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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
BAKERSFIELD FIRE DEPT.
Prevention Services
0 if 2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME ) � �
INSPECTION DATE
INSPECTION TIME
ADDRESS
31v1 a S1n�r� �.Sh tom. r
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
C("', 1( 0'a P �)
CONSENT IO INSPECT NAME/TITLE
T�(o
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)
3210043
10
f PA -
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
13'qlat ;�'
61 e
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
HOUSEKEEPING (CFC: 304.1)
Awov, u^_ 4r_1�
FIRE PROTECTION (CFC: 903 & 906)
3030032
1
(,13 3 Fe 6 -3
SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Sip -nature of Receipt
E x p Ia,�w
F>e wt.. a a_ �- r t �' `t S e� e
Inspector:
�-4 �ZZ
POST INSPECTION INSTRUCTIONS: J�
• Correct the violation(s) noted above by
• 3
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)