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CONSENT
BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST Q - 2101HStreet
.°� Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan ' • ' Tel.: (661) 326-3979
Inspection Fax: (661) 852-2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
Cr, o A t-o-A u- �-
ADDRESS ` �-- ,PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT IBUSINESS ID NUMBER
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 R S
V=Violation; 1,11 Minor
Violation
ACTIVE HAZARDOUS MATERIALS PERMIT
(BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED
ANNUALLY (CCR: 2729.1)
3210043
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)
PROPER SEGREGATION OF MATERIAL
(CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY
(CCR: 2729.2(3)(b))
COMMENT
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(o, 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 Signature of Receipt
om P A vat
,Explain:
Inspector• CJ
POST INSPECTION INSTRUCTIONS: /,5 -3
�f
• 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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 6/2021)