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~ POOL SWEEP SHOP 3701 COLUMBUS STREET UNIFIED PROGRAM INSPECTION CHECKLIST ~ Prevention Services A F R S F, D 9001Yuxtun Ave., Suite 210 _.:..~ FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program '°R'"' Tel.: (661) 3zs-3979 Fax: (661) 872-2171 • i~ FACILITY NAME INSPECTIO DA TE INSPECTION T 1ME T V / 1 i V ADDRESS PHONE NO. NO OF EMPLOYEES a ~ v C7 FACILITY CONTACT ~ BUSINESS ID NUMBER ~ ._ 15-021- J163~" Section 1: Business Plan and Inventory Program. ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSItIeSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES Cd^ ^ VERIFICATION OF LOCATION a ^ PROPER SEGREGATION OF MATERIAL CT ^ VERIFICATION OF MSDS AVAILABILITY ` 1 ^ VERIFICATION OF HAZ MAT TRAINING '' l J ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES id ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ' he Origih ^ HOUSEKEEPING t a) v Yourr Back ~ lard run Store ^ FIRE PROTECTION ~ ~ Complete Service d~ Repair for Your Pool or Spa ~ ^ SITE DIAGRAM ADEQUATE & ON HAND e DI Sweep Shopp 3701 Columbus St. O...J D_ Q.... @..r.-IC~~ Gn4n.efinl'1 re o~~nc ANY HAZARDOUS WASTE ON SITE? EXPLAIN: - --• -- -r-- ---rr...-., --- Davld Monslbala Phone: 661-871-1300 Owner Fax: 661-871-1446 www.poolsweepshop.com Email: Poolshoppe®aol.com QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 - Inspector (_ ease Print) Fire Prevention / 1" In /Shift of Site/Station # Business Site /Responsible Party (Please Print) ^ YES ~NO White -Prevention Services Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev.-09/05 ..z UNIFIED PROGRAM INSPECTION CHECKLIST :>. ~ ~ ~~, SECTION 1 Business ,Plan and Inventory Program Bakersfield Fire De tj~ , P Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: X661) 326-3979 FACILITY NAME WSPECT N DATE INSPECTION TIME PHONE No No of Em l ADDRESS ~ . . p oyees ~~v ~ c~.~~s _ FACILITYCONTACT _ __ _ Business ID Number 15-02 /'~/~l . Section 1: Business Plan and Inventory Program 3 ©3 'Z ~eutine ^ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-in do C V ~ V=vio atonn~~ OPERATION ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS- PROPERLY LABELED COMMENTS ^ ^ I"IOUSEKEEPING ^ FIRE PROTECTION ~ P[.~~~ ~~'/,1r, ~ Z /t t i0 (~ =C , ~T^~iSft~~_ ^ ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ~VO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIOtV~ PLEASE CALL US AT (661 ~ 326-3979 ~„~ ~ ^'~`s p13 Ins ctor Please Print Fire Prevention 1st-In/Shift of Site a Business Site Responsible Party (Pie Print) White • Environmental Services Yellow -Station Copy Pink -Business Copy o~ B