITE FACILITY F~/~ C '~ OWNER ~ ~ ADDRESS ~ ~ ~r ADDRESS "~0 ~ ~ ~ c~, z~P .~. ~ ~ ~ c,~, z~P¢~ -. ¢~ INS~UCTIONS: Please ~11 for an ins~r on~ when each group of ins~ons w~ ~e same numar are ma~. They will run in ~nsecu~e order ~ginninI w~ numar 1. ~ NOT ~ver work for any num~md group until all ~ms in ~at group am signed off by ~e Perm~ng Aurora. Following ~ese ins~u~ons will reduce ~e numar of required ins~on vis~ and ~erefore prevent assessment of add~onal fees. TANKS AND BACKFILL INSPECTION I DA~ I INSPECTOR ~c~ll of Tank(s) S~rk Test Ce~on or Manufa~res Me~od Ca~odic ProlCon of Tank(s) PIPING SYSTEM Piping & Raceway w/Collection Sump Corrosion Protection of Piping, Joints, Fill Pipe Electrical Isola~on of Piping From Tank(s) Cathodic Protection System. Piping SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION Liner Installation - Tank(s) 5/.?z Liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) Leak Detector(s) for Annular Spaca-D,W, Tank(s) Monitoring Well(s)/Sump(s) - H20 Test Leak Detection Device(s) fOr Vadose/Groundwater FINAL II .. I Monitoring Wells, Caps & Locks %" I Fill Box Lock I Monitoring Requirements CONTRACTOR ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ffl¢,Slw,, h~.voc5 INSPECTION DATEo[.tdgs ADDRESS ~(~3 3 .~l'rr 6T- PHONE NO..'~3-/'l(o~ ~.l ' FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section I: Business Plan and Inventory Program [~ Routine [21 Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~/ Business plan contact intbrmation accurate ~/ Visible address [/ Correct occupancy jr Verification of inventory materials V Verification of quantities ~ Verification of location bt' Proper segregation of material sot Verification of MSDS availability b/ Verification of Haz Mat training ~ Verification of abatement supplies and procedures V/ Emergency procedures adequate p/ Containers properly labeled ~ Housekeeping t,/ Fire Protection ,p/ ~ 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 Business ponsible Party White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~ie~'~ h,~.Oor5_ INSPECTION DATE ~l[l!fS Section 2: Underground Storage Tanks Program [~Routine [~l Combined ~ Joint Agency [] Multi-Agency [~1 Complaint [] Re-inspection Type of Tank _-q¢~./-~ Number of Tanks ~ Type of Monitoring tqm' ~ Type of Piping /_ ~o/- OPERATION C V COMMENTS Proper tank data on file 9/ Proper owner/operator data on file V/ Permit fees current Certification of Financial Responsibility V/r Monitoring record adequate and current Maintenance records adequate and current ~r Failure to correct prior UST violations V, Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank 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? Inspector:C=C°mpliance '~V=Vi°lati°n~ Y=Yes N=NO [fll~__~/l~..~ Office of Environmental Services (805) 326-3979 Bus~nesskJSt[e ~espons~ble Party White - Env. Svcs. Pink - Bus/ness Copy INSPI~ION ' ~akersfield Fire Dept. i ..