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UNIFIED PROGRAM INSPECTION CHECKLIST; e E R s F. D 900 Truxtun Ave., Suite 210
- _ ------ _----- -_ - -_- - - - - - -_ __ FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ARrx T Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME ,
INSPECTION DAT
INSPECTION TIME
ADDRESS
E7/ / S O
NO OF EMPLOYEES
FACILITY CONTACT >
BUSINESS ID NUMBER
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C3 CORRECT OCCUPANCY
Section 1: "Business Plan and Inventory Program
I- ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
❑ APPROPRIATE PERMIT ON HAND
❑ Business PLAN CONTACT INFORMATION ACCURATE
❑ VISIBLE ADDRESS
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C3 CORRECT OCCUPANCY
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I10 ❑ VERIFICATION OF INVENTORY MATERIALS
Fier- ❑ VERIFICATION OF QUANTITIES
&1� ❑ VERIFICATION OF LOCATION
0- ❑ PROPER SEGREGATION OF MATERIAL
ET"" El VERIFICATION OF MSDS AVAILABILITY
❑ ✓❑ VERIFICATION OF HAZ MAT TRAINING
0' ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
l� ❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HA�ys O�US W,AA TE TE? DYES ❑ NO
EXPLAIN: 4r, ! r .YS$ ` 4UA-
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979.
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Inspe r (Please Print) Prevention / 1" In / Shift of Site /Station # siness Site / Responsible Party ( ase Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05