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)