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�-- BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST Q 2101HStreet
E �f
D Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan Tel.: (661) 326-3979
Inspection Fax: (661) 852-2171
FACILITY NAME ..�-r �« INSPECTION DATE INSPECTION TIME
ADDRESS { PHONE NO. NO OF EMPLOYEES
ZZ5
FACILITY CONTACT 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 1
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
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
XAdo( ///)ov, VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) 1010004 `Av1'(vre_�
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
rx
VERIFICATION OF LOCATION (CCR: 2729.2)
1-7 p
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
t FK
`
M
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
cl-Y
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
.
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
1010010
iQ
e Y�CC ;2 lCtAolt.
3030007
to �K. &.0A
4U►�_ ol 6
HOUSEKEEPING (CFC: 304.1)3
FIRE PROTECTION J�IJ (CFC: 903 & 906)
3030032
-Q [e
1010005
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Recei t
f.
Explain:
' .
Inspector: AAA r
POST INSPECTION INSTRUCTIONS: / ! / ��. Y\
• Correct the violation(s) noted above by !/
• 2,
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)