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HomeMy WebLinkAboutHAZMAT INSP (NO DATE)BAKERSFIELD FIRE DEPT. Prevention Services H r: R 17 1 D --- ........... ................ ....... UNIFIED PROGRAM INSPECTION CHECKLIST E 2101 H Street A T r Bakersfield, CA 93301 Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979 Fax: (661) 852-2171 'L 4TE -.9-70]2:l 't, ayrr inc� ;;'"I liroc H%e FACILITY NAME INSPECTIbN DATE INSPEdTION TIME CF_+�_ i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... X X XX d ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION C V C=Cornpliance OPERATION V=Violation COMMENTS Pn ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) 1:1 ADDRESS APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) PHONE NO. NO OF EMPLOYEES ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) ❑ FACILITY CONTACT BUSINESS PLAN CONTACT INFORMATION ACCURATE (OCR: 2729.1) BUSINESS ID NUMBER :,f-7 7 E-1 ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ ❑ VERIFICATION OF QUANTITIES Consent to Inspect Name /Title ❑ ❑ VERIFICATION OF LOCATION i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... X X XX d ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION C V C=Cornpliance OPERATION V=Violation COMMENTS 171 ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) 1:1 ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) ❑ ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (OCR: 2729.1) E-1 ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑ ❑ PROPER SEGREGATION OF MATERIAL (CFO: 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) ❑ 1:1 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: Signature of Receipt: I I 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 — Business 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)