Loading...
HomeMy WebLinkAbout1218 STINE ROAD (2)Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST rh , 0 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program r Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO. NO OF EMPLOYEES APPROPRIATE PERMIT ON HAND ❑ FACILITY CONTACT BUSINESS ID NUMBER 15 -021- 5Qp L, ?j Secti'on'1: Business Plan and Lnven`to.ry, Program ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI- AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v c C= Compliance OPERATION V= Violation COMMENTS ❑ ❑ APPROPRIATE PERMIT ON HAND ❑ ❑ BUSItIeSS PLAN CONTACT INFORMATION ACCURATE ❑ ❑ VISIBLE ADDRESS ❑ ❑ 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 ❑ ❑ HOUSEKEEPING ❑ ❑ FIRE PROTECTION ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ❑ YES XN 0 EXPLAIN- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Business Site / Responsible Party (Please Print) 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 E_ �K E R_S F 1 E\1, D FIRE DfpARTM NT V� 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 PHONE NO. Fax: (661) 872 -2171 APPROPRIATE PERMIT ON HAND c FACILITY NAME Ake, 11 P INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO. NO OF EMPLOYEES APPROPRIATE PERMIT ON HAND ❑ FACILITY CONTACT BUSINESS ID NUMBER 15 -021- 5O0 L4 2) 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 ❑ ❑ Business PLAN CONTACT INFORMATION ACCURATE ❑ ❑ VISIBLE ADDRESS ❑ ❑ 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 ❑ ❑ HOUSEKEEPING ❑ ❑ FIRE PROTECTION ❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ❑ YES XNO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 r . Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # White — Prevention Services Yellow - Station Copy Business Site / Responsible Party (Please Print) Pink — Business Copy FD 2155 (Rev. 09/05