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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
BAKERSFIELD FIRE DEPT.
FACILITY NAME I
INSPECTION DATE I
INSPECTION TIME
ADDRESS P
PHONE NO. N
NO OF EMPLOYEES
FACILITY CONTACT B
BUSINESS ID NUMBER
Consent to Inspect Name/Title
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION I
C V u=uompiiance OPERATION COMMENTS
V=Violation
.2' ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
f� ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
Er ❑ CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
42-" ❑ BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
21' ❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
El ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4)
4Er' ❑ VERIFICATION OF LOCATION (CCR: 2729.2)
3 ❑ PROPER SEGREGATION OF MATERIAL (CFC: 5004.1)
P' ❑ SAFETY DATA SHEET AVAILABILITY (CCR: 2729.2(3)(b))
B ❑ VERIFICATION OF HAZ MAT TRAINING (CCR- 2732)
0' ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731 (c))
Er 1-1 EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
-a' ❑ CONTAINERS PROPERLY, LABELED (CCR: 66262.34 (f); CFC: 5003.5)
a ❑ HOUSEKEEPING (CFC: 304.1)
,E3" ❑ FIRE PROTECTION (CFC: 903 & 906)
P- F-1 SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES ,,L."'NO
Explain: Signature of Receipt.
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE-'
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:
C,
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (t1 at 'all violatl'o'ns have been corrected as noted)
Date
Pink Prevention Services Copy
FD2155 (Rev 1/14)
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:
C,
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (t1 at 'all violatl'o'ns have been corrected as noted)
Date
Pink Prevention Services Copy
FD2155 (Rev 1/14)