~ OF ENVIRONMENTAL SERVICES HAZARDOUS MATERIALS 1715 Chester Av.c. Bakersfield, CA 93301 Date Completed3//o/,~ 7 Business Namei r~-M-,- A,~e c4 Location: ~Oz.~ ~l'~r ~r' Business Identification No. 215-000 1 2.S I (Top of Business Plan) Station No. Shift Inspector ..4'k%,~. d¢~/cro..,~( Arrival Time: Departure Time: Inspection Time: Adequ~qu~te Inadequate Adequate Inadeq~a!e Address Visable I~' i-I Emergency Procedures Posted 13 Correct Occupancy ~ 13 Containers Properly Labled I~ 13 Verification of Inventory Materials ~ 13 Comments: Verification of Quantities I~~ 13 Verification of Location ~ 13 Verification of Facility Diagram I~ 13 Proper Segregation of Material I]3/ r'l Housekeeping ~ 13 Fire Protection I~' 1:3 Comments: Electrical ~ 13 Comments: Verification of MSDS Availablity E1 ~ Number of Employees: ,~ UST Monitoring Program ~z' 13 Comments: Verification of Haz Mat Training 13 I~ Permits I~. 13 Comments: Spill Control I~z. 13 Hold Open Device ~ 13' Verification of Hazardous Waste EPA No. Abbatement Supplies and Procedures I-I ~ / Proper Waste Disposal I~1'. 13 comments: Secondary Containment ~f/ 13 Secudty ~ 13 Special Hazards Associated with this Facility: Violations: Mo ,J~,Jt-kor, z~d 1~,~(¢,,~c_ ~%oo~c__ Plan..~o m~os ~ ~,~ <~'g~& ~ ~ ,' < ~ ~ All Items O.K Business O~erlManag~ PRINT NAME ~ ~IG~UR~ ' CorrecUon Needed ~ite-H~ Mat Div. Yellow-S~tion C~y Pink-Business Copy UNDERGROUND STORAGE TAI INSPECTION e Bakersfield Fire Dept. FACILITY NAME /~-Y~-~ll~.. ,~f~Var~ BUSINESS I.D. No. 215-000 FACILITY ADDRESS ~flZ.~ ~c ~ Cl~ ,~ ~ ZIP CODE FACILI~ PHONE No. ~ ~ INSPECTION DATE ~/10/~7 t ~ ~ P~ Pr~ TIME IN TIME OUT cl~ ~[~'~ ~J~ ~ INSPECTION ~PE: / ~7~ /~7~ S~e' S~e ROUTINE ~ FOLLOW'UP i~,~ ~ /~ ~ REQUIREMENTS ~ no ~a y~ ~ ~a la. F~s A & B Su~ 1 b. F~ C Su~ lc. O~ing F~ Pa~ ld. S~te Sumharge Pa~ le. S~te~nt of Fi~l Res~nsibil~ Su~ lf. Wr~en Contract E~sts ~n ~ & O~ to O~e UST ~. ~lid O~mting Pe~ 2b. Ap~ov~ Wr~en Ro~ine MonR~ng Pr~ure 2c. Una~h~ Relea~ Res~n~ Plan ~. Tank Int~r~ Test in ~a 12 M~ths /n/u/~ 3b. Pre~u~ Piping Int~r~ Test in Last 12 U~t~[ ' ~. Suction Piping ~ghtness Test in Last 3 Years ~. Gmvi~ FI~ Piping T~htn~ T~ in Last 2 Y~m ~. Test ResuRs Subm~ Within ~ Da~ 3f. Dal~ ~sual MonR~ing of Su~i~ Pr~t Piping ~. Manual Invento~ R~cil~ti~ Each Month ~. Annual Invento~ R~iliati~ Statement Su~ ~. Metem Calibmt~ Annually 5. W~ Manual Tank Gauging R~ds f~ Small Tan~ 6. Month~ Statisti~l Invento~ R~ciliation R~uBs 7. Monthly A~atic Tank Gauging Resu~s 8. Ground Water MonR~ing 9. ~r MonRoring 10. Continuous IntemtRial MonRodng f~ Doubl~Wal~ Tan~ 11. M~hanical Line Leak Det~tom 12. El~tmnic Li~ Leak Det~om 13. C~tinuous Piping MonRoHng in Sum~ 14. A~atic Pump Shrift Ca~bil~ 15. Annual Maintenan~Calibration of Leak Det~t~ Equi~nt 16. Leak Det~tion Equipment and T~t Meth~s L~t~ in L~113 Se~ ~ 17. Wr~en R~ords Maintain~ on SRe 18. Re~ Chang~ in U~g~Conditions to O~ti~nR~ng Pr~ures of UST S~tem WRhin ~ Da~ 19. Re~d~ Una~hor~ Relea~ WRhin 24 H~m ~. Approv~ UST S~tem Re~im a~ U~md~ 21. R~rds S~ng Cath~ Pmt~t~ Ins~ti~ ~. ~ur~ MonR~ng Wells ~. Drop Tu~ ~__-~ .