HomeMy WebLinkAbout416 WORKMAN_HMBP 6.1.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory. Program
I
FACILITY NAME
Services
R MTNPrevention
900 'IYuxtun Ave:, Suite 210
i l a
Bakersfield, CA 93301
ADDRESS
Tel.: (661) 326 -3979
NO OF EMPLOYEES
Fax: (661) 872 -2171
FACILITY NAME
INSPE ION ATE
INSPECTION TIME
AsfCc N q, l N D 0-S-r 2/ A Z_
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APPROPRIATE PERMIT ON HAND
ADDRESS
PHONE NO.
NO OF EMPLOYEES
q, 0 2 Y-V\ A
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
,° FSection �Bslness�Plan,andlnventory 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
'0�' ❑
PROPER SEGREGATION OF MATERIAL
❑
VERIFICATION OF MSDS AVAILABILITY
❑ ❑
VERIFICATION OF. HAZ MAT TRAINING
❑ ❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
-Q
f
KD ❑
EMERGENCY PROCEDURES ADEQUATE
.;Eg ❑
CONTAINERS PROPERLY LABELED
❑
HOUSEKEEPING
'❑ '$b
FIRE PROTECTION
L
❑ _�-O
SITE DIAGRAM ADEQUATE & ON HAND
moo. -
r°'.J "S -CY6
PIA
ANY HAZARDOUS WASTE ON SITE? ❑ YES- --b NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
C, &�_ Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Business Site / R nsible Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05