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BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLISTI 2101 H Street
Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan . Tel.: (661) 326 -3979
Inspection :. Fax: (661) 852 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
V= Violation; 1,11 Minor
ADDRESS �,
PHONE N,O. �qp�
NO OF EMPLOYEES
ISE3
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
FACILITY CONTACT F
BUSINESS ID NUMBER
Consent to InspectName/Title
3210043
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3F i 3-
Sec on 1.. Bus�ne s, Plan and Inve o Pr
t� nt ry ograrn
_:.:.. ,.,,......: ,_.._�. „__..... ... _ ......... ... .. ... �:� „ ..: ?. ., ?,. .Yl:., r,r a':., , ..., :�, i33. r rY Ir,.,
�,M` ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v C=Compliance OPERATION
V= Violation; 1,11 Minor
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
CERS INFORMATION 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
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))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010��"
CONTAINERS PROPERLY LABELED (CCR: 66262.34ft 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 I'"`NO
Si nature ofRecey t —�'
° ... �+
Explain:..o,,
CERS
Violation COMMENT
Inspector: _J ,m, F � .-I -) LA
POST INSPECTION INSTRUCTIONSc
• Correct the violation(s) noted above by _n I
• Within 5 days of correcting all of the violations, sign and turn a copy of this page to: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 9/2017)