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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
ADDRESS
FACILITY CONTACT
CONSENT TO INSPECT NAME/TITLE # ;le
11YAAJA(jC-K. r`
�-� BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
' Tel.: (661) 326-3979
Fax: (661) 852-2171
INSPECTION DATE INSPECTION TIME
Z ;`
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
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
f _ q
--
VISIBLE ADDRESS (CFC: 505.1,
BMC: 15.52.020)
CORRECT OCCUPANCY
(CBC: 401)
VERIFICATION OF INVENTORY MATERIALS
(CCR:2729.3)
1010004
oe ep x� !
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
1010006
VERIFICATION OF LOCATION �►
(CCR: 2729.2)
A
A
PROPER SEGREGATION OF MATERIAL
(CFC: 2704.1)
t
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
HOUSEKEEPING
(CFC: 304.1)
FIRE PROTECTION
(CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Sil4nature of Receipt
Explain:
;
Inspector: 1/1 4 Ir J(J;4J.'.1
POST INSPECTION INSTRUCTIONS: 3
• 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)