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E' ROUTINE [1 COMBINED 171 JOINTAGENCY El MULTI-AGENCY El COMPLAINT RE- INSPECTION
C V C=C10 mpiance OPERATION
II
v= Vio►ation; I,Minor
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
u, BAKERSFIELD FIRE DEPT:
COMMENT
Prevention Services
B EX 6 F4 R 2101 H Street
UNIFIED PROGRAM INSPECTION CHECKLIST��'
Bakersfield, CA 93301
1010008
Tel.: (661) 326 -3979
Fax: 852 -2171
S E CT 10 N 1: HazardouS Materials Business Plant
(661)
.Ins ion
FACILITY NAME
INSPECTION DATE
11 ot.
INSPECTION TIME
VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3)
r r o 411 � }`
VERIFICATION OF QUANTITIES (CCR: 2729.4)
1010006
ADDRESS,
PHONE NO.
_ ->
NO OF EMPLOYEES
"
all _ ' 2 L,
FAC IL TY CONTACT,.
JAI
BUSINESS ID NUMBER
VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
'jjj.S
A
VERIFICATION OF ABATEMENT SUPPLIES& PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(17, CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
Consent to Inspect Name/Title
1010010
Nom..,wfi
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keIn,'."...at..?e �.p. a.. k�tat+ ,.xaY^��.s,�.. -�.; G. �.+H,.. >..,:tusz:
E' ROUTINE [1 COMBINED 171 JOINTAGENCY El MULTI-AGENCY El COMPLAINT RE- INSPECTION
C V C=C10 mpiance OPERATION
II
v= Vio►ation; I,Minor
APPROPRIATE PERMIT ON HAND (BMC:15.65.080)
CE RS
Violation
COMMENT
3010001
BUSINESS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
1010008
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
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
A
VERIFICATION OF ABATEMENT SUPPLIES& PROCEDURES (CCR: 2731(c))
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
CONTAINERS PROPERLY LABELED (CCR: 66262.34(17, CFC: 2703.5)
HOUSEKEEPING (CFC: 304.1)
1010010
3030007
L'e FIRE PROTECTION (CFC: 903 & 906)
3030032" 1 '
NIJ
' SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2) 1010005
NY HAZARDOUS WASTE ON SITE? ES ❑ NO Sianature ofRecei t
Explain:
.*
Inspector•�°te�a
POST INSPECTION INSTRUCTIONS:k.
• Correct the violation(s) noted above by
e,< try i,gait
• Within 5 days of correcting all of the violations, sign and return a copy "of tliis 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 8H14)