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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
FACILITY NAME
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INSPECTION TIME
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NO OF Etv]PLOYEES
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FACILITY CO AC
1
1 F
*A 1
INESSItS% ID.NUMBER
Consent to Inspect No /T It
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
23 13 /VLI) f" [Cj°,
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Section 1: Hazardous Materials Business Plan and Inventoiy Prc gram
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
V
( C =Compliance OPERATION
COMMENTS
V= Violation
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❑
VISIBLE ADDRESS (CFC: 505.1, 9MC: 15.52.020)
G G S �- C
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
23 13 /VLI) f" [Cj°,
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❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
D 7
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR:2729.1)
❑-
VERIFICATION OF INVENTORY MATERIALS
{CCR: 2729.3)
- -- '
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
❑
VERIFICATION OF LOCATION
(CCR: 27292)
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❑
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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❑
VERIFICATIONOFABATEMENTSUPPLIESANDPROCEDURES
(CCR:2731(c))
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❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
F(
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
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❑
HOUSEKEEPING
(CFC: 304.1)
❑
0.\
FIRE PROTECTION
(CFC: 903 & 906)
(l
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE?
YES ❑
NO
Explain:
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Signature of Reed t
POST INSPECTION 1NSTRUC'1'IUNS LWlK Kh1 UK1V -i - t"ggvtviri.u+rvas:
•
Correct the violation(s) rated abe by
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• Within 5 days of correcting all o_ the violations, sign and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
•'Krim- Business Copy Yellow Business Copy to be Sent in after retum to Compliance
Signature (that all violations have been corrected as noted)
Date
Pink Prevention Services Copy
FD2155 (Rev 1114) '
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