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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
FACILITY NAME
ADDRESS
(0 DO O -1) , S f ,r : c'f
FACILITY CONTACT
;ONSENT 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
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 (rrR• 9794 11 r
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
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VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
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V) e- t ea
f
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VERIFICATION OF LOCATION (CCR: 2729.2)
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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)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CCNTAINERS PROPERLY LABELED CCR: 66262.34 f CFC: 2703.5
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3030007
HOUSEKEEPING (CFC: 304.1)
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FIRE PROTECTION (CFC903 & 906)
:
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO Si�jnatnreofRecei
t
,Explain:
1A w .. A
POST INSPECTION INSTRUCTIONS:
• 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)
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