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Home My WebLink AboutHAZMAT INSPUNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program FACILITY NAMEINSPEC Tam Giy Ct ��✓2MS NSPEU ION TIME io: y Prevention Services e 900 Truxtun Ave., Suite 210 FACILITY CONTACTy� Bakersfield, CA 93301 Mrs Mr Tel.: (661) 326-3979 ❑ VERIFICATION OF INVENTORY MATERIALS Fax: (661) 872-2171 FACILITY NAMEINSPEC Tam Giy N OA 3 im NSPEU ION TIME io: y J ADDRESS f`L/fJ/ MAS Vi /L P 'jj_17i49s) OOYEs aro-I- FACILITY CONTACTy� USINESS IF NUMBER-O2t- ❑ CORRECT OCCUPANCY C v ( C=COMPliance) OPERATION V=Vlolatlon Section 1: Business Plan and Inventory Program ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION C v ( C=COMPliance) OPERATION V=Vlolatlon COMMENTS ❑ APPROPRIATE PERMIT ON HANG p ❑ BUSITUNS PLAIN CONTACT INFORMATION ACCURATE X ❑ VISIBLEADDRESS ❑ CORRECT OCCUPANCY ❑ VERIFICATION OF INVENTORY MATERIALS ❑ VERIFICATION OF QUANTITIES ❑ VERIFICATION OF LOCATION ❑ PROPER SEGREGATION OF MATERIAL t� ❑ VERIFICATION OF URGE AVAILABILITY ❑ VERIFICATION OF HAZ MAT TRAINING A11VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ql ❑ EMERGENCY PROCEDURES ADEQUATE • ` ❑ CONTAINERS PROPERLY LABELED X-1-1 HOUSEKEEPING lll��l YJ ❑ FIRE PROTECTION ,\ ❑ SITE DIAGRAM ADEQUATE 80N HAND ANY HAZARDOUS WASTE ON SITE? ❑ YES ANO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 336-3979 V 4r v/ Ot y Inspector (Please Print) Fire Prevention 11° In I Shift of Site/Station At Business I Responsible Party (Please Print) White- Prevention Services Y¢IIow Station Copy Pink -Business Copy FD2155 (Rey. 09105 .. .. �. „" ,rw,,...h:y,. .v ;w hwe ;rvr' 4.. ar;, � `" s . 3R^,.';,.: � - . . zr;= •`°^r , :.`k b «,:.n,,.. BAKERSFIELD FIRE DEPT. z Prev6ntion Services UNIFIED PROGRAM 'INSPECTION CHECKLIST. {4 2101'H Street xx `_ Bakersfield, CA 93301 t " SECTION 1: Hazardous Materials Business Plan , Tel.: (661) 326 -39 9 Inspection Fax; (661) 852= 2171 C= Compliance - C �/ - OPERATION v= violation; 1,11 Minor C E RS Violation COMMENT " APPROPRIATE PERMIT ON HAND. (BMC: 15.65.080) 3010001 . CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1) 3210043 VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT OCCUPANCY (CBC: 401) 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) VERIFICATION OF-SDS AVAILABILITY (CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING (CCR'2732) 1020002 VERIFICATION OF,ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) 1010010 EMERGENCY PROCEDURES AD EQUATE (CCR: 2731) CONTAINERS PROPERLY LABELED (CCR: 66262.34(17, CFC: 2703.5), 3030007 HOUSEKEEPING (CFC: 304.1) t� FIRE - PROTECTION (CFC: 903 & 906) 3030032 SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005 NY HAZARDOUS WASTE ON SITE? 171 YES , NO Si atureofRecei t, Explain: Inspector: "� ��,�.� .,..:�"��+" �a�� „s�•' *��,�'��;�v'�;�.:�tr�' 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 , ` FD2155 Rev 9/2017 White Business Copy Yellow—, Station Copy ' ; , Pink:'— Prevention Services' ,” r, ( ) BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTIOf N CHECKLIST f t, ; ' 2101 H Street Bakersfield, .CA 93301 SECTION 1 Hazardous Materials,80piness Plan Tel.: (661) 326 -3979 Inspection Fax: (661) 852 -2171 INSPECTION DATE INSPECTION TIME FACILITY NAME ,. � PHONE NO. NO OF EMPLOYEES ADDRESS r y�' a , BUSINESS ID NUMBER FACILITY CONTACT Consent to Inspect Name /Title ROUTINE El COMBINED E1 JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V C= Compliance OPERATION C E RS Violation COMMENT Viol V= Violation; 1,11 Minor # APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) 3010001 CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1) 3210043 VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) CORRECT. OCCUPANCY (CBC: 401) 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) VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b)) 1� VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) 1020002 VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 1010010 ; CONTAINERS PROPERLY LABELED (CCR: 66262.34 ft CFC: 2703.5) 3030007 HOUSEKEEPING (CFC: 3041} r w, (CFC: 903 & 906) ��,�'�,"�'�„�'�" � � FIRE PROTECTION 3030032 r ( ` r"4 SITE DIAGRAM ADEQUATE & ON HAND ( CCR: 2729.2) 1010005 ' ; YES;, ''❑ NO Siena urt of Recei t NY HAZARDOUS WASTE ON SITE. Explain:'' a y Inspector: W "' ._i�.rZ� , ° t"� ?i,�',�t�'� % n ap�Sy� =a• "94d .n!;?Y' .. POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Signature that all violations have been corrected as noted) 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 Date White - Business Copy Yellow - Station Copy Pink — Prevention Services FD2155.,(Rev 9/2017) .t k_ aRTM BAKERSFIELD FIRE DEPT. Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST < 2101 x street Bakersfield, CA 93301 Haz -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME 5) ADDRESS PHONE NO. NO OF EMPLOYEES 'f FACILITY CONTACT ..a BUSINESS ID NUMBER a. c- onsent to Inspect Name /Title 0 ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V ( C= Compliance) OPERATION V= Violation COMMENTS Lt ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑' /~ ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) rte❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) Q� ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) Q ❑ SITE DIAGRAM ADEQUATE & ON HAND ,1' (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? Q YES ❑ NO Explain: Si nature 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 Signature (that all violations have been corrected as noted) Date Pink Prevention Services Copy FD2155 (Rev 1/14) der