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UNIFIED PROGRAM INSPECTION CHECKLIST A A R s
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SECTION 1: Business Plan and Inventory Program ° aerM
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
COMMENTS
APPROPRIATE PERMIT ON HAND
ADDRESS HONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
15 -021-
Section 1: Business Plan and Inventory Program
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
CORRECT OCCUPANCY
VERIFICATION OF INVENTORY MATERIALS
VERIFICATION OF QUANTITIES
VERIFICATION OF LOCATION
PROPER SEGREGATION OF MATERIAL
VERIFICATION OF MSDS AVAILABILITY
VERIFICATION OF HAZ MAT TRAINING
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
EMERGENCY PROCEDURES ADEQUATE
CONTAINERS PROPERLY LABELED
HOUSEKEEPING
FIRE PROTECTION n
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? YES, NO
EXPLAIN: K Mhx 16ey. kv,,, g u\ ,+a_ 5 l- S a Q n
QUES ONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
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Inspector (Please Print) Fire Pre ention / f In / S ift of Site /Station # Business Site / esponslble Party (Please Print)
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WhiteWhite — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05