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BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST;' FIRE F 2101 H Street
, ---- - ---- I.., ................................... ..........
Haz-Mat Business Plan and Inventory Program
A R3.11 T Bakersfield, CA 93301
Tel.: (661) 326-3979
.. 4( Fax: (661) 852-2171
FACILITY NAKP--, ------ INSPECTION DATE INSPECTION TIME
57- 0
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
) ,A)
Consent to Inspect Name/Title
1
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION I
C
V
C=Compliance) OPERATION
V=Violation
COMMENTS
'od
❑
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
z
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
❑
X
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
/0
❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
7
)D
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
I
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
A
❑
HOUSEKEEPING
(CFC: 304.1)
-Z'l
❑
FIRE PROTECTION
(CFC: 903 & 906)
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? Zl YES ❑
NO
Explain:
Si2natui"
eeduM
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• 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)