HomeMy WebLinkAboutHAZMAT INST 6/4/2015BAKERSFIELD FIRE DEPT.
Prevention Services
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UNIFIED PROGRAM INSPECTION CHECKLI 'I V 2101 H Street
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A aRrm T Bakersfield, CA 93301
Haz-Mat Business Plan and Inventory Program Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
PHONE NO.
NO OF EMPLOYEES
C)
FACILITY CONTACT
BUSINESS ID NUMBER
n
Consent to Inspect Name/Title
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ROUTINE COMBINED ❑ JOINT AGENCY El MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
• 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
Signatre( "at all violations have been corrected as noted)
4-
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)
C
V
C=Compliance) OPERATION
V=Violation
COMMENTS
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❑
VISIBLE ADDRESS (CFC: 505.1,
BMC: 15.52.020)
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❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
"0
'10
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
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❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
UK
1:1
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
1:1
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
Me
❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
El
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
ED
❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
ED
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
Mc
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
'El
1:1
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
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1:1
HOUSEKEEPING
(CFC: 304.1)
0
❑
FIRE PROTECTION
(CFC: 903 & 906)
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❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? 1:1 YES M
NO
Explain:
L
Signature of Receipt:
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
Signatre( "at all violations have been corrected as noted)
4-
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)