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6200 HARRIS_HMBP 4.16.11
UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory, Program R DARTPrevention Services M 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 872 -2171 FACILITY NAME �l INSPECTION DATE q_& -� INSPECTION TIME ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT --r(^ 1 / eJ / BUSINESS ID NUMBER 15 -021- $ectloln1 BusmessrPlan and Inventory Program ROUTINE -❑ COMBINED ❑ JOINTAGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS ❑ APPROPRIATE PERMIT ON HAND ❑ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE ❑ VISIBLE ADDRESS ❑ CORRECT OCCUPANCY ❑ VERIFICATION OF INVENTORY MATERIALS ❑ VERIFICATION OF QUANTITIES ❑ VERIFICATION OF LOCATION ❑ PROPER SEGREGATION OF MATERIAL ,( fth ❑ 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 REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 Inspector (Please Print Fire 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 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST ! B r FIRE 900Truxtun'Ave., Suite 210 { Bakersfield, CA 93301 DEPAitrm Nr SECTION V- Business Plan and Inventory Program I r 1% Tel.: (661) 326 -3979 ', 449* Fax: (661) 872 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS �✓ i U � -�- r r 'I � PHONE NO. 7 - 7a� NO 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 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 J. ❑ VERIFICATION OF MSDS AVAILABILITY �© ❑ VERIFICATION OF HAZ MAT TRAINING (RF ❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES r .�- ❑ EMERGENCY PROCEDURES ADEQUATE ❑ CONTAINERS PROPERLY LABELED ❑ HOUSEKEEPING ❑ FIRE PROTECTION �I ❑ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ❑ YES Cid NO EXPLAIN: . . t___ma-1 l Ri%i QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 1 4 1%, " Inspector (Please Print Fire Prevention 1' In / Shift of Site /Station # White - Prevention Services Yellow - Station Copy Business Site / Responsible Party (Please Print) Pink - Business Copy FD 2155 (Rev. 09/05