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�,• -•� BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST
2101 H Street
b Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan C Tel.: (661) 326-3979
Inspection Fax: (661) 852-2171
FACILITY NAME /
�i SYer (f a Y W
ADDRESS n� t� L CAA)
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FACILITY CONTACT
CONSENT TO INSPECT NAME/TITLE
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INSPECTION DATE INSPECTION TIME
/0 IZ, / /Z 2
PHONE NO. NO OF EMPLOYEES
USINESS ID NUMBER
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 T
V=Violation; I, I I Minor Violation COMMENT
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)
VERIFICATION OF LOCATION (CCR: 2729.2)
1010006
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS 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
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Si nature of Recei t
Explain:
Inspector: - ��-
POST INSPECTION INSTRUCTIONS:
• 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
3:S qo.X 1-1 ydv I;C-_
White - Business Copy Yellow - Station Copy Pink - Prevention Services FD2155 (Rev 6/2021)