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HomeMy WebLinkAbout5230 WOODMERE DRIVE_HMBP 3.28.11UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program l Prevention Services A E R S F t o 900 Truxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 A RTN N T Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME INSTION DATE PEC , .. i INSPECTION TIME Al ADDRESS NO. �- Vpu O OF EMPLOYEES 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= 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? ❑ YES 0,NO EXPLAIN QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 Inspector (Pleas (rrint) Fire Prevention / 1" In / Shift of Site /Station # Business Site / Responsible Party (Please Print) nor -ouri White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05 UNIFIED PROGRAM INSPECTL(n WC-HECKLIST SECTION 1: Business Plan and Inventory Program FACILITY NAME Prevention Services B Adtff E R S F t E L D FIRE = 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 DE,ARrM � r f -1 p Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME COMMENTS -s. - II R /1; ADDRESS _ PHONE NO. NO OF EMPLOYEES -?- 3 0 ���UrL -a 6 q- FACILITY CONTACT BUSINESS ID NUMBER VISIBLE ADDRESS 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 1 ❑ ❑ APPROPRIATE PERMIT ON HAND Q` ❑ Business PLAN CONTACT INFORMATION ACCURATE �. ❑ VISIBLE ADDRESS Y \ ❑ CORRECT OCCUPANCY Cam]{ t ❑ VERIFICATION OF INVENTORY MATERIALS rr ` ❑ VERIFICATION OF QUANTITIES P9_ ❑ VERIFICATION OF LOCATION © V111 ❑ PROPER SEGREGATION OF MATERIAL V ❑ VERIFICATION OF MSDS AVAILABILITY [A, ❑ VERIFICATION OF HAZ MAT TRAINING - ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES tgf ❑ EMERGENCY PROCEDURES ADEQUATE Ed ❑ CONTAINERS PROPERLY LABELED ❑ HOUSEKEEPING ❑ ❑ FIRE PROTECTION I� ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ❑ YES &;" NO w Z Uhf • ' �'{ °1 e`i \ `iGt ^`l f-( � -I.e r,�!?C `7 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 - Ag Inspector (PleasetPrint) Fire Prevention / 'Is` 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'