Loading...
HomeMy WebLinkAboutHAZ-BUSINESS PLAN 5/13/2015BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST I .E ........... ... `° n 2101 H Street FIRE / iii Bakersfield, CA 93301 HaZ -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 �- Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME �.,� ADDRESS PHONE NO. �r NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER x,.`# :. "` '�.,,: -. f"`-''.� 'i.: +.r't 'Jr'K" pj.ra /'�:',1 C..•0" f -. _�(df Le+ Consent to Inspect Name /Title POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE: • 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— Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date Pink Prevention Services Copy FD2155 (Rev 1/14) ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v ( C= Compliance OPERATION V =Violation COMMENTS 'f ❑ VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020) 0 ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ CTS CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) $ , LEI ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ET ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ET ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) [5 ❑ VERIFICATION OF LOCATION (CCR: 2729.2) C ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) C-r}'" ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) E' ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 2 ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) EIS ❑ HOUSEKEEPING (CFC: 304.1) ET ❑ FIRE PROTECTION (CFC: 903 & 906) [ff ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES Er'NO Explain: i nature of Receipt: POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE: • 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— Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date Pink Prevention Services Copy FD2155 (Rev 1/14) BAKERSFIELD FIRE DEPT. -- Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST A F..R...`._F_` 1 n 2101 H Street FIRE T 1 CA 9330 ARTM 1 Bakersfield, d 14n7-Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Consent to Inspect Name /Title ±�... i.. _ ......1'!....4i .. ............... ............................... . ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V r C= Compliance) OPERATION l V= Violation COMMENTS Ef ❑ VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020) K ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ Ef CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) :5 .....- �... L ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) Ef ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) Ef ❑ 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)) Z ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) 9- ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) Er ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ©' ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) 9 ❑ HOUSEKEEPING (CFC: 304.1) 15 ❑ FIRE PROTECTION (CFC: 903 & 906) Lr ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES ©°NO Explain: Signature of Receipt: PUNT 11V,Y1+,t;' ION 11VJ'1'KUt:'1IONN YOK KETURN-TO- I;UMFULA1VU : • 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 1 Signature (that AVviolations have been corrected as noted) 6ZI.4, 5- Date Pink Prevention Services Copy FD2155 (Rev 1/14)