HomeMy WebLinkAbout6009 coffee bp 11-27-12KERN BUSINESS FORMS - (661) 325 -5818 - #6013
BAKERSFIELD F RE DEPT . :'
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U`N'I F a E ® .,P RO G RAi M a: N S"P E C T l' �N C H E C K L LS I' B - 2101 H Street '
ARM Bakersfie1d;.CA9330`1:
$"E: T O N ' :.. BUSII'IeSS PIc'�11 ca11C� 011!/e11t01�/ PI"Og "a111 Tel'.; (661:)'- 326 -3979. "
Fax: (6 6.1) 852 =2171 .
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FACILITY NAME"
INSPECTION�DA+E—,
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ADDRESS
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PHONE NO. <
.NO OF EMPLOYEES "
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PIN
FACILITY CONTACT
BUSINESS ID NUMBER" -
Consent to `Inspect Name /Title
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. ROUTINE COMBINED ❑ JOINT`AGENCY ❑ t: MULTI . AGENCY ❑ COMPLAINT ❑ RE- INSPECTION , _
C= Compliance
C V (' - ) OPERATION
COMMENTS
V= Violation
❑ APPROPRIATE. PERMIT ON HAND (BMC: 15.65.080)
",R ❑ BUSi1leSS PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
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❑ '. ; VISIBLE ADDRESS (CFC: 505:1;' BMC: 15.52.020)
❑ .', CORRECT OCCUPANCY (CBC: 401 "),
❑.: VERIFICATION OF INVENTORY MATERIALS, (CCR: :2729,.3)'
R. ❑ VERIFICATION OF QUANTITIES; (CCR: 2729.4)
;
❑ VERIFICATION OF LOCATION (CCR." 2729.2)
t ❑ PROPER, SEGREGATION, OF MATERIAL (CFC: 2704.1)
❑ VERIFICATION'OF MSDSAVAILABILITY ` (CCR: 2729.2(.3)(b })
❑ VERIFICATION OF HAZ MAT.TRAINING " (CCR: 2732)
❑ . VERIFICATION OF ABATEMENT SUPPLIES &PROCEDURES (CCR .
❑ EMERGENCY PROCEDURESADEQUATE -(CCR: 2731)
El CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5)
❑ HOUSEKEEPING (CFC: 304
❑ FIRE PROTECTION (CFC: 903 & 906)
�.. SITE DIAGRAM'ADEQUATE,& ON HAND (CCR: 2729 2)
ANY HAZARDOUS WASTE ON SITE? . ❑ YES ❑ NO
SWitatureof:Receipt
E"xPIairr: ,
POST INSPECTION INSTRUCTIONS:
o Correct the violation(s) noted above by : - ,Signature (that all violations have een corrected as noted) '
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• Within .5 days of correcting all of the violations, sign :and return a copy this page to: