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UNIFIED PROGRAM INSPECTION, CHECKL ST
SECTION 1: Hazardous Materials Business
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BAKERSFIELD FIRE DEPT.
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FACILITY NAME
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INSPECTION DATE
INSPECTION TIME
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MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
Violation
COMMENT
ADDRESS
PHONE N0.
NQ,OF EMPLOYEES
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APPROPRIATE PERMIT ON HAND (BM
:15.65.080)
FACILITY CONTACT
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BUSINESS ID NUMBER
BUSINESS PLAN. CONTACT INFORMATION ACCURATE (C
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Consent to Inspect Name/Title,
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C V C= Compliance OPERATION
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ROUTINE ❑ COMBINED ❑ JOINTAGENCY El
MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C= Compliance OPERATION
CERS
V= Violation; 1,11 Minor
Violation
COMMENT
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APPROPRIATE PERMIT ON HAND (BM
:15.65.080)
3010001
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BUSINESS PLAN. CONTACT INFORMATION ACCURATE (C
R:2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BM G:
15.52.020)
CORRECT OCCUPANCY
(CBC:401)
VERIFICATION OF INVENTORY MATERIALS (CCR:
2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR:
2729.4)
1010006
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VERIFICATION OF LOCATION (CCR:
2729.2)
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PROPER SEGREGATION OF MATERIAL (
FC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING
CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (C
R: 2731(c))
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(0, GFC:
2703.5)
3030007
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HOUSEKEEPING
CFC: 304.1)
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FIRE PROTECTION (CF G:
903 & 906)
3030032
00
SITE DIAGRAM ADEQUATE & ON HAND (CR:
2729.2)
1010005
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ANY HAZARDOUS WASTE ON SITE? DYES ❑ NO
ignature of'Recei ti
Explain:.'.
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Inspector: AL
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 age to: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 9330
Date
White — Business Copy Yellow — Station Copy Pink — evention Services
FD2155 (Rev 8//14)