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HomeMy WebLinkAboutHAZMAT INSP 6/12/2015UNIFIED PROGRAM INSPECTION CHE ............................................... � I Haz-Mat Business Plan and Inventory Program FACILITY NAME ADDRESS �Ooo /kit, FACILITY CONTACT consent to Inspect Name/Title- BAKERSFIELD FIRE DEPT. Prevention Services B F�_�R S F I D L IS T FI RE E 2101 H Street 7, ARF T Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 INSPECTION DATE INSPECTION TIME 6, PHONE NO. NO OF EMPLOYEES BUSINESS ID NUMBER Er ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION C V ( u=uompiiance ) OPERATION COMMENTS • 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) V=Violation 0' ❑ VISIBLE ADDRESS (C FC: 505. 1, B I AC: 15.52.020) El ❑ APPROPRIATE PERMIT ON HAND (B C: 15.65.080) CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e) .E] ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) El ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) El ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ?E ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) 1�0 ❑ 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) P ❑ FIRE PROTECTION (C C: 903 & 906) ❑ SITE DIAGRAM ADEQUATE & ON HAND (C(' R: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? -Z YES ❑ NO Explain: Signature of Receipt-1 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)