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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
BAKERSFIELD FIRE DEPT.
Prevention Services
f F" R S F I I. " 2101 1-1 Street
FIRE
ARTM T Bakersfield, CA 93301
FACILITY NAME
v
C= Compliance OPERATION
INSPECTION DATE
INSPECTION TIME
ADDRESS
V= Violation
PHONE NO.
q?�'-.
NO OF EMPLOYEES
FACILITY CONTACT
❑
VISIBLE ADDRESS (CFC:505.1,BMC:15.52.020)
BUSINESS ID NUMBER -
Consent to InspeFt Name /Title
15.65.080)
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F:� Sectlon i. Hazardous Ausiness Plan an d Inventory P.ragram
�- ROUTINE ❑ COMBINED
❑ JOIN❑ MULTI - AGENCY
❑ COMPLAINT ❑ RE- INSPECTION
C
v
C= Compliance OPERATION
COMMENTS
V= Violation
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LI
❑
VISIBLE ADDRESS (CFC:505.1,BMC:15.52.020)
LLS f C i S _(n+r
15.65.080)
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❑
APPROPRIATE PERMIT ON HAND
(BMC:
V2 el c lz C/
[I /
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
112
/ (�/ •-7
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR:2729.1)
EY
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
❑
❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑'
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)
i
EY+
"❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
`.
LJ
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
(CCR:2731(c))
[S
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
\ \\
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
f
11
❑
HOUSEKEEPING
(CFC: 304.1)
❑
FIRE PROTECTION
(CFC: 903 & 906)
/
❑
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2 (3))
NY HAZARDOUS
WASTE ON SITE? ❑ -YES +
NO
Explain:
i nature of Recei t;�
POST INSPECTION INSTRUCTIONS HUR RETURN- rU -wVTVW . Nry z:
• 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
Whim — Business Copy Yellow — Business C.11 to be Se-t in aver Iaum m Compliance Pink Prevention Services Copy FD2155(Rev 1/14)