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UNIFIED PROGRAM INSPECTION CHECKLIST
Haz-Mat Business Plan and Inventory Program
a BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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ADDRESS
PHONE NO.
NO OF EMPLOYEES
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CERS UPDATED FOR THE CURRENT CALENDAR YEAR (H&S 25404(e)
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FACILITY CONTACT
BUSINESS ID NUMBER
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onsent to Inspect Name /Title
VERIFICATION OF QUANTITIES (CCR: 2729.4)
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C v
( 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)
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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))
❑
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731(c))
❑
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
❑
CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
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HOUSEKEEPING (CFC: 304.1)
❑
FIRE PROTECTION (CFC: 903 & 906)
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
NY HAZARDOUS
WASTE ON SITE? ❑YE$ IANO
Explain:
i nature of Receipt:
POST INSPECTION INSTRUCTIONS FOR RETURN -TO- COMPLIANCE:
• Correct the violation(s) noted above by Signature (that all violations have been corrected as noted)
• 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 b
Date
White — Business Copy Yellmv— Bueiness Copy he be Scn, Compliance Pink Prevention Services Copy M2155 (Rey 1114)