HomeMy WebLinkAbout11500 BRIMHALL ROADUNIFIED PROGRAM INSPECTION CHECKLISTji Prevention Services
a E R S F t o 900 Truxtun Ave., Suite .210
-- -- - -- FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program " f Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPE TION D TE
INSPECTION TIME
lr W-A --r � �.0 (C C-
16
ADDRESS
PHONk NO.
NO OF EMPLOYEES
so
❑ VERIFICATION OF INVENTORY MATERIALS
FACILITY CONTACT
USINESS ID NUMBER
Q-OS 1 G
15-021 -
Section `1: Business Plan and Inventory Program
P� ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v ( C= Compliance OPERATION
V= Violation
COMMENTS
❑ APPROPRIATE PERMIT ON HAND
❑ BUSII1eSS PLAN CONTACT INFORMATION ACCURATE
❑ VISIBLE ADDRESS
❑ CORRECT OCCUPANCY
❑ VERIFICATION OF INVENTORY MATERIALS
❑ VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
❑ PROPER SEGREGATION OF MATERIAL
I�❑ VERIFICATION OF MSDS AVAILABILITY
❑ VERIFICATION OF HAZ MAT TRAINING
(�(�
W -6 �""�
`v
El 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 1111z, NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
i
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bu ' ess Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST E E R S F t 900 Truxtun Ave., Suite 210
FiRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ARTM r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPE TION D TE
INSPECTION TIME
1. W +►T G.� SEQ..0 f G C
( I 0
11
ADDRESS
PHONL NO.
NO OF EMPLOYEES
)) Soo g 2 ,. M ?-� �.� !� XXI
❑ VERIFICATION OF INVENTORY MATERIALS
/—�
FACILITY CONTACT
BUSINESS ID NUMBER
❑ VERIFICATION OF LOCATION
15 -021-
C v c C= Compliance OPERATION
V= Violation
COMMENTS
Section :1:'- Business Plan and Inventory Program
n❑
EROUTINE
11
COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT
RE- INSPECTION
C v c 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
❑ PROPER SEGREGATION OF MATERIAL
6�..// VERIFICATION OF MSDS AVAILABILITY
G� ❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
r0l'� ❑ EMERGENCY PROCEDURES ADEQUATE
V ❑ CONTAINERS PROPERLY LABELED
1� ❑ HOUSEKEEPING
;`b ❑ FIRE PROTECTION
�` �❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES )4Z NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bu ' ess Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05