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- :~rv- - _ Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST ` ~ B F R S, n 900 Truxtiin Ave., Suite 210 - FARE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° aRrIN Tel.: (661) 326-3979. - - ~ Fax: , (661) 872-2171 FACILITY NAM ~ - - INSPECT N ATE INSPECTION TIME ~~ 8 6 0 7 ADDRESS ~~ ~ ( ~ ^ P~~~ ~ OOFF~pPLOYEES C{ ., © ~ ~~ ~ \ ~~~ ' J FACILITY CONTACT BUSINESS ID NUMBER 1.5-021- ~ ~, f -- - Section 1: Business Plan and Inventory Program ~ . ^ ROUTINE ,,., L`YCOMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIrIeSS PLAN CONTACT INFORMATION ACCURATE - ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION - / LX ^ 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 ANY HAZARDOUS WASTE ON SITE? ^ YES ~NO EXPLAIN: / l QUESTI~NS REG~RDI~1G THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire ~t?Cention / 1" In /Shift of Site/Station # _ - _ White -Prevention Services - .Yellow -.Station Copy Pink -'Business Copy- fD 2155 ~~ (Rev. 09105 - ~~ INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST 1 B D E R S F I L D P/BE AIirTM T 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 FACILITY NAME: ~til[~ u-c~S INSPECTION DATE: ~ b 8 Section 2: Underground Storage Tanks Program ^ Routine m/Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank ~ .~~ 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) 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: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) FIRE :PREVENTION INSPECTION ~ / ,~'~~ • BAKERSFIELD FIRE DEPT. '~ ~ ~~'' t, ti B S F t L D Prevention Services ' PARE 900 Truxtun Ave., Ste. 210 ~~~ ARTM T Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT BLOCK NO. DATE q ZZ ~ G/'1 ! EE ~ ~~ FACILITY ADDRESS ~\\ ; !~ CITY, STATE, ZIP 2 _ ~ ` ~~ \~ y ~~ ~ ~ i r ~ ~~ r` ~ t `~ C~ 1. FACILITY NAME ~ /'"~ ~~.~~ ~t cz.U` ~C/ MANAGER'S NAME FAAC'ILITY PHONE NO. ~+ ~ ~l~ ~ `s~Z~ ~ BUSINESS OWNER'S NAME AND ADDRESS _ CITY, STATE, ZIP OWNER'S PHONE NO. BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, 21 P, BILLING PHONE NO. ~u OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS VIOLRTION REQUIREMENTS ~~ CHECKED BELOW No.- COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) 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.) q 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 ---------------------- g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once e c e 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 (doorlwindow) to SIGNS fire escape. (U.F.C.) 8 Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the correct address of the building. (B. M.C.) (U.F.C.) g Repair all (cracks/holes/openings) in plaster in (location) _ __________. Plastering --------------------------- FIREDOORS/ ~ 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.) ~ J 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) --% '~ , l _________ to clearly indicate it as an exit. (U.F.C.) ~/ 3 ~' --------------------- STORAGE 1g Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire ~ escapes/stair shafts are to be maintained free from obstructions at all times.) (U. F.C.) r 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 780 2 U.F.C. or 8.49.040 o f the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 -g o j ~p r~~~ ~~"C\ \G~i~\pn. '-,tGd e GC C7 ~~~Ll' ~"~~I~SSV 0•--~ e y+ d 0 a.. ~ ~ ~ ¢._ ~ ~ ~ O r ~ ~ .-_, °` S ~d Sid ..r, 1 a."i'e G tom' ~~S ~x-~ a f ~ U ~ - ~r t 0 ~'' .~G d ~. CUSTOMER: f ~r+ GZ ~ Q~r,i nA~ ~~ Y LEGEND: a (Signature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE U.B.C. UNIFORM BUILDING CODE ~ 0, B.M.C. BAKERSFIELD MUNICIPAL CODE G ~ , 4 ~ INSPECTOR: ~.„ ~ AP NO.~ / . N.F.P.A. NATIONAL FIRE PROTECTION (SlgnatUre) ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE t I White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05) FIRE PREVENTION INSPECTION ` >3 E R S F t L D P/RE ARTM T BAKERSFIELD FIRE DEPT. /J 0~ Prevention Services ~ ~ I 900 Truxtun Ave., Ste. 210 ~/1i Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 852-2171 DISTRICT ~ BLOCK NO. DATE `~ 1 O ` EE FACILITY ADDRESS ~ 7 ~ ~ (~ !1 ' ~Q f f ~~ ` CITY, STATE, ZIP ;~ ~ _ ~ ~~~ ~~\ r l • tR ) C•, FACILITY NAME ~~ C O.~S ~ ( LtZ C%-v C~~' F ' l T HON N MANAGER'S NAME C`~ e. ~t ' BUSINESS OWNER'S NAME AND ADDRESS . CITY, STATE, ZIP R' PHON 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 D /~ ^ YES ^ NO VX CORRECT ALL VIOLATIONS VIOLRTION REQUIREMENTS CHECKED BELOW no. COMBUSTIBLE WASTE I DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) 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 heigl~~~a it it window) to SIGNS fire escape. (U.F.C.) 1... g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the correct address of the building. (B. M.C.) (U.F.C.) a g Repair all (crackslholes/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 & 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 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 ~~ d c. s ., Sc ! V ~ t_c c~d°R S ~ 6 e? Sc, 1 u C ~ t. ~'~"-" a ,; L ' ~ f ) ~..