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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
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INSPECTION DATE
6 i 25'j 1</
INSPECTION TIME
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PHONE NO. jC(C�Ci
NO OF EMPLOYEES
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FACILITY CONTACT
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BUSINESS ID NUMBER
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onssqeppnt to Inspect Name/Title
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(BMC: 15.65.080)
Section 1; Hazardous Materials Business Plan and InventoF, Program
❑ ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY
❑ COMPLAINT ❑ RE- INSPECTION
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C= 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)
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
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❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR:2729.1)
❑
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)
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❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
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SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
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❑
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 (f); CFC: 5003.5)
❑
HOUSEKEEPING
(CFC: 304.1)
FIRE PROTECTION
(CFC: 903 & 906)
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
NY HAZARDOUS
WASTE ON SITE? 13 YES W
NO
Explain:
i nature of Receipt:
PUS 1AUYEU110A IINNI UU 11VAN FUR RZI uxlvav -..ury r..u.lva.n: p- . . / —
• 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
Signature (that all violations have been corrected as noted)
Date
White - Business Copy Yellow - Basinays Copy to lre Sent in alter return to Complinare Pink Prevention Services Copy M2155 (Rev 1114)