~ F RE-INSPECTION D~ ~ RECEIVED BY: FD 1~9 ~ e o? Bakersfield, CA9330t .... FACILITY NAME ~io~.,~-a £,'n ~,n~5 BUSINESS I.D. No. 215-000 FACILITY ADDRESS ' ~.~_9,~ ~,~.~ CITY FACILITY PHONE No. ~ ~,g. ,ff ~, ~ ID* ID# ~D~ INSPECTION DATE II/,-~/'~ / o~] ~,~', ,.~.,v~ Product Product TIME IN c~ '.~O TIME OUT INSPECTION TYPE: Iq 7~ /q'7~ /~?~' Size Size Size ........ ROUTINE FOLLOW-UP REQUIREMENTS yes no iVa yes no n/a yes no n/a la. Forms A & B Submitted lb. Form C Submitted .~ lc. Operating Fees Paid ld. State Surcharge Paid le. Statement of Financial Responsibility Submitted lf. Written Contract Exists between Owner & Operator to Operate UST c~ 2a. Valid Operating Permit ~ 2b. Approved Written Routine Monitoring Procedure 5, 2c. Unauthorized Release Response Plan ~ ~v~ ~1~.. v/ v/ ~" : 3a. Tank Integrity Test in Last 12 Months ; . 3b. Pressurized Piping Integrity Test in Last 12 Months 2,, 3c. Suction Piping Tightness Test in Last 3 Years 3d. Gravity Flow Piping Tightness Test in Last 2 Years ~. Test Results Submitted Within 30 Days 3f. Daily Visual ~lonltoring of Suction Product Piping ,~. M.nua~ ~.vent~ry.~n~,~ticn Each Month ~.. ~W~:c'~, 4b. Annual Inventory Reconciliation Statement Submitted 4c. Meters Calibrated Annually 5. Weekly Manual Tank Gauging RecOrds for Small Tanks. 6. Monthly Statistical Inventory Reconciliatiod Results I./ ~,/' 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring ,/ g. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks ,/ 11. Mechanical Line Leak Detectors ~ 12. Electronic Line Leak Detectors ~" 13. .Continuous Piping Monitoring in Sumps 14. Automatic Pump Shut-off Capability ,/ ,-'" '-'"" 15. Annual Maintenanca/Calibraticn of Leak Detection Equipment cf?;... ~ ,-~5, 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series v/ 17. Written Records M~intained on Site 0~ c~'~'~ ~,, .'~, ~. v'"" v/ ~'~ 18. Reputed Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days 19. Repo~led Unauthorized Release Within 24 Hours 20. Approved UST System Repairs and Upgrades 21. Rec~.rds.Showing-Cathodic.~roteCtion Inspection , 22. S~ured Monitofing...,W.~ellS/ 23. Drop Tube RE-INSPECTION DATE ._.~. ;~/5~z'/ _ ',' RECEIVED BY: INSPECTOR: ./~. ,~/.~- //., 0[~. ..... FFICE TELEPHONE No. ~j:'.'.~ - ~- ~' ?~' ! FD 1669 UNOERGROu~D HAZAROOU~ SUBSTANCE STORAGE FACILITY : ' .... ~ INSPECTION REPORT T FACIL~T..,Y NAME:F!EZTA .............................................................................................................................................................................................................................................. OWNER~ NAME:J:.EF~RT~: ~ROTHER5 COMMENT;.,: ...... t ............................................................................................................... --~ .................................................................................................. ITEM V ~ CLAT I ONS/'OBSERVAT 5~$ "' I. PRIMARY CONTAINMENT MONITORING:----~-& ~ ~'~ ~ ~ ,: :,.. c. ~oa,,~=. Inventory d. In-tank Level Sensing Device e. Gnoundwa~ar ~onitoring f. Vadose Z~e ~onitoring >.: a. Liner b. Double-~ailed 8. UNAUTHORIZED ~ELEASE ~-~/~ ," : .KERIN~i)UNTY AIR POLLUTION CeNTRe ISTRICT' ~"~;" 2700 "M" Street, Suite 275 .. Bakersfield, CA. 93301 - ' ·PHASE II'VAPOR RECOVERY iNSPECTION FORM " ~mpany Address ~0 ¢ ~ ~~ .... ¢' City ;~'~ ~ ~ . '~, · 2. CHECK VALVE . ." 