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FACILITY NAME
INSPECTION DATE INSPECTION TIME
ADDRESS
HONE NO. O OF EMPLOYEES
FACILITY CONTACT A.
USINESS 1D NUMBER
Consent to Inspect Narne/Title
Section 1. Business Plan and Inventory Program
E ROUTINE ❑ COMBINED
❑ JOINT AGENCY ❑ MULTI -AGENCY ❑ COMPLAINT ❑ RE -INSPECTION
C V = ornp lance OPERATION
V=Violation, 1.11 Minor
Violation COMMENT
ACTIVE. HAZARDOUS MATERIALS PERMIT
z. (BMC.15.65.080)
3010001
4- CEF b' I; FORMATION ENTERED & UPDATED ANNUALLY (CCR: 2729 1
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1010008
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VI ISLE ADDRESS (CFC-. 505;1, BMC. 15.52 020)
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CORRECT OCCUPANCY (CBC: 401)
1f VERIFICATION',OF INVENTORY MATERIALS (CCR: 272 ,3
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�%E#�IF ATION OF 6E7ANTlTIES
F (CCR; 2729.4)
1010006 N s
VERIF ATION OF LOCATION (CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL
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(CFC: 2704.1)
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VERIFICATION OF SDSAVAILABILITY (CCR: 3b 2729.2
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VERIFICATION OF HAZ MAT TRAINING (CCR: 2732)
1020002
VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES
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(CCR: 2731(0)I
EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
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Y C
1010010 1 }
CONTAINERS PROPERLY LABELED (CCR: 66262.34(#), CFC: 2703.5)
3030007
HOUSEKEEPING (CFC•. 304.1)
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FIRE PROTECTION (CFC 903 & 906)ot
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3030032 :.n
SITE. DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2)
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1010005
NY HAZARDOUS WASTE ON SITE? Q ES ❑ NO
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Explain:ot
Inspector:.
1110ST INS11ECTION INSTiti C'I'IQNS
* Correct the violations) noted above by �`�_ 2
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• Within 5 days of correcting 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)113
Date
White — Business Copy Yellow --- Station Copy Pink —.Prevention Services FD2155 (Rev 612021)