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FACILITY NAME
INSPECTION DATE
INSPECTION TIME
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Violation
COMMENT
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
consent to inspect Name/Title
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ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V= omp lance OPERATION
C E R S
V =Violation; 1,11 Minor
Violation
COMMENT
#
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
3010001
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)
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
1010004
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
VERIFICATION OF, LOCATION (CCR: 2729.2)
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))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC: 304.1)
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FIRE PROTECTION (CFC: 903 & 906)
3030032
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
-
k Y HAZARDOUS ' WASTE ON SITE? 12.-YES 0 NO
Signature ofRecei t ktmi „
Explai "rr;:
Inspector•
POST INSPECT N IN
• Correct the vio o,n(s) noted above by
• Within 5 days of c' cting all of the violations, sign and return a copy of this page to: Signature (that all violations have been corrected as noted)
Bakersfield Fire D Prevention Services 2101 H Street California 93301
Date
White — Busine Copy Yellow — Station Copy Pink — Prevention Services
FD2155 (Rev 8/114)