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Home My WebLink About3004 JEWETT Avenue_HMBP 12.1.09UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program FACILITY NAM en Prevention Services H E R S 900 Truxtun Ave., Suite 210 AFIRE A R FM r Bakersfield, CA 93301 FACILITY CONTACT met` G Tel.: (661) 326 -3979 V Fax: (661) 872 -2171 FACILITY NAM en INSPECTION DATE op INSPECTION TIME ADDRESS � � O � PHONE NO. � NO OF EMP YEES FACILITY CONTACT met` G BUSINESS ID NUMBER 15 -021- 4o O 6 Q BUSIneSS PLAN CONTACT INFORMATION ACCURATE 0 ROUTINE El COMBINED C1 JOINT AGENCY DMULTI-AGENCY 11 COMPLAINT El RE-INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS EK ❑ 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 V0 VERIFICATION OF MSDS AVAILABILITY ❑ VERIFICATION OF HAZ MAT TRAINING �, t /0 ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ❑ EMERGENCY PROCEDURES ADEQUATE ❑ CONTAINERS PROPERLY LABELED ❑ HOUSEKEEPING FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE O SITE? EXPLAIN: e � C ° ❑ NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 Inspector (lease Print) Fire Pre tion / 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