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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
74 7
ADDRESS
CloO
FACILITY CONTACT
CONSENT TO INSPECT NAME/TITLE
�•---•� BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
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Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (6611852-2171
INSPECTION DATE INSPECTION TIME
_ _Z z'
PHONE 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 _
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
1010004
1010006
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)
LA V qit�
�, t e c
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)
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)
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Explain:
3030032
4�
1010005
Si nature of Recei
Inspector: V"` rV ` 0AW1 2 _
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)