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KERN BUSINESS FORMS - (661) 325-5818 - #6013
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BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED 'PROGRAM INSPECTION CHECKLIST
B,,._ > _. R .5. F ��_ L. I?
FIRE 210.1 H' Street
ARTM r' e1d; CA
.93301'
Bake'rsfi,
SECTION. 1.: Business: Plamand``Inventory. Program Tel.: (661)326 -3979
ti Fax: (661) 852 -2171
FACILITY NAME iNSPECT10 DATE ” .INSPECTION TIME
11 ADDRESS PHONE NO. NO OF EMPLOYEES-
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to inspect Name/ ftle=Y.,.
3 5`
z i
ROUTINE COMBINED ❑ J. k. Y� ._ ❑ MULTI-AGENCY I ,.k ...,:_.,.
OINT AGENCI Y ❑ COMPLAINT El . RE- INSPECTION
C =Compliance
V ( ) OPERATI.ON
COMMENTS
V =Violation
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El APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
D °� El CORRECT OCCUPANCY (CBC: 401)
r/T [I VERIFICATION OF INVENTORY MATERIALS (CCR 2729:3)
16 ❑ VERIFICATION OF QUANTITIES (CCR 2729.4)
d'•
!`3 El VERIFICATION OF LOCATION (CCR 2729.2)
El PROPER SEGREGATION OF MATERIAL (CFC 2704.1)
VERIFICATION OF.MSDS AVAILABILITY. (CCR: 2729 2(3)(b))
❑ VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
❑r` . ❑ VERIFICATION OF ABATEMENT SUPPLIES &:PROCEDURES (CCR; 2731(c))
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,1 ❑ F1 EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
[" El CONTAINERS. PROPERLY LABELED (CCR: 66262.34(17, CFC 2703.5)
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�n ❑ HOUSEKEEPING (CFC:304.1)
❑- ❑ FIRE PROTECTION (CFC: 903 & 906)
nom! ❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
ANY H.A Z A R D O U S WASTE O N SITE? [I YES �T N O Signature of ReeeaAt
Explain:
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POST INSPECTION INSTRUCTIONS:
• 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: