HomeMy WebLinkAbout9/2012UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
1 tFIR
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2.171
FACILITY NAME
Cad
INS,ECyION D TEq/Z 11
INSPECTION TIME
ADDRESS
c)
PHONE NO.. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
Consent to Inspect Name /Title
Section1: Business.Plan and Inventory Program.
ROUTINE COMBINED JOINT AGENCY MULTI- AGENCY COMPLAINT RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS.'
APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
90 Business PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1) i _„
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
OCrZ 1 77Z--S O
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
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Ci
JJ ,
f
VERIFICATION OF QUANTITIES (CCR: 2729.4)
VERIFICATION OF LOCATION (CCR: 2729.2)
CFC: 2704.1) PROPER SEGREGATION OF MATERIAL ( CFC:
VERIFICATION OF MSDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE, ON SITE? YES NO Signature of Receipt
Explain:
POST INSPECTION INSTRUCTIONS:
Correct the violation(s) noted above by
Within 5 days ofcorrecting all of the violations, sign and return a copy ofthis page to:
Bakersfield Fire. Dept., Prevention Services, 2101 H Street, California 93301
Signature (that all vio ations have been corrected as noted)
a] /z
Date
White —Business Copy Yellow — Business Copy to be Sent in alter return to Compliance Pink — Prevention Services Copy F132155 (Rev 6H] 0)
5
UNIFIED PROGRAM INSPECTION CHECKLIST.
SECTION 1: Business Plan and Inventory Program
tS P I E I_D
RE
rM r
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield; CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
C 1
INSS CTION DATE
L'
INSPECTION TIME
ADDRESS _
0
PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
Consent to Inspect Name /Title
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED 1:1 JOINT AGENCY El MULTI-AGENCY El COMPLAINT RE- INSPECTION
C V C= Compliance OPERATION
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
Cl nO Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) U A',
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC:401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CFC: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(1], CFC: 2703.5)
HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) j
1
ANY HAZARDOUS WASTE ON SITE? El YES NO Signature of Receipt y r/
Explain:
POST INSPECTION INSTRUCTIONS:
Correct the violation(s) noted above by
Within 5 days of correcting all of the violations, sign and return a copy ofthis page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
bj
Signature (that all vio ations have been corrected as noted)
Z
Date
While — Business Copy Yellow — Business Copy to be Sent in alter return toCompliance Pink — Prevention Services Copy FD2155 (Rev 6//10)