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uwFiFn pRnGROM INSPECTION CHECKLI T
SECTION 1: Hazardous Materials Business Plan
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FACILITY NAME„ . . _
INSPECTION DATE
INSPECTION TIME
f�T G
APPROPRIATE PERMIT ON HAND (BMC
15.65.080)
ADDRESS
PHONE NO.
NO OF EMPLOYEES
BUSINESS PLAN CONTACT INFORMATION ACCURATE (C
R: 2729.1)
1010008
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name/Title
:
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F�O ROUTINE ❑COMBINED ❑JOINT AGENCY El MULTI-AGENCY El COMPLAINT ❑ RE- INSPECTION
= omp lance
C V OPERATION
V= Violation; 1,11 Minor
C E R S
Violation
COMMENT
APPROPRIATE PERMIT ON HAND (BMC
15.65.080)
3010001
Ar
BUSINESS PLAN CONTACT INFORMATION ACCURATE (C
R: 2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BMC
15.52.020)
>(
F1
CORRECT OCCUPANCY
(CBC:401)
.«
VERIFICATION OF INVENTORY MATERIALS (C
R: 2729.3)
1010004
VERIFICATION OF QUANTITIES (C
R: 2729.4)
1010006
VERIFICATION OF LOCATION (C
R: 2729.2)
X
PROPER SEGREGATION OF MATERIAL (C
C: 2704.1)
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
VERIFICATION OF HAZ MAT TRAINING (
CR: 2732 }
1020002
�' s':.�;� _'�' �,""'•, d i ��'w. �'e;�.� "4 r r:�`.�'
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (C (JR:
2731(c))
N.
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
1010010
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), GFC:
2703.5)
3030007
HOUSEKEEPING
CFC: 304.1)
FIRE PROTECTION (CF G:
903 & 906)
3030032
",'
SITE DIAGRAM ADEQUATE & ON HAND (CR:
27292)
1010005
ANY HAZARDOUS WASTE ON SITE? ❑ YES 04 NO
Sig natureofReceipt
Explain:
Inspector:
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 9330
Date
White — Business Copy Yellow — Station Copy Pink — Prevention Services
FD2155 (Rev 8H14)