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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT,
Prevention Services
2101 H Street
Bakersfield, CA 93301
' Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME
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INSPECTION DATE
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INSPECTION TIME
ADDRESS �
S� e�
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
CONSENT TO INSPECT NAME/TITLE
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)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
1010008
2 �o
V6SIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
� 1�b
CORRECT OCCUPANCY (CBC: 401)
00
VERIFICATION OF INVENTORY MATERIALS { (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES %1 (CCR: 2729.4)
1010006-.0k
7- %A C o
VERIFICATION OF LOCATION ! 04 A1 IC'V, (CCR: 2729.2)
X tj Yc> ir4z emu_
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)l
v
-3 7 F
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
,
toe
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
(<-te y-
let"
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))PO
Ca
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(o, CFC. 2703.5)
3030007
v U
HOUSEKEEPING (CFC: 304.1)
tic
FIRE PROTECTION (CFC: 903 & 906)
3030032
—
If
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Si nature of Receipt
Explain:
Inspector: W. VL4 G�I
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
Signature (that all violations have been corrected as noted)
White — Business Copy Yellow — Station Copy Pink — Prevention Services
Date
FD2155 (Rev 7/2022)