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HomeMy WebLinkAboutHAZ-BUSINESS PLAN 2/5/2015BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST 2101 H Street aRT Bakersfield, CA 93301 Haz -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 LabFax: (661) 852 -2171 FACILITY NAME INSPECTION 'DATE INSPECTION TIME { py ADDRESS PH,QNE NO. j NO.OF EMPLOYEES yg FACILITY CONTACT BUSINESS ID NUMBER Consent to Inspect Name /Title ::: {!;r;i.l(' ?:`i'':::::::: �:::: :.:: p. d. is ;>,.. :: �t%^ iiiii:.; '•::r "'iiEi' ";::::.�EE`:::;�E:: °.E. ?; rE';tfE�'t:; ? %::::: i;S _ .......................... Msi .rll.a.r ..B.. r es�......... __ ..........�.... � ................................................................... ............................... . >t �.. �........�l.azardo.0 !�........ �... ray....... . Sleet �.... _...... � ............. ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V C= Compliance) OPERATION COMMENTS V= Violation EL. ❑ VISIBLE ADDRESS (CFC: 505:1; BMC:15.5.2.020) ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ CERS UPDATED: FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ET ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR:. 2729.2) tFl ❑ PROPER SEGREGATFE'S` ION OF MATERIAL (CFC: 5004.1) Q ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ VERIFICATION OF HAZ;MAT TRAINING (CCR: 2732) L`1 ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑/ ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) El, ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) 0 ❑ HOUSEKEEPING (CFC: 304.1) ❑ ❑ FIRE PROTECTION (CFC: 903 & 906) El ❑ 'SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? 2 YES ❑ NO E'x p I a i n': ISignature of Receipt: POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: ' • Correct the violation(s) noted above by Signature (that all violations tiave been corrected as noted) • 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)