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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
ADDRESS
e,
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
_A 40e ems.
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C V C=Compliance OPERATION
V=violation; 1,11 Minor
C E R S
Violation
#
COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
Q t V
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
,
5
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
C1C?4 0i
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SIDS 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
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HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
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ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Signature of Receipt
✓ �-
Explain:
Inspector:
t^ I/'vk
POST INSPECTION INSTRUCTIONS: /
• Correct the violation(s) noted above by Z(p 2
• NVIthin 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
NN'hite — Business Copy Yellow — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 6/2021)