~- ~ ¢ ~r ~J 1 R.... an ti C~'~" , ~ ~ C. a r u GIC,~ t c.,4.. -Try ~li Cc'~. C,~r6~faSS\ a `} !{~~~ (' _ } y 1 J ~ i CUSTOMER: ~ ,-"r-('-~ '~/ / ~ j f~ ~ / ~-~ ' ~ LEGEND: (Signature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE U.B.C. UNIFORM BUILDING CODE ` ~.,, , ~ ~ ~ B.M.C. BAKERSFIELD MUNICIPAL CODE INSPECTOR: t ~/r -- AP NO.: ~ f N.F.P.A. NATIONAL FIRE PROTECTION (Signature) ~ ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE ~~~ „~~ ~ 1\ PAC' White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (ReV. 09/05) ~1NI~IE® PROGRAM INSPECTION CHECKLIST SECTAON 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NA;~E INSP CTIO DATE INSPECTION TIME ADDRESS ~~ PHO E No. No. of Employees ------ ~~ (_ ~~~~ ,_.~~s~~,------..-------------- --------- ~~sg~, _ __ Jam- -_. __ ---- -- FAC IL ITYCONTACT t 15-~21- Section 1: Business Plan and Inventory Program ^ Routine ombined O Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection ~% V \V=Voatolnnce~ OPERATION COMMENTS L`6~ ® APPROPRIATE PERMIT ON HAND L~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS _----.._ ~^ CORRECT OCCUPANCY I CII~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES __ ~^ VERIFICATION OF LOCATION ~^ PROPER SEGREGATION OF MATERIAL LT ^ VERIFICATION OF MSDS AVAILABILITYE LAY ^ VERIFICATION OF FIAT MAT TRAINING C3 ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES <'J ^ EMERGENCY PROCEDURES ADEQUATE C~7 ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING LI ^ FIRE PROTECTION L~f ^ SITE DIAGRAM ADEQUATE 8c ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES i3 NO EXPLAIN: QUESTIONS CARDING T IS INSPECTIONS PLEASE CALL US AT ~C6'I ~ 326-3979 r~ 7 - - ~-rI _.... . __ -----------------. Inspector Badge No., White -Environmental Services Yellow -Station Copy usiness Site Responsible Party Pink -Business Copy ~'{ ~-- Prevention Services UNIFIED PROGRAM LNSPECTION CHECKLIST B._... E..R-_s F t 9ooTruxtun Ave., suite 210 _ .___ ._...I? -- - =--~- -~ ~==------- ---~~ -~ °~ ~- -- ! FARE Bakersfield, CA 93301 SECTION. 1: Business Plan and Inventory Program ~" ARTM r Tel.: (661) 326-3979 - ~ Fax: (661) 872-2171 FACILITY NAME - - INSP E ION D TE INSPECTION TIME ~I //~~ c~-v~ ~Q~s ~ b ~ ~ 11 S tY ~y ~b /r. ADDRESS 2a ~~I~ ~ PHONE NO. `3~ ~ Gad NO OF EMPLOYEES s ~ ~ . FACILITY CONTACT BUSINESS ID NUMBER „ 15-021- Section 1: Business Plan and Inventory Programs ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance` OPERATION V=Violation / COMMENTS ^ APPROPRIATE PERMIT ON HAND ,~ . ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY /~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL A 006 ~} ^ VERIFICATION OF MSDS AVAILABILITY ` ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~, ^ EMERGENCY PROCEDURES ADEQUATE t , ~f' ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ .~ SITE DIAGRAM ADEQUATE & ON HAND Qtly»~ 1°,iY~.+wco.,., Lor.~ ~ `3 ~4nr ..a~~.,_ ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US A7 (661) 326-3979 Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # ^ YES -I~10 cv,[ Iti(c,1^ 7' ~11~-`Gl~ KBF-6013 _ White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 • • INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: 1-al o w a~ ~ S l~ B E R S F I L D PIPE A/PTM T Section 2: Underground Storage Tanks Program INSPECTION DATE: ~ C / y DG ^ Routine {~ Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank ~ W .S"7=<< Number of Tanks Type of Monitoring ~.o Type of Piping Qy~Su.R,ce P...-- ) 1 1 flL 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 o Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank 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 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placardingllabeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 KBF-7335 White -Prevention Services Aggregate Capacity Number of Tanks Busi ess i e Responsi rty Pink -Business Copy FD 2156 (Rev. 09/05) v ~~- - -`~a...~~_ -S_ .. ,~~^, . ~ ' . ~ti _-:r R, ._ _._,.,r,r - :.- -" ~~,-~..;;,,,..v.r T -.,:.....,.,,~•=,`«.^r ~ -..~.-..:'.v.,.;,;'s.:...,,,.v..! ..~i:_c,,:;.,...:.,,:...- ~,,...,;..:_.-... w `tir,:-,.~...~ - wc..i3::•..,.-.- . . u:^ - ..::a: y.; ~,,,,; .;,~.~;M~l-+"':•+v+~y..,,~.f' ~~, Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enironmental Services 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 ~ ~ ~p,~,};~~',~n ; ~„ Tel: (661)326-3979 FACILITY NA ma i iu uHi t marts, i ivn i imc _ _ ___ ow _s___ ~~.__1~k~-- ----- ---- ---- - --- -------- -_ --- -- ---- - - -- ~ ? -Q-~------ ----- ---------- -- _ ADDRESS PH E No. No. of Employees ~"'" FACILITYCONTAC Business ID umber 15-02 l - ~~.