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FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
PHONE NO
NO OF EMPLOYEES
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BUSINESS IDy NUMBER
FACILITY CONTACT
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Consent to Inspect Name /Title
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❑...MULTI - AGENCY ❑ CO:,,
,:.❑ COMBINED. MPLAINT ❑ RE- INSPECTION
C� ,ROUTINE
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C V ance OPERATION
C E R S
violation
COMMENT
V= Violation; 1,11 Minor
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)
;4d
CORRECT OCCUPANCY (CBC: 401)
i
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))
1
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
1010010
:
CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
3030007.
HOUSEKEEPING (CFC: 304.1)
ti �S
FIRE PROTECTION (CFC: 903 & 906)
3030032+
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SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
1010005
ANY HAZARDOUS WASTE ON SITE? `Z„YES ❑ NO
i nature of Receipt
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:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White — Business CoDv Yellow — Station Copy Pink — Prevention Services
Signature (that all violations have been corrected as noted)
Date
FD2155 (Rev 804)