HomeMy WebLinkAboutHazmat Inspection 01/08UNIFIED PROGRAAA INSPECTION CHECKLIST
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SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
' Tel: (661)_326-3979
FACILITY NAME WSPECTION DATE INSPECTIO TIME
(,/ `~ A ~ ~/ _.__ -...-------- -_ . PHONE No. No. of Employees -
ADDRESS ---/ / ~J I ~`v`(/~ ~~~-J~// -~D
Business ID Number -- - -- - -
FACILITYCONTACT
~-/i,.., ~Llr/~ ~ 15-021- (~d/Z//
Section 1: Business Plan and Inventory Program
L~toutine ~ Combined O Joint Agency OMulti-Agency ~ Complaint O Re-inspection
ANY HAZARDOUS WASTE ON SITE: OYES IJ IVO
EXPLAIN:
•
QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~GG'I~ 326-3979
__r~~-T~~y_6A~G~~'~-------.----------- .-----.__ __
Inspector (Please Print) Fire Prevention 1st-In/Shik of Site
White -Environmental Services Yelkrw - Stettin Copy
Busi Site Responsib Party se Print)
8
.Pink -Business Copy
.
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CITY OF BAKERSFIEI.D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd I;'loor, Bakersfield, CA 93301
F ACILlTY NAME C¿:-D h /Þ.s-hrl"1 Dr( f I
ADDRESS /'/31 tl4¡è-ß.H, .4vR
FACILITY CONTACT ~A;:' f?h,-/ ÿ<J.j
INSPECTION TIME / Pl'~r£,
INSPECTION DATE / ¡ /2-0/ c>3
PHONE NO. 3z-s--S-9/ '7
BUSINESS ID NO. 15-210- /2/ Ý
NUMBER OF EMPLOYEES / ~-
Section I:
~outine
Business Plan and Inventory Program
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TlON C V COMMENTS
Appropriate permit on hand v DfC4 'an
v .....
Business plan contact information accurate
,
Visible address v
....
Correct occupancy v
Verification of inventory materials v
þ v
Verification of quantities
Verification of location vV )~/-5 ÇL!I..../ d øi _
/j):E: ¿-J /Y) ð J =-¡
Proper segregation of material v /'
Verification of MSDS availability 0/
Verification of Haz Mat training /
.
Verification of abatement supplies and procedures ¡r
. v'
Emergency procedures adequate /'
Containers properly labeled :/ VVV
Housekeeping /' ~u?; ) Ii ¡/'fj C I /
Fire Protection ¡/ .H~ ( é5:?3:S3
.. .IE:,
Site Diagram Adequate & On Hand
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
I:J Yes
~/
White - Env, Svcs.
Yellow· Station Copy
Pink - Business Copy
Inspector:
Questions regarding this inspection? Please call us at (661) 326-3979
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HAZARDOUS MATI: IALS INSPECTION v~. ~akerstield Fire Dept.
,: Hazardous Materials Division
~.~~ Œ~!~~~Ì
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8 l; I 25 1::194 //./1.,,/;,,',;
(Top of Business Plan) L: /
C '''''''''AII . y_____ !
Inspector C UWI'f/\L-/ --~~,---.- I
, ---- --- -
3,O':J Inspection Time: Â':) /J?"l.Mv,r
[j
[j
Verification of Location ø 0
. ~ Pro~regation"! Material ~ 0
,0 . h ~~~(YyV,~(¿
Verification of MSDS Availability ~ 0
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Business Name:
Location:
Business Identification No. 215-000 00 I Â I Lf
Station No.:2.. Shift fl
Arrival Time: :2.:4 0 Departure Time:
Verification of Inventory Materials
Verification of Quantities
Comments:
Number of Employees:
Verification of Haz Mat Training
Comments:
Verification of Abatement Supplies & Procedures
Comments:
Date Completed I ()- ")4 -9 if
I
Adequate
Inadequate
f1k
~
fÃ
o
~
D
Emergency Procedures Posted
Containers Properly Labeled
Comments:
Verification of Facility Diagram
Special Hazards Associated with this Facility:
~
~
~
D
D
D
Violations:
7jJm 1) í;,~ 171
Business Owner/Manager PRINT NAME
All Items O.K L]
orrection Needed ~
§
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White-Haz Mat Div
Yellow-Station Copy
Pink-Business Copy
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e Bakersfield Fire Dept. e
HAZARDOUS MATERIALS DIVISION
Date Completed
q-)-{ -Ciz.