~~ ' f Section 1: Business Plan and Inventory Program ^ Routine ombined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection i ~% V \V=Vioatiolnnce~ OPERATION COMMENTS ~ ' ~ ' ~^ APPROPRIATE PERMIT ON HAND ~~ --,~---j- - ------ ------_------- ------------_- __- ---.. _._ ....... ...........-- - --- -- LY' ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE i.~/ ^ VISIBLE ADDRESS LAY ^ CORRECT OCCUPANCY I l11/ ^ VERIFICATION OF INVENTORY MATERIALS -. ._ LSV ^ VERIFICATION OF QUANTITIES ~^ VERIFICATION OF LOCATION ^ P ROPER SEGREGATION OF MATERIAL L'?" ^ VERIFICATION OF MSDS AVAILABILITYE ---- A ?~ ---/--------- ----------------------- _- ----- ---- --- -- tSY ^ VERIFICATION OF.HAT MAT TRAINING _ _ --- - --- -- - _. _ _-- --- -_ -~ -- ---- -- --- ~ ~ 206 C~" ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE . Ld" ^ CONTAINERS PROPERLY LABELED © O HOUSEKEEPING --J- -------------------- --------------..------------ U ^ FIRE PROTECTION ---------------------- ------- ----- - ------- ------___.. ~^ SITE DIAGRAM ADEQUATE & ON HAND i ANY HAZARDOUS WASTE ON SITE: OYES LW NO EXPLAIN: QUESTIONS R~GARDING T IS INSPEC710N~ PLEASE CALL US AT ~C6'I) 3Z6-3979 Inspector Badge No., White -Environmental Services Yellow - Stetbn Copy usiness Site Responsible Party Pink -Business Copy ,;~ .= .~ ~t~~` '~~ ~ CITY OF BAKERSFIELU FIRE DEPARTMENT ,6 ~ ~ ~~ OFFICE OF ENVIRONMENTAL. SERVICES `P .y~~ UNIFIED PROGRAM INSPECTION CHECKLIST A'w ~gti,,!'~~ 1715 Chester Ave., 3r`' Floor, 13akersfield, CA 93301 FACILITY NAME ~4a~Q~dS ~tul ~~-~' INSPECTION DATE-'~~~C~ Section 2: Underground Storage Tanks Program ^ Routine ~ombined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type of Tank ~tV FC S Number of Tanks 3 Type of Monitoring _ Cf.ly~ Type of Piping ~~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit tees current Certification ot• Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No ~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on the with OES Adequate secondary protection Proper tank placarding/labeling [s tank used to dispense MVF? If yes, Does tank have overtill/overspill protection'? C=Compliance ~ V=Violation Y=Yes N=NO ~ - ` ~' Inspector: Office of Environmental Services (661) 6-3979 N~hitc -Env. Svcs. usiness Site Responsible Party Pink -Business C~~py ~~ i i ~ ! ~,~ T~xa .w ` `•. i 0'~' T ~ C[TY OF BAKERSFIELD FIRE DEPARTMENT 1~ ~ ~~~, ~ ~~~ OFFICE OF F,NVIRONMENTAL SERVICES ` ~`° , y~`1 UNIFIED PROGRAM INSPECTION CI~~CKL.IST ~w ~g~,0'~ 1715 Chester Ave., 3r`' Floor, Bakersfield,`" ~A 93301 -,.. FACILITY NAME ~ocilac~.'~ Itnlul ~'~~C-~ INSPECTION DATE_ ~~~~C-~_~___ ,.- Section 2: Underground Storage Tanks Program ^ Routine ~ombined ^ Joint Agency ^MultrAgency ^ Complaint ^ Re-inspection Type of Tank t1,~,FC ~ Number of Tanks ~ Type of Monitoring CL1~ Type of Piping ~(_ ~ ~~ t ~ ~1 OPERATION C V t COMMENTS Proper tank data on the 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 U5T violations Has there been an unauthorized release? Yes No ~~ Section 3: Aboveground Storage Tanks Program TANK SIZES} Type of Tank 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: ul,~~ ~ ~~LUY~/I ~ Office of Environmental Services (661) 6-3979 White - env, Svcs. AGGREGATE CAPACITY Number of Tanks _--- usiness Site Responsible Party Vink - ftusiness Cory Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION~CHECKLIST Enironmental Services i 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 ~~ Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME -----~1 ot~a~ ~__ _1~~ ~ ~~ ~ --~~--- ---- -- ------------ _ _-- --~--- -._.-..------------ -- _ Q'~-~ '-o-~~- _ ----- - ----- --_ ADDRESS HONE No. No. of E~loyees -- ----y 0 ( . c (~ Te c ~r~-~-- ----__ _- ----- ---- --- _- --- ------- 397 ' 7` 00 - - _-. - ~- - -- - - FACILITYCONTACT Business ID Number 15-42 l - Section 1: Business Plan and Inventory Program ^ Routine L~-Combined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection ,~C/~V \ V=Vio aponnce l OPERATION C1 ^ APPROPRIATE JPERMIT ON HAND LV~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE H' ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~/' ^ VERIFICATION OF QUANTITIES I.~ ^ VERIFICATION OF LOCATION LU/ ^ PROPER SEGREGATION OF MATERIAL ^ I.~ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ L9~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ (EMERGENCY PROCEDURES ADEQUATE m/^ CONTAINERS PROPERLY LABELED L`-f ^ HOUSEKEEPING L4V ^ FIRE PROTECTION LW ^ SITE DIAGRAM ADEQUATE 8c ON HAND COMMENTS ANY HAZARDOUS WASTE ON SITE?: ^ YES ~ NO EXPLAIN: QUESTIONS REGARDING T . S IN ~ ECTlON~ PLEASE CALL US AT ~C)6'I ~ 3Z6-3979 ~ I Ins ector Bad a No... ~ Bu iness i ' n ' P P 9 s Ste Respo slble arty White -Environmental Services Yellow -Station Copy Pink -Business Copy Ptw~~' `~ ~~\ CITY OF BAKERSFIEi.D FIRE DEPARTMENT ~~ ~ M~ OFFICE OF ENVIRONMENTAL SERVICES y~' UNIFIED'PROGRAM INSPECTION CHECKLIST =;wE'~g~,~~'~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME ~otya r S !'Zt t~tt l~inr~' INSPECTION DATE ~ O ~ (~ ' O ~' Section 2: Underground Storage Tanks Program ^ Routine '~ Combined ^ Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection Type of Tank S itI% 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 cun-ent 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 ~ % I Inspector: ~ ~ Office of Environmental Services (661) 326-3979 Business Site Responsible Party white - inv. 