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UNIFIED PROGRAM INSPECTION CHECKLIST
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 %
F
CER S
Violation
INSPECTION DATE
INSPECTION TIME
5
s / /
ADDRESS 7(11
PHONE NO.
NO OF EMPLOYEES
Sc�
VISIBLEADDRESS (CFC: 505.1, BMC: 15.52.020)
FACILITY CONTACT
73 sc
L . � r M� ld,��
BUSINESS ID NUMBER
Consent to Inspect Name/Title
CORRECT OCCUPANCY (CBC: 401)
Un "tit? e S de
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C V - omp lance OPERATION
V=Violation; I, I I Minor
CER S
Violation
COMMENT
/SPP 0PRIATE PERMIT ON HAND3010001
_- (BMC: 15.65.080)
CERS INFORMATION ENTERED & I,PDATED ANNUALLY (CCR: 2729.1)
3210043/.--
VISIBLEADDRESS (CFC: 505.1, BMC: 15.52.020)
73 sc
L . � r M� ld,��
CORRECT OCCUPANCY (CBC: 401)
Un "tit? e S de
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
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
Signature of Receipt
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Explain: -
A C ed- S-fv- e e -4 A.P v -.s 1 C-0 xfi;
Inspector: ^4 Dow...-
POST INSPECTION INSTRUCTIONS: Y
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• Correct the violation(s) noted above b
• Within 5 days of correcting all of the violations, sign and return a copy f this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White - Business Copy Yellow - Station Copy Pink - Prevention Services
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Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 9/2017)