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Home My WebLink About1800 height hmbp 4.6.20Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST H E R S F, 0 900 Truxtun Ave., Suite 210 FARE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ""'"' r Tel.: (661) 326 -3979 Fes: (661) 872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO, NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15 -021- ANY HAZARDOUS WASTE ON SITE? ❑ YES ENO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 01,4 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site Station # Business Site / Responsible Party (Please Print) White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05 Section 1: Business Plan and Inventory Program I<ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C V r C= Compliance OPERATION l V= Violation COMMENT S I ❑ APPROPRIATE PERMIT ON HAND L� ❑ Business PLAN CONTACT INFORMATION ACCURATE ❑ VISIBLE ADDRESS E3 ❑ CORRECT OCCUPANCY ❑ VERIFICATION OF INVENTORY MATERIALS VeA E� � G It M/ ❑ VERIFICATION OF QUANTITIES El/ ❑ VERIFICATION OF LOCATION ❑ PROPER SEGREGATION OF MATERIAL ❑ VERIFICATION OF MSDS AVAILABILITY ❑ VERIFICATION OF HAZ MAT TRAINING D ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES C ❑ EMERGENCY PROCEDURES ADEQUATE 9 ❑ CONTAINERS PROPERLY LABELED r ❑ HOUSEKEEPING - a El ❑ - FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ❑ YES ENO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 01,4 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site Station # Business Site / Responsible Party (Please Print) White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05