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 FACILITY NAME /4ot~ar, dfi ~unt IIAtr{ ~ INSPECTION DATE it~[J ADDRESS O9.OI -' _13e. llt' '-Get'ate_ PHONENO. ~qT' 76~(9 ' FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~ Routine [~Combined [~l Joint Agency [~ Multi-Agency [~ Complaint l~ 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 L, ' 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?: [~l Yes [~l No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 White-Env. Svcs. Yellow - Station Copy Pink-Business Copy Ins pectorl CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME..~0UJttfd~ ]h. lvx, ~l/l(tx~ *(o INSPECTION DATE Section 2: Underground Storage Tanks Program [~[ Routine [~ombined [] Joint Agency [] Multi-Agency ,t//[] Complaint [] Re-inspection Type of Tank .a--t0{:: Number of Tanks Type of Monitoring ,art¢ Type of Piping OPERATION C V COMMENTS Proper tank data on file %,/ Proper owner/operator data on file kd/ Permit tees current ~ ) /~0 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 ~u3:,i~C$s oi~c ..os~:tsi lehl~a, rty 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 ./-]da/attd5 ~;~ai /tlt:1c ~fo INSPECTION DATE Section 2: Underground Storage Tanks Program [~outine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank AtO~ Number of Tanks Type of Monitoring ,qT'6, Type of' Piping /. OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file V/ Permit tees current l/ Certification of Financial R'esponsibility Monitoring record adequate and current V' Maintenance records adequate and current V 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? C=Compliance V=Violation Y=Yes N=NO // Inspector: ;~, Omce of Environmental Services (805)326-3979 'Business Site Responsible ~'arty 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 //o~a,~.l_q i~,m, lltl~4[ ~& INSPECTION DATE ADDRESS ~~ qOol ~{[cT~NE NO. ~7- FACILITY CONTACT BUSINESS ID NO. I5-210- NSPECT ON Tree UM ER OF EMPLOVE S Section 1: Business Plan and Inventory Program [~]"Routine I~] Combined 1~1 Joint Agency 1~ Multi-Agency 1~1 Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand V Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location V Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate L~/ Containers properly labeled V / Housekeeping Fire Protection Site Diagram Adequate & On Hand V C=Compliance V=Violation Any hazardous waste on site?: I~l Yes [~No Explain: Questions regarding this inspection? Please call us at (805) 326-3979 While - Env. Svcs. Yellow - Station Cop), Pink - Business Copy UNDERGROUND STORAGETAN JSPECTION Bakersfield Fire Dept. FACILITY NAME ,/-~uJec~_(~ )ht~ ,' /~,'iac~- BUSINESS I.D. No. 215-000 ~( FACILI~ADDRESS ~0 I F~(~ ~r~t~ Cl~ ~ ZIP CODE ~ FACILI~ PHONE NO. ~ 7" ~O0 ~ ~ [q l INSPECTION DATE .q,.~1~ ~ Pr~uct Pr~uct Pr~u~ TIME IN TIME OUT d~ ~lo~ .~,~ ~t Insl ~te Inst Date Insl ~le INSPECTION ~PE: ( q ~ ~[ / ~ f ~ Size Size S~e ROUTINE FOLLOW-UP ~ ~ ~ ~ [~,~ O i~ ~0~ REQUIREMENTS yes no n/a yes no ~a yes no la. Forms A & B Submiff~ 1 b. Form C Submiff~ lc. O~rating F~s Paid ld. State Surcharge Paid le. Statement of Financial Res~nsibili~ Submiff~ lf. Wri~en Contract Exists ~een Owner & O~rator to O~rate UST 2a. Valid O~mting Permit 2b. Approved Wriffen Routine Mon~oring Pr~edure 2c. Unauthoriz~ Release Res~nse Plan 3a. Tank Integrity Test in Last 12 Months ~ 37/~ ~ ~ 3b. Pressur~ Piping Integrity Test in Last 12 Months V ~ ~. Suction Piping ~ghtness Test in Last 3 Years ~ ~ ~. Gravi~ Flow Piping Tightness Test in Last 2 Years ~ ~ ~. Test Results Submi~ed Within 30 Days ~ ~ 3f. Daily ~sual Mon~oring of Suction Pr~uct Piping~ ~ ~. Manual Invento~ R~onciliation Each Month ~ ~ ~ ~. Annual Invento~ R~onciliation Statement Submiff~ ~. Meters Calibrat~ Annually 5. Weekly Manual Tank Gauging R~ords for Small Tanks 6. Monthly Statistical Invento~ Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks 11. M~hanical Line Leak Detectors 12. El~tronic Line Leak Det~tors 13. Continuous Piping Monitoring in Sumps 14. Automatic Pump Shutoff Capabili~ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Det~tion Equipment and Test Meth~s Listed in LG-113 Series 17. Wriffen Records Maintained on Site ~ O 18. Re~ Changes in Usage/Conditions to Operating/Monitoring Pr~edures of UST System Within ~ Da~ 19. RepoSed Unauthorized Release Within 24 Houm 20. Approved UST System Repairs and Upgrades 