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hmbp 2019 4001 AUBURN ST
FACILITY 'NAME ZA A / INSPECTIO DATE I INSPECTION TIME ADDRESS --- PHON�E'NO. �/r� ", ! NO OF EMPLOYEES d GAG ,r / FACILITY CONTACT BUSINESS'ID NUMBER ..5..,,.... � .,..,,, z .., ,...... < . ,,..., m. ... »-. .. . � � ...»+ _ .n. a,. k., ,. .�-- �..,..~x �..,_ r ...._M. _ wu, _ x. . ,: -: -.sa.. , k•... s,. ,3:�, 4. z ,s�,✓" &.. '... ,. ;., „, i..r?a1” .,,, ... » ,. ... ,. .. ., .n f .�.,.n g xtv ............ ..4. ,..,.1. :. -:�` y m,:.1 „a.. , 4 , S .r,,.,»�, � r ..r,..v.� � '^€. xg,< - rt .�,�. ...., �,.» z✓ a o a.�:a »a,c� .< r, ?� . „e,.,.,� , � 'zP „oaf, ,a .:. Vii"•. 3 T'E ,, ,:.,.,... .e,ti., r.. :..n. �, :.... :.. ... . , , ^c L. nS�aC' }n � ... � ., .......... � 'mss �.. fi :... _ .b4i .. .a. r. "t .:. r,- •i r*. � .a., , a 4 ""z f .t • 5 ' .:,.. ,. Y W r ....3 a :•:.n.,'h�,..r .......... .......::.�.., .fi rm..... :,. x., �-:� „._..,_» .a: ,,.:,.,, ,,, ... „,z.;.� a.< , .. zc .�•..,af-..,. a.... b,. ,�s,...,xi�xa�r"�3..:.,,�.: .,�. .Y:r. �'..,ra,k3. . �s�, ,.'F,. ...2�. » >�'» ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ 'COMPLAINT ❑' RE- INSPECTION C- Compliance V ( ) OPERATION COMMENTS V =Violation ©': ❑ APPROPRIATE PERMIT ON HAND ❑/'� ❑ BUSIC1eSS PLAN CONTACT INFORMATION ACCURATE ❑t ❑ VISIBLE ADDRESS ❑D ❑ CORRECT OCCUPANCY L�J ❑ VERIFICATION OF INVENTORY MATERIALS El ❑ VERIFICATION' OF QUANTITIES ❑ ❑ VERIFICATION OF LOCATION ' [D/' ❑ PROPER SEGREGATION OF MATERIAL CY' ❑ VERIFICATION OF MSDS AVAILABILITY 13” ❑ VERIFICATION OF HAZ MAT TRAINING fA , ® ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES f ❑ EMERGENCY'PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED ®� `❑ HOUSEKEEPING i ❑ ❑ FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND KBF-6013' ANY HAZARDOUS WASTE ON SITE? '2"YES ❑ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326- 3979 Inspector (Please Print) Fire Prevention / 1s' In / Shift of Site /Station # 5 Business Site / Responsible Party (Please Print) µ. White Prevention Services Yellow- Station Copy--,,-, Pink — Business Copy FD 2155 (Rev. 09/05 t