HomeMy WebLinkAbout4199 UNION AVE HMBP 6.4.15UNIFIED
Haz-Mat 13,
BAKERSFIELD FIRE DEPT.
Prevention Services
FL�F E.J. P
F I
P ;E
PROGRAM INSPECTION CHECKLIST . 1 2101 H Street
FIRE
A jr JW Ir
aRTM r Bakersfield, CA 93301
0:
usiness Plan and Inventory Program Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
"j
PHONE NO.
Ci
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
7
i-ul
[3 ❑ CIERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
Consent to Inspect
Name/Titiq
I r j
NI <' ".1, _( -: � �'�
0?" ❑ B I LSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
'e-
0--itI I bUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
C V u=uompiiance) OPERATION
COMMENTS
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• Correct the viiolation(s) noted above by
• Within 5 days of correcting all of the violations, sign and return a copy of this page to:
Bakersfield F� ire Dept., Prevention Services, 2101 H Street, California 93301
White —Business Copy I Yellow — Business Copy to be Sent in after return to Compliance
S T
Signature (that all violations have been corrected as noted)
-7 - 2-- 1
Date t) (-' (-' I C_ �'
Pink Prevention Services Copy fZ — 0''a...
V=Violation
3" 01
❑ VISIBLE
ADDRESS (CFC: 505.1, BMC: 15.52.020)
❑ D" A I rPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
7
[3 ❑ CIERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
0?" ❑ B I LSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
❑, V
RIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
Lam" ❑ V
RiFICATION OF QUANTITIES (CCR: 2729.4)
Ey ❑ VERIFICATION
OF LOCATION (CCR: 2729.2)
B" ❑ P
�OPER SEGREGATION OF MATERIAL (CFC: 5004.1)
❑ 19- S
FETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b))
❑ a VERIFICATION
OF HAZ MAT TRAINING (CCR: 2732)
❑ ❑ VI
ERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
4� C_
1:1 EMERGENCY
PROCEDURES ADEQUATE (CCR: 2731)
1
EY 1771 CONTAINERS
PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
❑ HO'USEKEEPING
(CFC: 304.1)
❑ El/ FIRE
PROTECTION (CFC: 903 & 906)
❑ SITE
DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS
WASTE ON SITE? ❑ YES ❑ NO
Explain:
1
ignature of Receipt:
>441�
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• Correct the viiolation(s) noted above by
• Within 5 days of correcting all of the violations, sign and return a copy of this page to:
Bakersfield F� ire Dept., Prevention Services, 2101 H Street, California 93301
White —Business Copy I Yellow — Business Copy to be Sent in after return to Compliance
S T
Signature (that all violations have been corrected as noted)
-7 - 2-- 1
Date t) (-' (-' I C_ �'
Pink Prevention Services Copy fZ — 0''a...