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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT.
Prevention Services /
2101 H Street �� f
Bakersfield, CA 93301 e
... Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
CERS
Violation
INSPECTION DATE
INSPECTION TIME
ADDRESS I 1
- 7 D
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 = ompiance OPERATION
V= violation; I, I I Minor
CERS
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)
3210043
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
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'QV
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
-��.�' C*.A
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
u
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
n
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)+
1010 010
r.
1 +t 4 r" 1.•.. +�- C� l / "Q
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
� ��' r-eS 5 164.p,_ c/,L4
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Receipt
_7 �t
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS: - - -
• Correct the violations noted above b AA � r '�� - �' (,(-�
O 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
White - Business Copy Yellow - Station Copy Pink - Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 9/2017)
02-
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9
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