HomeMy WebLinkAbout2191 mt vernon hmbp 6.4.20Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST. A E R S F, � 900 TruxtunAve., suite 210
FARE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program "'�r"' t Tel.: (661) 326 -3979
Fes: (661) 872 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
30
ADDRESS P&NEN6.1 NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
15 -021-
ANY HAZARDOUS WASTE ON SITE? ❑ YES 4R..NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspe or (Please Kint) Fire Prevention / 1St In / Shift of Site/ tati n #
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
&3-...R,O U T I N E ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
V
C= Compliance
r OPERATION
l
COMMENTS
V= Violation
U(
❑
APPROPRIATE PERMIT ON HAND
ET
❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
❑
VERIFICATION OF INVENTORY MATERIALS
1!r
❑
VERIFICATION OF QUANTITIES
❑
VERIFICATION OF LOCATION
❑
PROPER SEGREGATION OF MATERIAL
99"'
❑
VERIFICATION OF MSDS AVAILABILITY
0/
❑
VERIFICATION OF HAZ MAT TRAINING
1Y
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
L�1
❑
EMERGENCY PROCEDURES ADEQUATE
C
❑
CONTAINERS PROPERLY LABELED
[V
❑
HOUSEKEEPING
Ind`
❑
FIRE PROTECTION
❑
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES 4R..NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspe or (Please Kint) Fire Prevention / 1St In / Shift of Site/ tati n #
Business Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05