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Home My WebLink About141 BLISS StreetN.IFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services B r 1 0 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 r Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME A INSPECT ON ATE INSPECTION TIME ADDRESS iq I± PHONE NO. ?j-7 - 72-7e NO OF EMPLOYEES -t9- FACILITY CONTACT BUSINESS ID NUMBER SectionA. 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 I� ❑ VISIBLE ADDRESS$ '0A I lF ❑ CORRECT OCCUPANCY jot ❑ VERIFICATION OF INVENTORY MATERIALS �7 ❑ VERIFICATION OF QUANTITIES ❑ VERIFICATION OF LOCATION ❑ PROPER SEGREGATION OF MATERIAL p� [� ❑ VERIFICATION OF MSDS AVAILABILITY ❑ VERIFICATION OF HAZ MAT TRAINING L 1 ual, out& 11 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ❑ EMERGENCY PROCEDURES ADEQUATE 1. ❑ CONTAINERS PROPERLY LABELED JV ❑ HOUSEKEEPING I� ❑ FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND KBF -6013 ANY HAZARDOUS WASTE ON SITE? ❑ YES 1� NO EXPLAIN: QUESTIONS Ft� R� G THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 ZL f^. 6"6 Inspec r (Please Print) V Fire Prevention 11" In / Shift of Site /Station # Business Site / Responsible Party (Please Print) /0-?0 White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05 �ti r 11940IED PROGRAM INSPECTION CHECKLISTI"� SECTION 1: Business Plan and Inventory Program • Prevention Services A "7RTN 900 Truxtun Ave., Suite 210 I Bakersfield, CA 93301 : Tel.: (661) 326 -3979 Fax: 872 NO OF EMPLOYEES (661) -2171 FACILITY NAME //)) INSPECTION DATE INSPECTION TIME COMMENTS I ❑ ADDRESS l li ri S L • PHO E NO. �yv ? .3-7 -�� /O NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER - ❑ VISIBLE ADDRESS Section 1: Business Plan and Inventory Program ❑ ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v ( C= Compliance OPERATION V= Violation COMMENTS I ❑ APPROPRIATE PERMIT ON HAND ❑ Business PLAN CONTACT INFORMATION ACCURATE C� ❑ VISIBLE ADDRESS I lI ❑ CORRECT OCCUPANCY ❑ VERIFICATION OF INVENTORY MATERIALS 4 ❑ VERIFICATION OF QUANTITIES \ ❑ VERIFICATION OF LOCATION r F ❑ PROPER SEGREGATION OF MATERIAL P 7 � ❑ VERIFICATION OF MSDS AVAILABILITY I ❑ VERIFICATION OF HAZ MAT TRAINING /a ( 01 x , 4 ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ❑ EMERGENCY PROCEDURES ADEQUATE �J ❑ CONTAINERS PROPERLY LABELED ❑ HOUSEKEEPING ❑ FIRE PROTECTION 19 El SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ❑ YES [� NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 L �c t• S Inspector (Please Print) Fire Prevention / 1s` In / Shift of Site /Station # Business Site / Responsible Party (Please Print) m 10-?0 White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05