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HomeMy WebLinkAbout2016 hazmat STOREBAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST t, A.. E__R_ S F...1 r. -- 2101 H Street ,{ F /RE : :.:.x,::v::Y.v.xv.w:..:. .... n...........:>: f:}..... vnn.. v? x:. ..:.v.....d...:..,,.»..,.,..... ..,.....v........s...S.... .5.. .x,...x:.. ... , .• .x..:.. x..v CG1:.v un.u... i ? >: ?i:nJ'N»...... x TM' f O J? AR B ak ersfield 'CA 93301 HaZ -Mat Business Plan and Inventory Program t Tel.: (661)326 =3979 Fax: (661) 852 -2171 FACILITY NAME INSPECT^ /T}ION DATE i~ INSPECTION TIME ADDRESS PHONE NO. NO OF—EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER. (CPC: 505.1, BMC: 15.52.020) Cons,knt to Inspec m Title G...... .....H.a alr`±d....:..Msil�lrll.. � .... �' �`...... iE' ��, �w►...........<" L ..............._ �........ .......�'.............._....... ....................... ............................... ,ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C u l C= Compliance. OPERATION V= Violation COMMENTS ❑ VISIBLE ADDRESS (CPC: 505.1, BMC: 15.52.020) ❑ APPROPRIATE PERMIT ON HAND (BMC:15.65.080) ja ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) Ile- ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) ❑ SAFETY.DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ', ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) r ❑ HOUSEKEEPING (CFC: 304.1) E] FIRE PROTECTION (CFC: 903 & 906) . ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES IO Explain: Signature of R ' t: POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: • 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: Bakersfield Pire 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 FD2155 (Rev 1 /14)