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HomeMy WebLinkAbout6001 COFFEE ROAD_HMBP 2.7.11UNIFIED PROGRAM INSPECTION CHECKLIST. a >< F R 5 P 1 F/RE D ARTMFIyr SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 (561) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME �z1'« INSPECTION DATE INSPECTION TIME ADDRESS C) V, C 0 n Y PHONE f_ ' NO OF EMPLOYEES (BMC: 15.65.080) l],, ❑ FACILITY CONTACT BUSINESS ID NUMBER IJ- ❑ VISIBLE ADDRESS Consent to Inspect Name /Title Section 1: Business Plan and Inventory Program ❑ ROUTINE 0,COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION Ir C v c C= Compliance OPERATION V= Violation COMMENTS ❑�, ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) l],, ❑ Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) IJ- ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) ©J ❑ CORRECT OCCUPANCY (CBC: 401) (]3 ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) ®v ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) 1�0 ❑ VERIFICATION OF LOCATION (CCR: 2729.2) ❑0 ❑ PROPER SEGREGATION OF MATERIAL (CFC: 2704.1) l ' ❑ ❑ VERIFICATION OF MSDS AVAILABILITY O� n r " (CCR: 2729.2(3)(b)) "O' ❑ VERIFICATION OF HAZ MAT TRAINING �`O (CCR: 2732) ®) ❑ VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) C)- ❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ©_- ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) r ❑ ❑6 HOUSEKEEPING (CFC: 304.1) - 7 l 0 ❑ ` FIRE PROTECTION (CFC: 903 & 906) 0` ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? 0 >YES ❑ NO. �1t � Signature of Receipt } )%kA Explain: r t i1 POST INSPECTION INSTRUCTIONS: r • 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 Signature (that all violations have been corrected as noted) Date Pink — Prevention Services Copy FD2155 (Rev 600) .- :;;4, FEB -07 -2011 16:41 From:RITE AID06366 6615670935 kCNN DU01,11=0 F011Ma- Im1) =C6 wlB - NYIIU UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program To:COB ru FACILITY NAME INSPE ADDRESS PHONEI •V Qa � C.O�¢CL e��' FACILITY CONTACT (� BUSINE: _ � �. RO S•+'r V rya � ��C Y\ �} � G Consent 10 InSpOCt Npm9ffIIIB Section 1: Business Plan and Inventory Program ❑ ROUTINE COMBINED 0 JOINT AGENCY Q MULTI- AGENCY 0 COMPLAII _.... C =Compliance. ...._ - -._... C V ( ) OPERA710N COI v.vlolnriun P. III BAKERSFIELD FERE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301. Tel.: (661) 326 -3979 Cax: (661.) 652 -2171 N DATE INSPECTION TIME O.o l I NO OF EMPLOYEES 71� 0 M_ APPROPRIATE PERMIT ON HAND (13MC 15,85.000) VERIFICATION OF HAZ MAT TRAININC dP" (CCR: 2702) ❑ Business PLAN CONTACT INFORMATION ACCURATE (CCR 2729 1) VERIFICATION OF A13ATEMF_ -NT SUPPLIES N PROCEDURE$ (CCR: 2731(c)) Q VISIBLE ADDRESS (CFC: 506. 1. BMC' 16 52 020) (CCR 2731) ❑ CORRECT OCCUPANCY (CBC' 401) HOUSEKEEPING O VERIFICATION OF INVENTORY MATERIAL,$ (CCR' 2729.3) ❑ VERIFICATION OF QUANTITIES (CCR. 2729.4) FIRE PROTECTION (CFO. 903 a 906) lOJ ❑ VERIFICATION OF LOCATION (CCR' 2729 2) \� ANY HAZARDOUS WASTE ON SITE? dil YES ❑ NO _..._— ... ...... — ❑ PROPER SEGREGATION OF MATERIAL (CFC 2704 1) 'OS "1' lNtiP :C:'1•IC1N INS`I'N11(:'1'1(.INb`: P. III BAKERSFIELD FERE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301. Tel.: (661) 326 -3979 Cax: (661.) 652 -2171 N DATE INSPECTION TIME O.o l I NO OF EMPLOYEES 71� 0 VERIFICATION OF M$OS AVAILABILITY Q ���6 (CCR. 2729.x(3)(e)) NZI 0 VERIFICATION OF HAZ MAT TRAININC dP" (CCR: 2702) ❑ VERIFICATION OF A13ATEMF_ -NT SUPPLIES N PROCEDURE$ (CCR: 2731(c)) ❑ EMERGENCY PROCEDURES ADFQUATe (CCR 2731) ❑ CONTAINERS PROPERLY LABELED (CCR 86262 34(f), CFC 2703.6) HOUSEKEEPING (CFC: 304 1) rpr� ?27`�r/j� rv- ��• qY ❑ B O FIRE PROTECTION (CFO. 903 a 906) ,a ❑ SITE DIAGRAM ADEQUATE B ON HAND (CCR: 2729.2) \� ANY HAZARDOUS WASTE ON SITE? dil YES ❑ NO ld Explain'. %l �}'6.. a r'.. --- - -° ........ _,,y,� - 'OS "1' lNtiP :C:'1•IC1N INS`I'N11(:'1'1(.INb`: C'urrcut Lho vialul,iu n(w) notul above by — ,l +` bign wrc (Lhnt v Lions hove `CU µrrrCClCd ao no(cd) Within 5 days o('correcting all ol'the violutiony, r:ign and to urn a copy oI -Ihis page lo: l}� BakurSliold fire Deln., Pruvunli)n Survla,•v, :!10 1 11 titrocl; Cal II'arnla 93301 L- Doc While Ilg611" ( 'ly)y Yvil— UusilWw C•upy lot he tiwn In utter rultY'n to Vilinpllmma Nook I'mvmlGue R-1—Cq)y Itl'�'.I S3 (Itev Nil al