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FACILITY
ADDRESS
FACILITY
CONSENT
BAKERSFIELD FIRE DEPT.
UNIFIED PROGRAM INSPECTION CHECKLIST'
SECTION 1: Hazardous Materials Business Plan
Inspection
NAMEV 0 V 1 0 '�7 ICXAA
5
CONTACT
TO INSPECT NAME/TITLE
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
C V C=Compliance OPERATION
C E R S
V=violation; 1, I I Minor
Violation
COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
C,ER�FORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
— U z 3
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
/
! C�
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
6� ckj A c.A�_
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)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
1020002
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
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
i nature of Receipt
Explain:
Signature (that all violations have been corrected as noted)
)ate
FD2155 (Rev 6/2021)