Business Name: ~O Ul?~r r-l
Location: \L\~\ {)(\ ~ Ov\
Business Identification No. 215-000
Station No. r\().1, ~ Shift
ld- \<1
(Top of Business Plan)
Inspector ~,(
Adequate Inadequate
Verification of Inventory Materials D D
Verification of Quantities D D
Verification of Location D D
Proper Segregation of Material D D
Comments:
Verification of MSDS Availablity D D
Number of Employees
Verification of Haz Mat Training D D
Comments:
Verification of Abatement Supplies & Procedures D D
Comments:
Emergency Procedures Posted D D
Containers Properly Labeled D D
Comments:
Verification of Facility Diagram D D
Special Hazards Associated with this Facility: ~«1 i 11<)[)J en -nn ~,I .sutFur,·c ACId.
I
i' nV(? J\-mro ~i S\Dn (,~ChQrt
Violations:
All Items O.K . ~
Correction Needed D
Business Owner/Manager
FD 1652 (Rev. 1-90)
White-Haz Mat Div, Yellow-Station Copy Pink-Business Copy
e ~- ~~/
Bakersfield Fire Dept. e
HAZARDOUS MATERIALS DIVISION
Date Completed
Business Name: ( A E (~ (^)p s~e..v n ~~ ~ :¡:: [v I A )
Location: L ~ I Ù VI/a n A V ,
I \ /;:;).0 / C1 J
/ /
REce\VEO
NOV 2. 5 \99'
Or) I 'd-I L (Top of Business Plan) H~7 MAT- OW.
A Inspector _QIV S / ú..)e-be--v
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Adequate Inadequate
Business Identification No. 215-000
Station No.
~
Shift
Verification of Inventory Materials
Verification of Quantities
Verification of Location
Proper Segregation of Material
Comments:
~
~
~
&J
D
D
D
D
~
o
Number of Employees
Verification of MSDS Availablity
q
Verification of Haz Mat Training
énts:
~
D
~
D
Verification of Abatement Supplies & Procedures
Comments:
Emergency Procedures Posted
Containers Properly Labeled
Comments:
D
121
~
D
D
Verification of Facility Diagram
Special Hazards Associated with this Facility: -l:.5
ttJ
Violations:
m u Cv~J
F'L.f;- J 027Î'
-~
L-J
All Items O.K. D
Correction Needed ¢
FD 1652 (Rev. 1-90)
White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy
/
· ~~d~Pt.
Hazardous Materials Inspection
Date Completed '/I-IIf- e¡ 0
/
-
I
Business Name:
GEO (..vES"-~~"-1 1)R..\LLlNc... FW/DS
Station No, ~
Shift Þr
Inspector BONNE. A..
RECEIVED
NOY 2 1 1990
HAZ, MAT, DIV.
Location:
I ¡.¡.. '3 I
UN' ON AvE.,
Plan ID # 215-000 /:¡ILf- (Top right comer Business Plan)
Proper Segregation of Material
~. -t;; b?- ?p~at~
ø 0
o 0
o 0
(;}~cation of Inventory Materials
Verification of Quantities
Verification of Location
Comments: .5DO ~~L ~oP~E. TÃ~~ )
.3 500 GA:L. of MVI- 2... ßL.e.N D
(#-3 R-F>- \I\M~ØLE-)
[Ø 0
Verification ofMSDS Availability
, I - OF-AcE. T t,JPl:Ite..\o\Ovse...
Number of Employees 5 - D R.\V~~'>
Verification of Haz Mat Training
[Ø
o
Comments:
Verification of Abatement Supplies & Procedures
rø
o
Comments:
Emergency Procedures Posted
[0
[Ø
o
o
Containers Properly Labeled
Comments:
Verification of Facility Diagram
[0
o
Special Hazards Associated with this Facility:
Violations:
FD 1652 (Rev. 3-89)
White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
/