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�¢ BAKERSFIELD FIRE DEPT.
Prevention Services
la R. R, 8 F r l 2101 H Street
UNIFIED PROGRAM 'INSPECTION CHECKLIST Bakers�ield,CA93301
,+i! R f Tel.: (661) 326 -3979
SECTION 1 :: Hazardous Materials Business Plan Fax: (661) 852 -2171
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ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT USINESS ID NUMBER
Consent to Inspect Name/Title
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"'0 ROUTINE ❑ COMBINED 1:1 JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT RE- INSPECTION
C. V= omp lance OPERATION C E R S
V =Violation ;l,l1 Minor 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)
CORRECT OCCUPANCY (CBC: 401) 1010004 VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006
Q4 VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
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1020002 VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) 3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906) 3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005
ANY HAZARDOUS WASTE O N SITE ? 0, Y E S W "NO Signatu rof Recei t
Explain: 1 �w � ( .. dam• ....o f.,,, �. •. 'i ., .....
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Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 81!14)
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I: . v. N�t ,S.
4 � :F z 6P, .E,.
CF , ,T,.. � . I., O
N e }T.'v.� £v
Iv . . :
1)
k” S
S i
"'0 ROUTINE ❑ COMBINED 1:1 JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT RE- INSPECTION
C. V= omp lance OPERATION C E R S
V =Violation ;l,l1 Minor 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)
CORRECT OCCUPANCY (CBC: 401) 1010004 VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006
Q4 VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
'. . �
. r a
wErJ t
, £
• ..w. : .
PE
.. ...:
J
t« -1 * L�O
1020002 VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) 3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906) 3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005
ANY HAZARDOUS WASTE O N SITE ? 0, Y E S W "NO Signatu rof Recei t
Explain: 1 �w � ( .. dam• ....o f.,,, �. •. 'i ., .....
• • vr.�fA�< .,� <.�... 3r...":. <
Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 81!14)
• • vr.�fA�< .,� <.�... 3r...":. <
Inspector:
POST INSPECTION INSTRUCTIONS:
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: Signature
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 81!14)