HomeMy WebLinkAbout2015 WESTWIND DRIVE #9Preventiom Services •
UNIFIED PROGRAM INSPECTIO.N! .CHECKLIST'% ~~ R~ p 900Truxtun~Ave.,,Suite 210~:
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SECTION 1: Business Plan and Inventory Program ~ ° aRrM Tel:: (661} 326-3979
- ~ ~. F~: (661)~`$72-2171
FACILITY NAME INSPEC ON ATE NSPECTION TIME
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ADDRESS
( ` PHONE NO. NO OF E LOYEES
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FACILITY CONTACT - ~ , BUSINESS ID NUMBER
15-021-
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^ ROUTINE
^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( c=comp~iance~ OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND ~ _
[~ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ~
^ VISIBLEADDRESS • ' •
^ CORRECT OCCUPANCY
^ VERIFICATION~OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES.
G~G, C'~ ~~} SMu~I O C G~f ~ Y
^ VERIFICATION OF,LOCATION
^ PROPER SEGREGATION"OF MATERIAL
I~ ^ VERIFICATION OF MSDS AVAILABILITY :
J~' ^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
L~J ^ EMERGENCY PROCEDURES ADEQUATE
1G ^ CONTAINERS PROPERLY LABELED
~ ^ HOUSEKEEPING
^ I~V FIRE PROTECTION ~ ~ .~ .
^ ^ SITE DIAGRAM ADEQUATE & ON HAND ~ ~ ~
ANY HAZARDOU.S WASTE ON SITE? ^ YES C~i1~lO
EXPLAIN:
~ " . ~
QUESTIO~S REGA~iDI~G THIS INSPECTION? P~ease en~~ us aT (661 ~ 326-3979
(Please Print) Fire Prevention / 1" In / Shift of Site/Station #
. White - Prevention Services
Busin s e/ Responsible Party (Ple rint
Yellow - Station Copy Pink - Business Copy
FD 2155 (Rev. 09/O5
__. P I . : . . ... _ _ . .
_ _ .. ~ . ~ ~ . . ~ . ~ ' . . " . .
~ ~ . ~ Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST°f.
V~, B•A F_ R_S ~, ,,: 900 'IYuxtun Ave:, Suite 210
---_ -, --- --- - - `-=--~~ F~aE. Bakersfield,. CA 93301
SECTION 1: . Business Plan and Inventory Program ~~ ;° ARrM Tel.: (661) 326-3979
. ~ ~ ~ Fax: {661) 872-2171
FACILITY NAME ' . ; . INSPEC •ION ATE, ,, INSPECTION TIME.
ADDRESS HON NO. NO OF EMPLOYEES
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. ( ~ ` O ~~ - . . .
FACILITY CONTACT - ~
`~ BUSINESS ID NUMBER
;,. _ 15-021=
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~. Section`1 ~Business Pian~and`In~entory Programµ~~ ~~~g ~~~~ .'' ~="°
^ ROUTINE ; ~'OMBINED`•>~ ^ .JOINTAGENCY ^ MULTI-AGENCY . ^ .COMPLAINT, ^ RE-INSPECTION
s~ - _ .. _.. _ - . .
C V ( c=comP~iance~ OPERATION ` -
V=Violation : ~ . . COMMENTS
^ APPROPRIATE PERMIT ON HAND .
Q~^ BUSIfI@SS PLAN CONTACT INFORMATION AGCURATE ' .
8 o VISIBLE ADDRESS
.,
~~^ CORRECT OCCUPANCY . ,
y~ ^ VERIFICATION OF INVENTORY MATERIALS .
, ' ,
r -" ^ VERIFICATION OF QUANTITIES "
_ ~
~
~^ VERIFICATION OF LOCATION .
~ ^ PROPER SEGREGATION OF MATERIAL
~ ^ VERIFICATION OF MSDS AVAILABILITY ~ ,
,~Y^ VERIFICATION OF HAZ MAT TRAINING _
^• VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES .. ~
ld ^ EMERGENCY PROCEDURES ADEQUATE .
~''~ ^ CONTAINERS PROPERLY LABELED ~ .
~ ^ HOUSEKEEPING
^ Lv FIRE PROTECTION
~ .
^,. ^ SITE DIAGRAM ADEQUATE 8 ON HAND _ ~
ANY HAZARDOUS WASTE ON SITE? ^ YES ~NO
EXPLAIN:
QUESTIO S REGAr DI G THIS INSPECTION? e~ease cnt~ us nT (661) 326-3979 ~ •. ' ~
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nspector (Please ~in ) . ' irc~~revention /'1" In / Shift of Site/Station #. ' Busine"s ~S' e / Responsible.Party. (Pleas ~Pri~ ~ ~.
White - Prevention Services Yellow = Station Copy '- , Pink - Business Copy FD 2.155 (Rev. 09/O5
C~-c~. Fv~rt. C'~Z ? 2~ c. F
SELF-CERTIFICATION CHECKLIST
Fire Prevention
~
H g H R S P 1 S D
FIRd
D - ARTM T
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BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave Suite 401
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
FACILITY NAME: ! i D ~~ ELF-CERTIFICATION DATE:
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ADDRESS: (C m lete Address with City, tete and ' ' Zip Code) j
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' HONE N MBER:
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FACILITY CONTACT: AX NUMBER:
~~I• 3~ ~ 0~~8
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DO NOT DISCARD - FAILURE TO~RETURN~WILL, RESULT"IN FIRE- DEPARTMENT 1NSPECTtON =
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INSTRUCTIONS: Please verify and check each item as appropriate. Include comments on each line or at the botrom as necessary.
hen completed, make a second copy for your records and mail the original to the address above. Failure to return will result in inspecdon.
Y N OPERATION COMMENTS
^^ Spent fluorescent tubes saved in a suitable container and recycling' ame:
~
(If you rely on an outside agency for the recycling, please indicate the name, address, and phone nu ba~ of tha
agency ihat removes your tubes.) f,,~ ~ ~~ ~~~ ~~~Z ~~ vt c~.~..~ F~
..,x~ rl.2-.- ~. ~. ~,~~ ~ 3a ~
Phone No.:
l i 5 S 14 (~os ~}- 0~~1~~a (:pr ~/ ~ ddress:
^ Waste batteries saved in suitable container for recycling*
^ Discarded electronic devices saved for recycling'
^^ Discarded items containing Mercury saved for recycling" -p
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^^ Discarded non-empty aerosol spray cans saved for recycling" ~
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..._....._ .
^ Current annually serviced "ABC Type" fire extinguisher every 75 feet of travel
^ Extension cords not used in place of what should be permanent wiring
^ All exits indicated by exit signs, not more than 100 feet apart, if occupant load
is 100 or more
^ Minimum of 30 inches of clearance in front of electrical panels
^ Cover plates installed on all electrical outlets, switches, and junction boxes (no
exposed wiring)
^ Flammable and combustible material stored properly and not adjacent to a
source of ignition (check hot water heater and furnace area)
Do you use or store any hazardous materials on site?
q^ Does your building have a~ monitored fire alarm system?
^ Does your building have a fire suppression (sprinkler) system?
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COMMENTS:
~QUESTIONS.REGARDING THIS CHECKLIST? PLEASE CALL US AT (661) 326-3979
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Signature , Business Site / Responsible Party (Pleas rint)
\ ~~~~~D 2155b (Rev. 09/06)
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