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F ACILITY NAME
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INSPECTION DATE
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INSPECTION TIME
ADDRESS
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PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT
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USINESS ID NUMBER
Consent to Inspect Name/Title
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ROUTINE ❑COMBINED ❑JOINT AGENCY ❑ MULTI- AGENCY ❑COMPLAINT ❑ RE- INSPECTION
omp lance
C V OPERATION
C E R S
V =Violation; 1,11 Minor
Violation
COMMENT
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APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
3010001«.`
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BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008.
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
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CORRECT OCCUPANCY (CBC: 401)
X
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
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VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF LOCATION (CCR: 2729.2)
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PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES ,, (CCR: 2731(c))
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EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
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HOUSEKEEPING (CFC: 304.1)
FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
NY HAZARDOUS WASTE ON SITE p�YES ❑ N O
Signature of Receipt ..
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Explain:
Inspector: _.F . .. ry...
POST INSPECTION INSTRUCTIONS:
0 Correct the violation(s) noted above by
• Within 5 days of correcting all of the violations, sign and retum' a copy of this page to: Signature (that all violations have been corrected as noted)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White Business Copy Yellow - Station Copy Pink - Prevention Services FD2155 (Rev 8//14)