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BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 2101 H Street.
�� Bakersfield, CA 93301
Haz-Mat Business Plan and Inventory Program Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
S'C
Consent to Inspect Name /Title ; r
ROUTINE El COMBINED El JOINT AGENCY ❑ MULTI- AGENCY El COMPLAINT El RE-INSPECTION
C V
C C= Compliance) OPERATION
V= Violation
COMMENTS
❑
VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020)
°❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
❑
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)
El
VERIFICATION.OF QUANTITIES
(CCR: 2729.4)
❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
l 1, __1
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
ZF ❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
ja ❑
EMERGENCY. PROCEDURES ADEQUATE
(CCR: 2731)
-12 ❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
❑
HOUSEKEEPING
(CFC: 304.1)
11, ❑
FIRE PROTECTION
(CFC: 903 & 906)
112"" ❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? 'YES ❑
NO
Explain:
Si2nature of Receipt:
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)