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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Hazardous Materials Business Plan
Inspection
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BAKERSFIELD FIRE DEPT,
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME r
J V" 64 C%/e
INSPECTION DATE
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INSPECTION TIME
ADDRESS f
& r r a
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT '
S
BUSINESS ID NUMBER
CONSENT TO INSPECT NAME/TITLE
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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
7- 4A) 4,�
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
4
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(�, CFC: 2703.5)
3030007
R
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HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION - ' (CFC: 903 & 906)
3030032
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y
SITE DIAGRAM ADEQUATE & ON HANDS (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
Si nature ofRecei t,/ 1J:14.._
Explain:
Inspector: W - (All j)(0k
POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by 5�5 l 1
` -`
• 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)
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White — Business Copy Yellow — Station Copy
Pink — Prevention Services
Date
FD2155 (Rev 7 2-022)