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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
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INSPECTION DATE
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INSPECTION TIME
ADDRESS
(,1_171
1011 IWQ)
PIJONE NO.
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NO OF EMPLOYEES
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FACILITY CONTACT
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BUSINESS ID NUMB
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Do to to Inspect Name /Title
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Section 1: Hazardous Materials Business Plan and Inventory 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)
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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)
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
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VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
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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VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
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CONTAINERS PROPERLY LABELED (CCR: 66262.34 (t); CFC: 5003.5)
❑
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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: 1 1
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
Sigmi Ere (tfik all violations have been corrected as noted)
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Date
White — Business Copy Yellow — Business Copy to ho Sent in diu,nilumto Compliaoee Pink Prevention Services Copy FD2155(Re, 1/14)