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BAKERSFIELD FIRE DEPT,
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 2101 H Street
Bakersfield, CA 93301
SECTION 1: Hazardous Materials Business Plan Tel.: (661) 326-3979
Inspection '"`�,../ Fax: (661) 852-2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT IBUSINESS ID NUMBER
CONSENT TO INSPECT NAME/TITLE
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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
V=violation; I, I I Minor
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
C E R S
Violation
COMMENT
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
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 (CCR: 2729.2)
1010004
1010006
f
1
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PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1020002
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
3030007
3030032
1010005
FIRE PROTECTION (CFC: 903 & 906 )
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Y1 Q �Y' Sf
Si nature of Receipt f ,
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Inspector: W V%A- CC L-V 2 " .1
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by l Z_
• 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)
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