HomeMy WebLinkAboutHAZ-BUSINESS PLA 5/20/2015k
BAKERSFIELD FIRE DEPT.
Prevention _Services
E. R F'. I L D
- ; �_ 1
. . . ........ ... .....
UNI F1 ED'PflOG RAM., INSPECTION CHECKLIST I. F1 E 2101 H Street"
A Jr rN r
aArm Bakersfield, CA 93301
r
Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
INSPECTION DATE
e-
INSPECTION TIME
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
_-M 77
D-0 \ 4.'",
❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
nsent to Inspect Name/Title
ED ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
,ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
C V C=Compliance) OPERATION
COMMENTS
V=Violation
❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
1 1 VA,
ED ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
ut CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
ire
CD ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
® ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
ED ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4)
❑ VERIFICATION OF LOCATION (CCR: 2729.2)
D ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1)
1:11 ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b))
❑ ❑ VERIFICATION OF HAZ MAT TRAINING (OCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
❑ 171 EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
11 ❑ HOUSEKEEPING (CFC: 304.1)
Ef, ❑ FIRE PROTECTION (CFC: 903 & 906)
'Er—, ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
V.,
ANY HAZARDOUS WASTE ON SITE? ❑ YES ,,,NO-
Explain:
$ignature of Receiipt:,
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 adviolations have be I en corrected as noted)
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)_
UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
BAKERSFIELD FIRE DEPT.
Prevention Services
13 r R F I L D
I T'
..........................
FIRE 2101 H Street
A aRFff T Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
7DR�ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
C v
C=Compliance) OPERATION
V=Violation
COMMENTS
" rkl ❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
4 6
❑
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
[1 ❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR:2729.1)
I ❑
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
❑
VERIFICATION OF QUANTITIES (CCR: 2729.4)
❑
VERIFICATION OF LOCATION (CCR: 2729.2)
E ❑
PROPER SEGREGATION OF MATERIAL (CFC: 5004.1)
E ❑
SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b))
E ❑
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1: ❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
F ❑
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1: ❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
j
❑
HOUSEKEEPING (CFC: 304.1)
❑
FIRE PROTECTION (CFC: 903 & 906)
,R ❑
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES NO
Explain:
fj1A
ignature of Receipt:
POST INSPECT14YN INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• L 75
Correct the violation(s) noted above by Signature (that alf violations have been corrected as noted)
• Within 5 days of correcting all of the violations, sign and return a copy of this page to:
t� 1z' -le,
Bakersfield Fire Dept., Prevention Services, 2 101 H Street, California 93 301 '5 20
Date
White - Business Copy Yellow - Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14)