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UNIFIED PROGRAM INSPECTION CHECKLIST'' H E R s F. 0 900TruxtunAve., Suite2lo
_ _ _ ____ -
~°-~--~-------~ FiRe Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ~ ARTM r Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME
~~-~~.~ ~,~~~~. INSPECTION DAT
tZr, l INSPECTION TIME
ADDRESS - ~ -
(~ I, 2~--~- s~ ~ ~ I PHON NO.
-~~~0 NO OF EMPLOYEES
FACILITY CONTACT
,
~ (~ C~/ BUS ES ID NUMBER
15-021- ;~
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Q, OX
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D~~_ Sec#ion 4: Business Ilan and Inventory Program
ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTI N
C V ( C=Compliance OPERATION
V=Violation COMMENTS
^ ^ APPROPRIATE PERMIT ON HAND
^ ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE DEC 1 ~ X006
^ ^ VISIBLE ADDRESS
^ ^ CORRECT OCCUPANCY
^ ^ VERIFICATION OF INVENTORY MATERIALS l~~ U~ ~~~. ~ ~`~
^ ^ VERIFICATION OF QUANTITIES
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^ ^ VERIFICATION OF LOCATION ' ,JS~i~~ S~~~ ~~ t~S~C ~~,K
^ ^ PROPER SEGREGATION OF MATERIAL
^ ^ VERIFICATION OF MSDS AVAILABILITY
^ ^ VERIFICATION OF HAZ MAT TRAINING
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^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Q ~
U J
^ ^ EMERGENCY PROCEDURES ADEQUATE ~
^ ^ CONTAINERS PROPERLY LABELED
^ ^ HOUSEKEEPING
^ ^ FIRE PROTECTION
^ ^ SITE DIAGRAM ADEQUATE & ON HAND
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ANY HAZARDOUS WASTE ON SITE? ~ES ^ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # sin ite / esponsi P e Prl
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05