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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
V) G - s.
INSPICTION DATE
t I cn ( , }
INSPECTION TIME
ADDRESS
COMMENTS
PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT
BMC: 15.65.080)
BUSINESS ID NUMBER
Consent to Inspect Name /Title
E4
Section 1: Business Plan and Inventory Program
ROUTINE - COMBINED JOINT AGENCY MULTI- AGENCY COMPLAINT RE- INSPECTION
C v c C= Compliance OPERATION
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
E4 Business PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
N C2
81, VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
1M CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CFC: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(1), CFC: 2703.5)
HOUSEKEEPING CFC: - 304'1
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES NO i e
nit • I save
Explain:
POST INSPECTION INSTRUC "r1ONS:
Correct the violation(s) noted above by
Within 5 days ofcorrecting all ofthe violations, sign and return a copy ofthis page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow —Business Copy to be Sent in alter return to Compliance Pink — Prevention Services Copy FD2155 (Rev 6//10)