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HomeMy WebLinkAboutBUSINESS PLAN NO. ~-' ~ ~/~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ,~'-~'~-q -04 NEW ACCOUNT ADDRESS CHANGE[ CLOSE ACCT FINANCE CHARGE OTHER ADJ CUSTOMER NAME MAILING ADDRESS I~~ ,..'~'~ .~"~-- CI~ ~~~%¢~ ~ STATE ~ ZIP CODE ~~/ SITE ADDRESS PARCEL NUMBER (IF APPLICABLE) ADJUSTMENT CHG DATE CHARGE CODE Ai~IUSTMENT AMOUNT REMARKS: APPROVED BY r,_..~~, /~,~ -1~ ~ ~ B~e~field F~e Dept. ~~H~KLIST ~ En~onment~ Se~ices 1715 Chester Ave SECTION 1 Business Plan and Invento~ Program Bakersfield, CA 93301 ~ Tel: (661)326-3979 FACILITY NAME ~ INSPECTION DATE ] INSPECTION TIME Soction ~: 8uainaaa Plan and Invan~ Pr~mm  outino ~ Combin~ ~ Joint AgenCy ~ Multi-Agency ~ Complaint ~ Ro-inspection C V [ C=Compliance ) OPE~TION COMMENTS ~ V=Violation ~ ~ BUSINESS P~N CONTACT INFORMATION ACCU~TE ADDRESS A VISIBLE ~ ~ VERIFICATION OF INVENTORY MATERIALS ~ ~ VERIFICATION OF OUANTITIES ~ ~ VER~FICATION OF LOCATION ................................................................................................................................................................... P~oP~R SEGREGATION O~ ~A~ERIAL . ' ~ . / ~ ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~* EMERGENCY PROCEDURES ADEQUATE ~ ~ CONTAINERS PROPERLY ~BELED ~ ~ HOUSEKEEPING ..................................................................... ~ ....................................................................................... ~ D F~E P~O~ECm,O. ~ ~ S~TE D~G~U AD~eU~TE & O~ H~ND ANY HAZARDOUS WASTE ON SITE?; /~YEs ~1 No EXPLAIN: 5~---~'~k ~ '~ t .~C,~.../'~ ~.O ~.(..~/o,~.~ ~---~ ~Zt~%, ~_.~?_//~J/~ ~_.(~ ~f~/ ~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ........ ............................. _ ....... / Inspector Badge No,, Business Site Responsible Parly White - Environmental Services Yellow - S~ation Copy Pink. Business Copy