HomeMy WebLinkAboutBUSINESS PLAN 7/16/2007.UNIFIED. PROGRAM INSPECTION CHECKLIST
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SECTION 1: Business Plan and Inventory Program
~" Prevention Services
B n r R s r ,- ~ „ 900 Truxtun Ave., Suite 210
FiaF' Bakersfield, CA 93301
/Iarui Tel.: (661) 326-3979
2171
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(661) 872
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FACILITY NAME ~ - INSPECTION DATE INSPECTION TIME
~ tiYC.o '~ ~ - SLR: A.~~ .?- /(o-d %~S'D
ADDRESS N NO.
PH
O O OF EMP OYEES
I~~~ ~~Q~ /
~
~) ~4~.7-C7~~
FACILITY CONTACT - ~
~ BUSINESS ID NUMBER
15-021-C~Da3~
'~ r""_ ~~Ai-// N 4 K,4
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
^ - BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS - }
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
C~ ^ VERIFICATION OF LOCATION-
^ PROPER SEGREGATION OF MATERIAL 9
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VJ ^ VERIFICATION OF MSDS AVAILABILITY ' ~ ~ ar x.. ~ ~ -
C,~ ^ 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? Id YES ^ NO
EXPLAIN: L.C~ ~-fJ ~ OJT
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 # Business Site /Responsible Party (Please Print)
White -Prevention Services Yellow -Station Copy Pink -Business Copy. FD 2155 (Rev- 09/05
MATE~,LS ~ ~kersfield Fire Dept.
Haz~i'rdous Materials Division
Date Completed
Business Name: *~t U~4~ ~ ~ ~
I
Business Iden~ca~on No. 215-000 ~ ~ 0.~ (Top of Business Plan)
Sta~on No. ~ 8hi~ ~ Inspe~or ~o ~
~al Time: 0~' Depa~re Time: 0 ?' ~ ' Inspe~on Time:
~~~ ~d~quate Inad~quat~
Vefifica~on of Oua~es ~ ~ ~OV T 5 ~994
Verification of Location ~ / ~ HAZ. MAT. DIV.
plo ee Proper Segrega~on of Material
Verification of MSDS Availabili~ ~
V~ri~ca~on of Ha2 ~at lrainin~ ~
V~fifica~on oI ~batem~nt 8uppli~ & ~rocedures ~
Comm~n~:
Contain~r~ ~ropo~ [abol~d ~
mmen~: Verification of Facil~ Diagram ~
Special. HazardsAssociated~isFacili~: ~ ~.~)~} ~0 ~,q~,
Viola~on~:
Business Owner/Manager FIRINT NAME SI Correction Needed
White-Haz Mat Div Yellow-Station Copy Pink-Business Copy