HomeMy WebLinkAbout6511 LAVENDAR GATE DRIVE_HMBP 2.17.10UNIFIED PROGRAM INSPECTION CHECKLISTII
SECTION 1: Business Plan and Inventory Program
FACILITY NAME
Prevention Services
B E R S F I _o
900 Truxtun Ave., Suite 210
F /RE
Bakersfield, CA 93301
ARTM
Tel.: (661) 326 -3979
❑
Fax: (661) 872 -2171
FACILITY NAME
INSPE TION rTE
2 I
INSPECTION TIME
ADORE S
PHONE NO.
O OF EMPLOYEES
S l i LA U c N.o A � �� E OSL
❑
FACILITY CONTACT
3USINESS ID NUMBER
b 1 1"_ l Git
15 -021-
�`te_ t" n 1 Business Plan -and Inventory Program
OUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
v
C= Compliance OPERATION
V= Violation
COMMENTS
❑
❑
APPROPRIATE PERMIT ON HAND
❑
❑
BUSIf1esS 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 l r
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979 q�?
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bu ' s Site / Responsible Party (Please Print)
White — Prevention Services Yellow - Station Copy Pink — Business Copy FD 2155 (Rev. 09105
d
UNIFIED PROGRAM INSPECTION CHECKLIST prevention Services
A E a s F 0 900 Truxtun Ave., Suite 210
- FiRE _ Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program D ARTM T Tel.: (661) 326 -3979
y Fax: (661) 872 -2171
FACILITY NAME
`P- L Q rR �R S E 21) 1 C C
INSPE TION TE
Z l% / U
INSPECTION TIME
ADDRESS
fi.S I ► LAVG AP, C A ?4rc off...
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
15 ► L,-- Q-O & 1 CA
15 -021-
-
Section 1: Business Plan and hI entory Program
OUTINE ❑ 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 REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station # Bu ' e s Site / Responsible Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05