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POST INSPECTION INSTRUCTIONS-
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• Within 5 days of correcting all of the violations,sign and return a copy of this page to;
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Bakersfield Fire Dept..,Prevention Services,2101 H Street,California
Date
. White Business Copy Yellowy-Business Copy to be.Sent in after return to Compliance Pink—Prevention Services Copy FD2155( ev 61110)
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POST INSPECTION INSTRUCTIONS: ,
• Refer to the back of this inspection report for regulatory citations and corrective actions
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• Correct the violations)noted above by Signature(that all violations have beef.corrected a noted)
• Within 5 days of correcting all of the violations,sign and return a copy of this`page to
Balrersfeld Fire Dept.,Prevention Services,2101 H Street California 93301
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Date
White.—Business Cop y Yellow—Business Co py to-be Sent in•after return I to Com p li•ance ;I � Pink Prevention Services Co p
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POST INSPECTION INSTRUCTIONS:
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Correct the violation(s)noted above by Signature(that all violations have been corrected s 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�Street California 93301�,
Date
White -Business Copy Yellow=Business Copy to be Sent in after return to Compliance Pink--Prevention Services Copy FD2155(Rev 6//10,)
� BAKERSFIELD FIRE DEPT,
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POST INSPECTION INSTRUCTIONS.
• Correct the violation(s)noted above by Signature(that all violations have been-co ted as noted)
• Within 5 days of correcting all of the violations,sign and return a copy of this.page to: `� t 1
Bakersfield Fire Dept.,Prevention Services,21.01 H Street,California 93301
Date
White—Business Copy Yellow-Business Copy to be Sent in after return to Compliance Pink—Prevention Services Copy FD2155(Rev 6M)
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BAKERSFIELD.FIRE DEPT,
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wn n. :....x, w.�w ARTN� r Bakersfield CA-933-01
SECTION-1 ;,- :y Business Plan and Inventory'.Prog.ram r Tel.:. (661) 326-3979.'
Fax: (661) 852-2171
FACILITY NAME ' INSPECTION.TI E
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(BMC: 15.65.080)-
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❑. El VISIBLE ADDRESS
(CFC:505.1,BMC:15.52.020) J •
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0 0 VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2:(3)(b))
El" ❑ VERIFICATION OF HAZ MAT TRAINING (CCR:2732).
ET 0 VERIFICATION OF ABATEMENT SUPPLIES&PROCEDURES (CCR:2731(c))
::❑ ❑ EMERGENCY PROCEDURES ADEQUATE (CCR:2731)
• 0 CONTAINERS PROPERLY LABELED (CCR:66262.34(f),CFC:2703.5)
0 HOUSEKEEPING (CFC 304.1)
0 FIRE PROTECTION (CFC:903&906)
❑ SITE DIAGRAM ADEQUATE&ON HAND.: (CCR:2729.2)
ANY HAZARDOUS WASTE O N S I'T E? 0,1 Y E S ❑.:.No Signature of Receipt
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• Correct the violation(s)noted above by Signature(that all violations have been corrected as noted)
• Within 5 days of correcting all of the violations,sign and return a copy of this page to: r b�
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 I FD2155(Rev 6HI O)
'
BAKERSFIELD FIRE.DEPT,
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■ »..w. ARTM J Bakersfield; CA 93301
S E C T 10 N 1.0 Business Planand Inventory Program Te .. (661) 326-3979
Fax: (661.) 852-2171
FACILITY NAME
:.�� .- INSPECTION DATE'' INSPECTION TIM
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PHONE NO NO'OF EMPLOYEES
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0 rif VERIFICATION OF INVENTORY MATERIALS (CCR:2729.3)
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tyti 11 E PROPER SEGREGATION OF MATERIAL - (CCR:2704.1) -
El E VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2(3)(6))
E E VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
`,<}` VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731))
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ANY HAZARDOUS WASTE ON SITE? ❑ YES' `E NO Signature of Receipt
Explain: V,jV
POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for regulatory citations and corrective actions `,�n }�h<; �J.' •. ~
• Correct the violation(s)noted above by 1_Signature(that dal'violations have beef corrected a 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 he Sent in after return to Compliance Pelt Prevention Services Copy FD2155(Rev 1 12/11)
BAKERSFIELD FIRE DEPT,
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El El SITE DIAGRAM ADEQUATE&ON HAND (CCR:2729.2)
ANY HAZARDOUS WASTE ON SITE? ❑YES 0 NO Signature of Receipt
Explain:
- .
