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BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 2101 H Street
Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan Tel.: (661) 326-3979
Inspection Fax: (661) 852-2171
FACILITY NAME A
1r l� 200'�-�e�
INSPECTION DATE
INSPECTION TIME
ADDRESS 5-1vv e / -ff Z
l
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT l
�-
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 C E RS
V=violation; 1,11 Minor Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
N�P K je)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
�i I f 4P 4-4-
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)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SIDS 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 'Si nature ofRecei t
A
Explain:
Inspector: I
e0q4L'___
POST INSP CTION INSTRUCTIONS:
• Correct the violation(s) noted above by 17-15-
• 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
Signature (that all violations have been corrected as noted)
'45
White — Business Copy Yellow — Station Copy Pink — Prevention Services
Date
FD2155 (Rev 6/ 2021)