HomeMy WebLinkAboutHAZMAT INSP 9-2013FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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ROUTINE. ❑ CO . , ......... -..
AGENCY ❑ COMPLAINT � RE- INSPECTION
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PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER -
Consent to Inspect Name /Title
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.... MBINED ....,_> ❑ JOINT AGENCY ❑ MULTI= :..•. ...:. ... ..
ROUTINE. ❑ CO . , ......... -..
AGENCY ❑ COMPLAINT � RE- INSPECTION
C Compliance R e T
M M r^ T
V= Violation
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APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ;
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Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ,
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
❑
CORRECT OCCUPANCY (CBC: 401)
❑
VERIFICATION OF INVENTORY. MATERIALS (CCR: 2729.3)
b ❑
VERIFICATION OF QUANTITIES.. (CCR: 2729.4)
CJ
VERIFICATION OF LOCATION (CCR: 2729:2)
❑
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
l ❑
VERIFICATION OF MSDS. AVAILABILITY {CCR: 2729.2(3)(b))
. ❑
:VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
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f ❑
VERIFICATION OF ABATEMENT SUPPLIES &PROCEDURES (CCR: 2731(c))
. F ❑.
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
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CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
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HOUSEKEEPING (CFC: 304.1)
` ❑
FIRE PROTECTION _ (CFC: 903 & 906)
❑ ❑
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
ANY HAZARDOUS
WASTE ON SITE? YES ❑ NO
5atu_ r� of °Receipt - --:
Explain:'
POST INSPECTION INS'T'RUCTIONS:
• Correct the violation(s) noted above by : Signature (that all violations have been corrected as noted)
• Within 5
days of correcting all of the violations, sign and return a copy of this page to:
7`"(
Bakersfield
Fire Dept., Prevention Services, 2101 H Street, California 93301
- Date
White —Business Copy Yellow - Business Copy to be Sent in after return to Compliance Pink — Prevention Services Copy PD2155 (Rev 600)
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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APPROPRIATE PERMIT ON HAND
ADDRESS
❑
PHONE NO.
NO OF EMPLOYEES
-� ❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
�a ❑
FACILITY CONTACT
(CBC: 401)
BUSINESS ID NUMBER
Consent to Inspect Name /Title
(CCR: 2729.3)
`❑ ❑
4" Act
VA C. � 't' Ic
' ROUTINE ❑ COMBINED ❑. JOINT AGENCY ❑ MULTI- AGENCY ❑ «COMPLAINT ❑ RE-INSPECTION «.
C= Compliance
V= Violation
COMMENTS
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
❑
Business PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
-� ❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
�a ❑
CORRECT OCCUPANCY
(CBC: 401)
❑� ❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
`❑ ❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
:EY El
VERIFICATION OF LOCATION
(CCR: 2729.2)
C ❑
PROPER SEGREGATION OF MATERIAL
(CFC: 2704:1)
E' ❑
VERIFICATION OF MSDS:AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
El � N:k
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)
U ❑
FIRE PROTECTION
(CFC` 903 & 906)
1 -
❑ ❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? QtYES ❑
NO
Sig-natureofReceipt /7
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 of this page to:
n-1, f 1d F• De t 'Prevention Services 2101 H Street California 93301
Signature (that all violations have been corrected as. noted)
a ers 1e ire p .,
Date
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink — Prevention Services Copy
FD2155 (Rev 6//10)