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BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM INSPECTION CHECKLIST H A K F R s F I E L D Prevention Services Division
_ _ _ 2101 H Street
����DEPARTNEmr Bakersfield, CA 93301
Phone: 661-326-3979
Fax: 661-852-2171
NOTICE OF VIOLATION / SUMMARY OF VIOLATIONS
CLASS Il AND CLASS I VIOLATIONS
Owner/Operator: „�A� His
Facility: _
Address:
SUMMARY OF VIOLATIONS
Item VIOLATION
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Notice Of Violation: Fass 11 and/or Class I Violations were found during this inspection as
noted in the following Summary of Violations.
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The violations indicated in this inspection report must be corrected within 30 days, unless
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otherwise noted.
Formal enforcement will be initiated for all Class I Violations, and for any Class II violations not
corrected within the required timeframe. This report does not represent that there are no other
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violations at this facility. A re -inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item VIOLATION
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REQUIREMENT FOR CORRECTION DATE FOR
OF VIOLATION CORRECTION
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Inspectors
Signature:
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Received by.
[Phone:
Print Name: U
Date:
Date: -71
White — Business Copy Yellow — Business Copy to be sent in after Return -to -Compliance Pink — Prevention Services Copy