I
POST INSPECTION INSTRUCTIONS:
• Refer to the bock of this inspection report for regulatory citations and corrective actions
Correct the vi- ation(s)noted above by Signature(that all violations have been corrected a 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 in after return to Compliance Pink Prevention Services Copy FD2155(Rev 12/11) -
- �, BAKERSFIELD FIRE'DEPT,
'
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Rakersfield' CA 93301
SECTION4:, Bushess Plan % + Tel.: 661 326-3979
and Inventory Program. k , ( )
Fax: (661) 852-2171
FACILITY NAME INSPECTION DATE INSPECTION TIM
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PROPER SEGREGATION OF MATERIAL (CCR:2704.1)
El J
VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2(3)(8))
❑ VERIFICATION OF HAZ MAT TRAINING CCR:2732
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0 ❑ EMERGENCY PROCEDURES ADEQUATE (CCR:2731)
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ANY HAZARDOUS WASTE ON SITE? 1:1 YES ❑ NO
Signature of Receipt
•�
Explain: �-��
aK
POST INSPECTION INSTRUCTIONS:
I "bw.ar
• Refer to the back of this inspection report for regulatory citations and corrective actions
• Correct the violation(s)noted above by Signature(that all violations have been corrected.a 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 «+ W
Date
White Business Copy Yellow---Business Copy to be Sent in after return to Comphance Pink Prevention Services Copy FD2155(Rev 12/11)
B AKER F I ELD FIRE DEPT,
ti
UNIFIED PROGRAM INSPECTION CHECKLIST 1-1,11' ' B .E R.s. L D
Prevention
Services
FIRE 2101 H Street
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❑ VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2(3)(b))
t❑ ❑ VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
:E] ❑ VERIFICATION OF ABATEMENT SUPPLIES'"&PROCEDURES (CCR:2731(c))-
EMERGENCY PROCEDURES ADEQUATE (CCR 2731)
f] ❑ CONTAINERS PROPERLY LABELED (CCR:66262.34(f),CFC:27015).
r❑• ❑ HOUSEKEEPING (CFC:304.1)
s
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SITE DIAGRAM ADEQUATE&ON HAND .(CCR:2729.2)
ANY H A'Z A R D O U S WASTE.O N SITE? ❑ YES ❑ N O Signature,of Receipt
Explain:
POST INSPECTION INSTRUCTIONS
• Correct the violation(s)noted above by Signature(that all violations have been corrected as,noted)
• Within 5 da y s 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 ..j -
Date
White—Business Copy Yellow Business Copy to be Sent in after return to Compliance Pink—Prevention Services Copy FD2155(R v 6//10)
I
BAKERSFIELD FIRE DEPT,
•
P reventon Services ,
, •
TBA r ,
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Bakersfield CA 93301
SECTION 1 Tel.: ,Busi ness Plan and Invento Pry gram, (061):-.326-3979'
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E E CORRECT OCCUPANCY (CBC:401)
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El VERIFICATION OF QUANTITIES (CCR:2729.4)
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IJwrL� E PROPER SEGREGATION OF MATERIAL (CCR:2704.1)
-', E VERIFICATION OF MSDS AVAILABILITY {CCR:2729.2(3)(6))
❑ VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
wt E VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731))
tr �' E EMERGENCY PROCEDURES ADEQUATE (CCR:2731)
3 E CONTAINERS PROPERLY LABELED (CCR:66262.34(F),CFC 2703.5)
}' E HOUSEKEEPING (CFC:304.1)
❑ FIRE PROTECTION (CFC:903&906)
�' ❑ SITE DIAGRAM ADEQUATE&ON HAND (CCR:2729.2)
ANY HAZARDOUS WASTE ON SITE? E YES E NO _ Si:tm_ature of Receipt
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POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for regulatory citations and corrective actions9
