HomeMy WebLinkAbout2100 BRICYN LANE_HMBP 4.29.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
A e R S F, 0 900 Truxtun Ave., Suite 210
F /RE Bakersfield, CA 93301
ARfM Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPE ION D TE
INSPECTION TIME
ADDRESS
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PH NE NO.
NO OF EMPLOYEES
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FACT ITY CONTACT
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BUSINESS ID NUMBER
15 -021-
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❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
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c C= Compliance OPERATION
V= Violation
COMMENTS
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APPROPRIATE PERMIT ON HAND
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Business PLAN CONTACT INFORMATION ACCURATE
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VISIBLE ADDRESS
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❑
CORRECT OCCUPANCY
❑
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VERIFICATION OF INVENTORY MATERIALS
❑
❑
VERIFICATION OF QUANTITIES
❑
❑
VERIFICATION OF LOCATION
❑
❑
PROPER SEGREGATION OF MATERIAL
❑
❑
VERIFICATION OF MSDS AVAILABILITYh
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❑
❑
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 ❑ NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
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Inspector (Please PrintT Fire Prevention / 1" In / Shift of Site /Station # Business Site / Responsible Party (Please Print)
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White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST prevention Services
e E R s F ,_ ,_0 900 Truxtun Ave., Suite 210
-M - -FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ''RrM T Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPEC ION D TE
�Z �J
INSPECTION TIME
,Q
APPROPRIATE PERMIT ON HAND
ADDRESS
PH NE NO.
NO OF EMPLOYEES
FACILITY CONTACT
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BUSINESS ID NUMBER
15 -021-
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❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C V
(C= Compliance OPERATION
V= Violation
COMMENTS
❑ ❑
APPROPRIATE PERMIT ON HAND
❑_i ❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
C ❑� ❑
CORRECT OCCUPANCY
❑ ❑
VERIFICATION OF INVENTORY MATERIALS
❑ ❑
VERIFICATION OF QUANTITIES
❑ ❑
VERIFICATION OF LOCATION
❑ ❑
PROPER SEGREGATION OF MATERIAL
❑ ❑
VERIFICATION OF MSDS AVAILABILITY
L
❑ ❑
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 ❑ NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / I" In / Shift of Site /Station # Business Site / Responsible Party (Please Print)
I
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST B K E R s F, e 0 900Truxtun Ave., Suite 210
- - -- - - - - -- — - -_ -=j III FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ° PARTM . r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
t
INSPECTION TIME
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ADDRESS
2 1 �r�
PHONE NO. -
O OF EMPLOYEES
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FACILITY CONTACT �7
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BUSINESS ID NUMBER
15 -021-
�Sectionn 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
n❑
❑
CORRECT OCCUPANCY
!ff
❑
❑
VERIFICATION OF INVENTORY MATERIALS
❑
❑
VERIFICATION OF QUANTITIES
❑
❑
VERIFICATION OF LOCATION
❑
❑
PROPER SEGREGATION OF MATERIAL
❑
❑
VERIFICATION OF MSDS AVAILABILITY
`i �., rar. ;. C, f
3�
❑
❑
VERIFICATION OF HAZ MAT TRAINING
❑
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
❑
EMERGENCY PROCEDURES ADEQUATE
❑
❑
CONTAINERS PROPERLY LABELED
❑ C.O' HOUSEKEEPING
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❑
❑
FIRE PROTECTION
,
❑
❑
SITE DIAGRAM ADEQUATE & ON HAND
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ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print)f Fire Prevention / I" 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