HomeMy WebLinkAbout4101 EMPIRE DRIVE_HMBP 5.13.11� Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST'
900 Truxun
Ave., Suite 210
-- -- - -- -- - - -- -- - — _ -- -- - -- — F/RE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Progra r Tel.: (661) 326 -3979
m ARr�n
Fax: (661) 872 -2171
FACILITY NAME /
f C. �-
INSPECTION DATE
5, �
INSPECTION TIME
9 �,
ADDRESS
C+10 t Dr. # /3 co DICs F o
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021- p O Z_q t
C
v
Section 1: Business Plan and Inventory Program
COMMENTS
❑ ROUTINE
❑
COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT
❑ RE- INSPECTION
C
v
c C= Compliance OPERATION
V= Violation
COMMENTS
I�
❑
APPROPRIATE PERMIT ON HAND
¢i
❑
BUSIneSS PLAN CONTACT INFORMATION ACCURATE
❑
VISIBLE ADDRESS
VJ
❑
CORRECT OCCUPANCY
Z]
❑
VERIFICATION OF INVENTORY MATERIALS
P
❑
VERIFICATION OF QUANTITIES
In
❑
VERIFICATION OF LOCATION
®
❑
PROPER SEGREGATION OF MATERIAL
(a
❑
VERIFICATION OF MSDS AVAILABILITY
0
❑
VERIFICATION OF HAZ MAT TRAINING
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
EMERGENCY PROCEDURES ADEQUATE
21
❑
CONTAINERS PROPERLY LABELED
0
❑
HOUSEKEEPING
PPS
❑
FIRE PROTECTION
Wf
❑
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? cPLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bus' es Si / Respo ib a Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05