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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
R _RS_ F F 2_ D
FIRE
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
P` ( r
c= Compliance OPERATION
V= Violation
L.Y G'
INSPECTION DATE
2f_
INSPECTION TIME
2_ J (D
ADDRESS
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NO. NO OF EMPLOYEES
FACILITY CONTACT C
L
SLTSTNES,810 NUMBER
Consent to Inspect Name /Title
CORRECT OCCUPANCY
Section 1: Business Plan and Inventory Program
Q OUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C v c= Compliance OPERATION
V= Violation
COMMENTS °
210 APPROPRIATE PERMIT ON HAND BMC: 1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES CCR: 2729.4)
rJ VERIFICATION OF LOCATION CCR: 2729.2)
0 PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
0r
VERIFICATION OF MSDS AVAILABILITY
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CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
An SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES NO Signature ofReceiot
Explain:
POST INSPLC;'I ION INS I RUC; I IONS:
Refer to the back ofthis inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by i re (that all violations have been corrected as noted)
Within 5 days ofcorrecting all of the violations, sign and return a copy of this page to: n _
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 C-1y
Date
White — 13usincssCopy YeIIOW — 13usincssCopy to be Sent in after return to Compliance Pink Prevention Services Copy FD2155 (Rev 12/1 I )
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
ft
S P I P
IRE
RTM T
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel::' (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME , Aid INSECT ON DATE INSPECTIOtJ TIME
IF
APPROPRIATE PERMIT ON HAND
ADDRESS PHONE NO.. NO PF EMPLOYEES
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
FACILI C TACT r
VISIBLE ADDRESS CFC: 505.1, BMC: 45.52.020)
BU Its SS ID NUMBER
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS
Consent to Inspect Name /Title
Section 1: Business Plan and Inventory Program
D— OUTINE COMBINED JOINTAGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 1.65.080)
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
7 VISIBLE ADDRESS CFC: 505.1, BMC: 45.52.020)
CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
VERIFICATION OF QUANTITIES. CCR: 2729.4)
VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
El VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(8))
VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES D NO SianatureofReceiat
Explain:
POST INSPECTION INSTRUCTIONS: /
Refer to the back ofthis inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by Si that al. lolations have been corrected as noted)
Within 5 days of correcting all ofthe violations, sign and return a copy of this page to: `
1BakersfieldFireDept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy Yellow— Business Copy to be Sent in alter retuni to Compliance Pink Prevention Services Copy FD2155 (Rev 12/11)
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