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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
PC u r �. i� C
ADDRESS
2 L, 5'
FACILITY CONTACT
lvav- _/ / . P? 6'� rot vtj'oe-
I
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
° Bakersfield, CA 93301
Tel.: (661) 326-3979
�•.�� Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
/- ze, - 2 3
PHONE NO. NO OF EMPLOYEES
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 I
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
C E R S
Violation
COMMENT
3010001
3210043
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)
VERIFICATION OF LOCATION (CCR: 2729.2)
1010004
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)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
1010010
,,.
3030007
FIRE PROTECTION (CFC: 903 & 906)
3030032
4--' Z
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
1010005
Signature of Receipt
Explain:
Inspector: 12 vz W FI.Q..
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:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow — Station Copy Pink --- Prevention Services FD2155 (Rev 6/2021)