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UNIFIED PROGRAM INSPECTION CHECKLIST 1-1,11'' �B .ERs - LD
Prevention
Services
FIR� 2101 H Street
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n.. na �R ��► r Bakrsfield` CA 93301
S.326 .E CT I O N 1 Business: Plan and Invento Prograrn :i'4 Tel.: (661) -3979
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Fax: (661) 852 -2171
FACILITY NAME .
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INSPECTION TIME
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ADDRESS' j
PHONE NO.
NO OF EMPLOYEES
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VISIBLE ADDRESS
FACILITY CONTACT
BUSINESS ID NUMBER
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CORRECT OCCUPANCY.
Consent to Inspect Name /Title
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ROUTINE ❑ '-COMBINED ❑ . JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE-INSPECTION',
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C= Compliance
( ) OPERATION...
V= Violation
COMMENTS
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.060)
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❑
Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
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❑'
VISIBLE ADDRESS
(CFC: 505.1, BMC: 15.52.020)
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❑
CORRECT OCCUPANCY.
(CBC: 401)
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❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
90
❑
VERIFICATION OF QUANTITIES
(CCR: 2729:4)
.❑
❑
VERIFICATION OF LOCATION :
(CCR: 2729.2)
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PROPER SEGREGATION OF MATERIAL
(CFC: 2704.1)
❑
VERIFICATION OF MSDS AVAILABILITY
(CCR: 2729.2(3)(b))
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❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
:D
❑
VERIFICATION OF ABATEMENT SUPPLIES "& PROCEDURES (CCR: 2731(c))-
,E
❑
EMERGENCY PROCEDURES ADEQUATE '
(CCR: 2731)
❑
CONTAINERS PROPERLY LABELED
(CCR: 66262.34(f), CFC: 27015).
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❑
HOUSEKEEPING
(CFC: 304.1)
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❑
FIRE PROTECTION
(CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND
.(CCR: 2729.2)
ANY HAZARDOUS WASTE .O N SITE? DYES ❑ NO
Signature, of Receipt
Explain:
•
• 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 co of this page e to:
y g � g copy p g
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 (R v 6//10)
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