HomeMy WebLinkAboutBUSINESS PLAN INSPECTION/~
UNLFfED PROGRAM INSPECTION .CHECKLIST
SECTION 1: Business Plan and Inventory Program
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~~* Prevention Services
B A e R s F _, n 900 Truxtun Ave., Suite 210
P~dr<E Bakersfield, CA 93301
aRrdN Tel.: (661) 326-3979 .
Fax: (661) 872-2171
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FACILITY NAME INSPECTION DATE INSPECTION TIME
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Section 1: Business Plan and Inventory Program
^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance- OPERATION
V=Violation COMMENTS
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^ APPROPRIATE PERMIT ON HAND
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L~1 ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE
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^ CORRECT OCCUPANCY
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L`J ^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
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LET ^ VERIFICATION OF LOCATION
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^ PROPER SEGREGATION OF MATERIAL `
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L~' ^ VERIFICATION OF MSDS AVAILABILITY y
L,d ^ VERIFICATION OF HAZ-MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
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iCa' ^ 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
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Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Bu Hess Site / Responsi e ( lease Prin
^ YES ^ NO
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INSPECTION RECORD
ENT'D JAN ~.1
Bakersfield Fire Dept.
1715 Chester Ave.
Bakersf field, CA 93301
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DATE: FACILITY ADDRESS: ~ ZIP: FE
FACILITY NAME: ~/'~ ~ ~ ~ ~"
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MANAGER NAME: 0. ~ P L... ~ ~ (' ~S (
BUSINESS OWNER NAME, ADDRESS, ZIP CODE FACILITY PHONE . ~~--,'G.~i
BILL TO: (IF DIFFERENT FROM ABOVE}--NAME, ADDRESS, ZIP CODE, PHONE No.
OCC TYPE OCC LOAD
/~c~" No. OF FLOORS
~ HI RISE BLDG.
YES O NO RISER DATE
VIOLATION NOTICE CORRECTION:
1. DATEbFREINSPECTION
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FD1952
Bakersfield Fire Dept.
UNIFIED PROGRAM INSPECTION CHECKLIST -~ Enironmental Services
_- . ;, -: ~~ 1715 Chester Ave
SECTION 1 Business P{an and {nventory Program Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME INSPECTION DATE INSPECTION TIME
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ADDRESS PHO E N No. of Employees
FACILITYCONTACT ENT°D JAN 12 Business ID NumGer
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Section 1: Business Plan ar-d Inventory Program
Routine ^ Combined ^ Joint Agency ^MuIti-Agency ^ Complaint ^ Re-inspection
~% ~ \V=Voatlonnce~ OPEFYATION COMMENTS
I~ ^ APPROPRIATE PERMIT ON HAND
I~1 ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
is ^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ ~ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
C~ ^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITYE
^ VERIFICATION OF HAT MAT TRAINING
~J ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
C~I ^ EMERGENCY PROCEDURES ADEQUATE
Ip ^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
r~ ^ FIRE PROTECTION ~
C~ ^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (66 ~~ 326-3979
~~
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Inspector (Please Print) Fire Prevention 1st-InlShift of Site
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UNI lED PR~GRAM IN'PECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
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Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield. CA 93301
Tel: (661)326-3979
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\(90 _ \6)\Øe.-~ _ ~º________
FACILlTYCONTACT
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Business ID Number
15-021- 00 13 Ö 7
" Se.ction1 : Bùsi'1ess Plan and InvêritòryProgram
~ Routine,
D Combined
D Joint Agency
D Multi-Agency
D Complaint
D Re-inspection
C V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
121 D ApPROPRIATE PERMIT ON HAND
----~~----~--------------------_._----- .__._-----~-,_._-----~---_._-------------_._._-_._.__.-------..-----------.-----.
3' D BUSINESS PLAN CONTACT INFORMATION ACCURATE .,. £. 2(1)3
, , ----..--------------,-,-,- -'------,--------- ,OC-l..---,----,-,,-------------------______,__,..,________,___________,
121 D VISIBLE ADDRESS
. --------------.-----------------. --. - -...---------'---------.-----_____.___.___.._~._.______n. ____________ _..______ ____.
D CORRECT OCCUPANCY
-------.-------------------.------- -----.-------.---.-----.-...--.------.--.---------.-.----------------.---.- ---_._-_._----~---_...-
r; D VERIFICATION OF INVENTORY MATERIALS
.-------------.----.-. --- -.-------..-.------.-----------.------.---..----..---------~-.. -- .-..-. - -.------.--
ø 0 VERIFICATION OF QUANTITIES
~--~---_._---------------------_._---_._------- -----------------.----.------------------.------..-.-----.--.--------....-.-.-------
I2J D VERIFICATION OF LOCATION
--~-----------_._-- -----------_._----_.._.._----~--~-_._----_._._------_.----.--.-.-
ø D PROPER SEGREGATION OF MATERIAL
-----------------.-----. ---------.---..----------- --..--.-----.------.-----. ------------------..--.-.---
I1f 0 VERIFICATION OF MSDS AVAILABILlTYE
---- ---------------....-.---....-- -----.-.----------.-----..---.--------------..-------.-----.-------
?J D VERIFICATION OF HAT MAT TRAINING
--.------------.----....---.-
---------------_._-----_._~.~_._-----_._-_..__._----- ..-.- ------.----.---.-----.
IZI D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
-------.-.----------- ------.--.----.--...-.------.-.-------------..----.---------.---------.--
: ~.. ::::::~~ :~:~~E:::UATE ~~==--=~t==~--=~====-=-==-==~=
~~__ HOUSEKEEPING____________t=_________________.._____·__--------,-----------,
ø D FIRE PROTECTION
-~--_._._---_.._---_._--_..- ------------.----..--------.----.-----------.----------._~..--------_.-
!if D SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
DYES
9' No
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:5;,
~C V
v
EXPLAIN:
White - Environmental Services
Yellow - Station Copy
Pink· Business Copy
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irty`• •~~ CITY OF BAKERSFIEI.D F1RE DEPARTMENT
~ ~ OFFICE OF ENVIRONMENTAL SERVICES
~ ~~ UNIFIED PROGRAM INSPECTION C.HECKI.IST
4
~w„~' ;~~~_ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
OCj 2 4 2003
FACILITY NAME ~ r~ ~ tJ~C. ~ ~~ INSPECTION DATE ~b -' 2L ' a3 _
ADDRESS ! ~ D~ T u PHONE NO. ~S~2 - ?3`~/
FACILITY CONTACT -~~ ~ '- BUSINESS ID NO. 15-210- o ~ ~-0Z / - ~°~ 3D j'
INSPECTION TIME___ NCIMBER OF EMPLOYEES _
Section 1: Business Plan and Inventory Program
[~ Routine ^ Combined ^ Joint Agency ^MuIti-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 ~ ~AJ l~
Proper segregation of material f
Verification of MSDS availability Gti.. i_ ~/~
Verification of Naz Mat training ~ /3 a 9
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 to (66l) 326-3979
White -Env. Svcs. Yellow • Station Copy Pink • Business Copy
.>~.~ .. a Q,,~-
Business Si Re onsible Pa
Inspector:
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