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HomeMy WebLinkAbout3000 SILLECT AVENUE_ VALLEY DECAL HAZ MOVEDUNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program. Prevention Services R F R S r 1 ._,_, 900 Truxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 JD ARTM Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME I �at�o �•ecg 1 1Nc INSPECTION DATE INSPECTION TIME 'ADDRESS I Sac ❑ PHONE NO. NO OF EMPLOYEES FACILITY CONTACT ❑ ❑ BUSINESS ID NUMBER ' ❑ ❑ 15 -021- Section 1: Business Plan and In�ento.ry 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 PROCEDUR ❑ ❑ 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 / 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 o- Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST A R R R S F I\ ° 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 ° ARrM Tel.: (661) 326 -3979 SECTION 1: Business Plan and Inventory Program Fax: (661) 872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO. NO OF EMPLOYEES „C ❑ FACILITY CONTACT BUSINESS ID NUMBER 15 -021- 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 t I 4 ❑ ❑ 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 ❑ NO 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;' 1 FIRE J SECTION 1: Business^P..lan and Inventory Program 'j °EV'wr Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) -872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME COMMENTS ❑ ❑ ADDRESS Pwt PHONE NO. NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15 -021- 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 ) ` V ❑ ❑ VERIFICATION OF MSDS AVAILABILITY ❑ ❑ VERIFICATION OF HAZ MAT TRAINING ❑ ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURE ❑ ❑ 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 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # White — Prevention Services Yellow - Station Copy 0 Business Site / Responsible Party (Please Print) Pink — Business Copy FD 2155 (Rev. 09/05