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HomeMy WebLinkAboutHAZMAT INSP 2/2008r =- - - Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST >3 r R s F . n .900 Truxtun Ave:, Suite 210 - FIRE -Bakersfield, CA 93301 • SECTION 1: Business Plan-and lnventory_ Program "erM r Tel.;: (661) 326-3979 . _ ~ Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME CP ~~~®~..,~~, A~~ S r,~.~-~ '~ - ~ ~ 7 ter; ~~ ADDRESS ~ - - - PHONE NO. NO OF EMPLOYEES 160 'S3 A~•=.~. s - 32s"'~f?'~ k"' FACILITY CONTACT -' BUSINESS ID NUMBER L.y nl t-~ -T'~.1Z.1 C.U ~ -rtq 15-021-~?!3 /') (p'~ Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation C_O_MMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIn2SS PLAN CONTACT INFORMATION ACCURATE ^ -VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL /.~p~ F IV~tn ~ I I . bbe Y 4{ 4,J Id ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES 1 ILI ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDO~U"S~ WASTE ON SITE? LI YES ^ NO EXPLAIN: (/C/~STi~ O/L~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 ~~ .~ N-r Inspector (Please Print) Fire Prevention / 1'~ In /Shift of Site/Station # Bu ess Site /Responsible Party (Please Print) White -Prevention Services '~ Yellow -Station Copy Pink -Business Copy ~ FD 2155 (Rev. 09/05 UNIFIED PROGRAM INSPECTION CHECKLIST ~~i, '.::':t~U~Y:~!~{iRsiti+t~R Y~:, .A'.^'(:-~f4.'. Tr: .:~ £. .''-::-:.. ~.. -a.:.. _°. ~~a .. ..:: a,`: . .- ;. ..:. s:'. ~`.~::-.. '.. .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a p Prevention Services ~~iYS 900 Truxtun Ave., Suite 210 ~RrN Bakersiield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY N A ME NSPECTION DATE INSPECTION TIME / ~ (,~~4LIF d nll.~ ~6 ~'Al srS' ~-/ 81700 ~~~5" ADDRESS HONE NO. O OF EMPLOYEES /ova rc 3z.r-~ ~ ~'z ~ FACILITY CONTACT USINESS ID NUMBER n/_ 15 021 ~ ~ q~M..~ r s~ az~c~,~ ~-,~ - -~ <(~ Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c_compliance) OPERATION V=violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSOS AVAILABILITY - -- N~~ A ~ FS Q y ~^~ --- t 1 ~i ~L u ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE _ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 6 ON HAND ' ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: ~ _ REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-3979 /~1 C L5 ~Ji7. ~~s~ ~ "B Inspector (Please Print) Fire Prevention / 1„ In / Shift of Site/Station q P White - Prwention Serviees Yellow -Station Copy Pink - Business Copy FD2049 (Rw. OZN181 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~.~/, ~a, ,n, la g.~To 3/',-'i5, INSPECTION DATE ADDRESS /Oo /~ ~.t,/~e/, c~7--, PHONENO. ~ o~ _~ % ~O FAClLITYCONTACT ._-~_/~-e ~'a/oe,~,~.t~a BUSINESS ID NO. 15-210- INSPECTION TIME ',~ O ~,~ ,,a o ~e ,,~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program .,~ Routine [~l Combined {~ Joint Agency ~ Multi-Agency [~ Complaint ~l Re-inspection OPERATION C V COMMENTS Appropriate permit on hand 'X' Business plan contact information accurate /~ Visible address ~ Correct occupancy ,/~ Verification of inventory materials )~ Verificationofquantities < 0T/,OO ,~o[Io.,,s /~.//~Tf O~ ~ Verification of location X Proper segregation of material ~ Verification of MSDS availability /x Verification of Haz Mat training 'K Verification of abatement supplies and procedures ~, Emergency procedures adequate ~ Containers properly labeled ~ Housekeeping ~ Fire Protection X Site Diagram Adequate & On Hand ~ C=Compliance V=Violation Explain:Any hazardous waste on site?: [~l Yes ~No .~~~ . ... Questions regarding this inspection: Please call us at (661) 326-39'/9 ~siness Site,J~spons~e Party White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: f.~,'/'J~