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BAKERSFIELD FIRE DEPT.
• - UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services
2101 H Street
SECTION 1: Hazardous Materials Business Plan Bakersfield Tel.: (661)326-3979� CA 93301
Inspection Fax: (661) 852-2171
FACILITY NAME
Ax 9
INSPECTION DATE
-1r71
INSPECTION TIME
3i
/7
ADDRESS W
JJ v a cc
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; I, I I 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
—
7-5
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
2
CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
P6 Ac le cl
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SIDS 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(o, 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? ❑ YES ❑ NO
Si2nature of Receipt •
Explain:
Inspector: JZ!::!�
ram`
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
Signature (that all violations have been corrected as noted)
White — Business Copy Yellow — Station Copy Pink — Prevention Services
Date
F132155 (Rev 6/2021)