HomeMy WebLinkAbout9000 MING AVE HMBP 6.12.15 RITE AIDBAKERSFIELD FIRE DEPT.
UNIFIED PROGRAM INSPECTION CHECKLIST R
...R---s .F..i. Prevention Services
E. f.
FIRE - 2101 H Street
ARTM T Bakersfield, CA 93301
Haz -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979
• 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
ce:W.(
Date
Pink Prevention Services Copy
l violations have been corrected as noted)
FD2155 (Rev 1/14)
ROUTINE ❑ COMBINED ❑ JOINT AGENCY
j
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Fax: (661) 852 -2171
FACILITef AME 3
r a
INSPEETIONJ DATE
INSPECTIeN TIME
C
V
( C= Compliance) OPERATION
V= Violation
ADDRESS
4
❑
PH N,E NO.
f$
NO OF EMPLOYEES
❑
APPROPRIATE PERMIT ON HAND
I .
FACILITY CONTrAl2-;T _
BUSINESS ID NUMBER
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
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Consent to Inspect Name /Title
(CCR: 2729.1)
❑
VERIFICATION OF INVENTORY MATERIALS
• 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
ce:W.(
Date
Pink Prevention Services Copy
l violations have been corrected as noted)
FD2155 (Rev 1/14)
ROUTINE ❑ COMBINED ❑ JOINT AGENCY
❑ MULTI - AGENCY
❑ ;COMPLAINT ❑ RE- INSPECTION
C
V
( C= Compliance) OPERATION
V= Violation
COMMENTS
❑
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)
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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)
4
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
Imo;.
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
C1µ
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
Q.
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
1
❑
HOUSEKEEPING
(CFC: 304.1)
L'
❑
FIRE PROTECTION
(CFC: 903 & 906)
1�3'
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES NO
i
Explain:
Signature of Receipt: Z
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
ce:W.(
Date
Pink Prevention Services Copy
l violations have been corrected as noted)
FD2155 (Rev 1/14)