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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
�--•,� BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
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Bakersfie d, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
NSPECTION TE
Q�Zfi IZZ.
SHONE NO.
USINESS ID NUMBER
NSPECTION TIME
NO OF EMPLOYEES
CONSENT TO INSPECT NAMEfTITLE
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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
V=violation; 1,11 Minor Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080 ) 3010001(.C�
YCERS INFORMATION ENTERED UPDATED ANNUALLY (CCR: 2729.1) 321004312-la4�6�-
..,
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 K.- (CCR: 2729.2)
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A
1010004
r) R
1010006
3
3
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING �_...`'� j'�' (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
1020002
EMERGENCY PROCEDURES ADEQUATE
CONTAINERS PROPERLY LABELED
HOUSEKEEPING
FIRE PROTECTION
(CCR: 2731)1 1010010
(CCR: 66262.34(f), CFC: 2703.5) i 3030007
(CFC: 304.1
SITE DIAGRAM ADEQUATE 8 ON HAND
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NY HAZARDOUS WASTE ON SITE? El YES
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C.0, 8e+Eck--'r
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(CFC: 903 & 906) 5
3030032 � �; � 7- ?- 2. L C r C � J
(CCR:2729.2) 1010005
❑ NO Signature of Receipt,
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-r A io k e e4 ec f o g
Inspector: hA PV
POST INSPECTION INSTRUCTIONS: f�
• 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
�t'Ou,i,le- - .Se� tl IC p N r C
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services
FD2155 (Rev 6/2021)