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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
.°�
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME f INSPECTION DATE INSPECTION TIME
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ADDRESS � ? A ^Q��L� 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
C V C=Compliance OPERATION
V=Violation; 1,11 Minor
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
C E R S
Violation
3010001
3210043
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))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
1010004
1010006
1020002
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) 10,0010
❑ RE -INSPECTION
COMMENT
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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
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NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Signature of Receipt
Explain:
L. r
Inspector: 0� o c -k
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by /Z
• 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)