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BAURSFIELD FIRE DEPT.
Prevention Services
$ E R S >; i �>w 2101 H Street
UIVIkED P "ROGRAM INSPECTION CHECK IST � Bakersfield, CA:93301
Tel.: (661) 326 -3979
SECTION 1: Hazardous Materials Business Plan Fax: (661) 852 -2171
Inenear-finn
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
Violation
+"
ADDRESS
PHONE NO.
NO OF EMP40YEE�S
APPROPRIATE PERMIT ON HAND (BM
:15.65.080)
FACILITY CONTACT
BUSINESS ID NUMBER
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR:
2729.1)
Consent to Inspect Name/Title
C V C=Gompliance OPERATION
CERS
-
ROUTINE ❑ COMBINED ❑ JOINTAGENCY
MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C=Gompliance OPERATION
CERS
V =violation; 1,11 Minor
Violation
COMMENT
APPROPRIATE PERMIT ON HAND (BM
:15.65.080)
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR:
2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BM
:15.52.020)
ft
CORRECT OCCUPANCY
(CBC: 401)
,.
VERIFICATION OF INVENTORY MATERIALS (CR:
2729.3)
1010004
�
VERIFICATION OF QUANTITIES (CCR:
2729.4 )
1010006
”
VERIFICATION OF LOCATION (CCR:
2729.2)
;2
'PROPER SEGREGATION OF MATERIAL (
FC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR:
729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
1020002
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 ON SITE? YES ❑ NO
Sienature ofRecei t
° _
Explain: j
Inspector: A!,.
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:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White — Business Copy Yellow — Station Copy Pink Prevention Services
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SignatuYe (that all violations have been corrected as noted)
?, _.
Date
FD2155 (Rev 8H14)