HomeMy WebLinkAbout3720 GOSFORD ROAD_HMBP 6.3.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
H I_ __,D 900 TrUxtun Ave., Suite 210
Bakersfield, CA 93301
r Tel.: (661) 32 6 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTIOy.TIytE
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3
6/Z —
ADDRESS
PHONE NO.
NO OF EMPLOYEES
❑ VERIFICATION OF INVENTORY MATERIALS
FACILITY CONTACT
BUSINESS ID NUMBER
❑ VERIFICATION OF LOCATION
15- 021 - CZ9&7 ae.>.7
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
❑ 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?
EXPLAIN:
❑ YES ❑ NO
QUESTIONS REGARDIN HIS 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)
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White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05