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SECTION 1 Hazardous Materials Business Plan Fax: (661) 852 -2171
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FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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ADDRESS
PHONE NO.
NO OF EMPLOYEES
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
FACILITY CONTACT
BUSINESS ID NUMBER
9
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Consent to Inspect Name/Title
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
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C V _ lance OPERATION
V= Violation; 1,11 Minor
CERS
Violation
COMMENT
,.
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c ))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
oignature ofRecei t
Explain
Inspector.
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: Signature (that all violations have been collected as noted)
Bakersfield fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink - Prevention Services FD2155 (Rev 8H14)