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UNIFIED PROGRAM INSPECTION CHECKLIST
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SECTION 1 Business .Plan and Inventory Program
Bakersfield Fire Dep~E~ ? ~ ~ -
Environmental Services ~~' ,
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Te_l: (661)_326-3979 __ __
FACILITI' "~ INSPECTION D/~ INSPECTION TIME
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ADDRESS PHONE No. o. of Employees .
FACILI NTAgT I _ t llusiness ID Number
~(~Sh uc. '-~ ub ~Jl~ 1 s-021- e3~o32
Section 1: Business Plan and Inventory Program
Routine ^ Combined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection
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C V OPERATION
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( COMMENTS
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^ APPROPRIATE PERMIT ON HAND
^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~~.~~ ~Q,S _~ b. l0-,~~r -'1"~Q-<re
^ VISIBLE ADDRESS
^ CORRECT QCCUPANCY
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VERIFICATION OF INVENTORY MATERIALS - _. -.
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^ VERIFICATION OF QUANTITIES
^ .VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL "
^ VERIFICATION OF MSDS AVAILABILITYE -
^ VERIFICATION OF HAT MAT TRAINING
~- ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES "
^
EMERGENCY PROCEDURES ADEQUATE _....___
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CONTAINERS PROPERLY LABELED
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^ HOUSEKEEPING
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FIRE PROTECTION __
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^ SITE DIAGRAM ADEQUATE S ON HAND
ANY HAZARDOUS WASTE ON SITE?: /~ES ~NO
EXPLAIN:
• QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~GC)') ~ 326-3979
Inspector (Please Print) ~ Fire Prevention 1st-In/Shik of Site
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Busirfess Site Re nsible Party (Please Print)
White -Environmental Services Velknv - Station Copy Pink - Business Copy
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x~'°~~ Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST e .4 F`R s >: , o .900TruxtunAve., Suite 2ro
F~ae Bakersfield, CA 93301
SECTION 1 : BUSI11@SS Plan and IIIV@tltOf')/ Program _ aer~ Tel.: (661) 326-3979
n ~, y~~ „/- Fax: (661) 872-2171
FACILITY NAME - ~ _
A-C" U !~/1-o U (' l i2-Dl~l INSPECTION DATE
12-iy-- 0 6 INSPECTION TIME
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ADDRESS
~Od (~IJtQ~ PHONE NO.
~Z3-Sa/s NO OF EMPLOYEES
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FACILITY CONTACT BUSINESS ID NUMBER
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Section 1'. Business Plan and Invehtory 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 ~ ~ 2006
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
i,~' ^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGAT{ON OF MATERIAL /(1
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^ VERIFICATION OF MSDS AVAILABILITY
^ ^ 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
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
~U~ N~,~ 2~ `~ 6 ~
Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station # usiness ite i Responsible Part Yeas Print)
^ YES ~ NO
White -Prevention Services - -.. Yellow -Station Copy Pink -Business Copy - ~ FD 2155 (Rev. 09/05