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UNIFIED PROGRAM INSPECTION CHECKLIST`
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT,
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
3010001
ADDRESS
HONE NO.
NO OF EMPLOYEES
Vi-Y e14'
J
3
FACILITY CONTACT
BUSINESS ID NUMBER
J
1
F
CORRECT OCCUPANCY (CBC: 401)
Consent to Inspect Name le
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
Ace 1 4
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
5
Section 1: Business Plan and Inventory Program
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C= Compliance
OPERATION C E R S
V= Violation; 1,11 Minor 'Violation 'I COMMENT
POST INSPECTION INSTRUCTIONS:
• 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: Signatur (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 '
Date
White —Prevention Services Yellow — Station Copy Pink — Business Copy FD2155 (Rev 3/2019)
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
VERIFICATION OF LOCATION (CCR: 2729.2)
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
1010008
J
PROPER SEGREGATION OF MATERIAL CFC: 2704.1)
)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
J
1
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
J
POST INSPECTION INSTRUCTIONS:
• 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: Signatur (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 '
Date
White —Prevention Services Yellow — Station Copy Pink — Business Copy FD2155 (Rev 3/2019)
VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010004
VERIFICATION OF LOCATION (CCR: 2729.2)
1010005
PROPER SEGREGATION OF MATERIAL CFC: 2704.1)
)
J
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
J
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
J
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
J
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? M YES ❑ NO
i2nature of Receipt "
Explain-
Inspector:
POST INSPECTION INSTRUCTIONS:
• 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: Signatur (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 '
Date
White —Prevention Services Yellow — Station Copy Pink — Business Copy FD2155 (Rev 3/2019)