HomeMy WebLinkAbout4840 BRUNDAGE LANE_HMBP MOVEDPrevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST i 4!',. 900 Truxtun Ave., Suite 210
-- — -- - - -- — FIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program *ARFM r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
W c4 l Co f` -I-e, r A3 `,
COMMENTS
❑
ADDRESS 14a ^
PHONE N0.
NO OF EMPLOYEES
c�
❑
❑
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
Section,11 Burliness 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
1
�J
❑
❑
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 ❑ NCI
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
Kb -UU1J
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 3 a 900TruxtunAve., Suite 210
- Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
W011 CO ��i er ��,�10��•�
❑
❑
ADDRESS 4S 1-f o �{
PHONE NO.
NO OF EMPLOYEES
N� b ! r.
BUSIneSS PLAN CONTACT.INFORMATION ACCURATE
FACILITY CONTACT
BUSINESS ID NUMBER
VISIBLE ADDRESS
15 -021-
5eCti ' 1: Bushes Plan acid Inventory Progii'am x -
❑ 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
1 Q
❑
❑
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? ❑ YES ❑ (NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" 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
r. Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 9 K E _RS F I H L D 900 Truxtun Ave., Suite 210
-- - -`- - -- - ! sIRE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program °,ARrM �r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
W^h1 C ate r iQ a (3A3 S 1
COMMENTS
ADDRESS
PHONE NO.
NO OF EMPLOYEES
4840 C
❑
FACILITY CONTACT
BUSINESS ID NUMBER
15 -021-
Section =1;: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
v
c C= Compliance OPERATION
COMMENTS
V= Violation
❑
❑
APPROPRIATE PERMIT ON HAND
❑
❑
Business PLAN CONTACT INFORMATION ACCURATE
❑
❑
VISIBLE ADDRESS
❑
❑
CORRECT OCCUPANCY `q
❑
❑
VERIFICATION OF INVENTORY MATERIALS
❑
❑
VERIFICATION OF QUANTITIES
❑
❑
VERIFICATION OF LOCATION
❑
❑
PROPER SEGREGATION OF MATERIAL
\
❑
❑
VERIFICATION OF MSDS AVAILABILITY
`1
❑
❑
VERIFICATION OF HAZ MAT TRAINING
❑
❑
VERIFICATION Of ABATEMENT SUPPLIES AND PROCEDURES
i
V
❑
❑
EMERGENCY PROCEDURES ADEQUATE
��
❑
❑
CONTAINERS PROPERLY LABELED
G
❑
❑
HOUSEKEEPING
❑
❑
FIRE PROTECTION
❑
❑
SITE DIAGRAM ADEQUATE & ON HAND
I
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
Ker -oUld
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05