HomeMy WebLinkAbout5405 HARRIS_HMBP 4.6.11UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
FACILITY NAME
Prevention Services
B A B R S P 1
900 Truxtun Ave., Suite 210
FIRE
Bakersfield, CA 93301
c ARTM
Tel.: (661) 326 -3979
NO OF EMPLOYEES
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
❑ Business PLAN CONTACT INFORMATION ACCURATE
ADDRESS ('
NO.
PHHONE^
NO OF EMPLOYEES
O �r r,
-7
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FACILITY CONTACT
BUSINESS ID NUMBER
❑ VERIFICATION OF LOCATION
15 -021-
E
Sectlon!1 Business Pian'and:invento Pr`
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ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C v c 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?
EXPLAIN:
❑ YES 040
( ^ ,2.1
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
� � � Business Site /Res Responsible Part Please Print
Inspector (Please P�) Fire Prevention / I" In / Shift of Site /Station # P y ( )
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services
A A 7JFTNAN
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program °Eiv Tel.: ( 661) 326 -3979
I Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
❑ Business PLAN CONTACT INFORMATION ACCURATE
ADDRESS
PHONE NO.
NO OF EMPLOYEES
Q 1 r < :
`3 _tj% -- 7a o0
FACILITY CONTACT
BUSINESS ID NUMBER
r
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
LL
❑ VISIBLE ADDRESS
❑ CORRECT OCCUPANCY
❑ VERIFICATION OF INVENTORY MATERIALS
$J. ❑ VERIFICATION OF QUANTITIES
❑ VERIFICATION OF LOCATION
❑ PROPER SEGREGATION OF MATERIAL
❑ VERIFICATION OF MSDS AVAILABILITY
I ❑ VERIFICATION OF HAZ MAT TRAINING
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
G ❑ EMERGENCY PROCEDURES ADEQUATE
V ❑ CONTAINERS PROPERLY LABELED
❑ HOUSEKEEPING
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
❑ YES (�AO
QY14"
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
J50.1- A 4 -G-
Inspector (Please P' dFire 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