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E ROUTINE ❑ COMBINED ❑ ,JOINT AGENCY" ❑
MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
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BAKERSFIELD FIRE DEPT.
C V i C= Compliance OPERATION
Prevention Services
UNIFIED PROGRAM
INSPECTION CHECKLIST....'
B °" E..R S F.._I. -..A
2101,H Street
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-FIRE
Bakersfield, CA 93301
Haz -Mat Business Plan and Inventory Program
C: 15.52.020)
Tel.: (661) 326-3978
ax: (661) 852 -2171
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FACILITY NAME
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❑ APPROPRIATE PERMIT ON HAND (B
INSPECTION DATE
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INSPECTION TIME
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❑ 19 . CERS UPDATED FOR THE CURRENT CALENDAR YEAR i
H &S 25404(e)
ADDRESS
NO.
NO OF EMPLOYEES
❑ L BUSINESS PLAN CONTACT INFORMATION ACCURATE
CCR: 2729.1)
yPHONE
CCR: 2729.3)
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FACILITY^ CONTACTn
BUS�?IN}'ESSq ID NUMBER
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[I VERIFICATION OF QUANTITIES
CCR: 2729:4)
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Consent to Inspect Name /Title
❑ ❑ VERIFICATION OF LOCATION
CCR: 2729.2)
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E ROUTINE ❑ COMBINED ❑ ,JOINT AGENCY" ❑
MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V i C= Compliance OPERATION
COMMENTS
V= Violation
L ❑ VISIBLE ADDRESS (CFC: 505.1, B
C: 15.52.020)
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❑ APPROPRIATE PERMIT ON HAND (B
C: 15.65.080)
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C-ry Z
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❑ 19 . CERS UPDATED FOR THE CURRENT CALENDAR YEAR i
H &S 25404(e)
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❑ L BUSINESS PLAN CONTACT INFORMATION ACCURATE
CCR: 2729.1)
13/0 VERIFICATION OF INVENTORY MATERIALS
CCR: 2729.3)
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[I VERIFICATION OF QUANTITIES
CCR: 2729:4)
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❑ ❑ VERIFICATION OF LOCATION
CCR: 2729.2)
EEr ❑ PROPER SEGREGATION OF MATERIAL
CFC: 5004.1)
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❑ ❑ SAFETY DATA SHEET AVAILABILITY (CCR:
2729.2(3)(b))
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2732)
❑ Ole' VERIFICATION OF MAT TRAINING
(CCR:.
❑, VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
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2731)
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❑ EMERGENCY PROCEDURES ADEQUATE
(CCR:
ET'' ❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f);
CFC: 5003.5)
❑ HOUSEKEEPING. �� �
(CFC: 304.1)
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El 0' ,, FIRE PROTECTION ::(C
C: 903 & 906)
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❑ SITE DIAGRAM ADEQUATE & ON HAND (C
R: 2729.2 (3))""
ANY HAZARDOUS WASTE ON SITE? ❑ YES ,Cf NO
Explain:
i nature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE:
• . Correct the violafion(s) noted above by l �. ' f a (_ I ,
Signature (that all violations have been corrected as noted)
• 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
Date
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Pink Prevention Services Copy FD2155 (Rev, 1/14).