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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT,
Prevention Services
_ 2101 H Street
o� Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME �
q C��NT ®rte
(INSPECTION DATE
07 - 0� ^
INSPECTION TIME
1030
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name /Title
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; I, I I Minor Violation
C O M M E N T
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) 3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1):! 1010008
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
1
CORRECT OCCUPANCY (CBC: 401)
a
i
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
a
VERIFICATION OF QUANTITIES (CCR: 2729.4)
VERIFICATION OF LOCATION (CCR: 2729.)
21010005
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
1010004
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
.d
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
../
V`
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
(/
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
�(
HOUSEKEEPING (CFC: 304.1
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE? YES ❑ NO ISianatureofRecei
t
xpIain.
Inspector: 0 1AV
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:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White — Prevention Services Yellow — Station Copy Pink — Business Copy
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 3/2019)
1