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BAKERSFIELD FIRE DEPT.
Prevention Services
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UNIFIED PROGRAM INSPECTION CHECKLIST FIRE 2101 H Street
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Bakersfield, eld C 9
Haz -Mat Business Plan and Inventory Program Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
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ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
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Consent to Inspect Name /Title
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V
( C= Compliance, OPERATION
V= Violation
COMMENTS
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VISIBLE ADDRESS (CFC: 505. 1, B MC: 15.52,020)
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/APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
I ❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
E ❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
❑', ❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
I? ❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
E7 ❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
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EY ❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
E ❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
E ❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
EK ❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
2' ❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
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HOUSEKEEPING'
(CFC: 304.1)
ED,, ❑
FIRE PROTECTION
(CFC: 903 & 906)
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES
NO
Explain:
i nature of Receipt.
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YU)ST MSY1:U 1'10N 1NSTRUU:'1'1UNS YOR RL+'TU"- T0- U:0MYLIANU E:
• 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 1/14)
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