HomeMy WebLinkAbout2021_10_19 Jack In The Box #3199 hmbpJ
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
CERS
Violation COMMENT
INSPECTION DATE
'INSPECTION TIME
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
/ -7% k
ADDRESS
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
,PHONE NO.
NO OF EMPLOYEES
r �-ezg(l
-
FACILiTY CONTACT
BUSINESS ID NUMBER
CORRECT OCCUPANCY (CBC: 401)
J0 <
f 1 I /C
'7
Consent to Inspect Name/Title
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006J_1A
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v r�
VERIFICATION OF LOCATION(CCR: (CCR: 2729.2)
T
Section 1:
Business Plan and Inventory Program
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
❑ ROUTINE
❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
c V = ompiance OPERATION
V=Violation; 1,11 Minor
CERS
Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
1010008
41
6w
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)
1010006J_1A
/��jj� )i -160 _l
v r�
VERIFICATION OF LOCATION(CCR: (CCR: 2729.2)
T
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))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
Cr
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
-
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
0/1—art-r, 4 _C-4cI C; � r
i r
SignatureofReceipt
Explain: Xj N.>
Inspector:.-,`Af �' _.art �% � /'� <.r U 5
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by r ��•�
• 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 — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
i
FD2155 (Rev 6/2021)