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UNIFIED PROGRAM INSPECTION CHECKLIST
-- SECTION 1: Business Plan and Inventory Program
^ YES ^ NO
FACILITY NAME ~ INSPECTIO INSPECTION TIME.
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ADDRESS (~ /~,/'~
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;)% HONE O OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
~~~~
15-021-
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Section 1: Business Plan and Inventory Program ~
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^ ROUTINE ^
COMBINED ^ JOINT AGENCY ^
MULTI-AGENCY --
^ COMPLAINT __
^ RE-INSPECTION
C . V (c=compliance OPERATION
V=Violation COMMENTS
^ ^ APPROPRIATE PERMIT ON HAND
^ ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE
^ ^ VISIBLE ADDRESS
^ ^ CORRECT OCCUPANCY
^ ^ VERIFICATION OF INVENTORY MATERIALS
^ ^ VERIFICATION OF QUANTITIES
^ ^ VERIFICATION OF LOCATION
^ ^ PROPER SEGREGATION OF MATERIAL
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^ ^ VERIFICATION OF MSDS AVAILABILITY ~ -~ ~ j ~-L3~\ ~/o '
^ ^ VERIFICATION OF HAZ MAT TRAINING
^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
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^ ^ EMERGENCY PROCEDURES ADEQUATE
^ ^ CONTAINERS PROPERLY LABELED
^ ^ HOUSEKEEPING
^ ^ FIRE PROTECTION
^ ^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
•
Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Business Site /Responsible Party (Please Print)
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. Prevention Services
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A F R s e , . „ 900 Truxturi-Ave., Suite 210
FARE Bakersfield, CA 93301
ARTM Tel.: - (661) 326-3979
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Fax: (661) 872-2171
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_White--Prevention Services Yellow -Station Copy Pink -Business Copy - - - FD 2155 (Rev. 09!05