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HomeMy WebLinkAbout108 MADISON STREET (3)Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST e e R 3 F , . 0 900Truxtun Ave., Suite 210 FIRS I Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program oVARrm ,r Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME INSPEC ION DATE INSPECTION TIME BUSIneSS PLAN CONTACT INFORMATION ACCURATE S'" ;I7 s- ADDRESS PHONE Nb. I, W NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15 -021- Section 1: Business Plan and Inventory Program 53- ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS I- APPROPRIATE PERMIT ON HAND BUSIneSS PLAN CONTACT INFORMATION ACCURATE P- VISIBLE ADDRESS fY CORRECT OCCUPANCY P"' VERIFICATION OF INVENTORY MATERIALS El- VERIFICATION OF QUANTITIES l(Y VERIFICATION OF LOCATION IK PROPER SEGREGATION OF MATERIAL Q/ VERIFICATION OF MSDS AVAILABILITY I VERIFICATION OF HAZ MAT TRAINING Imo" VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE 4K CONTAINERS PROPERLY LABELED Q HOUSEKEEPING FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? YES 03 INC EXPLAIN QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 e L (Q, a, 14 41-2 -1 A LA_ le Ins? or (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Business Site 7 Responsible Party (Please Print) White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05