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UNIFIED PROGRAM INSPECTION CHECKLIST JF R s F I D 900 Truxtun Ave., Suite 210
FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program aRr� Tel.: (661) 326 -3979
g Fax: (661) 872 -2171
FACILITY NAME INSPECTION DATE INSPECTION TIME
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
15 -021-
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
❑
v
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( C= Compliance OPERATION
l V= Violation
APPROPRIATE PERMIT ON HAND
COMMENT S
❑
❑
Business PLAN CONTACT INFORMATION ACCURATE
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❑
VISIBLE ADDRESS
❑
❑
CORRECT OCCUPANCY
❑
❑
VERIFICATION OF INVENTORY MATERIALS
❑
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VERIFICATION OF QUANTITIES
❑
❑
VERIFICATION OF LOCATION
❑
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PROPER SEGREGATION OF MATERIAL
❑
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VERIFICATION OF MSDS AVAILABILITY
❑
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VERIFICATION OF HAZ MAT TRAINING
❑
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
❑
EMERGENCY PROCEDURES ADEQUATE
❑
❑
❑
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CONTAINERS PROPERLY LABELED
HOUSEKEEPING
❑
❑
FIRE PROTECTION
❑
❑
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 15t 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