HomeMy WebLinkAboutBUSINESS PLAN(I ~
II KERN PULMONARY DIAGNOSTICS
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UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME ,` INSPECTION DATE INSPECTION TIME
ADDRESS \ ~ ~ U ONE No. No. of ~ ployees
------~°l ~ ~_-fit ~t _~~ ~!~_ ~--___(~.~ - -- ----------- 3~~ ~~S'~ _ _ _- - -- --- ----- -
FACILITYCONTACT Business ID Number
,~ r,~-_ 15.021-
Section 1: Business Plan and Inventory Program
Routine. ^ Combined O Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection
C V \V=Vioatonncel OPERATION
J COMMENTS
^
APPROPRIATE PERMIT ON HANG t
n
^
[ _ BUSINESS PLAN CONTACT INFORMATION ACCURATE
~ ^ VISIBLE ADDRESS
~7 ^
1------ - --- - ----- ------ ----
CORRECT OCCUPANCY ~
- -------------------------._.....---
---.._..------------__
~----------
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
,~ ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITYE
^ VERIFICATION OF FIAT MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~I ^
-1 -- - EMERGENCY PROCEDURES ADEQUATE
--- ------ -...~ -- ---- .. --- - --
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- ........ . .....- - - . _._ __
l~ ^ CONTAINERS PROPERLY LABELED
l~b ^ FIOUSEKEEPING
^ FIRE PROTECTION
'Q ^ SITE DIAGRAM ADEQUATE 8c ON HAND
ANY HAZARDOUS WASTE ON SITE: ^ YES C~ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~ 'I ~ 26-3979
Inspector Badge No.,
White -Environmental Services Yellow - Stettin Copy
__ ac~k~. _ ~_. _~_®_~ ~ ate.--
Business Site Responsible Party
Pink • Business Copy
+ KERN PULMONARY DIAGNOSTICS __________________________ SiteID: 015-021-000828 +
Manager
Location: 3941 SAN DIMAS ST 102
City BAKERSFIELD
BusPhone: (661) 323-4350
Map 103 CommHaz Extreme
Grid: 19B FacUnits: 1 AOV:
CommCode: BFD STA 04
EPA Numb:
SIC Code:8071
DunnBrad:77-005-5574
Emergency Contact / Title Emergency Contact / Title
MARK POLLARD / OWNER ELI / R
Business Phone: (661) 32.3-4350x Business Phone: (661) 323-4350x
24-Hour Phone (661) 5$7-7811x 24-Hour Phone (661) ~-~-~
P Phone (661) 3~ c Pager Phone ( ) - x
Hazmat Hazards: Fire Press ImmHlth
Contact Phone: (661) 323-4350x
MailAddr: 3941 SAN DIMAS ST 102 State: CA
City ~ BAKERSFIELD Zip 93301
Owner MARK L POLLARD Phone: (661) 323-4350x
Address 3941 SAN DIMAS ,ST 102 State: CA
City BAKERSFIELD Zip 93301
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of law that I have personally
examined and am familiar with the information
submitted and the information is true,
accu ate, a comple ,
3- 3~
Si na ure Date
ANT"a M~ ~ ~ ~ zees
-1- 03/03/2006