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5300 WIBLE ROAD_HMBP 3.8.11
UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B_ r R s P 1 . 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 f yo jC / INSPECTION DATE 'f `z"i rl 11 INSPECTION TIME ADDRESS PHe_ONE O. NO OF EMPLOYEES L.A Ja I C(' p — (BMC: 15.65.080) FACILITY CONTACT BUSINESS ID NUMBER C brzfa.[- 2' ciz Business PLAN CONTACT INFORMATION ACCURATE Consent to Inspect Name /Title Section 1: Business Plan and Inventory Program, 0 ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v ( C= Compliance OPERATION V= Violation COMMENTS ❑ ❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) N[• -J PQZM 1T W "t Lt_ j L ISSUE ❑ ❑ 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) (_AJ f StC �2 Of 1_ ❑ ❑ VERIFICATION OF QUANTITIES (CCR: 2729.4) �` 3 �� J tJ ❑ 11 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(17, 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? ,DYES ❑ NO Signature ofRecei 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 of this page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Signature (t�lI 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) UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B 1 _B R 5 F \ ) _I P_ 1 FIRE D ARTNE, BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME INS E Y20N PATE INSPECTION TIME H,, )U jDAi COMMENTS ❑ ADDRESS _ 5 OC) Li, f34. PHONE NO. - +'L?dU NO OF EMPLOYEES S� FACILITY CONTACT BUSINESS ID NUMBER LUR�� 21 Cam. Business PLAN CONTACT INFORMATION ACCURATE Consent to Inspect Name /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) NC_' -j ❑ ❑ 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) 7 � i� ❑ ❑ 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: POS "1' INSPECTION INSTRUCTIONS: • Correct the violation(s) noted above by • 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 White — Business Copy Yellow — Business Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) t..� Date Pink — Prevention Services Copy FD2155 (Rev 010)