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UNIFIED PROGRAM INSPECTION CHECKLIST ;�ov
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 �... C
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INSPE f ION DATE
�X
INSPECTION TIME
ADDRESS -- -
4,4 Cn Q- P5 he-
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
V= Violation; 1,11 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
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006(
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VERIFICATION OF LOCATION (CCR: 2729.2)
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
Sianature of Recei t
Explain: Q w` •
5- t. �.i� `��� r C �/ V'� .
Inspector:
POST INSPECTION INSTRUCTIONS:
• Correct the violations noted above b Q ��'
O Y 44
• Within 5 days of correcting all of the violations, sign and return a copy d "Ku age 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)