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Tel.: (661) 326 -3979
Fax: (661) 852-2171
FACILITY NAME
INSPECTION DATE
INSPECTION.TIME
ADDRESS
PHONE NO.
NO OF EMPLOYEES
BUSINESS ID NUMBER
FACILITY CONTACT
Consent to Inspect ame/Title
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- ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI-AGENCY ❑ COMPLAINT 1771 RE-INSPECTION
C V C=Compliance OPERATION
CERS
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
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VISIBLE ADDRESS (CFO: 505.1*, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
C_
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VERIFICATION OF INVENTORY MATERIALS (CCR; 2729.3)
1010004
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VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
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- 2729.2)
VERIFICATION OF LOC ATION (CCR.
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PROPER SEGREGATION OF MATERIAL (CFC: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
F CC— CC, n4 C��
V
C ) 0
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VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
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 (CFC:'304.1)
I C1.1
A
PROTECTION, (CFC: 903 & 906)
3030032
Z70 J 'Erg
SITE DIAGRAM ADEQUATE & ON -HAND (CCR: 27292)
1010005
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ANY HAZARDOUS WASTE ON SITE? El YES NO
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Signature of Re ipipt/
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS.
Correct the violation(s) noted above by 4Z)
• 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 8//14)