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COMPLIANCE INFO_PRE 2019
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PR0519282
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
3/29/2019 3:27:06 PM
Creation date
6/8/2018 5:16:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0519282
PE
1921
FACILITY_ID
FA0014424
FACILITY_NAME
Tracy Volkswagen
STREET_NUMBER
2605
STREET_NAME
AUTO PLAZA
STREET_TYPE
WAY
City
TRACY
Zip
95304
CURRENT_STATUS
01
SITE_LOCATION
2605 AUTO PLAZA WAY
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\A\AUTO PLAZA\2605\PR0519282\COMPLIANCE INFO.PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
10/19/2015 11:30:13 PM
QuestysRecordID
2819614
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Pre-Inspection <br /> Health and Safety Assessment <br /> Facility Name- VJ FA#: FADD I y ya y <br /> Location aLW5 AUTo PL AZA WAY PR* ?9_p 5 190Ma- <br /> Business Type: ice.)-M SAk-E--SZ&GPAtP_ 4oe>E <br /> nifially Completed By: l_ Date: S— (J <br /> Instructions: Fill out this form as best as possible before the initial inspection and complete the remaining information during or after <br /> the inspection. Subseauent Inspections: Review facility file and chemical inventory information, along with the information on this <br /> form, to become familiar with potential hazardous substances and/or conditions at the facility and any control or precautionary <br /> measures that should betaken prior to conducting the inspection activity.Update/complete form as needed.Sign and date below. <br /> Chemical Hazards I Physical Hazards <br /> ❑ Carcinogens: ❑ 1 Oxygen Deficiency: <br /> ❑ Corrosives: ❑ Noise: <br /> _kTFlammables: vei5 ct46MS ❑ Excavations: <br /> ❑ Gases: ❑ Climbi <br /> ❑ Metals: ❑ Explosion: <br /> ❑ Oxidizers: ® Heavy Equipment:VEH((,LE Lt FTS <br /> ❑ PCBs: ❑ Heat or Cold Stress: <br /> ❑ Explosives: ❑ Other: <br /> Bit olo ical Hazards Personal Protective E ui ment <br /> ❑ Dos ❑ Hard Hat ❑ CPC-T ek <br /> ❑ Snakes ® Safety Vest ❑ CPC-Other: <br /> ❑ Insects 19 Protective Boots ❑ APR Respirator <br /> ❑ Poisonous Plants ® Go les/Glasses ❑ SCBA Respirator <br /> 11 Other: ❑ Hearin Protection ❑ Other: <br /> By signing below, I am declaring that I have reviewed the health and safety information for this facility prior to my <br /> inspection and that I have performed, and will perform during the inspection, the following actions: <br /> I have reviewed this form and the facility file for information on the business type of operation,compliance history, prior <br /> releases and response,and other health and safety related information. <br /> I have reviewed the properties and hazards associated with the chemicals in the chemical inventory submitted by the <br /> facility. <br /> I have searched out and evaluated information on the properties of the chemicals at the facility, using the internet and <br /> other resources,for chemicals I am not familiar with at this time. <br /> I have reviewed the facility information with my supervisor if I could not determine the most appropriate health and safety <br /> precautions needed for this facility. <br /> I have gained an awareness of the potential hazards at the facility and have determined the appropriate health and safety <br /> precautions needed to perform my inspection. <br /> Before beginning the inspection, I will review the facility's health and safety information and rules with the owner/manager <br /> and wear the appropriate personal protective equipment. <br /> During the inspection, I will observe the labeling and condition of hazardous materials containers and conveyances,the <br /> posting of placards and warning signage,and the actions of the facility employees and guests to identify any potential <br /> unsafe conditions that may arise cluring the ins ection. <br /> Staff Signature Date Staff Signature Date <br /> 2,6 <br /> /S <br /> San Joaquin County Environmental Health Department;1868 E.Hazelton Avenue;Stockton,CA 95205;209.468.3420 <br /> EHO 48-06-12-2013 Pre-Inspection Health&Safety Assessment <br />
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