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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 NAMEL
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INSPE TION_DATE
INSPECTION TIME
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ADDRESS � 13
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PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name/Title
A�10101'
1(92,3 5008
`_AA��AY � � �■■ABY AAA �IAY AYY IYtIA Y�A Yui �YA YVA Y�
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
169
C V C=Compliance OPERATION
V=Violation; 1,11 Minor
CERSo`
M o l at i o n
COMMENT
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
el
CERS INFORMATION ENTERED DATED ANNUALLY (CCR: 2729.1)
3210043
7 ff
tip U; �) a) e (f 6
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
�r,.i� .+ 4 1
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
5
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL .1)
VERIFICATION OF SDS AVAILAI ))
VERIFICATION OF HAZ MAT TRS t
VERIFICATION OF ABATEMENT
EMERGENCY PROCEDURES ADE )
--
CONTAINERS PROPERLY LABELE 500 � ,CFC. 2703.5)
1020002
1010010
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
� qe �' V� � +� � 6' x ! rt!)
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
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ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Sip -nature of Receipt
4
----�--
Explain: -
Inspector: _�-
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by-"�- r
• Within 5 days of correcting all of the violations, sign and return a copy,on this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California -93301
Signature (t tit aAation h "fie een corrected as noted)
Date
White - Business Copy Yellow - Station Copy Pink - Prevention Services FD2155 (Rev 9/2017)
11