HomeMy WebLinkAboutBUSINESS PLAN 6/4/2013FACILITY NAME
INSPECTION DATE
INSPECTION TIME
d
n,ar.- 1.•
fig.-..
�. -_-- .- ' � i ..a_..W l� / ij+rr � S '
�
� �
� >M !
r R
tom•, «�.
�.._ . - .- ._.._._...�
ADDRESS
PHONE NO.
NO OF EMPLOYEES
_
E7 ❑ VISIBLE ADDRESS
FACILITY CONTACT
BUSINESS ID NUMBER
E .❑ CORRECT OCCUPANCY
15-021-
1b ��
' E VERIFICATION 'OF •INVENTORY MATERIALS
ROUTINE 0 COMBINED D JOINT AGENCY El MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V u= compliance) OPERATION
V= Violation
COMMENTS
Er APPROPRIATE PERMIT ON HAND
AE-' ❑ Business PLAN :CONTACT.INFORMATION ACCURATE
E7 ❑ VISIBLE ADDRESS
E .❑ CORRECT OCCUPANCY
' E VERIFICATION 'OF •INVENTORY MATERIALS
i
❑'. ❑ VERIFICATION OF QUANTITIES
y r
i
0T. ❑ VERIFICATION OF LOCATION
0 ❑ PROPER SEGREGATION OF MATERIAL .
ET ❑ VERIFICATI1ON OF MS— DS AVAILABILITY
❑ VERIFICATION OF HAZ MAT TRAINING
9C.�' ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
0 ❑ EMERGENCY PROCEDURES ADEQUATE
❑`'^ ❑ CONTAINERS PROPERLY LABELED
❑� ❑ HOUSEKEEPING
13f;,, ❑ FIRE PROTECTION
0'. ❑ SITE DIAGRAM ADEQUATE & ON�HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES Cr NO
EXPLAIN: _.
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 t
St sponsible arty (Pease Ir n
a Business. Site/ Re P I P'
.Inspector (Please Print) )"
� � Fire Prevention / 1 In /Shift of Site /Station
White - Prevention Services Yellow -Station .Copy Pink — Business Copy FD 2155 (Rev.
D9/05