HomeMy WebLinkAbout5625 GOSFORD ROAD_HMBP 5.14.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
rAR n 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
....,
❑ BUSIneSS PLAN CONTACT INFORMATION ACCURATE
3o ---
ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
G n I (_ C--3z LL- n �-c� n c�
BUSINESS ID NUMBER
15- 021 - 0DZ el (0.3
Section 1:. BusinessRlan'a�nd Inirentory= 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
I ❑ 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
d.
❑ HOUSEKEEPING
r,
❑ FIRE PROTECTION
❑ SITE DIAGRAM ADEQUATE & ON HAND
rcnr -Buis
ANY HAZARDOUS WASTE ON SITE? --KYES ❑ NO
EXPLAIN: -;2� O
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bus "Responsible
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09/05