21. Records Showing Cathodic Protection Inspection 22. Secured Monitoring Wells 23. Drop Tu~ INSPECTOR: ~ OFFICE TELEPHONE NO. FD 1~9 (rev. 9/~) CORREC ON NOTICE Bakersfield Fire Dept. Office. of Environmental Services You are hereby required to make the following corrections ~[ ~}~ ,, ~>~ , at the above location:., I '~/~- ~~~Z'--~ '~ ~ /~,~, ~~, m C~ ~ __ . ~~/~ ~~ ~a yes no ~a yes no ~a : ._- // -- Completion Date for Cor;ections 4~/r~ . Date /~/~(~ _ _ _ ~ / ' Inspector ~ 326-3979 16. Leak Det~tion Equipment and Test Methods Listed in L~-I 13 Sories 17. Wri~en Records ~aintained on Site ~ ~ 6. Re~ed Changes in Usage/Conditions to Opsmting/Monitodng Procedures ol UST System Within ~0 1 ~. RepoSed Unautho'~ed Rolease Within 24 ~ours 20. Approved UST System Repairs and Upgrades 2i. Records Showing Cathodic Protection fns~ection 22. Secured Monitoring Well~ ~ ~ ~ ~ "" 23. Drop Tu~ RE-INSPECTION D~TE ~ ~ RECEIVED BY: I~8~ClOR: ....... OFFICE I~kfi~O~[ ~o. UNDERGROUN[ STORAGE TA{III INSPECIION '.'/.;Baker'sfield Fire Dept. ' ':~i Bakersfield, CA 93301 ~?.~.?~,-,1> BUSINESS I.D. No. 215-000 FACILITY NAME FAClLITYADDRESS ~//~! L~/~ ~.~?_ .~r~.,,~.__.CITY ~.. ~,~I~. ZlPCODE~--~' -~.~>.~ FACILITY PHONE No. :~'?~ ?~4~ ~C~ ~D~ ~D~ ~D~ INSPECTION DATE Product : Product ,,~ Productt,,. TIME IN TIME OUT Insl Date Insl Date Inst Date INSPECTION TYPE: Size Size Size ROUTINE ~ FOLLOW-UP REQUIREMENTS yes no n/a yes no n/a yes no n/a la. Forms A & B Submitted 1 b. 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 2a. Valid Operating Permit 2b. Approved Written Routine Monitoring Procedure '.~ 2c. Unauthorized Release Response Plan.' / 3a. Tank Integrity Test in Last 12 Months 7/~/(~ C'] //C~Vi ~, 3b. Pressurized Piping Integrity Test in Last 12 Mo~th~.s ( 4~'~c~ 3c. Suction Piping Tightness Test in Last 3 Years ¥""~~ -/ t,~ ~ /.~ 3d. Gravity Flow Piping Tightness Test in Last 2 Years ,L'PT ~/~ 3e. Test Results Submitted Within 30 Days td 3f. Daily Visual Monitoring of Suction Product Piping -~ ~,,.~ 4a. Manual Inventory Reconciliation Each Month 4b. Annual Inventory Reconcd~abon Statement Submitted 4c. Meters Calibrated Annually 5. Weekly Manual Tank Gauging R~cords for Small Tanks ~,' 6. Monthly Statistical Inventory Reconciliation Results, 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring ~" 9. Vapor Monitoring ~/'PT'~' ,~',~ 10. Continuous Interstitial .Monitoring for D(~Ubl'~-Walled Tanks 11. Mechanical Line Leal~ Detectors 12. Electronic Line Leak Detectors . >.- ~ , .- -.,, ~,' 13. Continuous Piping Monitoring in Sumps 14. Automatic Pump Shut-off Capability 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Detection Equipment and Test Methods l~isted in LG-113 Series 17. Written Records Maintained on Site ~.-~(2(~ ' 18. Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days 19. Reported Unauthorized Release Within 24 Hours 20. Approved UST System Repairs and Upgrades 21. Records Showing Cathodic Protection Inspection 22. Secured Monitoring Wells 23. Drop Tube REqNSPECTION DATE ,,, RECEIVED BY: II~PECTOR: '-'.~.~-/~.~ ff'~:~.~,.. ~------~.,~ x'd~--~ OFFICE TELEPHONE No. FD 1669 (rev. 9~95) UNDERGROUND $,~ .RAGE tl~IK!INS~EC~ION ~?.~:::i~,::~'.~i;*~Oiiii?~;¥,.. ;'~ Fire Dept. . .,~ ' ', ~ : ~ Bakersfield, CA ~3301 FACILI~ NAME t6~L~ BUSINESS I.D. No. 215-000 FACILI~ADDRESS ~O~ ~ ~~ CI~ ~5~ ZIP CODE FACILI~ PHONE NO'. ~ ~ INSPECTION DATE t 0 / ~ ~/~ I / ~ % ~.~ TIME IN I ~ ,o~ TIME OUT ()~ I~ ~, INSPECTION ~PE: IO/~ ~/~ S~e S~e S~e ~.~ ROUTINE ~' FOLLOW-UP ~,~0 I 2./O~ ~ REQUIREMENTS ~ no ~a ~ ~ ~a la. F~s A & B 8ubm~ ~ ~ lb. F~ C Su~ 1c. O~mting F~ Pa~ ~ ~ · ;' Id. ' State Sum~rge Paid ~ ~ le. State~nt of Fi~l R~si~l~ Su~ ~ lf. Wr~en Cont~ E~sts ~n ~er & O~mt~ to O~e UST~ ~ ~' ~. ~lid O~mting Pe~ ~ ~ ~ 2b. Ap~ov~ Wr~en Ro~ine MonRofing Pr~ure ~ ~ ~ 2c. Una~ho~ Relea~ Res~n~ P~n ~ ~ ~ ~ ~. Tank Int~ T~t In Last 12 Months /~ / 3b. Pre~ur~ Piping Int~ri~ Test in Last 12 Months ~.~ -~ ([~ ~ ~ ~. Suction Piping ~ghtness T~t in Last 3 Y~rs ~ ~ ~. Gmv~ FI~ Piping ~ght~ T~ in Last 2 Yearn V / ~. T~t R~uEs Subm~ Within ~ Da~ v ~ / 3f. Dai~ ~s~l MonRoring of Suct~n Pr~ Piping // ~. Manual Invent~ R~cil~tion Each M~th //' ~. Annual Invento~ R~nciliati~ Statement Su~ ~ ~/ / ~. Metem Calibmt~ Annual~ / ~/ ~ 5. W~ Manual Tank Gauging R~ds f~ Small Tan~ ~ 6. Mont~iy' Statisti~l Invento~ R~nciliation R~uRs ~ ~/~ ~ 7. Mo~hN A~atic Tank Gauging R~uRs ~ ~ 8. Ground Water ~nRoHng /~ 9. ~r MonAoHng ~ ~ 10. Continuous IntemtRial Mon~oHng f~ Doubl~Wall~ Tan~ .