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PAKERSFIELD FIRE DEPT,
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST
,Q 2101 H Street
SECTION 1 Bakersfield, CA 93301 Hazardous Materials Business Plan • ` Tel.: (661) 326-3979
Inspection ``.,../ Fax: (661) 852-2171
FACILITY NAME / / `
INSPECTION DATE
INSPECTION TIME
ADDRESS t-
PHONE NO.
NO OF EMPLOYEES
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
V=violation; I, I I Minor
C E R S
Violation,
COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3010001
3210043
l r
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
1010004
1010006
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
VERIFICATION OF QUANTITIES (CCR: 2729.4)
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
410OW5 Dreol�o�-�
1 t '
Q�tid/ au'lrc
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
1020002
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)
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
3030032
.•-
1010005
Si nature of Receipt
y.9—
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Explain:
Inspector: Y"__ U
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by V l'
• 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 933 01
" 1 tiILj Z�`�
3
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow -- Station Copy Pink — Prevention Services FD2155 (Rev 6/2021)