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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Ins !on
Prevention Services
E R S F I S F I L
2101 H Street
FIRE Bakersfield, CA 93301
Tel.: (661) 326-3979,
Fax: (661) 852-2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
V=Violation; 1,11 Minor
Violation
COMMENT
ADDRESS
PHONE NO.
NO OF EMPLOYEES
3010001
FACILITY CONTACT
USINESS ID NUMBER
rns;nt to inspect Name/Title
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
❑ ROUTINE 171 COMBINED ❑ JOINTAGENCY ❑ MULTI-AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
C V G=Gornpliance OPERATION
CERS
V=Violation; 1,11 Minor
Violation
COMMENT
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
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
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES& PROCEDURES (CCR: 2731(c))
A.1
1
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
i gnature of Receipt
Explain:
inspector:
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: Signatum(t6t all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 21,01 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 8//14)