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s. W BAKERSFIELD FIRE DEPT.
Prevention Services
B 6 R s F 2101 H Street
UNIFIED PROGRAM INSPE TION CHECKLIST��` Bakersfield, CA 93301
A'l! tA! T Tel.: (661) 326 -3979
SECTION 1: Hazardous Materials Business Plan Fax: (661) 852 -2171
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FACILITY NAME
LA04,
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INSPECTION DATE
9-� -I �
INSPEQ4TION TIME
0.5 W) 4)
ADDRESS
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PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
BUSINESS PLAN CONTACT INFORMATION
_02
onsent to Inspect Name/Title
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CROUTINE ❑ COMBINED a ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V = omp lance
OPEF#ATION
V =Violation; 1,11 'Minor
CERS
Violation
COMMENT
'
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)
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CORRECT OCCUPANCY
(CBC: 401)
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)
...,,,,,,333
VERIFICATION OF SDS AVAILA13
LITY (CCR: 2729.2(3)(b)}
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
1020002
VERIFICATION OF ABATEMENT
SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES AD�EQUATE
(CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED
(CCR: 66262.34(f), CFC: 2703.5)
I
3030007
HOUSEKEEPING
(CFC: 304.1)
FIRE PROTECTION
(CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON
HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE ?.
❑ YES ❑ NO
Nignature ofRecei t
Explain:
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Inspector:
POST INSPECTION INSTRUCTIONS: -
• Correct the violation(s) ;noted above by )'
• Within 5 days of correcting ll of the violations; sign and return a copy of this page to: Signature (that all violations have been corrected as noted) '
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Bakersfield Fire Dept., Prevention Servic s, 2101 H Street, California 93301
Date -'
White — Business Copy y llow — Station Copy Pink — Prevention Services FD2155 (Rev 8/114)