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FACILITY NAME
INSPECTION DATE
INSPECTION TIME
v= Violation; 1,11 Minor
Violation
COMMENT
AD RESpS
PHONE NO.
NO OF EMPLOYEES
,e
V t
FACILITY CONTACT
BUSINESS ID NUMBER
Consent to Inspect Name /Title
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V C= Compliance OPERATION
C E RS
v= Violation; 1,11 Minor
Violation
COMMENT
APPROPRIATE PERMIT ON HAND ; (BMC: 15.65.080)
3010001
CERS INFORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729.1)
3210043
1 a
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY (CBC: 401)
4
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)
r,
�a
VERIFICATION OF SDS AVAILABILITY (CCR: 2729.2(3)(b))
'
r
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: 66262.34ft CFC: 2703.5)
I
3030007
HOUSEKEEPING (CF.C: 304.1)
6.
'"FIRE PROTECTION 1, (CFC: 903 & 906)
3030032
tW ty 6 g J q
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
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ANY HAZARDOUS -WASTE ON SITE? ES ❑ NO ISienatureofReceipj
Explain:
Inspector:
POST INSPECTION INSTRUCTIONS: P 'r
• 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 93301
Date
White — Business Copy Yellow — Station Copy” Pink?= Prey-Ft ion Services FD2155 (Rev 9/2017)