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HAZ-BUSINESS PLAN 4/27/2015
BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST} A___. _F_R-- S.F_1- - -A 2101HStreet FIRE f :,:.:::..:. .:.:.........:...> h:..: h.:. x........:....,, ....,,..,...................... � � _ _ ...... a .......:..,..�:., «..w.......... 301 Bakersfield, CA 93 ersfi 1 B ak Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979 1% Fax: (661) 852 -2171 FACIL;IT,y NAME INSPECTION.DATE INSPECTION TIME ADDRESS PHONE NO. _ NO OFF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER Consent to Inspect Name /Title ........... SSG........ ......... . r ...Pr. ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V C= Compliance OPERATION V= Violation COMMENTS ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) LI ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) ` ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) Q ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑ ❑ 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) ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES NO Explain: i nature of Receipt: • R YUS'1' INNFE(:' ION INN'1'KUUTIONN FUR KL+ ''TURIN- TU- UUMFUA1NUE: 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: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White — Business Copy Yellow — Business Copy to be Sent in after return to Compliance Signature (dd @? 6 ns have been c ecd..as noted) Date Pink Prevention Services Copy FD2155 (Rev 1/14)