HomeMy WebLinkAbout4901 COMMERCE_HMBP 4.23.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan.and Inventory Program
40*r Prevention Services
B F. R S f T 0 900 Truxtun Ave., Suite 210
R. Bakersfield, CA 93301
v aerM Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPEfTION TIME
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ADDRESS
PHONE NO.
NO OF E EES
bI rv�
❑ CORRECT OCCUPANCY
FACILITY CONTACT
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Sectlon;l Business Plan�and Inventor -y Program
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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? 11 YES ENO
EXPLAIN: V N IV1q.,1JNI If i) S l
�QUESTIONS REGA(RDINjG� THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
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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
UNIFIED PROGRAM INSPECTION .CHECKLIST
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SECTION 1: Business Plan and Inventory Program '1
B A R B R S r I F I. D
PI;E
DIP r,
Prevention Services
900 Truxtun Ave: Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INS(/,
INSPECTION TIME
/
❑ BUSIneSS PLAN CONTACT INFORMATION ACCURATE
ADDRESS
PHONE NO.
NO OF EMPLOYEES
L 01 5N I
INK
FACILITY CONTACT
S- te"tJ` 9ER 0-3 4:!4
El VERIFICATION OF INVENTORY MATERIALS
a.o%a� VCdLi7�
-Section 1: -Busines�s.Plan and l,nventory Program
Jr 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
11 VISIBLE ADDRESS
• ❑ CORRECT OCCUPANCY
El 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
Ch ❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ❑ YES R-NO
EXPLAIN: 0 rj n1Pc TJ N F= t, <, I' j-g7
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Business Site / Responsible Pa Please Print
Inspector (Please Print) Fire Prevention / 1" In /Shift of Site /Station # P nY ( )
White - Prevention Services Yellow - Station Copy Pink - Business Copy I FD 2155 (Rev..09 /05