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HomeMy WebLinkAboutHAZMAT INSP 2015UNIFIED PROGRAM INSPECTION CHECKLIST Haz-Mat Business Plan and Inventory Program FACILITY NAME ADDRESS ( 1 c) Av FACILITY CONTACT Consent to inspect Name /Title ............ 'R­ ' 0" *U" 'T­ I 'N" ' 'E'* E"I" C­ 0", M B I N E D ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT El RE-INSPECTION BAKERSFIELD FIRE DEPT. COMMENTS Prevention Services F. F �5 EA. FIRE 2101 H Street fARr r Bakersfield, CA 93301 . Tel.: (661) 326-3979 Fax: (661) 852-2171 ❑ HOUSEKEEPING (CFC: 304.1) INSPECTION DATE INSPECTION TIME ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) FIRE PROTECTION (CFC: 903 & 906) Vi ❑ ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) PHONE NO NO OF EMPLOYEES -Ef ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) BUSINESS ID NUMBER ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) 7 ............ 'R­ ' 0" *U" 'T­ I 'N" ' 'E'* E"I" C­ 0", M B I N E D ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT El RE-INSPECTION ❑ 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)) C V u=uornpiiance) OPERATION COMMENTS (CCR: 2731) V=Violation ED ❑ ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) (CCR: 66262.34 (f); CFC: 5003.5) ❑ .01 APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ HOUSEKEEPING (CFC: 304.1) ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) FIRE PROTECTION (CFC: 903 & 906) Vi ❑ ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) (CCR: 2729.2 (3)) -Ef ❑ 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)) Explain: Signature of Receipt:_- ................. .... POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE: • Correct the violation(s) noted above by Signature (that all viblations have been corrected as noted) • Within 5 days of correcting all of the violations, sip 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) 1:1 EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ED ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) Vi ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES 471 NO Explain: Signature of Receipt:_- ................. .... POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE: • Correct the violation(s) noted above by Signature (that all viblations have been corrected as noted) • Within 5 days of correcting all of the violations, sip 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)