HomeMy WebLinkAbout1141 COLUMBUSUNIFIED PROGRAM. INSPECTION CHECKLIST,
SECTION 1: Business Plan and Inventory Program
8 E 7! F I D
FIRE
D ARrN
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAM,
R1 L
INSPECTTIIOq� DATE
51/
INSPECTION TIME
1cs TT S l� S rl2 wT ..� ,"
i
/ S ' 0-L-) — (bp
ADDRESS
W Cv1 �tis
PHONE NO. q
327' / SZ
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
'
VISIBLE ADDRESS
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v
C= Compliance OPERATION
V= Violation
COMMENTS
?-d�z, �?
APPROPRIATE PERMIT ON HAND
/ S ' 0-L-) — (bp
1 3 S5
❑ ❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
❑
VERIFICATION OF INVENTORY MATERIALS
❑
VERIFICATION OF QUANTITIES
'�Q. ❑
VERIFICATION OF LOCATION
❑
PROPER SEGREGATION OF MATERIAL
❑
VERIFICATION OF MSDS AVAILABILITY
-ti ❑
VERIFICATION OF HAZ MAT TRAINING
\
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
-b ❑
EMERGENCY PROCEDURES ADEQUATE
trZ ❑
CONTAINERS PROPERLY LABELED
�8. ❑
HOUSEKEEPING
❑
FIRE PROTECTION
❑ ❑
SITE DIAGRAM ADEQUATE & ON HAND
net -oust
ANY HAZARDOUS WASTE ON SITE? ❑ YES _�&0
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1st In / Shift of Site /Station #
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
JLAR S F , „ 900 Truxtun Ave., Suite 210
FIRE Bakersfield, CA 93301
rM r Te l.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAM
R L T
C= Compliance OPERATION
V= Violation
COMMENTS
INSPEFTIO DATE
3/
INSPECTION TIME
1 1cE T"
5 re 3 w7 N 4
Business PLAN CONTACT INFORMATION ACCURATE
.5) v
❑
ADDRESS
I t�
0 6As
❑
PHONE NO.
3Zl) -9 Sz
NO OF EMPLOYEES
5
FACILITY CONTACT
VERIFICATION OF INVENTORY MATERIALS
L•J� 1 f
BUSINESS ID NUMBER
15 -021-
VERIFICATION OF QUANTITIES.
�Qo ❑
VERIFICATION OF LOCATION
T'
-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
V Q) 3 S5
❑ ❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
Ik�J ❑
VERIFICATION OF INVENTORY MATERIALS
L•J� 1 f
❑
VERIFICATION OF QUANTITIES.
�Qo ❑
VERIFICATION OF LOCATION
❑
PROPER SEGREGATION OF MATERIAL
'2' ❑
VERIFICATION OF MSDS AVAILABILITY
C9 ❑
VERIFICATION OF HAZ MAT TRAINING
-- 0-- •0-- VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
v.
!�+
❑
EMERGENCY PROCEDURES ADEQUATE
(r&b ❑
CONTAINERS PROPERLY LABELED
❑
HOUSEKEEPING
❑
FIRE PROTECTION
❑ ❑
SITE DIAGRAM ADEQUATE & ON HAND
rdaaduF]
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES kQfN0
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station #
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05