3. FACE S~L ~ " 4. RING, RIVET 5. BELOWS ~ .' 6. SWIVEL(S) " .: 7. FLOW UMITER (EW) 1. HOSE CONDITION ' 3. CONFIGURATION .~ .:. 5. OVERHEAD RETRACTOR 6. POWER/PILOT ON 7.. SIGNS POSTED ., ~ ~ ~ ~ ~ ~ to s~stom ty~os: Keg to deficiencies: ~G= not ce~fiod, B~Balanco HE =Healey M= missing, TO= torn, F= fiat, 1~= tangled =~ed Oacket GH=Guff Hasselmann AB= needs adlustment, k= Ion~, kO= loose, =~irt H~ =Hasstoch S= sho~ MA= misali~noO, K= kinked, ~ ~ra~od. "~ ** I NSPECTIONRESULTS ** ~"~'~'~J~[/~-")~)J I '1 .I I I'1 I I I i Key to inspecbon results: ~ ~ank= OK, 7= Repair within seven days, T= Tagged (nozzle tagged out-of-order until repaired) U= Taggable violation but left in use. _. COMMENTS: ~I-OL~ATIONS:-'-SYSTEMS MARKED WITH A-~f-o~-u~/CODE'i-i~I~-I~PE{~IOI~i~REsuLTS,=~ARE IN'-VIOLATIOI~I OF KERN COUNTY AIR POLLUTION CONTROL DISTRICT RULE(S) 412 AND/OR 412.1. THE CALIFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES OF UP TO $1,000.00 PER DAY FOR EACH DAY OF VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLUTION OF THE VIOLATION. NOTE: CALIFORNIA HEALTH & SAFETY CODE SECTION 41960.2, REQUIRES THAT THE ABOVE LISTED 7-DAY DEFICIENCIES. BE CORRECTED WITHIN 7 DAYS. FAILURE TO COMPLY MAY RESULT IN LEGAL ACTION · '':;: 9~49..m~5 APCD F!LE ~ .. KERN LINTY AIR POLLUTION CON RO STRICT ! ,~" ' 2700 "M" Street, Suite 275 .. '.' Bakersfield, CA. 93301 " (805) 861-3682 PHASE I VAPOR RECOVERY INSPECTION FORM .Date ~/~/~ ~ '_' Phone ~ ~ ~ ' ~ ~ ~ ' System Typ axial ....- . " - -'_ ': · '":'~'~- ' "'-" '~_~:~'/'~h .'L_; ..... 7 ' ': .~' ' 2. TANK LOC REFERENCE : :" :,.': ' ' 4. BROKEN OR MISSING Yl~ GAP * 5. BROKEN CAM LOCK ON VAPOR CAP .-- 6. FILL CAPS NOT PROPERLY SEATED · %. .:'. . 7. VAPOR CAPS NOT PROPERLY SEATED ..... ~ :.~ -=" · 8. GASKET MISSING FROM FILL cAP 9. GASKET MISSING FROM VAPOR~CAP :_ 10. FILL ADAPTOR NOT. TIGHT ~.~/' ' -- ' 11. VAPOR ADAPTOR NOT TIGHT 12. GASKET BETWEEN ADAPTOR & FILL TUBE MISSING / IMPROPERLY SEATED 13. DRY BREAK GASKETS DETERIORATED 14. EXCESSIVE VERTICAL PLAY IN ~ COAXIAL FILL TUBE 15. COAXIAL FILL TUBE SPRING MECHANISM DEFECTIVE 16. TANK DEPTH MEASUREMENT 17. TUBE LENGTH'MEASUREMENT. 18. DIFFERENCE (SHOULD BE 6" OR.LESS) .19. OTHER 20. COMMENTS: ; .; r'~ ~' WARNING: SYSTEMS MARKED WITH A CHECK ABOVE ARE IN VIOLATION OF KERN COUNTY AIR POLLUTION CONTROL · "~' "' DISTRICT RULE(S) 209, 412 AND/OR 412.1. THE CAUFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES OF UP TO $1,000.00 PER DAY FOR EACH VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLUT; APCD FILE 9149~1010