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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301 (�
Tel,: (661) 326 -3979
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Fax: (661) 852 -2171
FACILITY NAME / t , /n
INSPECTION DATE
INSPECTION TIME
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_
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
ADDRESS
PHONE NO.
NO OF EMPLOYEES
CE RS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name /Title
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V = omp lance OPERATION
V= Violation; 1,11 Minor
CE RS
Violation
C O M M E N T
_
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
CE RS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
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A f i
CORRECT OCCUPANCY r (CBC: 401)
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VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
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VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
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PROPER SEGREGATION OF MATERIAL (CFC: 2704,1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
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
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Receipt
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS:
0 Correct the violation(s) noted above b
Y
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
`Vhite — Business Copy Yellow — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 9/2017)