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B E R S F-1 D
FIRE
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Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
DIr 1
INSPECTION DATE
45- -It - /6
INSPECTION TIME
1-bVr
ADDRESS
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PHONE NO.
L (f Y�r PU —7ZIrf
NO OF EMPLOYEES -
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V
( C= Compliance) OPERATION
V= Violation
COMMENTS
❑
APPROPRIATE PERMIT ON HAND
❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
❑
VERIFICATION OF INVENTORY MATERIALS
❑
VERIFICATION OF QUANTITIES
1 ❑
VERIFICATION OF LOCATION
❑
PROPER SEGREGATION OF MATERIAL
❑
t
VERIFICATION OF MSDS AVAILABILITY
❑
VERIFICATION OF HAZ MAT TRAINING
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
i
EMERGENCY PROCEDURES ADEQUATE
❑
CONTAINERS PROPERLY LABELED
❑
HOUSEKEEPING
C! ❑
FIRE PROTECTION
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SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
4l`'o'v 'J,41-zo xC_
Inspector (Please Print) Fire Prevention / 151 In / Shift of Site /Station #
Business Site / Responsible Part lease Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05