HomeMy WebLinkAbout1124 DOBRUSKY LaneUNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
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Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
O
INSPECTION DATE
(p-�j- Z_ � 0
INSPECTION TIME
13c�o
ADDRESS
'� t Z� �►J oCi'z•�S KK � , �v4-�5r�tr � . �1' 330 �
PHONE NO.
�'Z Zoo o l z
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
I &mTF'_ �$' li or o• r a
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ROUTINE ■ COMBINED ■ JOINTAGENCY ■ ■ COMPLAINT ■ RE—INSPECTION
C
v
C= Compliance OPERATION
V= Violation
COMMENTS
❑
APPROPRIATE PERMIT.ON HAND
❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
14
❑
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
�I
❑
HOUSEKEEPING
❑
FIRE PROTECTION
❑
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES Pr NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECT ON? PLE- E CALL US AT (661) 326 -3979
Ca
Inspector (Please Print) F' v ion / In / Shift of Site /Station # B ess Site / Responsible Party (Please Print)
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White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05