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Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST A n R' D 900 IYuxtun Ave:, suite 210XFI;E Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program aRr , Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
pe,z 5 J?— 9 — /i G'LJ
ADDRESS PHONE NO. NO OF EMPLOYEES
b ko 4e TZ — 4
FACILITY CONTACT K BUSINESS ID NUMBER
r i s l 15 -021-
Section 1: Business Plan and Inventory Program
1, ROUTINE COMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
12 APPROPRIATE PERMIT ON HAND
0 Business PLAN CONTACT INFORMATION ACCURATE
P- VISIBLE ADDRESS
E
El CORRECT OCCUPANCY
El VERIFICATION OF INVENTORY MATERIALS
12" VERIFICATION OF QUANTITIES
C VERIFICATION OF LOCATION
El PROPER SEGREGATION OF MATERIAL
4' VERIFICATION OF MSDS AVAILABILITY
2 VERIFICATION OF HAZ MAT TRAINING
9 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
EMERGENCY PROCEDURES ADEQUATE
P
Ir
CONTAINERS PROPERLY LABELED
HOUSEKEEPING
P FIRE PROTECTION
i] SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? WASTE ON SITE? S 9 NONO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 s
3 It
Inspector (Please Print) Fire P vention / 1" In / Shift of Site /Station # "Business Sit6 Responsible Paity,( e`Business Si / Responsible a s
Whi — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05