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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, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME r°
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INSPEC I N AT
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INSPECTION TIME
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ADDRESS
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PHONE „7N . ^ ?
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NO OF EMPLOYEES
FACILITY CONTACT
VAO A-,C
BUSINESS ID NUMBER
Consent to Inspect Name/Title
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
Section 1 Hazardous Materials Business loh, and invOrttory
ROUTINE ❑ COMBINED ❑ JOINTAGENCY
❑ MULTI- AGENCY ❑ COMPLAIN ❑ RE-INS OT 'IN
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( C= Compliance OPERATION
COMMENTS
V= Violation
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
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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
(CCRr272.9.2).
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❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
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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))
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
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❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (1); CFC: 5003.5)
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HOUSEKEEPING
(CFC: 304.1)
FIRE PROTECTION
(CFC: 903 is 906)
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SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
NY HAZARDOUS WASTE ON SITE? YES ❑
NO
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Explain:
Signature o ece' t: --
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POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE:
• 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, California 93301
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Signature (that all violations have been corrected as noted)
Date
White — Banhess Copy Yellow — Business Copy to be Seot in ufinr retain to Compliance /ink Prevention Services Copy FD2155(Rev1/14)
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