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HomeMy WebLinkAboutRALPHAEL AVE- CAL WA- HAZ-BUSINESS PLAN 6-20-2014BAKERSFIELD FIRE DEPT. Prevention Services A_. "LAR;rJ'ff ) UNIFIED PROGRAM INSPECTION CHECKLIST ' 2101 H Street ,....... A 330 'eld C 9 Bakersfield, Haz -Mat Business Plan and Inventory Program 41MV01 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME 69/z ADDRESS PHONE NO. NO OF EM,�C&EES K' Aut, FACILITY CONTA T BUSINESS ID NUMBER Consent to Inspect Name /Title 1 ❑ ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) F 3 ) ❑ ❑ HOUSEKEEPING (CFC: 304.1) i ❑ ❑ EIRE PROTECTION (CFC: 903 & 906) ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Explain: Si nature of Receipt: POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: • 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 — Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14) ❑` ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION �jll �( (( r- � V� ❑ ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) ❑ VERIFICATION OF LOCATION (CCR: 2729.2) C V ( C= Compliance OPERATION V= Violation COMMENTS ❑ ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) ❑ ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑ ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) (CC R: 2731 ) i ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) B T CCR• 2729 1 1 ❑ ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) F 3 ) ❑ ❑ HOUSEKEEPING (CFC: 304.1) i ❑ ❑ EIRE PROTECTION (CFC: 903 & 906) ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Explain: Si nature of Receipt: POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: • 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 — Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14) ❑ USINESS PLAN CONTACT INFORMATION ACCURA E ( ) �jll �( (( r- � V� ❑ ❑ 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) r ❑ ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) '� I ❑ ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) .� / Vi s ❑ ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑ ❑ EMERGENCY PROCEDURES ADEQUATE (CC R: 2731 ) 1 ❑ ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) F 3 ) ❑ ❑ HOUSEKEEPING (CFC: 304.1) i ❑ ❑ EIRE PROTECTION (CFC: 903 & 906) ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Explain: Si nature of Receipt: POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE: • 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 — Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14)