HomeMy WebLinkAbout3801 BURR STREET_HMBP NLIBUNIFIED PROGRAM INSPECTION CHECKLIST]
SECTION 1: Business Plan and Inventory Program
Prevention Services
B R S F I D 900 Truxtun Ave., Suite 210
F/ RE Bakersfield, CA 93301
ARrM T Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME [�
INSPECTION DATE
INSPECTION TIME
At,) C !%f / v aJ
❑ ROUTINE
❑
ADDRESS
PHONE NO.
NO OF EMPLOYEES
❑
Business PLAN CONTACT INFORMATION ACCURATE
FACILITY CONTACT
BUSINESS ID NUMBER
VISIBLE ADDRESS
15 -021-
C
v
Section 1: Busine °ss Plan and Inventory Program
COMMENTS
❑ 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
dry,
❑
❑
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 / 1s' 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
• r•
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST rAd 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
SGAj �►�b�I CA-r/ vA
❑ .
❑
ADDRESS Q /�
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PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
„ Sec" tlon1BusinessPlari .randI "nv en, tory *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
A
❑
❑
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 / 151 In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy
2
FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST!;
SECTION 1:^ Business Plan and Inventory Program
E /K E R S F I E\. D
FIRE
0 ARTMENT
v�
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME [� p
CJ�
INSPECTION DATE
INSPECTION TIME
ADDRESS 2
PHONE NO.
NO OF EMPLOYEES
COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT
❑ RE- INSPECTION
FACILITY CONTACT
BUSINESS ID NUMBER
❑
15 -021-
C
v
Section 1: Business Plan and Inventory Program
❑ ROUTINE
❑
COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT
❑ RE- INSPECTION
C
v
c C= Compliance OPERATION
COMMENTS
V= Violation
❑
❑
APPROPRIATE PERMIT ON HAND
❑
❑
Business PLAN CONTACT INFORMATION ACCURATE
A
❑
❑
VISIBLE ADDRESS
❑
❑
CORRECT OCCUPANCY
I
❑
❑
VERIFICATION OF INVENTORY MATERIALS
❑
❑
VERIFICATION OF QUANTITIES
•
❑
VERIFICATION OF LOCATION
•
❑
PROPER SEGREGATION OF MATERIAL
❑
❑
VERIFICATION OF MSDS AVAILABILITY
❑
❑
VERIFICATION OF HAZ MAT TRAINING
p L_
❑
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
v
0CC�
❑
❑
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