HomeMy WebLinkAbout532 BELLE TERRACE_HMBP NLIBUNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
FACILITY NAME
PPM-S__> MAGvk'z N
Prevention Services
A A E S P t E o
900 Truxtun Ave., Suite 210
,
FIRE
Bakersfield, CA 93301
°e.,aRrM r
Tel.: (661) 326 -3979
❑
Fax: (661) 872 -2171
FACILITY NAME
PPM-S__> MAGvk'z N
INSPECTION DATE
INSPECTION TIME
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
❑
15 -021-
Section 1 B PI ri, In�sentory 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 ❑ NO
EXPLAIN:
QUESTIONS REGARDIN INS I PLEAS AL US AT (661) 326 -3979
Inspector (Please Print) rev n / 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 I
-m� Business Plan and Inventory SECTION 1. Program
�• Prevention Services
e a b F> R s r i_E o 90017ruxtun Ave., Suite 210
F/RE Bakersfield, CA 93301
c ARTM �rr Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME ^
INSPECTION DATE I
INSPECTION TIME
^ I
ADDRESS P
PHONE NO. N
NO OF EMPLOYEES
FACILITY CONTACT B
BUSINESS ID NUMBER
15 -021-
Business Plan and Invento y "Program�
-❑ ROUTINE ❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v ( C= Compliance OPERATION COMMENTS
V= Violation
❑ ❑ 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 n
❑ ❑ 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 R��EE-GG�ARDING..,'
`IG C i(
Inspector (Please Print)
PLEAS
US AT (661) -326 -3979
In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
White – Prevention Services Yellow- Station Copy Pink – Business Copy FD 2155 (Rev. 09105
ANY HAZARDOUS WASTE ON SITE? ❑ YES ❑ NO
EXPLAIN:
QUESTIONS R��EE-GG�ARDING..,'
`IG C i(
Inspector (Please Print)
PLEAS
US AT (661) -326 -3979
In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
White – Prevention Services Yellow- Station Copy Pink – Business Copy FD 2155 (Rev. 09105