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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 A1 � �� E INSPECTION DATE
ADDRESS % d'
PHONE NO.
FACILITY CONTACT BUSINESS ID NUMBER
CONSENT TO INSPECT NAME/TITLE
INSPECTION TIME
NO OF EMPLOYEES
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑
RE -INSPECTION
C V C=Compliance OPERATION C_ER S
V=violation; 1,11 Minor Violation
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)
A f Ae c
CORRECT OCCUPANCY
(CBC: 401)
La t
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
`
0
VERIFICATION
S'
OF QUANTITIES (CCR: 2729.4)
1010006
QA,�
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)
-
FIRE PROTECTION (CFC: 903 & 906)
3030032
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE? ❑ YES DrINO Si2nature ofReceipt
..2 Explain: � � :
I n c n Pr m r • L/ t/i vq,< [ J11 _.�_�►..
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: Signature (that all violations have been
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 corrected as noted)
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services
FD2155 (Rev 6/2021)