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UNIFIED PROGRAM INSPECTION CHECKLIST °s9
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
INSPECTION DATE
INSPECTION TIME
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ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
ADDRESS
PHONE NO.
NO OF EMPLOYEES
111W.. )A4 D . 10FZ-0 <,4 L
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name/Title
Hnfl(l 0
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
If4#
CERS
Violation
COMMENT
r
ACTIVE HAZARDOUS MATERIALS PERMIT (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)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
1/
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
f
VERIFICATION OF HAZ MAT TRAINING (CCR: 27 32)
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)
303003-2-
030032SITE
SITEDIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
i nature ofReceipt,
Explain:
Inspector:
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:
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 6/2021)