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4100 MING Avenue_HMBP 4.16.10
UNIFIED PROGRAM INSPECTION CHECKLIST,, Prevention Services, a A r R s, 0 900 Truxtun Ave.,. Suite 210 FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° aRrM Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME 1 INSPECTION DATE INSPECTION TIME ❑ 4-16 - I a I v 3o ADDRESS PHONE NO. NO OF EMPLOYEES .LSO %A_#_ 1 FACILITY CONTACT . � LG BUSINESS ID NUMBER 15-021- dOa©S� f i ❑ - J kk ° e:$ectlon 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 11 ❑ VERIFICATION OF HAZ MAT TRAINING ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ' ❑ EMERGENCY PROCEDURES ADEQUATE C)" / ❑ CONTAINERS PROPERLY LABELED ❑ HOUSEKEEPING ❑ FIRE PROTECTION ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ❑YES XNO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 i�_, Q ' Nv�� % ft, �\) Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # BlusfneW 9ite-/ e ns le Pa I a White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05