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HomeMy WebLinkAboutINSPECTIONSUNIFIED PROGRAM INSPECTION CHECKLIST; .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services ~~~~ 900 Truxtun Ave., Suite 210 ~R>rr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE _ NSPECTION TIME z~ .a ~,u. ADDRESS HONE NO. O OF EMPLOYEES O D ~ ~o S' 3~ 3 3 r °~ FACILITY CONTACT USINESS ID NUMBER 15-021- 000 l a."~ 1< ~~ o ~ A Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION V-Violation COMMENTS INS ^ APPROPRIATE PERMIT ON HAND / 6~' . ^ BUSir1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ~'' t !,/ ~~~° ~j Aa ~fi ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ^ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINEHS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ~ NO ~~~~~ /_ .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 32t3-3979 L~ . ~~'~ 17iAr- e Inspector (Please Print) Fire Prevention / 1" In / Shift of SNe/Station / areas Site) ool She R y (Please Print) White -Prevention Sarviees Yetlow -Station Copy Pink -Business Copy FD2048 (Rw. 02/05) UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME / , Al INSPECTION DATE INSPECTION TIME ---------~-~-1'-C ~-R--~---------------- _..-------- - ---------- -- ------ --------- ~~~-~6~--- -- -~~3d~------- _. .4DDRESS ~ PHONE No. ~o. of Employees FACILITYCONTAC7 ~--- -----~---~-- -- --- ------ Business ID Number- -- -- c~Tu ot. 15-021- o~sld-? Section 1: Business Plan and Inventory Pn~gram Routine ^ Combined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection yC~ V lV=Vioaponnce~ OPERATION COMMENTS L_l ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY 1 -,,,J- - ~ -------------------- ----------.. _... __. U ^ VERIFICATION OF INVENTORY MATERIALS -J----------- - -------- ----------------------._ ...---~.---- _ ------- ------- --- -----..._..__.. _ - -_ _ _ _._._.. _ ..._ ..._. _._. D ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION .. _ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES ANO PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED © ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO EXPLAIN: n ~l QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66'I ~ 326-3979 ------~~.. ------__ _.~.~~y -------- ~e----- Inspector Badge No.; Business Site Responsible Party White -Environmental Services Vellow -Station Copy Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental .Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME L IN CA2~ -------------- INSPECTION DATE ~?~-I ~-~ INSPECTION TIME ~.~~-- ---- ADDRESS ~ 3 a o s-~ N ~ ~ ~ ~ ~ -- -- HO No. ~;J 93~ 33 No. of Employees _~y _ --- --- FACILITYCONTACT ~ Business ID Number 15-021- bOa~l ~ ~ r // 1N t C~ ,. Secfion 1: Business Plan.and Inventory Program ,Routine ^ Combined ~ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection ncel OPERATION C V p COMMENTS \V=Vioa on __ Crl' ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE L~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY '~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL IJ~ ^ VERIFICATION OF MSDS AVAILABILITYE ® ^ VERIFICATION OF HAT MAT TRAINING L`f ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - -------------- - --- -- ^ EMERGENCY PROCEDURES ADEQUATE ------- --------------------------------------- r --- - -- ---------- ---- CJ ^ CONTAINERS PROPERLY LABELED ---- ------------------ --------- -- ------------ ~^ HOUSEKEEPING ---- ---------------- --- - ^ FIRE PROTECTION - - ---------- ---------- ------------ ~^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: EXPLAIN: ^ YES l~'No QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979 -- ~ Inspector ~ --------------Badge No . White -Environmental Services Yellow -Station Copy ~ Business Site Responsible Party Pink -Business Copy ~ 3 UNIFIED PROGRAM INSPECTION CHECKLIST :~-. SECTION 1 Business Plan and Inventory Program C Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661)-326-3979 __ Section 1: Business Plan and Inventory Program ~outine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection r1 L J FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees FACILITYCONTACT Business 10 Number c L v ~ 15-021- ooa /a'7 ANY HAZARDOUS WASTE ON SITE?: OYES ^ NO EXPLA{N: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~66~~ 326-3979 ___L_-~~,,~.~~~s __~~.1va~--------1.~ ~~D _------------- ---- _- ----- Inspector (Please Print) Fire Prevention 1st-InlShifl of Site White -Environmental Services Yellow -Station Copy --~p,~L1.1t ulP~dc~-- B siness Site Response le Party (Please Print) rn g Pink • Business Copy Tom' CITY OF BAKERSFIELD FIRE DEPARTMENT b~ OFFICE OF ENVIRONIVIF.NTAL SERVICES ~p UNIFIED PROGRAM INSPECTION CHECKLIST ~ ~gtii~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME !~I ~G~.~ ADDRESS 3tx~ 577 N~ Q~Q • ~ a~ FACILITY CONTACT 1Mtt ~~-",~ S t r1.~r... t ~pw) INSPECTION TIME ~ O l~ e` +.i INSPECTION DATE N o~ S ~ ZOG z- PHONE NO. ,~- 3 3 -~ '~ 3 3 3 BUSINESS ID NO. 15-21 U- OD 127 Nt1MBER OF EMPLOYEES ( S Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Multt-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 Proper segregation of material 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 C=Compliance V=Violation Any hazardous waste on site?: Explain: Questions regarding this inspection`! Please call us at (661) 326-3979 [~ Yes 'No White -Env. Svcs. Yellow -Station Copy Pink -Business Copy Business Site Responsible Party Inspector: ~~ /~~i-~,~ 13f~ ~f ~~