- , ~/ 11. M~hani~l Li~ Leak Det~ ~/ ~ 12. El~tmnic Li~ Leak Det~tom /~ 13. Continuous Piping MonRoHng in Sum~ ~/ 14. A~omatic Pump Shrift Ca~bil~ '*"' ' " ~ ~ 15. Annual Maintenan~Calibmtion of Leak ~t~ Equi~ I; ~e 3 ~ ~ / 16. Leak Det~tion Equipment and T~ Metes List~ in LG-113 Se~ d ~ 17. Wr~en R~rds Maintain~ ~ SRe ~ ~ C ~ ~'~' ~ 18, Re~ Changes in U~g~CondR~s to O~mti~R~ng Pr~ur~ of UST S~tem WRhin ~ Da~ ~/ 19. Re~A~ Una~h~ Relea~ W~hin 24 Houm / ~. Approv~ UST S~tem Re,irs a~ U~m~ ~ ~ / 21. R~rds S~ng Cath~ Pr~ Ins~t~ ~ / ~. Dr~ Tu~ t ~ ~ ~ ; RE-INSPECTION DATE RECEIVED BY: INSPECTOR: ~/~ ~,, ';,~--- OFFICE TELEPHONE NO. COUNTY RESOURCE MANAGEMENT AGENC' KERN ENVIRONMEN''fAL EALTH SERVICES DEPARTMENT 2?00 "M" STREET; SUITE 300, BAKERSFIELD, CA..,.3301 (805)861-3636 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE FACILITY ~ INSPECTION REPORT * MI 28uuu,~ ~ T~ME IN TIME OUT NUMBER M I T%oOSTED? ) YES ' ...... 1~'8 ...... /¢ .................... ?~SPECT ION COMP L~ ~"~'~ ................................. I L [ TY NAME: ~.~.~.~.~.~,,'...~.,.,,~,~.~,~.~.~ ......................................................................................................................................................................................... ~L~TY ADDRESS:4201 BELLE TERRACE BAKERSFIELD, CA ~ ~ s N A ~ E:,~,,~,q.9...,q,LL,,.qg_~.~5~Z_.~.~,~ ................................................................................................................................................................. R A T 0 R S N A M E:..~,6 ~,~_.~..LL....qg~.~,~,~Z.....~ ................................................................................................................................................................. ~ENTS: TEN V I OLAT I ON S/OB,SE RVAT IONS !MARY CONTAINMENT MONITORING: ~Standard Inventory Control I Modified Inventory ControlI In-tank Level Sensing Device Groundwater Monitoring Vadose Zone Monitoring DARY 'CONTAINMENT MONITORING: :tton - ;OITION OF FACILITY ' · ': '~ KERN TY AIR POLLUTION CONTRO _,I:IICT 2700 "M" Street, Suite 275 Bakersfield, CA. 93301 (805) 861-3682 PHASE I VAPOR RECOVERY INSPECTION FORM Station'Name F~.~,~3 ~ /3'~]~f4w, ct"T"~ocation 424D/ _/~'"//_.~"_ ?~.~--~.~/~ .w~/~'~ P/O # ~mpany MailingAddress t~ ~ ~ ~ ~ ~otico ~ec'd BY TANK · 1 TANK ~2 T~K ~3 TANK ~4 1. PRODUCT (UL PUL, P, or R) 2. TANK LOCA~ON REFERENCE 3. BROKEN OR MISSING VAPOR CAP 4. BROKEN OR MI~ING FILL CAP 5. BROKEN CAM LOCK ON VAPOR CAP 6. FI~ CAPS NOT PROPERLY SEATED 7. VAPOR CAPS NOT PROPERLY SEATED " 8, GASKET MISSING FROM FILL CAP .. 9. ~SKET MISSING FROM VAPOR CAP 10, R~ ADAPTOR NOT TIGHT 11. VAPOR ADAPTOR NOT TIGHT 12. GASKET BE~EN ADAPTOR & FI~ ~BE MISSING / IMPROPERLY SEATED 13. DRY BR~K GASKE~ DETERIO~TED 14. EXCESSIVE VE~ICAL P~Y IN CO~IAL FI~ TUBE 15. COAX~L FILL TUBE SPRING ..' MECHANISM DEFE~IVE / 16. TANK DEPTH M~SUREME~ 17. TUBE LENGTH MEASUREMENT ' 18. DIFFERENCE (SHOULD BE 6" OR LESS) 19. OTHER 20. COMMENTS: /_~._),~",~_.,~.'7'"'._% ;~, ~X~~ / WARNING: SY~MS MARKED WI~ A CHECK ABOVE ARE IN VlO~ON OF KERN COUN~ AIR PO~U~ON CONSOL DIS~I~ RU~(S) 2~, 412 AND/OR 412.1. THE CALIFORNIA H~L~ & SA~ CODE SPECIFIES PENAL~ES OF UP ~ $1,~.~ PER DAY FOR EACH VIOLATION. ~PHONE (~5) ~1-3~2 CONCERNING FINAL RESOLU- ~-~o~ APCD FILE ' ~.: ~" 2700 "M" Street, Suite 275 Bakersfield, CA. 93301 (805) 861-3682 PHASE II VAPOR RECOVERY INSPECTION FORM Station Location ~,~/?¢"~ / ~--~._~/,/,.~_~ ~.~/:~ ~' P/O# Company Address ~.'O, ~'~-'~X ! ~4'? ~ City ~_'A. A~-~ ~-~ ~'"'./~//~ Zip Contact Phone System Type: BA RJ HI HE GH. HA Inspector ..¢'-~; ~ *-¢'.¢'~7., ~ ,~>..--'7 Date -~ - 2 ~ ~ ?..~ Notice Rec'd By NOZZLE cf GAS GRADE NOZZLE TYPE 1. CERT. NOZZLE 2. CHECK VALVE N O 3. FACE SEAL Z Z 4. RING, RIVET L E 5. BELLOWS 6. SWIVEL(S) 7. FLOW LIMITER (EW) 1. HOSE CONDITION V A 2. LENGTH ~ P 0 3. CONFIGURATION R 4. SWIVEL H 0 5. OVERHEAD RETRACTOR S E 6. POWER/PILOT ON 7. SIGNS POSTED Key to system types: Key to deficiencies: NC= not certified, B= broken BA=Balance HE =Healey M= missing, TO= torn, F= flat, TN= tangled RJ =Red Jacket GH=Gulf Hasselmann AD= needs adjustment, L= long, LOTM loose, HI =Hirt HA =Hasstech S= short MA= misaligned, K= kinked, FR= frayed, =~< INSPECTION RESULTS Key to inspection results: Blank= OK, 7= Repair within seven days, T= Tagged (nozzle tagged out-of-order until repaired) U= Taggable violation but left in use. COMMENTS: '/~,_~,~;Z~,,,z-/.'~ ' VIOLATIONS: SYSTEMS MARKED Wl~ A' "T OR U" CODE IN INSPECTION RESULt, ARE IN VIOLATION OF KERN COUNTY AIR POLLUTION CONTROL DISTRICT RULE(S) 412 AND/OR 412.1. THE CALIFORNIA HEAL~ & SAFETY CODE SPECIFIES PENAL~ES OF UP TO $1,~.~ PER DAY FOR EACH DAY OF VlOLA~ON. ~LEPHONE (805) 861-3682 CONCERNING FINAL RESOLU~ON OF ~E VIOLATION. NOTE: CALIFORNIA HEAL~ & SAFETY CODE SECTION 41960.2, REQUIRES THAT ~E ABO~ LIS~D 7-DAY DEFICIENCIES. BE CORREC~D WITHIN 7 DAYS. FAILURE TO COMPLY MAY RESULT IN LEGAL AC~ON 9149-10 ~5 APCD FILE ENVZRONMENTAL HEALTH :SERVICES DEPARTMENT ;2~30 ":~" STREET :~UiT~ 300 KERN C~dNTY AIR POLLUTION CONTROL'~.~TRICT 2700 "M" Street, Suite 275 Bakersfield, CA. 93301 (805) 861-3682 .- PHASE II VAPOR RECOVERY INSPECTION FORM Station Location %.Z~'.~/~/ ._.?.~...