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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Insaection
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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
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ADDRESS
P HONE NO.
NO OF EMPLOYEES
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FACILITY CONTACT
BUSINESS ID NUMBER
9
1
Consent to Inspect Name /Title _ "e;
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Section 1: Business Plan and Inventory Program
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v C= Compliance OPERATION C E R S
V= violation; 1,11 Minor Violation COMMENT
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)
CORRECT OCCUPANCY (CBC: 401)
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: Signature (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 INVENTORY MATERIALS (CCR: 2729.3)
1010004
V
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010004
V/
VERIFICATION OF LOCATION (CCR: 2729.2)
1010005
%
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
3030007
/
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
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: Signature (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 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
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Si2nat ure of Recei t
xplain:
Inspector: Aw
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: Signature (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)