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UNIFIED PROGRAM INSPECTION CHECKLIST F ........ .
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Haz-Mat Business Plan and Inventory Program
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FACILITY CONTACT
Consent to Inspect Name/Title
BAKERSFIELD FIRE DEPT.
VeA Prevention Services
. 1.1 D
2101 H Street
F Bakersfield, CA 93301
Tel.: (661) 326-3979
51 Fax: (661) 852-2171
NSPECTION DATE INSPECTION TIME
?HONE NO. NO OF EMPLOYEES
d
9'315 -- Q___2X 1
M8(NESS ID NUMBER
. I
❑ 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)
'9, ❑ HOUSEKEEPING (CFC: 304.1)
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❑ FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Explain: Signature of Receil*'
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POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• Correct the violation(s) noted above by Signature (that all violations have been corrected as noted)
I
• 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
Date
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14)
C v
C=Compliance) OPERATION
V=Violation
COMMENTS
0,0
VISIBLE ADDRESS (CFC: 505. 1, BMC: 15.52.020)
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
-Z] ❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H&S 25404(e)
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
Er- ❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL
(CFC: 5004.1)1
. I
❑ 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)
'9, ❑ HOUSEKEEPING (CFC: 304.1)
E�r
❑ FIRE PROTECTION (CFC: 903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Explain: Signature of Receil*'
e�
POST INSPECTION INSTRUCTIONS FOR RETURN-TO-COMPLIANCE:
• Correct the violation(s) noted above by Signature (that all violations have been corrected as noted)
I
• 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
Date
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 1/14)