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UNIFIED PROGRAM INSPECTION CHECKLIST ARTM T. Bakersfield, CA 93301
Tel.: (661) 326-3979 ; r
SECTION 1: Hazardous Materials Business Plan Fax: (66j) 852 -2171
Ins ction
FACILITY NAME
INSPECTION
INSPECTION TIME
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{DATE
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ADDRESS
PHONE NO. NO OF EMPLOYEES. ,
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BUSINESS ID NUMBER
FACILITY CONTACT.
Consent to Inspect Name/Title
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY 171 MULTI-AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C= Compliance OPERATION
C E R S
V= Violation; IjI Minor
Violation'
COMMENT
V
'APPROPRIATE PERMIT OWHAND (BMC: 15.65.080)
3010001
- 4) 0 7 Y,,;
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1.010008
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)��
CORRECT OCCUPANCY (CBC: 401)
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VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
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VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
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VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
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))
L'A
EMERGENCY PROCEDURES ADEQUATE , (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED ' (CCR: 66262.34(f), CFC: 2703.5)
,3030007
HOUSEKEEPING (CFC: 304.11)
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FIRE PROTECTION (CFC: 903 & 906)
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3030032
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U i�70,2 tA,,k
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
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fa' 0 :517��
ANY HAZARDOUS WASTE ON SITE? ❑ YES 21 NO
Signature. ofRecei t
Explain:
Inspector; . 1.: `.,e_ i < I ... $ .
POST INSPECTION INSTRUCTIONS: 4
• Correct the violation(s) noted above by � ;'
e 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— Copy Yellow — Station, Pink - Prevention. Services FD2155 (Rev 8%/14)