HomeMy WebLinkAbout4101 EMPIRE DRIVE_HMBP 5.11.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
E t E R S !I1
FIRE
ARTM r
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
7I 5
S - 100
ADDRESS
PHONE NO.
NO OF EMPLOYEES
❑ VERIFICATION OF INVENTORY MATERIALS
FACILITY CONTACT
BUSINESS ID NUMBER
Q ( k il
15 -021-
W
' Section 1:' Business Plan and Inventory Program
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v c 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
0/ ❑ VERIFICATION OF MSDS AVAILABILITY
❑ VERIFICATION OF HAZ MAT TRAINING
1:1 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
�/
Ii0 ❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
of ❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES l3�PG0
EXPLAIN
QUESTIONS REGARDING THI INSPECTION? PLEASE CALL US AT (661) 326 -3979
P J, r[4 /� �chmI' v '/
pector (Please Print) Fire revention / 1" In / hi of Site /Station # Business Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05