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7001 WHITE LANE STE 114_HMBP 5.26.11
UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program B �A-- G R S F I E L_D �( \ 1 FIRE D�.�ARTM T BAKERSFIELD FIRE DEPT. Prevention Services 2101 H Street Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 FACILITY NAME S c C= Compliance OPERATION INSPECTION DATE � INSPECTION TIME V= Violation 1;1�/❑ APPROPRIATE PERMIT ON HAND ADDRESS S! ❑ PHONE NO. NO OF EMPLOYEES 1 lei ti. 3 67 (61-94-?664- Z FACILITY CONTACT (CBC: 401) ' BUSINESS ID NUMBER VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) Consent to Inspect Na a /Title 0-"'0 VERIFICATION OF QUANTITIES (CCR: 2729.4) Section 1: Business Plan and Inventory Program ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ' ❑ COMPLAINT ❑ RE- INSPECTION C v c C= Compliance OPERATION COMMENTS V= Violation 1;1�/❑ APPROPRIATE PERMIT ON HAND (BMC: 15.65.080) S! ❑ Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) 0' ❑ VISIBLE ADDRESS (CFC: 505.1, BMC: 15.52.020) []" ❑ CORRECT OCCUPANCY (CBC: 401) ' 0/r❑ VERIFICATION OF INVENTORY MATERIALS (CCR: 2729.3) 0-"'0 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)) 0 1� VERIFICATION OF HAZ MAT TRAINING (CCR: 2732) ,Fel' E] VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) „Cl'❑ EMERGENCY PROCEDURES ADEQUATE (CCR: 2731) ©�❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34(f), CFC: 2703.5) ❑ HOUSEKEEPING (CFC: 304.1) FIRE PROTECTION (CFC: 903 & 906) !!! ❑ Q-- SITE DIAGRAM ADEQUATE & ON HAND y. (CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? ,2119ES ❑ NO Signature ofReceipt 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 While — Business Copy Yellow— Busi ps Copy to be Sent in alter return to Compliance Signature (that all violations have been corrected as noted) Date Pink — Prevention Services Copy FD2155 (Rev 010)