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HAZMAT INSP 4/15/2015
UNIFIED PROGRAM #'INSPECTION. CHECKLIST SECTION 1 Hazardous Materials Business Plan _.-Min. FACILITYMA NAME INSPECTION DATE INSPECTION TIME p� . ADDRESS �y� PHONE NO. NO OF EMPLOYEES .rte 4 k �� q�j} FACILITY CONTACT BUSINESS ID NUMBER 7 st""i' �t . ""`S °b. °{ Y� '� .N•:T+ Z'> Eby ' rh *...�.. ° n.�d to Inspect Name /Title , Consent .. ,..... 1, 0.. iY a . .,_. Wit• .�.. a . , a... s:"� .rs ,. , <.:: � . T, \ ,, ,;: . ,, r.. .., a.. :a�.� <., ,.. ::fi , , r a, ., . P /k .... , / ;. ..< ,_ .. ?,. ..,. ,x, u..x: ✓�, : r. _... .. , x c.wh.. .. 'c. .: €:`u . ., _. r•.. ,,.. :a �<... :.... q , . ,, a... -.., ,x, r., < ..z , �: ,.m. �, . ,.�, ._. '... ,. .,c ,.. .,. ,. .� P v�: 3. „ ■'w {, R...II. . �� . f... <�I�. ' p 3' i � � f $ � o'C<. ,n✓"� ..u' \.s. 6.� s �Em do., , { „x ,e xw �i'n 6.. ... tf,, ,�. Z u �� .. ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V C=Gompliance OPERATION CERS V =Violation; 1,11 Minor Violation COMMENT `w 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) .d 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 X, SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005 ANY HAZARDOUS WASTE ON SITE? 'R=YES ❑ NO Signature ofRecei Explain: g ” Inspector• x , 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 corrected as noted) Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Date White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 8//14)