HomeMy WebLinkAboutHMBP 2018QN,ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v ( C= Compliance) OPERATION COMMENTS
V= Violation
.. ❑ 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
9
❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
E ❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
CY ❑ HOUSEKEEPING
L9' ❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES X10
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Ins ector Please Print) a Prevention / 1St In / Shift of Site /Station # Business Site / Respo ible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM
INSPECTION CHECKLIST,,,.
900 TruXtun Ave. ; Suite 210
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Bakersfield, CA 93301
SECTION 1,:
Business Plan and Inventory Program
ARTM
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
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INSPECTION DATE
INSPECTION TIME
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ADDRESS
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FACILITY CONTACT
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BUSINESS ID NUMBER
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QN,ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v ( C= Compliance) OPERATION COMMENTS
V= Violation
.. ❑ 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
9
❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
E ❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
CY ❑ HOUSEKEEPING
L9' ❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES X10
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Ins ector Please Print) a Prevention / 1St In / Shift of Site /Station # Business Site / Respo ible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05