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SECTION 1 . Business Plan and Inventory Program Tel... . (661),32.6:3979
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Fax: (661) 52-2171
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FACILITY NAME:
INSPECTION DATE INSPECTION TIME
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PHO ENO. NO OF EMPLOYEES
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FACILITY CONTACT BUSINESS ID NUMBER
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Consent to Inspect Name/Title -
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'ROUTINE' ❑ :COMBINED El JOINT AGENCY ❑ MULTI-AGENCY
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COMPLAINT ❑ N..
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OPERATION
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C-Com
_ V=Violation
EJ COMMENTS
APPROPRIATE PERMIT ON HAND (BMC: 15':'65.080) .
'~ ❑ Business PLAN CONTACT INFORMATION ACCURATE (CCR:2729.1) -.
VISIBLE ADDRESS (CFC 505.1,BMC:15.52.020)
❑r ❑ CORRECT OCCUPANCY
I (CBC:401).
❑
VERIFICATION OF'INVENTORY MATERIALS ,
f
d E VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION.
(CCR:2729.2)
PROPER SEGREGATION OF MATERIAL CFC:2704
''In ❑, VERIFICATION OF MSDS AVAILABILITY CCR:2729.2(3)(b))
wl" VERIFICATION OF HAZ MAT TRAINING
(CCR:2732).
0 ❑ VERIFICATION OF ABATEM•ENT,SUPPLIES&PROCEDURES CCR:27.31(c))
EMERGENCY PROCEDURES ADE UA
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. - _Q TE. (CCR:2731) •. � ;. i ..
0 ❑ CONTAINERS PROPERLY.LABELED
• `..'•(CCR:66262.34(f),CFC:2703;5)
ET ❑ HOUSEKEEPING (CFC:304.1)
0<. ❑ FIRE PROTECTION (CFC 903&906)
0 ,SITE DIAGRAM ADEQUATE&ON HAND
(CCR;2729.2)
ANY H A Z A;R D O.:U S WASTE O:N SITE? YES ❑ NO Signature.of Receipt
Explain. i x
POST INSPECTION INSTRUCTIONS..
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Correct the violations noted above b `, Signature that all violations have been correc
ted as noted)
Within 5 days of correcting all of the violations,sign and return a copy off this page to:
Bakersfield Fire Dept.,Prevention Services,2101 H Street,California 93301
Date
i
White—Business Copy Yellow—Business-Copy to be Sent in after return to Compliance, Pink—Prevention Services Copy FD2 1 55(Rev 6//10)