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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
B_ ' E R S F I@ _D
FIRE
D ARTM
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
1
V
INSPECTION DATE
6-8-
INSPECTION TIME
ADD ESS
170
PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
7
Consent to Inspect Narne/Title
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C V c C= Compliance) OPERATION
V= Violation
COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
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)
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: 66262.34(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 INSPECTION INSTRUCTIONS:
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 H Street, California 93301
Signature (that all violations have been corrected as noted)
Date
White — Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink — Prevention Services Copy FD2155 (Rev 6H10)
j
e
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Fl_ H R S F I fl_ D
FIRE
v AN TME °r
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
Lna a 4 L_-'Q 9
ADDR SS PHONE NO. NO OF EMPLOYEES
J
FACILITY CONTACT BUSINESS ID NUMBER
Consent to Inspect Name /Title _•
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED JOINTAGENCY MULTI- AGENCY COMPLAINT RE- INSPECTION
C V C= Compliance OPERATION
V= Vi_ ola'ti6n
1
4 COMMENTS
APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
Business PLAN CONTACT- INFORMATION
ACCURATEr _(
CCR: 2729.1)
VISIBLE ADDRESS j(CFC: 605.1; BMC: 15.52.020)
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 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))
i
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 O,N SITE ?. YES NO
1
Signature of Receipt
Explain:
POST INSPECTION INSTRUCTIONS:
Correct the violation(s) noted above by
Within 5 days of correcting all of the violations, sign and return a copy ofthis page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street; California 93301
Signature (that all violations have been corrected as noted)
Date
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance Pink — Prevention Services Copy FD2155 (Rev 6!/10)