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KERN BUSINESS FORMS - (661)325- 5818- #6013
B RSFIELD FIRE •
,...� Prevention Services
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A E R ._S _F 2101 H Street LIST �►�
UNIFIED PROGRAM I hECTI ®IV �I'IE�I� � aRr� r Bakersfield, CA 93301
Tel.: (661) 326 -3979
SECTION 1: business Plan and Inventory Program
Fax: (661) 852 -2171
INSPECTION DATE INSPECTION TIME
FACILITY NAME ��� j ��j ^j , w ,�,,- D� 1� " l " %
A IL ) PHONE NO. NO OF EMPLOYEES
ADDRESS ��. -A U G,,
'Z,(' BUSINESS ID NUMBER
FACILITY CONTACT
Consent to Inspect Name /Title
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY
C C= Compliance) O p E RATIO N
❑ COMPLAINT ❑ RE- INSPECTION
COMMENTS
Signature of Receipt
ANY HAZARDOUS WASTE ON SITE? 'YES ❑ NO
Explain:
.POST INSPECTION INSTRUCTIONS:
S qaIlviol—ations have been corrected as noted)
rnrr.,r.t the violation(s) noted above by of this nase to: _.
V= Violation
APPROPRIATE PERMIT ON HAND
❑
Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1)
(CFC: 505.1, BMC: 15.52.020)
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
(CBC: 401)
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
F1
VERIFICATION OF LOCATION
(CCR: '2729.2)
❑
PROPER SEGREGATION OF MATERIAL
(CFC::2704.1)
❑
VERIFICATION OF MSDS AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
❑
VERIFICATION OF ABATEMENT SUPPLIES &- PROCEDURES (CCR: 2731(c))
❑
EMERGENCY PROCEDURES ADEQUATE
(CCR: 2731)
❑
CONTAINERS PROPERLY LABELED
(CCR: 66262.340, CFC: 2703.5)
(CFC: 304.1)
❑
HOUSEKEEPING
(CFC: 903 & 906)
❑
FIRE PROTECTION
17-1
SITE DIAGRAM ADEQUATE & ON HAND
(CCR: 2729.2)
❑ COMPLAINT ❑ RE- INSPECTION
COMMENTS
Signature of Receipt
ANY HAZARDOUS WASTE ON SITE? 'YES ❑ NO
Explain:
.POST INSPECTION INSTRUCTIONS:
S qaIlviol—ations have been corrected as noted)
rnrr.,r.t the violation(s) noted above by of this nase to: _.