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UNIFIED PROGRAM INSPECTION CHECKLIST >3 ERs F 1 D 900Truxtun Ave., Suite 210
- - - -- - -- — - �— — FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ARTH T Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY AME
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INSPECTION DATE
A—.23-1c)
INSPECTION TIME
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ADDRE S �(�
H NE NO. �n
O 0,� 1PLOYEES
Sr
❑
FACILITY CONTACT
3USINESS ID NUMBER
D -&
15- 021 -G�a
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Section 1:''Business Plan and InventdNy Piogram'
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
Sd
❑
VISIBLE ADDRESS
❑
CORRECT OCCUPANCY
❑
VERIFICATION OF INVENTORY MATERIALS
❑
VERIFICATION OF QUANTITIES
,C}
v1&4
❑
VERIFICATION OF LOCATION
❑
PROPER SEGREGATION OF MATERIAL
IR
❑
VERIFICATION OF MSDS AVAILABILITY
❑
VERIFICATION OF HAZ MAT TRAINING
LAC
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
EMERGENCY PROCEDURES ADEQUATE
❑
CONTAINERS PROPERLY LABELED
Ck
❑
HOUSEKEEPING
❑
FIRE PROTECTION
❑
SITE DIAGRAM ADEQUATE & ON HAND
Knr -WIJ
ANY HAZARDOUS WASTE ON SITE? ❑ YES P_NO
EXPLAIN:
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