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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
B E R 3 F 1 E_ D
FIRE
D ARTM rI
BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME QillcriO
IN TI N DATE INSPECTION TIME
ADDRESS srlda4 / ' 7/ 32 -
AO.
7
NO OF EMPLOYEES
FACILITY CONTACT
a-Id? F 11
BUSINESS ID NUMBER
Consent to Inspect Name/Title°
Section 1: Business Plan and Inventory Program
ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
Eh9 APPROPRIATE PERMIT ON HAND BMC: 15.65.080)
ff Business PLAN CONTACT INFORMATION ACCURATE CCR: 2729.1)
VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020)
CORRECT OCCUPANCY CBC: 401)
1 El L VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3)
E4,," VERIFICATION OF QUANTITIES CCR: 2729.4)
P
190'0' VERIFICATION OF LOCATION CCR: 2729.2)
PROPER SEGREGATION OF MATERIAL CFC: 2704.1)
LU' VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b))
dl0"" VERIFICATION OF HAZ MAT TRAINING CCR: 2732)
V VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c))
No-' El EMERGENCY PROCEDURES ADEQUATE CCR: 2731)
Cil," CONTAINERS PROPERLY LABELED (CCR: 66262.34(17, CFC: 2703.5)
HOUSEKEEPING CFC: 304.1)
C91"' FIRE PROTECTION CFC: 903 & 906)
A. v
LY' SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2)
ANY HAZARDOUS WASTE ON SITE? YES O Signature ofRecei
Explain:
POST INSPECTION INSTRUCTIONS:
6_11s 4
Correct the violation(s) noted above by
t vL
Within 5 days ofcorrecting all of the violati ns, sign anlf return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (th t all violations
eve /
been corrected as noted)
Date
Pink — Prevention Services Copy FD2155 (Rev 6//10)