HomeMy WebLinkAbout3920 BRUNDAGE LANE_CONTROL MOTION HMBPPrevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST a R s F , 0 90oTruxtunAve., Suite 210
C�_ _ -- - - - �__ --
* FI Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program "RrM f RE Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
9 Z-CV C �r
HONE NO.
O OF EMPLOYEES
• LA � Dfl Cr,,_ iJ
❑
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
10 NJ
❑
❑
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)
While - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST' rAft 900Truxtun Ave., Suite 210
Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program r Tel.: (661) 326 -3979.
4411111111111111`1`� Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
3 9
PHONE NO.
NO OF EMPLOYEES
APPROPRIATE PERMIT ON HAND
❑
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
Section 1: _8usiness.Plan a,nd 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
1
❑
❑
VERIFICATION OF LOCATION
J
❑
❑
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? ❑ 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
Business Site / Responsible Party (Please Print)
Pink — Business Copy
nor -ouw
FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLISTI
SECTION 1: Business Plan and Inventory Program
/� u
i
Prevention Services
B A x e R S F I e 1, 0 900 Truxtun Ave., Suite 210
FIRE Bakersfield, CA 93301
DEVPARTMEI�T Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS
HONE NO.
NO OF EMPLOYEES it
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= Compliance OPERATION
V= Violation
COMMENTS
❑
❑
APPROPRIATE PERMIT ON HAND
❑
❑
BUSIt1eSS PLAN CONTACT INFORMATION ACCURATE
❑
❑
VISIBLE ADDRESS
❑
❑
CORRECT OCCUPANCY
❑
❑
VERIFICATION OF INVENTORY MATERIALS
❑
❑
VERIFICATION OF QUANTITIES
❑
❑
VERIFICATION OF LOCATION
1
❑
❑
PROPER SEGREGATION OF MATERIAL
i�
❑
❑
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:
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
Business Site / Responsible Party (Please Print)
Pink — Business Copy
FD 2155 (Rev. 09/05