HomeMy WebLinkAbout9810 UNION AVENUE (2)UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
B E 11 F ..
FIRE
D AR TM r
Prevention Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
IN ECTIO DATE
INSPECTION TIME
ADDRESS O r U n 10 . J )
�BUSINESS
PHONE NO.
O OF EMPLOYEES
FACILITY CONTACT
ID NUMBER
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
�r
❑
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
sc Business Site / Responsible Pa Please Print
Inspector (Please Pnnt) Fire Prevention ! 1 In /Shift of Site /Station # P Party ( )
hbr- IJ
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1: Business Plan and Inventory Program
Prevention Services
R rA. I _ D 900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
r Tel.: (661) 32 6 -3979
Fax: (661) 872 -2171
FACILITY NAME
v
C= Compliance OPERATION
V= Violation
INS
ECTIO DATE
INSPECTION TIME
V �'- 1
_-2-0 h.%
W 1 �F. L_Fis S
BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
tZ 6
.0
ADDRESS 9 8 I 0
VISIBLE ADDRESS
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
❑
❑
BUSINESS ID NUMBER
❑
❑
15 -021-
Section 1: Business Plan, and Inventory Program
x'
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
C
v
C= Compliance OPERATION
V= Violation
COMMENTS
❑
❑
APPROPRIATE PERMIT ON HAND
S❑z� ❑
BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
.0
❑
VISIBLE ADDRESS
>EID ❑
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 / 1s' 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
T! Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIS
- - -- - - -- -------------------------------
H E 900 Truxtun Ave., Suite 210
F /RE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program i Or�PARrM r Tel.: (661) 326 -3979
Fax: (661) 872 -2171
FACILITY NAME
V
INS(PECTION / DATE
C
INSPECTION TIME
p. r- 1 Z, 0 �l ll� t 1. ,s S
'-;�1 Z.-5 i
ADDRESS � (� /�
PHONE NO.
NO OF EMPLOYEES
q
1 ' C) L/1 / I t1 1) Aj
❑ ❑ VERIFICATION OF INVENTORY MATERIALS
FACILITY CONTACT
BUSINESS ID NUMBER
❑ ❑ VERIFICATION OF LOCATION
15 -021-
Section 1: Business Plan and Inventory Program
❑ ROUTINE ❑ COMBINED ❑ JOINT AGENCY ❑ MULTI - AGENCY ❑ COMPLAINT ❑ RE- INSPECTION
.0 v ( C= Compliance OPERATION
V= Violation
COMMENTS
❑ ❑ APPROPRIATE PERMIT ON HAND
tl];, ❑ BUSRIeSS 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
❑��_P HOUSEKEEPING
❑ ❑ FIRE PROTECTION
❑ ❑ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN
❑ YES ❑ NO
i
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326 -3979
C.._ 1 ____ -- --
Inspector (Please Print) ' Fire Prevention / 1s' In / Shift of Site /Station #
Business Site / Responsible Party (Please Print)
nnr -oUIJ
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05