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HomeMy WebLinkAbout1200 COFFEE RD HMBP 9.30.14BAKERSFIELD FIRE DEPT. Prevention Services A.... F... R C F...1. r.. 1 UNIFIED PROGRAM INSPECTION CHECKLIST F;reE 2101 H Street ::i:$$i• .. .: : .. v. C....:..:..•... .v. r.nii: F:.. .. v::+YiY'• .. l.Y�'v',t:'S;':.. vi*:L::. r:.. v..x... :: }::;ni }i:j: .ti.vii::.:::4t:: '+;. v.:::.:::•::. v :.:i:ii:•i:::.inv,:::�•�n•.;y,. .::...:.:::.::: i:: ..;v:x::n;: :.::.v:.l�i'i.n..:.. F..: •:w ":{;'n; :::. •.. �.. :i::r.. n.:: n; .... :u• / ...... .v:«::.; .. .. ::' �:}.> .. ........ :. .n..: 4x:E•. �:: w. :Mn;; :•: n:' $�i$Y..:;i:•:v:,::•: i?:,'pa.r /:w:: .... ..n..•. .:... n.,.....:nv:v:J:<.:.iv:.,.: is :.::r.:.:. :::: ^. : :::: :.:v:: rv:nnw:;::.•,v},•:. ' : ": •: .. v.. �... rc. .: AR�'� r Bakersfield, CA 93301 HaZ -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME FA 5 i k 0 oo ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT. BUSINESS ID NUMBER ¢` Va Consent to Inspect Name/Title 1~ t 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 C V ( C= Compliance OPERATION V= Violation COMMENTS. J=' ❑ VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020) /El ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) /El ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e) 1.0 ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) LI ❑ VERIFICATION OF QUANTITIES (CCR: 2729:4) rMor ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1) ,� ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b)) 2- ❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) ❑ , VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c)) ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5) ,r❑ ❑ HOUSEKEEPING (CFC: 304.1) ❑ FIRE PROTECTION (CFC: 903 & 906) 1 ❑ SITE DIAGRAM ADEQUATE & ON HAND f (CCR: 2729.2 (3)) ANY HAZARDOUS WASTE ON SITE? ❑ YES NO Explain: a"- Pi S" / i � E A I. � Car ✓6r � C� � r Sn'F -, ft nature of. R ece" t: -� '� � �. i 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)