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Prevention Services
UNIFIED PROGRAM INSPECT]ON C HECKLIST .....:., . .. .s r.: p
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2101 Street
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(661) 326-3979 TI N 1 . B us in ess Plan and InvenY
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FACILITY NAME - INSPECTION DATE INSPECTION TIME
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ADDRESS
PHONE NO.-Ill, NO OF EMPLOYEES
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FACILITY CQ, TACT
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Consent to Inspect Name/Tithe
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' D COMBINED JOINT AGENCY ❑ MULTI-AGENCY ❑- COMPLAINT j. � RE-INSPECTION
�"� ROUTINE -
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C=Compliance
C V ( ) OPERATION COMMENTS
V=Violation
APPROPRIATE PERMIT ON HAND (BMC:1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR:2729.10
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C ❑ VISIBLE ADDRESS (CFC:505.1,BMC: 15.52.020) is
C`� D CORRECT OCCUPANCY (CBC.401)
❑ VERIFICATION OF INVENTORY MATERIALS -2729.3)
VERIFICATION OF QUANTITIES (CCR:2729.4)
EY' El VERIFICATION OF LOCATION (CCR:2729.2)
ET ❑ PROPER.SEGREGATION OF MATERIAL (CCR:2704.1)
❑ VERIFICATION OF MSDS AVAILABILITY (CCR 2729.2(3)(B))
00 El VERIFICATION OF HAZ MAT TRAINING (CCR:2732)
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VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR:2731))
13'4 EMERGENCY PROCEDURES ADEQUATE (CCR:2731)
2` 0 CONTAINERS PROPERLY LABELED (CCR:66262.34(F),CFC 2703.5)
CT HOUSEKEEPING (CFC:304.1)
t D FIRE PROTECTION (CFC 903&906)
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SITE DIAGRAM ADEQUATE&ON HAND (CCR:2729.2)
ANY HAZARDOUS WASTE ON SITE? (13N E S 1771 N O Signature of Receipt
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Explain:
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POST INSPECTION STRUCTIONS -
report for regulatory citations- ;
Refer to.the back of this inspection p g y. 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 Co Yellow r—Business Copy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155(Rev 12/11)
Copy :•