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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME E I
ca
ADDRESS
FACILITY CONTACT
CONSENT TO INSPECT NAME/TITLE
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT
BAKERSFIELD FIRE DEPT.
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
❑ RE -INSPECTION
C V C=Compliance OPERATION '
V=violation; 1,11 Minor
C E RSA
Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
3210043
.. --
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
/ Ve4e- -to v
VERIFICATION OF QUANTITIES (CCR: 2729.4)
co
1010006
M_
VERIFICATION OF LOCATION (CCR: 2729.2)
{
k �
-Add
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
-4 d f
C'A �
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))Vj
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
01
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
3030007
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
HOUSEKEEPING (CFC:304.1)
F
FIRE PROTECTION (CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
3030032
7
- �..
1010005
r
J
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Receipt
Explain: '
Inspector:
POST INSPECTION INSTRUCTIONS: Z
• 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)
NA-0
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