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SECTION _ _
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1 Business Plan and In�ento Pro _ ram E Tel. 661 32'6 3979
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Fax (661) 852 -2171
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FACILITY NAME
INSPECTION DATE
INSPECTION
TIME
onm 1'1. �' W % � l 4r,N � p lt"� .. M^ ._....� ' . '
Y �• p '..t�� '� i -`',.
❑ RE -INS
` ECTION
ADDRESS
PHONE NO.'
NO
OF EMPLOYEES
�Y 1`
: 1. u 7 �� �:� W. � -�... 1'� Tt tc'YA� ...a* � L�s4�^^��i�, 2 � ' ; •
_ �"ar'" �`3=°`� :�,.�-� 'tai'` :'� •�1} �!
(CCR: 2729.1)
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FA ,-]LITY�CONTACT
BUSINESS ID NUMBER
�s- f ryI
�1. i. :c•
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ntO ({ f_r 'f 1•% :{ w� r'j yF y`.
15.52.,020)
Consent :to Inspect Name /Title
i
1
. 7.
w
C = Compliance
C V OPERATION
V- Violation
•
ROUTINE
❑ COMBINED ❑ JOINT AGENCY.- ❑ MULTI- AGENCY ❑ - COMPLAINT
❑ RE -INS
` ECTION
,
C = Compliance
C V OPERATION
V- Violation
COMMENTS
APPROPRIATE PERMIT ON HAND (BMC:
15.65.080)
D ❑' Business PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
:
,
❑` . 0 . VISIBLE ADDRESS (CFC: 505. 1, BMC.
15.52.,020)
1
CORRECT OCCUPANCY
(CBC: 401)
0” ❑ VERIFICATION OF INVENTORY MATERIALS
I(CCR: 2729.3)
I
` VERIFICATION, Q UANTITIES
,
;(CCR: '2729.4)
0 El VERIFICATION 'Of LOCATION
(CCR:' 2729.2) .
0 ❑ PROPER SEGREGiATIO'N.OF MATERIAL
:
I
�(CFC: 2704..1)
El VERIFICATION OF MSDS AVAILABILITY {CCR: 2729.2 (3)(b))
C ❑ VERIFICATION OF HAZ MAT TRAINING I (CCR: 2732)
i
Dr ❑ VERIFICATION OF ABATEMENT'SUPPLIES & PROCEDURES (CCR: 2731(c))
'
Ell ❑ EMERGENCY PROCEDURES ADEQUATE
CCR: 2731
El CONTAINERS PROPERLY LABELED CCR: 66262.34 f CFC: 2703.5
:
El El HOUSEKEEPING (CFC: 304.1)
IRE PROTECTION � • . (CF C: 903 & 906)
..
•
SITE DIAGRAM ADEQUATE & ON HAND - ' . .
CCR: 2729.2.
3 In, ;( )
- -
ANY 'H A Z A' R D O U S WASTE OR SITE ? • 1 YES =: N O
, I
Signature of Receipt
Explain
POST INSPECTION INSTRUCTIONS:
• - Correct the violation(s) noted above by ! .: Signature (that all violations have b
Within 5 days of correctin g all of the violations, sign and return a co pY •pf this page to: _
Bakersfield )Fire Dept., prevention. Services, 2101. H Street, California 93301
Date
White —Business Copy Yellow — Business Copy to be Sent in alter return to Compliance.: Pink — Prevention Services Copy ;
en corrected as noted)
FD2155 (Rev 6H10)