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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
I RSFIELD FIRE DEPT.
Prevention Services
R - e x s r t. 0 2101 H Street
FIRE D ARTM Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
( C= Compliance OPERATION
V= Violation
Section is Business Plan and Inventory Proorpm
INSPECTION DATE
INSPECTION TIME
ADDRESS f
ROUTINE
❑
COMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT
PHONE. NO.
NO OF EMPLOYEES
FACILITY CONTACT -- "'
VISIBLEADDRESS
--
7/26//3 /f C(' P 7
BUSINESS 1D NUMBER
CORRECT OCCUPANCY
(CBQ 401)
C
❑
VERIFICATION OF INVENTORY MATERIALS
`7-7 2;
Consent to Inspect Name /Title
VERIFICATION OF QUANTITIES
_.
��❑
G ❑
C v
( C= Compliance OPERATION
V= Violation
Section is Business Plan and Inventory Proorpm
1;l_ ❑
APPROPRIATE PERMIT ON HAND
❑
ROUTINE
❑
COMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT
❑
RE- INSPECTION
C v
( C= Compliance OPERATION
V= Violation
COMMENTS
1;l_ ❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
❑, �❑
Business PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
L & S ic C L- v' / f
LJ' f ❑
VISIBLEADDRESS
(CFC: 505.1, BMC: 15.52.020)
7/26//3 /f C(' P 7
❑
CORRECT OCCUPANCY
(CBQ 401)
C
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
��❑
G ❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 2704.1)
Pe} ❑
VERIFICATION OF MSDS AVAILABILITY
(CCR: 2729.2(3)(b))
0 ❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
❑ ❑
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
' ' ❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
[7` ❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
❑•f ❑
l
HOUSEKEEPING
(CFC: 304.1)
.0 ❑
FIRE PROTECTION
(CFC: 903 & 906)
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? p4 ES
❑ NO
Signature of Receipt,-- I
Explain.
•.
POST INSPECTION
• 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:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, Califomia 93301
Signature (that all violations have been corrected as noted)
White - Business Copy Yellow - 6usinus Copy to be Sent in after return to Compliance Pink - Prevention Services Copy FD21SS(Pov 010)