HomeMy WebLinkAboutHAZMAT INSPUNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
FACILITY NAME
1�N+9oN,nGy
K"S✓ Cb -RS, ''�
INSPECTION TIME
Prevention Services
P n
900 Truxtun Ave., Suite 210
river
Bakersfield, CA 93301
rwrr
Tel.: (661) 326-3979
USINESS ID NUMBER
Fax: (661) 872-2171
FACILITY NAME
1�N+9oN,nGy
NSPECTION ATE
INSPECTION TIME
LTVS
u � jo
ADDRESS
Ivo/ /q2l. ✓,, .K'L.. A
PHON11i
77'sl'•+3
OF EMPLOYEES
FACILITY CONTACT ,,n
USINESS ID NUMBER
❑ VERIFICATION OF QUANTITIES
Section 1: Business Plan and Inventory Program
ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C v ( C=Coiip1hll OPERATION
V=Violation
COMMENTS
V`❑ APPROPRIATE PERMIT ON HAND
❑ Business PIAN CONTACT INFORMATION ACCURATE
ElVISIBLEADDRESS
J
19 ❑ CORRECT OCCUPANCY
1110 VERIFICATION OF INVENTORY MATERIALS
❑ VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
❑ PROPER SEGREGATION OF MATERIAL
VERIFICATION OF MSDS AVAILABILITY
�le/❑
❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
—/
II( ❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERSPROPERLYLABELED
❑ HOUSEKEEPING
-ii
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑YES A NO
EXPLAIN: 3AJA"_y
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL Us AT (661) 326-3979
Inspeobr(Pleese Print) Fire Prevention l 1" In I Shift of ShrIStation# Buslni one I Responsible Party (Please Print)
While- Prevention Services Yellow -Station Cory NO - Business Co,, FD2155 (Rev. 0405
C V C =Compliance OPERATION
V= Violation; im Minor
C E R S
Violation
COMMENT`
VERIFICATION OF ABATEMENT SUP PLIES & PROCEDURES (CCR: 2731.(c))
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010'
CERS INFORMATION. ENTERED &'UPDATED ANNUALLY (CCR: 2729.1)
3210043
CONTAINERS PROPERLY LABELED (CCR: 66262.34 ft CFC: 2703.5).
3030007
VISIBLE ADDRESS (CFC: 505.1; BMC: 15:52.020)
HOUSEKEEPING (CFC: 304.1)
*
CORRECT OCCUPANCY (CBC: 401)
FIRE PROTECTION (CFC:-903 & 906)
3030032
VERIFICATION OF INVENTORY MATERIALS, (CCR: 2729.3)
1010004
NY HAZARDOUS WASTE ON SITE? ❑.YES NO
Si nature of Receipt
Explain:
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010,006
VERIFICATION.OF' LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY .(CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUP PLIES & PROCEDURES (CCR: 2731.(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010'
CONTAINERS PROPERLY LABELED (CCR: 66262.34 ft CFC: 2703.5).
3030007
HOUSEKEEPING (CFC: 304.1)
*
FIRE PROTECTION (CFC:-903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE? ❑.YES NO
Si nature of Receipt
Explain:
-✓v'e -. `L %
FACILITY NAME
C <
ADDRESS
FACILITY CONTACT
Consent to :Inspect Name /Title
INSPECTION DATE INSPECTION TIME .
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
w6, 1 . C.
ANY HAZARDOUS WASTE ON SITE? YES ❑ NO
Signature ofRecei t'"�
t ,,� ;
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Date
FDZ155 Rev 9/2017
White — Business Copy Yellow — Station Copy Pink — Prevention Services ( )
)fi
,... .::..
k � Section Plan and Inventory Progra ml
ROUTINE ..._., ,. El COMBINED ❑, , u jO. ,....:.
INT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
C V C= Compliance OPERATION C E RS
v= violation; 1,11 Minor Violation COMMENT
flr APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) 3010001
Y V
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1) 3210043
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
3030007
1 C
CORRECT OCCUPANCY (CBC: 401)
3030032
R
1010005
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
ANY HAZARDOUS WASTE ON SITE? YES ❑ NO
Signature ofRecei t'"�
t ,,� ;
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Date
FDZ155 Rev 9/2017
White — Business Copy Yellow — Station Copy Pink — Prevention Services ( )
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
1020002
Y V
1010010
3030007
1 C
3030032
1010005
a S
Signature ofRecei t'"�
t ,,� ;
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Date
FDZ155 Rev 9/2017
White — Business Copy Yellow — Station Copy Pink — Prevention Services ( )