//'~/~. ~.?.:_~?z?.,~/~ P/O ~ ~ ~/~ --/~ Company Address ~ - ,~- ~_~ ,2 ~ City ~,~/~/~ Zip ~~ ..... BA ~ ~ .~E '~H, ~HA Contact ~/~ ~/~-Phone ~ ~-.~ System Type: ~~.,~ / ~,. Inspector ~ ~ Date ~: ~ ~ / Notice Rec'd By NO~LETYPE , ~ ~t~/~ ~ ~/~,~ ~,'~ ~ ~ ~ 1. CERT. NOZZLE 2. CHECK VALVE N O 3. FACE SEAL Z Z 4. RING, RIVET L J E 5. BELLOWS 6. SWIVEL(S) 7. FLOW LIMITER (EW) 1. HOSE CONDITION j ~/// V A 2. LENGTH P O 3. CONFIGURATION R 4. SWIVEL H O 5. OVERHEAD RETRACTOR .~.-- . S .... E 6. POWER/PILOT ON 7. SIGNS POSTED Key to system types: Key to defi(~]encies: NC= not certified, B= broken BA:Balance HE =Healey M= missing/' TO= torn, F= flat, TN= tangled RJ =Red Jacket CH=Gulf Hasselmann AD= ne~l§ adjustment, L= long, LO= loose, HI =Hirt HA =Hasstech S= short MA= misaligned, K= kinked, FR= frayed. INSPECTION RESULTS Key to ir~sPec'~'n results: B"l~'nk= OK, ~ 7= Repair within seven days, T= Tagged (nozzle tagged out-of:order until repaired) U= Taggabte violation but left in use. VIOLATIONS: SYSTEMS MARKED WITH A "T OR U" CODE IN INSPECTION RESULTS, ARE IN VIOLATION 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 .......... KERN COUNTY'AIR POLLUTION (~DNTROL DISTRICT 2700 "M" Street, Suite 275 ,. Bakersfield, CA. 93301 (805) 861-3682 PHASE I VAPOR RECOVERY INspEcTION FORM .. Company Mailing Address ~ ~ _~, ~ ~ City Inspector ...... No~e Rec'd By ~~ 1. PRODUCT (UL PUL, P, Or R) ~ / ~ ~ ~ 2. TANK LOCATION REFERENCE ~ ~/~]~/~ ~ 3. BROKEN OR MISSING VAPOR CAP .. BROKEN OR M SS NG F LL CAP 5. BROKEN CAM LOCK ON VAPOR CAP ' 6. FI~ 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 MEC~NISM DEFECTIVE 17." TUBE LENG~ MEASUREMENT /~Z /Z¢- ~ /Z~' / ~ // '" 19. OTHER 20. COMMENTS: WARNING: SYSTEMS MARKED WITH A CHECK ABOVE ARE IN VIOLATION OF KERN COUNTY AIR' POLLUTION CONTROL DISTRICT..BULE(S) 209, 412 AND/OR 412.1. THE CALIFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES . OF UP TO $1,000.00 PER DAY FOR EACH VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLU- *'~** TION OF THE VIOLATION(S) 44444444444,444444444444.444444.4.4,4***4**44*44**4 Environmental Sensitivity Inspection Time ,:.~ ,~ ?~/~ ~_ /~/~ U~DERGROUND HAZARDOUS SUBSTANCE STORAGE F AClLI~ to. of Tanks :/{. Is Information on Permit/Application Correct~ Y, ~ No__ Permit Po~ YI~ ~'. No__ ryp, of Inspection: ~outine ~ Complaint ' ~,in~ion ;omments: ITEM VIOLATIONS NOTED I. ~Primary Containment Monitoring: "~...a' Intercepting and Directing System '~' Standard Invento~ Control Monitoring c. Modifi~ Invento~ Control Monitoring ' d. In-Tank Level ~nsing Device e. Groundwater Monitoring f. V~ Zone Monitoring ~ ~ondary Containment Monitoring: a. Liner Double-Walled Tank c. Vault Piping Monitoring: b. Suction c. Gravity 6.} N~ Con~ru~ion/Modifi~tion 7. CIo~re/Abandonment t. Maintenance. ~en;ral ~f,~. a.d Operating Condition Facility :omment~Recommendations:.J'- ~~ Reinspection ~hedut~? Yes / .... '"'No Approx,m~e Re,n~,on Date ,'~ . . 4ealth 580 4113 170 (7-87) KERN' COUNTY 'AIR POLLUTION'CONTROL:DISTRICT 2700 "M" Street, Suite 275 Bakersfield, CA. 93301 (805) 861-3682 PHASE I VAPOR RECOVERY INSPECTION FORM _ Notice Rec'd By ~ TANK · 1 T~K ~ T~ ~3 TANK ~4 1. PR~UCT(ULPULP, or'R) ~L . ~k ~ ~ ~ 2. TANK LOCA~ON REFERENCE ~ ~ -- ~ ~$F 7. VAPOR CAPS NOT PROPERLY S~TED 8. ~SKET MI~ING FROM FILL CAP '~. 9. GASKET MISSING FROM VAPOR CAP L 10. FI~ ADAPTOR NOT TIGHT ~ 11. VAPOR ~APTOR NOT TIGHT 12~ ~SKET BE~EEN ADAPTOR & FI~ TUBE MISSING / IMPROPERLY SEATED 1~ DRY BRaE ~SKE~ DETERIO~TED .~.EXCE~IVE VE~ICAL PLAY IN COAX~L FI~ TUBE 15. CO~L FI~ T~BE SPRING MEC~ISM DEFECTIVE ~ 17. ~BE ~NG~ M~SUREMENT q' ~ 18- DIFFERENCE (SHOULD BE 6" OR LESS) ¢ t, ~1, ~/, D'' 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 CALIFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES OF UP TO $1,000.00 PER DAY FOR EACH VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLU- AO("~I'~ ~11 [~ :"-,? KERI~ DUNTY AIR POLLUTION CONTR(',' ISTRICT 2700 "M" Street, Suite 275 ... Bakersfield, CA. 93301 (805) 861-3682 --'t-- ------:;~-z'--~7~"' ~ ,., PHASE II VAPOR RECOVERY INSPECTION FORM Station Location ~20/ ~ '/'~t~¢:~--__/,~~2~/~ //~, Contact ¢'/9/mdrm Phone ¢~3 7W~' System Type: ~ Inspector -~, >~~ Date ~--~'~--~ Notice Roc'dBY 1. CERT. NOZZLE 2. CHECK VALVE 'N O 3. FACE SEAL Z Z 4. RING, RIVET L E 5. BELLOWS 6. SWIVEL(S) -/ 7. FLOW LIMITER/" (EW) ; 1. HOSE CONDITION V ~ A 2. LENGTH.- O 3. CONFIGURATION R 4. sWIVEL O 5. OVERHEAD RETRACTOR S E 6. POWER/PILOT ON 7. SIGNS POSTED Key to system types: Key to deficiencies: NC= not certified, B= broken BA=Balance HE=Healey M= missing, TO= torn, . F= flat;' TN= tangled RJ =Red Jacket GH=Gulf Hasselmann AD= needs adjustment, L= long, LO= loose, HI =Hirt HA =Hasstech S= short MA= misaligne.d, K= kinked, FR= frayed. ** ** 11 . I I I I Key to inspection results: Blank= OK, 7= Repair within seven /j~/,~ days, T= Tagged (nozzle tagged out-of-order Until repaired) .