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UNIFIED PROD
AM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
[ V a-L A i�C JS -5u e- t', vst 7 CV-7coll-
INSPECTION DATE
1? 4
INSPECTION TIME
ADDRESS
—7 �� �5
iy1 :4,%-'
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
3010001
BUSINESS ID NUMBER
Consent to Inspect Name /Title
C V = ompjance
V =Violation; 1,11
section : Business. Plan and Inventory Program
ROUTINE
I ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V = ompjance
V =Violation; 1,11
OPERATION
Minor
CERS
Violation
COMMENT
Y
APPROPRIATE
PERMIT ON HAND (BMC: 15.65.080)
3010001
CERS INFO
IRMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
VISIBLE ADDRESS
(CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY
(CBC: 401)
"?
VERIFICATION
OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION
OF QUANTITIES (CCR: 2729.4)
1010006
T
VERIFICATION
OF LOCATION (CCR: 27292)
PROPER SE
REGATION OF MATERIAL (CFC: 2704.1)
VERIFICATIiN
OF SDS AVAILABILITY (CCR: 27292(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 DIAGRAIM
ADEQUATE & ON HAND (CCR: 27292)
1010005
ANY HAZARDOUS WASTE
ON SITE? ❑ YES ❑ NO
i nature ofReceipt
Explain:
Inspector•
POST INSPECTION INST]
• Correct the violation(s)
• Within 5 days of correc
Bakersfield Fire Dept
White —
JCTIONS:
oted above by
ig all of the violations, sign and return a copy of this page to
Prevention Services, 2101 H Street, California 93301
Copy Yellow — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 9/2017)