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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
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H. _r_ H_ s r. I s I._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
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INSPECTION DATE INSPECTION TIME
s
COMMENTS
5 —,3 Q • I-,>, IJLI r
ADDRESS
11 2q3
PHONE NO. NO OF EMPLOYEES
Within 5 days of correcting all of the violations, sign and return a copy ol'this page to:
I b 0 - Y.3.: ) 9 c.y
FACILITY CONTACT BUSINESS ID NUMBER
c 3 7
Consent to Inspect Narne7ltlb
IJ
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
c v Q C= Compliance OPERATION
V= Violation
Refer to the of this report regulatory citations and corrective actions
COMMENTS
ID APPROPRIATE PERMIT ON HAND BMC: 1.65.080)
violations have be corrected as noted)
Within 5 days of correcting all of the violations, sign and return a copy ol'this page to:
BUSINESS PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020)
IJ CORRECT OCCUPANCY CBC: 401)
VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
C`1 VERIFICATION OF QUANTITIES CCR: 2729.4)
El VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CCR: 2704.1)
VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(B))
El VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR: 2731))
EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
El CONTAINERS PROPERLY LABELED CCR: 66262.34(F), CFC 2703.5)
111 HOUSEKEEPING CFC: 304.1)
FIRE PROTECTION CFC: 903 & 906)
SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? E] YES NO Si ature`ofRecei t
Explain:
POST INSPECTION INSTRUCTIONS:
back inspection forRefertotheofthisreport regulatory citations and corrective actions
Correct the violation(s) noted above by Signature (that all violations have be corrected as noted)
Within 5 days of correcting all of the violations, sign and return a copy ol'this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
White — Business Copy YCIIoW —I3LISilleSS Copy to be Sent in after return to Compliance Pink Prevention Services Copy P132155 (Rev 12/11)
BAKERSFIELD FIRE DEPT.
11NI lE® I I OCaRAM INSPECTION CHECKLIST;
Prevention Services
R _ P. R S I'
4 F /RE 2101 H Street
ARTM Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program
v
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
c.c'Z A s 5 - s'I - Z 06
ADDRESS `` \ ` PHONE NO. NO OF EMPLOYEES
Sx
FACILITY CONTACT BUST S ID NUMBER
VISIBLE ADDRESS
Consent to Inspect Name /Title
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED JOINTAGENCY MULTI- AGENCY COMPLAINT RE- INSPECTION
C v Q C= Compliance OPERATION
V= Violation
COMMENTS
O 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)
IS 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)
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 NO Signature of Receipt {
Explain:
POST INSPLC;'I ION INS'I RUC I IONS:
Refer to the back of this inspection report for regulatory citations and corrective actions
Correct the violation(s) noted above by
Within 5 days ofcorrecting all of the violations, sign and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 1-1 Street, California 93301
JC V-4'- c' .. //C
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow — Business Copy to be Sent in alter return to Compliance Pink Prevention Services Copy FD2155 (Rev 12/11)