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INSPECTION DATE
INSPECTION TIME
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ADDRESS
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NO OF EMPLOYEES
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FACILITY CONTACTt
APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
BUSINESS ID NUMBER
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Consent to Inspect Name /Title
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BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
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ROUTINE ❑ COMBINED. ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑, RE- INSPECTION
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C V C=Gompliance OPERATION
CERS
V= Violation; 1,11 Minor
Violation
COMMENT7�
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APPROPRIATE PERMIT ON HAND (BMC: 15.65.080)
3010001
Inc '� �= s �:�- _. ` ar;�� ate'
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BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010608
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VISIBLEADDRESS (CFC: 505.1, BMC: 15.52.020)
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CORRECT OCCUPANCY (CBC: 401)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
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))`'
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VERIFICATION OF HAZ MAT. TRAINING (CCR: 2732)
1020002
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VERIFICATION OF ABATEMENT. SUPPLIES & PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFG:. 304.1)
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FIRE PROTECTION (CFC: 903 & 906)
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3030032
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SITE DIAGRAM ADEQUATE & ON HAND. (CCR: 2729.2)
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1010005
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ANY HAZARDOUS WASTE ON SITE? ❑ YES A NO
Oignature of Recei s
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Explain:
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POST INSPECTION INSTRUCTIONS:
• Correct the violation(s) noted above by
• Within 5 days of correcting all of the violations, sign and return 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 804)