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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
ADDRESS
V.i In L� e L v#%_ $l A
FACILITY CONTACT
ONSENT TO INSPECT NAME/TITLE
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
-0 r- :L 3
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; I, I I Minor
C E R S
Violation COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY CCR: 2729.1
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3210043
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VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
cq r Q le rv,
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
Q_
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
-.35- Ace_`� _
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
14, C. r- 4r-%4 � 1-
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002t—
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
7 pw
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
-7
CONTAINERS PROPERLY LABELED {CCR: 66262.34(fl, CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO �Sip_nature of Receipt':`
Explain:
Inspector: be boll - Izvl t.&Vjc-
POST INSPECTION INSTRUCTIONS: , l
• Correct the violations noted above b '7 () Y7 r/,� -3
• «- ithin 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)
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