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Bakersfield CA 3 �1
Plana'nd Inventory E
-3979: SECTIONA: Business T.(661)3,26
fr. Fax. (661) 852 -2171
FACILITY' NAME
INSPECTION
IN S PE C TIO N DA T E
INSPECTION. TI MI
E'
ADDRESS
P H •-
PHONE N O
P
NO F E LOY
O
E S
�wR...a i L �•� � 4 VV .; `•%• .., f f 'yy -�,s
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APPROPRIATE PERMIT ON HAND
FACILITY CONTACT K s�
BUSINESS ID NUMBE R
W
iv
,
F1 :
- - - (CCR: 2729.1)
BUSineSS PLAN CONTACT INFORMATION ACCURATE
Consent to Inspect Name /Title
S ,
0 . ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI AGENCY D --COMPLAINT El RE- INSPECTION
C.
V
C= Compliance O P E RAT LO N
c
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
,
F1 :
- - - (CCR: 2729.1)
BUSineSS PLAN CONTACT INFORMATION ACCURATE
VISIBLE ADDRESS : '
(CFC: 505..1, BMC; 15.52.020)
i
El
❑,
CORRECT OCCUPANCY
(CBC: 401)
y
VERIFICATION OF INVENTORY MATERI ALS .
(CCR: 2729.3)
.
❑
O
VERIFICATION OF QUANTITIES .
(CCR: 2729.4)
❑
VERIFICATION OF LOCATION
(CCR:' 2729.2)
M
a
,,, ❑
0
: ,PROPER SEGREGATION OF MATERIAL
_
(CFC: 2704.1)..,
s
VERIFICATION OF MSDS AVAILABILITY;
(CCR:. 2729.2(3)(b))
P.
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
..
' t,,❑ .
, ❑.
VERIFICATION OF ABATEMENT SUPPLIES &, PROCEDURES (CCR: 2731(c))'
❑
❑
EMERGENCY PROCEDURES ADEQUATE ...
(CCR: 2731)
t;l
❑
CONTAINERS PROPERLY LABELED
(CCR: 66262.34(f), CFC: 2703.5)
:y
D
HOUSEKEEPING
(CFC: 304.1)
El
11
FIRE PROTECTION
(CFC: 903 & 906)
❑
:❑
SITE DIAGRAM ADEQUATE & ON HAND.'.
(CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? D YES ❑' N0='.
Signature of Receipt
Explain
. POST INSPECTION INSTRUCTIONS:',.,
Correct the violation(s) .noted above b Signature (that all violations lave been
Within 5 days of correcting all of the violations, sign n 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 in after return to Compliance Pink — Prevention Services Copy
,
corrected s noted) ,
,
FD21.55 (Rev 6//10)