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s�--� BAKERSFIELD FIRE DEPT.
UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services
2101 H Street
SECTION 1: Hazardous Materials Business Plan � � Bakersfield, CA 93301661 Tel.: ()
326-3979
Inspection Fax: 16611852-2171
FACILITY NAME 4
ADDRESS
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FACILITY CONTACT
;ONSENT TO INSPECT NAME/TITLE
INSPEf TION ATE 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
V=violation; 1,11 Minor
C E R S
Violation
COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080)
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
3010001
3210043
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r jQ r / Y ,j
.� 11 t f P C' 11 t� c1 r+A
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
•/�,- /'
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
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
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
ti
HOUSEKEEPING (CFC: 304.1)
�r e,
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
i ature of Receipt
Explain:
Inspector: i�'iA �j.
POST INSPECTION INSTRUCTIONS: j
• Correct the violation(s) noted above by %`'A- I/1A--''' /
• 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)
9