• Correct the violation(s)noted above by _ _ Signature(that all violations have been corrected as noted)
• Within 5 days of correcting all of the violations,sign and return a copy of this page to
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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 FM155(Rev 12/11)
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UNIFIED'PROGRAM-INSPECTION .CRECKLIST. - 2101 H Street
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Bakersfield' CA 93301•
SECTION 1 •Business Plan,and Inventory Program A - Tel:: (661) 326-3979'
Fax: (.661) 852-2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
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❑ MULTI-AGENCY.: ❑ COMPLAINT ❑ RE-INSPEC
C V ( C=Compliance) OPERATION COMMENTS
V=Violation
❑'J ❑ APPROPRIATE PERMIT ON HAND (BMC: 1.65.080)
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ADDRESS (CFC:505.1,BMC: 15.52.020)
,.a 0 CORRECT OCCUPANCY (CBC:401)
❑ VERIFICATION OF INVENTORY MATERIALS (CCR:2729.3)
0 El VERIFICATION OF QUANTITIES (CCR:2729.4)
M ❑ VERIFICATION OF LOCATION (CCR:2729.2)
r,r ❑ PROPER SEGREGATION OF MATERIAL (CCR:2704.1)
[3- ❑ VERIFICATION OF MSDS AVAILABILITY (CCR:2729.2(3)(B))
` ❑ VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
El ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731))
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0 ❑ EMERGENCY PROCEDURES ADEQUATE (CCR:2731)
171" ❑ CONTAINERS PROPERLY LABELED CCR:66 4(F),CFC 2703.5)
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HOUSEKEEPING (CFC:304.1)
n ❑ FIRE PROTECTION (CFC:903&906)
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ANY HAZARDOUS WASTE ON SITE? ❑YES ❑ NO Signature of Receipt
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Explain:
POST INSPECTION INSTRUCTIONS: ~�— _-
• Refer to the back of this inspection report for regulatory citations and corrective actions
• Correct the violation(s)noted above by - - Signature(that all violations have been corrected 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 in after return to Compliance Pink Prevention Services Copy FD2155(Rev 1.2/11)
Prevention Services
UNIFIED .PROGRAM INSPECTION CHECKLIST B A,. r R s z;E: 900 TruXtun Ave Suite 2 0
FIRE Bakersfield CA 93301
a A R Mimi
Tel. (66.1) 326-3979'
SECTION 1 : Business Plan and Inventory Program
Fax: (661) 872-2171
FACILITY NAME. INSPECTION DATE INSPECTION TIME
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C V C=Compliance
OPERATION E RAT I O N
C ) COMMENTS
V=Violation
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'Er' ❑ Bus.ine:ss PLAN:CONTACT.INFORMATION ACCURATE
T ❑ VISIBLE ADDRESS
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' 0 VERIFICATION'OF•INVENTORY MATERIALS
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❑' ❑ VERIFICATION OF QUANTITIES y r
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T ❑ VERIFICATION OF LOCATION
❑ PROPER SEGREGATION OF MATERIAL.
ET ❑ VERIFICATI1ON OF MS—DS AVAILABILITY
❑ VERIFICATION OF HAZ MAT TRAINING
9C.�' ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
0' ❑ EMERGENCY PROCEDURES ADEQUATE
❑`'^ ❑ CONTAINERS PROPERLY LABELED
❑� ❑ HOUSEKEEPING
[3f�;,, ❑ FIRE PROTECTION �---�� �. •,- � _-
❑" ❑ SITE DIAGRAM ADEQUATE&ON�HAND
ANY HAZARDOUS WASTE ON SITE? ❑YES Cr NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661).326-3979 t
a - i Site/Re Party I P'
St Business, sponsible (Pease Ir n
.Inspector (Please Print) )"
� Fire Prevention/1 In/Shift of Site/Station
White-Prevention Services Yellow-Station.Copy Pink—Business Copy FD 2155 (Rev.D9/05