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HomeMy WebLinkAboutHAZMAT INSP 4-25-2017BAKERSFIELD FIRE DEPT. -'w Prevention Services 3 "FL D H E R 8 F I ;E UNIFIED PROGRAM INSPECTION CHECICLISTI." ...... ...... FIR -E.. H Street a ARTM r Bakersfield, CA 93301 Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979 Fax: (661),,852-2171 INSPECTION DATI u INSPECTION TIME 12 04 _51 PHONE,1\10.j' `1 S NO OF EMPLOYEES �T. A Y, - 1 7 ""--'' BUS TNESS ID NUMBER LA 2A 6 FACILITY NAME ADDRESS FACILITY CONTACT C' 0 Consent to Inspect Name/Title X.: xxx ❑ SAFETY DATA SHEET AVAILABILITY (CCR ROUTINE ❑ COMBINED El JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT 1771 RE-INSPECTION C V u=uompwance OPERATION ❑ SAFETY DATA SHEET AVAILABILITY (CCR COMMENTS V=Violation ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) ❑ VISIBLE ADDRESS (C FC: 505. 1, B IV C: 15.52.020) (c)) ❑ APPROPRIATE PERMIT ON HAND (B C: 15.65.080) (CCR: 2731) El- ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) CFC: 5003.5) '19i" F-1 BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) (CFC: 304.1) � Egf ❑ FIRE PROTECTION (CF : 903 & 906) ❑ VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) R: 2729.2 (3)) ❑ VERIFICATION OF QUANTITIES CCR: 2729.4) E z ❑ VERIFICATION OF LOCATION (CCR: 2729.2) NEf ❑ PROPER SEGREGATION OF MATERIAL jCFC: 5004.1) ANY HAZARDOUS WASTE ON SITE? AYES ❑ NO Explain: , 12 ., , WA ql Ohoi dklft "1 N Ul- \gm 11, POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: A • Correct the violation(s) noted above by • Within 5 days of correcting all of the violations, sign and return- a copy of this Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance t�' N C _\ il Xr Signature (that all violations have been corrected as noted) iage to: Date Pink Prevention Services Copy FD2155 (Rev 1/14) ❑ SAFETY DATA SHEET AVAILABILITY (CCR 2729.2(3)(b)) ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ("CR:2731 (c)) ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) )9' ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) ❑ HOUSEKEEPING (CFC: 304.1) � Egf ❑ FIRE PROTECTION (CF : 903 & 906) Of ❑ SITE DIAGRAM ADEQUATE & ON HAND (C R: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? AYES ❑ NO Explain: , 12 ., , WA ql Ohoi dklft "1 N Ul- \gm 11, POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: A • Correct the violation(s) noted above by • Within 5 days of correcting all of the violations, sign and return- a copy of this Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance t�' N C _\ il Xr Signature (that all violations have been corrected as noted) iage to: Date Pink Prevention Services Copy FD2155 (Rev 1/14)