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FACILITY
ADDRESS
FACILITY
CONSENT
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BAKERSFIELD FIRE DEPT.
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
NAME
S Z I(I / ?_ 3
CONTACT
TO INSPECT NAME/TITLE
Section 1: Business Plan and Inventory Program
10'
El .." ROUTINE El COMBINED El JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ElRE-INSPECTION
Tel.: (661) 326-3979
Fax: (661) 852-2171
. Prevention Services
Q 2101 H Street
Bakersfield CA 93301
INSP CTION DATE INSPECTION TIME
PHONE NO. NO OF EMPLOYEES
BUSINESS ID NUMBER
C u c=Compliance Q p E RAT I O N C E R S
V=Violation; 1,11 Minor V i OI ati o n COMMENT
ACTIVE HAZARDOUS MATERIALS PERMIT (BMC: 15.65.080) 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) 1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4) 1010006 4� \
VERIFICATION OF LOCATION (CCR: 2729.2) < < <E tt
t P� tiC>
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
HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906) 3030032 -- % -- _
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005
ANY HAZARDOUS WASTE ON SITE? El YES ❑ NO Signature of Recei t
Explain:
Inspector: MA.,
POST INSPECTION INSTRUCTIONS: _ 22
• 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: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services FD2155 (Rev 6/2021)