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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
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ADDRESS !^ /
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FACILITY CONTACT
:ONSENT TO INSPECT NAME/TITLE
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��--� BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Y � I
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
PHONE NO. NO OF EMPLOYEES
I
BUSINESS ID NUMBER
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C V C=Compliance - --- OPERATION CERS
V=Violation; 1,11 Minor Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080) 3010001
CERS INFORMATION ENTERED & UPDATEE?.ANNUALLY (CCR: 2729.1) 321004301, Re e_
— p
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010004
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
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)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010010
3030007
3030032�-
�-
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Si nature ofReceipt �,�--
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Explain: '— •
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Inspector: fl-4pt"' r 0.
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
White — Business Copy Yellow — Station Copy Pink -- Prevention Services FD2155 (Rev 6/2021)