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Bakersfield,CA 9 3 3
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■ >:<:SECTION..1 I
Business Plan and Invert m ,,
Tel.:, (661) 326-3979 o Pro ra
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Fax: (661) 852-2171
:FACILITY NAME
INSPECTION DATE INSPECTION TIME
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ADDRESS
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EMPLOYEES
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� PHONE NO N O OF
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FACILITY CONTACT
BUSINESS'ID:NUMBER
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Consent.to Inspect Name/Title:
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ROUTINE ❑',COMBINED JOINT AGENCY ❑ 'MULTI AGENCY ❑ COMPLAINT ❑ RE-INSPECTION
C=Com,pliance
C V ( ) OPERATION
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V=violation COMMENTS
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CJ ❑ APPROPRIATE PERMIT ON HAND
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(BMC:15..65.080) ,
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13USIC1eS.S PLAN CONTACT INFORMATION ACCURATE - CCR:2729.1
❑ VISIBLE A DDRESS � (CFC:505.1,BMC:15.52.00._
)
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CORRECT OCCUPANCY. : (CBC:401)
. fa El VERIFICATION OF INVENTORY MATERIALS (.CCR:2729:3) I ,
El ❑ VERIFICATION OF
I ,
QUANTITIES:. � � (CCR:2729.4) ..
'' ❑ VERIFICATION'OF�LOCATI!ON (CCR--2729.2)
�El• ❑ : PROPER SEGREGATION OF MATERIAL
(CFC:2704.1)
•❑ ❑ VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2(3)(b
)) I •
❑f^V VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
. rh El VERIFICATION I O F;A
SUPPLIES _..�.._._
&..,PROCEDURES (CCR:2731(c))
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_ -
O Sr� 11 EMERGENCY PROCEDURES ADEQUATE (CCR:2731) •
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El ❑ CONTAINERS PROPERLY LABELED
(CCR:66262.34 f,CF.C''2703.5)
El HOUSEKEEPING CFC:304.1)
El n r,yar"
FIRE PROTECTION _ CFC:9
( 03&906) . . I
SITE DIAGRAM ADEQUATE&ON HAND
(CCR:2729..2)
ANY.HAZARDOUS WASTE ON-SITE?.. 0 YES '0 N O ' j Signature of Receipt
Explain.
POST INSPECTION INSTRUCTIONS
• Correct the violation(s)noted above by Signature(that all violations have been correcte as noted)
: 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
Date
White Business Copy Yellow-Business Copy-to be Sent i after retlxrn to,oinphance Pink—Prevent on Services Copy j FD2155(Rev 6//10)