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r BAKERSFIELD 'FIRE DEPT.
Cox-,.. Prevention Services
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UNIFIED PROGRAM'. INSPECTION CHECKLIST ;: 2101 H:Street
Bakersfield, CA 93301
661 : .
_ SECTION 1: Hazardous Materials Business Plan � �' Tel ( ) 326 -3979
Inspection Fax: (661) 852- 2171
FACILITY NAME I
INSPECTION DATE
INSPECTION TIME
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CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
PHONE No.
NO OF EMPLOYEES
CORRECT OCCUPANCY (CBC: 401)
FACILITY CONTACT , a w
BUSINESS ID NUMBER
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Consent to Inspect Name/Title
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
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PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
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❑ i COMBINED El JOINT AGENCY 171 MULTI-AGENCY 171 COMPLAIN T RE- INSPECTION
VERIFICATION'OF'HAZ` MAT TRAINING (CCR: 2732)
,ROUTINE
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VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES. (CCR: 2731(c))
C= Compliance
C V OPERATION
CERS ,
V= Violation; [,II Minor
Violation
COMMENT
HOUSEKEEPING (CFC: 304.1)
I"
FIRE PROTECTION (CFC: 903 & 906)
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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)
N`
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION'OF'HAZ` MAT TRAINING (CCR: 2732)
1020002
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VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES. (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.340, CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
I"
FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? 'YES, ❑ NO
Signature ofReceipt
Explain:
Inspector:":
POST INSPECTION INSTRUCTIONSs _
• Correct the violations) noted.above by
s Within 5 days of correcting all of the violations, sign and return 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 YeQw — Station Copy Pink — Prevention Services FD2155 (Rev 9/2017)