HomeMy WebLinkAboutHAZMAT INSP 6/22/2016UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
FACILITY NAME
ADDRESS ti
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FACILITY CONTACT
_'ons IUY to inspect Name/Title
j
mss, "',o � 'f'Dn' I Q_
100
BAKERSFIELD FIRE DEPT.
:
Prevention
Services
P -A R 2101 H Street FIRE
AR TN
F Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
3�5� 3's
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
:0
❑ HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? 171 YES JQ NO
Explain: ignature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
Correct the violation(s) noted above by SigKatuiff that all violations have 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)
.............
........................ ..... ........ ......................
...... .
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)
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR-: 2729.1)
'1�6'�).�VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)�
IC
IN
VERIFICATION OF QUANTITIES
CCR: 2729. .4)
'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 (0013:2731 (c))
10
❑
PrAr:nr_,i=r\iry PROCEDURES ADEQUATE
(CCR: 2731)
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
:0
❑ HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? 171 YES JQ NO
Explain: ignature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
Correct the violation(s) noted above by SigKatuiff that all violations have 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)