HomeMy WebLinkAbout2619 MT. VERNON AVENUE_CRUZ THRU HMBP 3.9.11UNIFIED PROGRAM, INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
B 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
C.Rvz J- (-KQ (iz-SJ
INSPECTION DATE
— 9 -2--3(c
INSPECTION TIME
IS ^j
ADDRESS ( 1k& ( V�2 w ��
t� ," V
PHONE -7 1 -to
NO OF EMPLO5 S
FACILITY CONTACT /
BUSINESS ID NUMBER
15- 021 - 100 36 3 Z
ICJ/ ❑ CORRECT OCCUPANCY
i 3 s Y
Section 1 �Buslness Planand In�entoyEProgram.,
,;6—ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑
MULTI-AGENCY ❑ COMPLAINT ❑ v RE- INSPECTION
C v C= Compliance OPERATION
V= Violation
COMMENTS
V❑ APPROPRIATE PERMIT ON HAND
0/0 Business PLAN CONTACT INFORMATION ACCURATE
LO/❑ VISIBLE ADDRESS
ICJ/ ❑ CORRECT OCCUPANCY
P/0 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
2/-'El EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
0 FT
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