HomeMy WebLinkAbout1121 COLUMBUS STREETUNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
A H R S F I D
FIRE
ARTM T
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPE TION DATE
INSPECTION TIME
❑ ❑ Business PLAN CONTACT INFORMATION ACCURATE
ADDRESS I `
Vv c) I u m a ks s r
HONE NO.
��.� _6117
O OF EMPLOYEES
2c�
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
/ c�c
❑ VERIFICATION OF LOCATION
Section 1: Business Plan and Rev Program
elg�ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v ( C= Compliance OPERATION
V= Violation
COMMENTS
❑ APPROPRIATE PERMIT ON HAND
❑ ❑ Business PLAN CONTACT INFORMATION ACCURATE
❑ VISIBLE ADDRESS
❑ CORRECT OCCUPANCY
❑ VERIFICATION OF INVENTORY MATERIALS
❑ VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
127 C3 PROPER SEGREGATION OF MATERIAL
/1)9
❑ 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
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES ENO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
57_
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station #
rl�
Kdr -WU
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST, B E R S F J D 900Truxtun Ave., Suite 210
FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program "R'"' ' Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPE TION DATE
INSPECTION TIME
\AT ERL-T If A0Z
S /U
i019
ADDRESS
1l2( w Cv1U�,13v�s sr
PHONE NO.
�2�- C�%i7
NO OF EMPLOYEES
2v
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
�� Y
❑ VERIFICATION OF LOCATION
}
Sect o�n "1: Business Plan and Inventory Program
ROUTINE El COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
,,EP ❑ APPROPRIATE PERMIT ON HAND
❑ ❑ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
❑ VISIBLE ADDRESS
"❑ CORRECT OCCUPANCY
❑ VERIFICATION OF INVENTORY MATERIALS
❑ VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
c/
ycf� ❑ PROPER SEGREGATION OF MATERIAL
/X
❑ VERIFICATION OF MSDS AVAILABILITY
❑ VERIFICATION OF HAZ MAT TRAINING
❑ ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
_I];, ❑ HOUSEKEEPING
,15D ❑ FIRE PROTECTION
❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES ENO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
C_ "��,�,.,�s.
Inspector (Please Print) Fire Prevention / 1" In / S ift of Site /Station #
\ l
White — Prevention Services Yellow - Station Copy . Pink — Business Copy FD 2155 (Rev. 09/05