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t WORSFIELD FIRE DEPT.
P s >I n :'Prevention Services
ID31 P. 2101 H Street
UNIFIED PROGRAM INSPECTION CHECKLIST FIRS Bakersfield, CA 93301
Tel.: (661) 326 -3979
SECTION 1 Hazardous Materials Business Plan Fax: (661) 852 -2171
Ins ion
FACILITY NAME
INSPECTION BATE
INSPECTION TIME
ADDRESS �
P. NE" NO.µ) � �
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name/Title
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ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V= omp lance OPERATION
C E R S
V =Violation; 1,11 Minor
Violation
COMMENT
x
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
.;
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
k5
CORRECT OCCUPANCY (CBC: 401 )
4.
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
x
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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))
EMERGENCYPROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING. (CFC: 304.1)
xj
.
FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES NO
Signa tureofRecei t
Explain:,: —
Inspector:
POST INSPECTION INSTRUCTIONS:
• 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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow— Station Copy Pink - Prevention. Services
FD2155 (Rev 8//14).