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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
INSPE TION DATE
b
INSPECTION TIME
COMMENT
if a P .f
ADDRESS
Sri
(BMC: 15.65.080)
PHONE NO.
NO OF EMPLOYEES
el) VV%,
OL'd tic I
FACILITY CONTACT
TU`
BUSINESS ID NUMBER
Consent to Ins ect Name/Title
r
VISIBLE ADDRESS
s . .� •
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C V C=Comphance OPERATION
V=Violation; 1,11 Minor
CER S
Violation
COMMENT
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
3010001
(CERS INFORMATION ENTERED & UPDATE51NNUALLY
(CCR: 2729.1)
3210043
VISIBLE ADDRESS
(CFC: 505.1, BMC: 15.52.020)
r •
CORRECT OCCUPANCY
(CBC: 401)
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
1010004
K V - J(L4
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
1010006
0 -
VERIFICATION OF LOCATION
(CCR: 2729.2)
1 �"
A
J4 LI C ift-
PROPER SEGREGATION OF MATERIAL
(CFC: 2704.1)
ANOA.-
QV 3
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
?to C (3
Se114
HOUSEKEEPING
(CFC: 304.1)
Q
*X
FIRE PROTECTION
(CFC: 903 & 906)
3030032
f
r � cr
ar
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Recdpt
Explain:
-
f
Inspector:
POST INSPECTION INSTRUCTIONS: r
• Correct the violations noted above b TMA<'0 / �---
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)
11