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Home My WebLink About104 CLYDE StreetJ UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services e 900'1Yuxtun Ave., Suite 210 - - -- -- — FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program "y T Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME (% INSPECTION DATE INSPECTION TIME W 1&;2010 �7 Ifit! Ott . L ADDRESS (t9T ^/ �� G!/ P$� / , 7,Z77e O OF EMPLOYEES Cs^� FACILITY CONTACT f; BUSINESS ID NUMBER 15 -021- ( I Se3ctlon1:$ Business Plana:and Inventory Program ❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v ( C= Compliance OPERATION V= Violation COMMENTS IA ❑ APPROPRIATE PERMIT ON HAND ❑ Business PLAN CONTACT INFORMATION ACCURATE I ❑ VISIBLE ADDRESS 4eA ❑ CORRECT OCCUPANCY ®I ❑ VERIFICATION OF INVENTORY MATERIALS IF ❑ VERIFICATION OF QUANTITIES QO ❑ VERIFICATION OF LOCATION gO ❑ PROPER SEGREGATION OF MATERIAL ❑ VERIFICATION OF MSDS AVAILABILITY Ig ❑ VERIFICATION OF HAZ MAT TRAINING ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ❑ EMERGENCY PROCEDURES ADEQUATE l ❑ CONTAINERS PROPERLY LABELED I ❑ HOUSEKEEPING 4" ❑ FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND Ktlr -ouij ANY HAZARDOUS WASTE ON SITE? ❑ YES 1�1 NO EXPLAIN: P QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 /E (.1a Inspect r (Please Print) )' Fire Prevention / 1" In / Shift of Site /Station # Business Site / Responsible Party (Please Print) -?C White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05 •• Prevention Services IFIED PROGRAM INSPECTION CHECKLIST, B /R__E_R s F 1 E�_D 900 Truxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ' "IT �' Tel.: (661) 326 -3979 L. 7 Fax: (661) 872 -2171 FACILITY NAME / INSPECTION DATE INSPECTION TIME / COMMENTS , / V cW % � §Le�I Lt S'. Q. ADDRESS e/ je ` j[_ Pg2 -7- 7Z�� OOFEM�OYEES tz�'° FACILITY CONTACT �j BUSINESS ID NUMBER I' >�' 0510- 15 -021- 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 1 ❑ Business PLAN CONTACT INFORMATION ACCURATE Ix ❑ VISIBLE ADDRESS Q ❑ CORRECT OCCUPANCY ❑ VERIFICATION OF INVENTORY MATERIALS C1I ❑ VERIFICATION OF QUANTITIES IF ❑ VERIFICATION OF LOCATION ` ❑ PROPER SEGREGATION OF MATERIAL ❑ VERIFICATION OF MSDS AVAILABILITY J C 1:1 VERIFICATION OF HAZ MAT TRAINING ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES IF ❑ EMERGENCY PROCEDURES ADEQUATE C ❑ CONTAINERS PROPERLY LABELED C ❑ HOUSEKEEPING l ❑ FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ❑ YES EXPLAIN: rtnr -ouia QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 11-1,01sl__t" 'A � el-I Inspector' (Please Print) s Fire Prevention / f In / Shift of Site /Station # Business Site / Responsible Party (Please Print) 1_?` White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09105