~ U= Taggabl.e violation but left in use. COMM N S VIOLATIONS: SYSTEMS MARKED WITH A "T OR U" CODE IN INSPECTION RESULTS, ARE IN VIOLATION 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 DAY,,S. FAILURE TO COMPLY MAY RESULT IN LEGAL ACTION Permits # c,){~'O 0 0/ Inspector · l~'"t Facility Name ,,z/o~;.~,'~t3 ]~ ~eIF Date {.J?o PIN~ INSPECTI~ C~C~ISl ~ce~}S ~ (:' ." :: . > / ~ ~o~ ~o ~ / / Plot Diagram Plot plan notes ~ . l '' - ) o~: : ,/J ~ ,~ ' , ~ p Yes No 1. Ali new and existing tanks located on plot plan? 2. Does tank product correspond to product labels on IZ {~} plot plan? / 3. Was,there no modifications identified which were t.~/ not depicted on the plot plans? If "No" described / 4. Are monitoring wells secure and free of water and l~" ~I product in sump? 5. Is piping system pressure, suction or gravity? '~ Yes No 6. Are Red Jacket subpumps and ail line leak detector I ~ accessible? Type of line leak detector if any ~/o-',~ ~u~C, 7. Overfill containment box as specified on application? If "No", what type and model number: a) Is fill box tightly sealed around fill tube? b) Is access over water tight? {~{~ c) Is product present in fill box? I_~{ 8. Identify type of monitoring: /'t~c,~o~/~'~6 ~£ / a) Are manual monitor,lng instruments, product and water finding paste on premises? b) Is the fluid level in Owens-Corning liquid level -{ monitoring reservoir and alarm panel in proper operating condition? c) Does the annular space or secondary containment {_-{ i~/ liner leak detection system have self diagnostic capabi I t ties? It' 'Wes", ts It functional _! If "~o", how is It tested fo~ proper operating condition? 9. Notes on any abnormal conditions: L~NL~ER(;RoLIND STORAGE FACLI.ITY PI.AN CHECK LIST ~t~pLICABILITY/EXEHP't'IONS (Facllitics in any of folio,wing categories are exempt) Facility has Hazardous Waste Facilities Permlt or ISD from DOHS Not storing hazardous substances Tanks not substantially underground Control of external parasites on cattle Farm tanks storing ~DiF's used to propel vehicles for ag purposes Storing HVF's for ag pest control by licensed pest control operator within one mile of farm Sumps, separators, storm drains, catch basins, ollfield gathering lines, refinery pipelines, lagoons~ evaporation ponds, and well ceilars APPLICATION COHPLETION Identification of responsible parties (24 hour) -.-' ~. Facility location adequately described '/ Workers' Compensation certificate or waiver /~c.5.~.,~'~ -;c~' '/ ~pplicant desires exemption from secondary containment fo£ M V~s ' (If "YES", the following subsectiqn must be completed with all "YES" answers in order for exemption to apply) ,/ Highest groundwater not within 50 feet of ground surface 7 Nearest surface Water is not within 75 feet of tank excavation ~ Nearest ag or domestic well is not within 50 feeC of tank excavation /~ Facility is not located in an aquifer recharge area ~--' Facility is not located in a unique wildlife habitat area, GENERAL DESIGN STANDARDS (asterisked items are N/A if ~/F exemption permitted) * Provides primary and secondary containment Primary containment product-tight / Approval by nationally recognized testing agency of tanks and equipment * Secondary containment compatible with product Secondary containment volume at least 100% volume of primary tank * If sec. cont. for more than one tank, must contain 150% of volume of largest primary tank placed in it, or 10% of aggregate volume, whichever is greater. If open to rainlSall, set'. cont. must also accomodate 2fi hr. rainfall Monitoring system within secondary containment, approved, and compatible Water intrusion into sec. cont.--monitoring and're~vtng Corrosion Protection-- Tanks Corrosion Protection-- Piping ?- % ~rrosion Protection-- Isolation of piping and tanks Overfill Protection (device ~/th alarm system) Pog~n~ial intermixing of ineo~a~lble substances prevented by separation ~ater and sewage lines no closer than 10 feet from tanks~ pipes~ fi wnitorir systems Approved backfill and bedding for tanks and piping Ca~hodtcally Protected Steel, Fiberglass' Reinforced Plastic, or Fiberglass Steel Tanks Leak Intercepting and Directing System PVC or better ,05~-, o~. ~ .... ~ ~orizontal and Vertical Sections half-slotted (typ, . ~ Sloped 1/4 inch per foot to ~ell 2 foot mnitoring sump or greater / ~ps at grade and belo~ sump sealed to be leak proof or~N, Vault, gan, or Trough ~-~/ Synche~ic Hembrane Liner or Sealed Concrete ' ~ '' Sloped 1/~ inch per foot to mnltoring ~ell .... ~ Under each tank and of size. to intercep~ leak from anywhere on Can .' ' '~tnimum 2~ ~nitoring veil or sump Leak ~Cectton/Honitorin8 Pr~surized Product Piping . ~ Leak: interception and direction system co ~nitortng ~e[1 .~/ Red 3acker (cannot be used alone) -, Overfill Protect ion Fill Box sealed leak-proof Visually ~nitored by facility operator