HomeMy WebLinkAboutHMBP INSP 2018Prevention Services
UNIFIES PROGR� M INSPECT[ON CHECKLIST n goo Truxtur><1 ve ,suite 210
ex «S <, k '� .,,.:.,�. ,.�:,.> :. , ,:„ a u:F „ ,::;.>..,. Mi ,s >.:;.::i v 4111 s . � , �� � F®RF Bakersfield, CA 93301SECTION 1: Business Plan and -Inventory Program ARr
Tel..: (66.1) 326 -3979
Fax: (661) 872 =2171
FACILITY NAME - K
INSPECTION DATE
*.
INSPECTION TIME
d 6A
C ❑ ' Business PLAN CONTACT INFORMATION'ACCURATE
ADDRESS f ;
PH °ONE NO. ,
NO OF EMPLO�;EES
FACILITY CONTACT +" ga
BUS N SSIDNUMBER
15 -021-
Y
❑�� ❑ :'VERIFICATION OF QUANTITIES
v
mr
nF..�::
>
„
�
,.,..,..�..�' .,. ,,..�..... f.i,. ,.,.
,.r2.�s;r. r,>,y3a ., �' x.:: ,,.„,:...:'xr:F!•z�. u.. '.z1 .�,. ,�. ,x,a x � ..,.,. :. .:� a:. „,n �. `S �<, .:,. .. t'.. . >.>c.. ,,.. .<i.k
�sqa -3 .. £- ,<,�.:A,y. S�Sx,,,�'s:,:',�4,.» ✓,�CiN. v% ,R,?,:e�'lR:iarsf'.`";,>^.t,”, ks.�;�t;;:nw�g2 .,.r,%,:.,, ,.> .. �;n..., x.y, s.,<.a ,,,,... >,,:s ,.".,n >. »:. :..� -...
� OUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION ka.
C V ( C= Compliance OPERATION
V= Violation
COMMENTS °
APPROPRIATE PERMIT ON HAND
C ❑ ' Business PLAN CONTACT INFORMATION'ACCURATE
I
VISIBLE ADDRESS
CORRECT OCCUPANCY
El/ ❑ ;' VERIFICATION OF INVENTORY MATERIALS
❑�� ❑ :'VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
'PROPER - SEGREGATION OF MATERIAL
❑1-`' El. VERIFICATION OF MSDS AVAILABILITY
' VERIFICATION OF HAZ MAT TRAINING
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
U/ ❑ _EMERGENCY PROCEDURES ADEQUATE r,
❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
t
❑ FIRE PROTECTION
-
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES 2A0
EXPLAIN: 4.0 v _
QUESTIONS REGARDINGTHIS INSPECTION? PLEASE CALLUS AT:(661)326 -3979
t spect r' (Please Print) 're Prevention,/ Is In / Shift of Site /Station # Business Site /Responsible Party Ewlease Print)
• °>
White — Prevention Services. Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
I 4