HomeMy WebLinkAboutHAZ-BUSINESS PLAN 5/22/2015BAKERSFIELD FIRE DEPT.
Prevention Services
P
E
UNIFIED PROGRAM INSPECTION CHECKLIST P. .1 7 FLA F., I
F1 2101 H Street
RFM T
Bakersfield, CA 93301
Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979
a� Fax: (661) 852-2171
FACILITY NAME
V
C=Compliance) OPERATION
INSPECTION DATE
INSPECTION TIME
A"
V=Violation
ADDRESS
❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
PHONE NO.
NO OF EMPLOYEES
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
/ 75
,0
FACILITY CONTACT
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
BUSINESS ID NUMBER
Consent to Inspect Name/Title
_'�Vx
Al. i$�l 97 0 0
x/a r�_ k - 7' 4
�'A ic 01
1 E9' ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION I
C
V
C=Compliance) OPERATION
COMMENTS
V=Violation
,E]
❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
,0
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
1Y
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
JZ
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
[2"
1:1
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
LJ ❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
1?
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
E`
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
❑
HOUSEKEEPING
(CFC: 304.1)
0
❑
FIRE PROTECTION
(CFC: 903 & 906)
Q/
El
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
Je
J
ANY HAZARDOUS WASTE ON SITE? TI YES ❑
NO
Explain:
Signature or Recelk:
irv3l 1L1'N3jrM_jLjLV1N IIN L5jLjKUk1jLJL%J1X.� VqJK MAL UKiN-_t%J-%_U1VWU1LA1NU1 :
• 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
\r\d V
Signature (that a' violations have been corrected as noted)
V^
u
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)