Laserfiche WebLink
PgUSN N COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES <br /> r. ? 2101 E. Earhart Avenue,Suite 300 <br /> e: -s <br /> Stockton,California 95206 <br /> Telephone:(209)953-6200 <br /> t`gCiRoaN�°'• Fax:(209)953-6268 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAME ADDRESS(Facility Being Inspected) <br /> /C!✓/n/ /t L-14—M � L7704F /7+11tr— C tv 9TZI z- <br /> ACCOUNT# START DATE(New Bus)JINSPECTION DATE JARRIVALTIME DEPARTURE TIME INSP OR NAME <br /> /3/07 - /-3/ - // /S C/ I / <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY WALK THROUGH YES NO <br /> 1.HMMP/Map On Hand and Easily Accessible ✓ 5. Facility Map Complete and Accurate <br /> 2.Business Identification Page Complete&Accurate 6. Employees Familiar with HMMP <br /> 3.Business HMMP Complete and Accurate 7. Training Records Available <br /> 4.Chemical Description Pages Complete and Accurate 8. Unsafe Conditions Observed(see details below) <br /> EXPLANATION OF FINDINGS AND COMMENTS <br /> r <br /> SHERWIN-WILLIAMS. <br /> Paint Stores Group <br /> AARON SULAMO <br /> Store Manager <br /> The Sherwin-Williams Company <br /> 3304 E.Hammer Lane,Stockton,CA 95212 <br /> sw85220sherwin.com www.shenvin-williams.com <br /> Ph:209-478-1014 Fax:209-478-8071 <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective Actions Additional <br /> To Be Submitted By: Referrals/Notes: <br /> ACKNOWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULTS <br /> Business Representative(Pnnt Name an tile) Business Representative( lgnature) <br /> A" WRITE COPY: OES <br /> /,r �arDA't PINK COPY: BUSINESS <br /> l REVV10 <br />