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eery a�.� orret r.n� <br /> �au!y COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES <br /> 2101 E. Earhart Avenue,Suite 300 <br /> Stockton,California 95206 FEB 2 2 2010 <br /> Telephone(209)953.6200 <br /> i•i.._.,d;;:� Fee!(209)953-6269 SAN JOAQUIN COUNTY <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION'AR1111BF EMERGENCY SERVIQE <br /> BW <br /> ADDRESS(Facility Being Inspected) <br /> START DATF(New Bur) INSPECTION DATE ARRIVALTIME DEPARTURE TIMF. INP R A <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY WALK THROUGH YES NO <br /> 1.HMMP/Map On Hand and Easily Accessible 6. Facility Map Complete and Accurate <br /> 2.Business Identification Page Complete&Accurate 7, Presence of Non-Listed Regulated Chemicals <br /> 3.Business HMMP Complete and Accurate 8. Employees Familiar with HMMP <br /> 4.Chemical Description Pages Complete and Accurate 9. Hazardous Materials/Waste Properly Labelled <br /> .Training Records Available 10. Conditions that would hinder implementation o <br /> Emergency Plan or increase risk of release are absent <br /> EXPLANATION OF FINDINGS AND COMMENTS <br /> 11 _ �c+ x 1 <br /> i — —22—l0 <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective ActionsAdditional <br /> o Be Submitted Bye 2 Referrals/Notes: <br /> CKNOWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULTS <br /> usmessepresentative(Priim^ tl <br /> Name and']ale) Hucrness eprosenmtivc(Signature) WHrTECOPY� OFs <br /> �F�rNtS Y' vyL4 { PINK COPY: UREV <br /> /, I�'A 12/06 <br /> TOTAL P.05 <br />