HomeMy WebLinkAbout621 21ST_HMBP 2.10.10UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
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F
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
r7A 14 a 4-m on/ Sv PP I = r ' s--
Z - /o -/o
1334
ADDRESS
DHONE NO.
O OF EMPLOYEES
C.v 2 \ E Z I 5r
- 3Zf' 71/Z
1 �-
FACILITY CONTACT
3USINESS ID NUMBER
1(4d ) C /rRx"V
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
1Y ❑ VERIFICATION OF LOCATION
❑ PROPER SEGREGATION OF MATERIAL
❑ VERIFICATION OF MSDS AVAILABILITY
7 ❑ VERIFICATION OF HAZ MAT TRAINING
C/ ❑ 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 /N0
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / I" In / Shift of Site /Station #
— 4pao; � !Pm or-
Business Site / Respon able Party (Please Print)
White – Prevention Services Yellow - Station Copy Pink – Business Copy FD 2155 (Rev. 09/05