HomeMy WebLinkAbout901 19 STREETUNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
rAR o 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME t
?Vto4ers
INSPECT ON ATE
INSPECTION TIME
►errs
S 3/ !1
71 30
ADDRESS
PHONE NO.
32?
NO OF EMPLOYEES
/3
FACILITY ONTACT
A14VAC
BUSINESS ID NUMBER
15 -021- 00)9t5
FSA Rn
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
�I
❑
VERIFICATION OF QUANTITIES
;5-
❑
VERIFICATION OF LOCATION
38.
❑
PROPER SEGREGATION OF MATERIAL
of
❑
VERIFICATION OF MSDS AVAILABILITY
t]'
❑
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 STE ON SITE? 'DYES a NO
EXPLAIN: 1 IV
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -397
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Inspector (Please Print) Fire Prevention / 1" In / Shift of Site /Station #
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05