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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME H,
ov
ADDRESS
1
FACILITY CONTACT
ONSENT TO INSPECT NAME/TITLE
BAKERSFIELD FIRE DEPT.
Prevention Services
e� 2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979 4
Fax: 661 852-2171
NSPECTION DATE INSPECTION TIME
'30;3- -
-
'HONE NO. NO OF EMPLOYEES
3USINESS ID NUMBER
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C
u
C=Compliance OPERATION
C E R S
Violation
COMMENT
V=violation; I, I I Minor
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
� 4P r 1Lot)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
VERIFICATION OF QUANTITIES (CC : 2729.4)
�,,� Ck its e dC"
1010004
1010006
lt� I ✓, I -Q/Vt C
-
-
VERIFICATION OF LOCATION f ,5CR: 2729.2)..0;
-
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
L)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
ILI
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
1020002
P s u / (�
lz� V. �jj;
1�
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(o, CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
F'RE PROTECTION (CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010010
3030007
3030032
1010005
2,5 . 5
7 F
WASTE ON SITE? ❑ YES ❑ NO
i natureofRecei
t
kNY
HAZARDOUS
xplain:
Inspector: #I ! i' v y ttAoV %ow-oo'
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by
3-
0 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 6i2021)