HomeMy WebLinkAbout4501 District Boulevard_HMBP 3.23.10�G 1
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
rLARYN D 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
3-
IN PECTION TIME
ow C/ , v
3`- ICJ
55
ADDRESS
NO.
17; 0
NO OF EMPLOYEES
.� 1 rTR)L l-v
Z j
FA CONTACT tt //
(At5tA) (T , tJ C
BUSINESS ID NUMBER
15- 021 -�� Ly�7f
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
❑
BUSII1eSS 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
❑
❑
VERIFICATION OF HAZ MAT TRAINING
❑
VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑
EMERGENCY PROCEDURES ADEQUATE
�I
❑
CONTAINERS PROPERLY LABELED
❑
HOUSEKEEPING
❑
FIRE PROTECTION
❑
SITE DIAGRAM ADEQUATE & ON HAND
Ker -ours
ANY HAZARDOUS WASTE ON SITE? r p1 YES ❑ NO
EXPLAIN: A A7 1 [f d I L W A 6j I t- 4-.4jsY E.,u K Z
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
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Inspector (Please Print) Fire Prevention / I" In / Shift of Site /Station #
White — Prevention Services Yellow - Station Copy Pink — Business Copy \/ FD 2155 (Rev. 09/05