HomeMy WebLinkAbout2016 hazmat STOREBAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST l A. FARE 2101 HStreet.
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Haz -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979
Fax: (661) 852 -217.1
FACILITY NAME I.NSPECTION.DATE INSPECTION TIME
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
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Consent to Inspect Name /Title
❑ ROUTINE `- 'COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
E�D ❑ FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
' ANY HAZARDOUS WASTE ON SITE? - WYE-8 NO
_5" ")
Explain: i nature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: ;J
• Correct the violation(s) noted above by Signature (that" all violations have been corrected as noted)
o Within 5 days of correcting all of the violations, sign and return a copy of this page to:
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 FD2155 (Rev 1/14)
C V C= Compliance) OPERATION
V =Violation
COMMENTS
Igo ❑ VISIBLE ADDRESS (CFC: 505.1, BMC :15.52.020)
❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
EL ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR. (H &S 25404(e)
'Q.. ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
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❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
E�D ❑ FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
' ANY HAZARDOUS WASTE ON SITE? - WYE-8 NO
_5" ")
Explain: i nature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: ;J
• Correct the violation(s) noted above by Signature (that" all violations have been corrected as noted)
o Within 5 days of correcting all of the violations, sign and return a copy of this page to:
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 FD2155 (Rev 1/14)
12 ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4)
❑ VERIFICATION OF LOCATION (CCR: 2729.2)
112:� ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1)
❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b))
❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
i ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
L ❑ HOUSEKEEPING (CFC: 304.1)
E�D ❑ FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
' ANY HAZARDOUS WASTE ON SITE? - WYE-8 NO
_5" ")
Explain: i nature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: ;J
• Correct the violation(s) noted above by Signature (that" all violations have been corrected as noted)
o Within 5 days of correcting all of the violations, sign and return a copy of this page to:
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 FD2155 (Rev 1/14)