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4621 BURR STREET
UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program D FIRE AR1M T BAKERSFIELD FIRE DEPT. Prevention Services 2101"14 Street Bakersfield, CA'93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME 0(D S ccfp < INSPECTION DATE 1 ( a, INSPECTION TIME ADDRESS J to r r t PHONE NO. Zl _ 3t NO OF EMPLOYEES 4-2— FACILITY CONTACT BUSINESS ID NUMBER Consent to Inspect Name/Title Section 1: Business Plan and Inventory Program ROUTINE n COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS APPROPRIATE PERMIT ON HAND BMC: 15.65.080) P h Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) k VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020) 8> CORRECT OCCUPANCY CBC: 401) z, VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) 9- VERIFICATION OF QUANTITIES CCR: 2729.4) 01 VERIFICATION OF LOCATION CCR: 2729.2) r PROPER SEGREGATION OF MATERIAL CFC: 2704.1) 91_ VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) j1 . C U r©::, VERIFICATION OF HAZ MAT TRAINING CCR: 2732) 1 iM VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) EMERGENCY PROCEDURES ADEQUATE CCR: 2731) o CONTAINERS PROPERLY LABELED CCR: 66262.34(17, CFC: 2703.5) 0 HOUSEKEEPING CFC: 304.1) S' FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? ' YES NO Signature of Receipt Explain: POST INSPN:CI'IUN INS'FRUC'1'IONS: Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy orthis page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Nm' Signature (that all violations have been corrected as noted) L- iI I * 4__ Date White — Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink — Prevention Services Copy F132155 (Rev6H10)