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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz -Mat Business Plan and Inventory Program
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, 3 AA 4� s
Tel (66. 326 -3979 '1
Fax: (661 2-2- 7,04 - AKIO
FACILITY NAME '
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INSPECTION DATE
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INSPEC_5ON TIME
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ADDRESS
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PHONE NO.
NO OF EMPLOYEES
FACILITY
CONTACT
BUSINESS ID NUMBER
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onsent to Inspect Name /Title
Seddon 1: Hazatdous Materials Business Plan and Inventory P.rograrn
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
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r = Compliance) OPERATION
V= Violation
COMMENTS
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
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APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
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❑
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CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H &S 25404(e)
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BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
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❑
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
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❑
VERIFICATION OF QUANTITIES (CCR: 2729.4)
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❑
VERIFICATION OF LOCATION (CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL (CFC: 5004.1)
❑
SAFETY DATA SHEET AVAILABILITY CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
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❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
❑
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EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
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❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
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❑
HOUSEKEEPING (CFC: 304.1)
❑
FIRE PROTECTION (CFC: 903 & 906)
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❑
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
N Y'' HAZARDOUS
WASTE ON SITE? ❑YES V NO
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Signature of Receipt:
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Correct the violation(s) noted above by 6 `" 7 � t
Within 5 days of correcting all of the violations, sign and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow — Business Copy in be Sent inaaer rewmto Compliance piM Prevention Services Copy M2135 mev 1114)