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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
F
ADDRESS
o
FACILITY CONTACT
CONSENT TO INSPECT NAME/TITLE
BAKERSFIELD FIRE DEPT,
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
HONE NO. NO OF EMPLOYEES
USINESS ID NUMBER
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
CERS INFORMATION ENTERED & UPDATED. ANNUALLY (CCR: 2729.1) 3210043 7 7
VISIBLE ADDRESS
(CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY
(CBC: 401)
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
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)
10,0010
CONTAINERS PROPERLY LABELED
(CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING
(CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906) 3030032 t ""
_ 1
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Signature of Receipt
Explain: -- -- - - -- - -- - --
Inspector: PV W"
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
White — Business Copy Yellow — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 6/2021)