HomeMy WebLinkAbout5175 GOSFORD ROAD_HMBP 5.13.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
H P R SF 1 _D 900 Truxtun Ave., Suite 210
F/RE Bakersfield, CA 93301
o ARrM IF Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
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INSPEC14ON DA
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INSPECTION TIME
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ADDRESS 5' 7 O��DD ^ ��
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NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
4�f iTY 9.4 S,
15- 021 -00/0/7
Section 1: Business Plan and Inventery Program
ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v c C= Compliance OPERATION
V= Violation
COMMENTS
❑ APPROPRIATE PERMIT ON HAND
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❑ Business PLAN CONTACT INFORMATION ACCURATE
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❑ 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 �NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
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Inspector (Please Print) Fire Prevention / 1s' 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