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~ F CI'T'Y OF BAKERSFIEI.D FIRE DEPAR"TMENT `'~'
OFFICE OF ENVIRUNhiF.NTAL SERVICES ~ ~11 ,
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r UNIFIED PROGRAM [NSPECTION CHECKLIST
:wF' ~~,~!' 1715 Chester Ave., 3'" floor, Bakersfield, CA 93301
FACILITY NAME ~I ~ ~_N•`~~,~ ~ ~.S
ADDRESS ~ L~ 3 `~ ~" S T
FACILITY CONTACT
INSPECTION TIME t S /h t ~/
INSPECTION DATE ~ ~ ~ ~
PHONE NO.
BUSINESS (D NO. (5-21 U- ~g 1
NLIMBER OF EMPLOYEES
Section l: Business Plan and Inventory Program
Routine ^ Combined ^ Joint Agency ^Muhi-Agency ^ Complaint ^ Re-inspection
OPERATION - ~ C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
'Verification of inventory materials
Verification of quantities
Verification of location ~ e~-
Proper segregation of material t . ` `
Verification of MSDS availability w„~~~~,J~y^~~~~-'~`" ~~~
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?: ^ Yes ^ No
Explain:
Questions regarding this inspection? Please call us.at (661) 326-3979
Whitr -Env. Svcs. Yellow • Station Copy Pink • Husiness Copy
Business Site Responsible Party
Inspector:
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