HomeMy WebLinkAbout4601 PACHECO ROAD_HMBP 4.6.11UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
R E R S F ,_ , „ 900 Truxtun Ave., Suite 210
FIRE Bakersfield, CA 93301
D ARTM Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAM ` \
INSPECTION DATE
INSPECTION TIME
/
❑ Business PLAN CONTACT INFORMATION ACCURATE
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
�I
BTJsINESS ID NUMBER
15 -021-
Section 1 B;usmess 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
❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
❑ EMERGENCY PROCEDURES ADEQUATE
❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES 0� NO
C- 6 9^�'
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Plea a Print) Fire Prevention / 'It In / Shift of Site /Station # Business Site / Responsible Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
� ��^ Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST { e -A/ R s r , E� n 900'Iruxtun Ave., Suite 210
F/RE Bakersfield, CA 93301
jI DE ffF Nr Tel.: (661) 326 -3979
SECTION 1: Business Plan and Inventory Program I v
Fax: (661) 872 -2171
FACILITY NAM \
INSPECTION DATE /
INSPECTION TIME
ADDRESS
HONE NO.Q
NO OF EMPLOYEES
FACILITY CONTACT
BUST—NESS ID NUMBER
15 -021-
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
Vl 11 EMERGENCY PROCEDURES ADEQUATE
CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES WNO
C G I^-
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326.3979
7 =<
Inspector Fire Prevention / 1" In / Shift of Site /Station # Business Site /Responsible Party (Please Print)
I
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05