Laserfiche WebLink
Awk <br /> COUNTY OF SAN JOAQUI RECEIVED <br /> OFFICE OF EMERGENCY SERVICES <br /> ROOM 610,COURTHOUSE <br /> 222 EAST WEBER AVENUE <br /> FEB - 8 2005 <br /> SAN JOAQUIN COUNTY <br /> STOCKTON, CALIFORNIA 95202 <br /> p r OFFICE OF EMERGENCY SERVICES <br /> A HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> FAX(209)944-9015 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAME TELEPHONE NUMBER <br /> Summit American, Inc. — DBA: Summit Roofing Service 825-3042 <br /> BUSINESS ADDRESS (Facility Being Inspected) <br /> 705 Industrial Park Drive, Manteca, CA 95337 <br /> FIRE DISTRICT INSPECTION DATE JARRIVALTIME DEPARTURE TIME 1INSPECTIONTYPE <br /> 24 Z— y —OS / y: �(7 / ,'5-.'3O HMMP <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY INSPECTION YES NO <br /> 1. Business HMME/Inventory On Site 7.Facility Map Complete and Accurate <br /> 2. HMMP/Map Easily Accessible to Employees t/ 8.Chemical Inventory Complete and Accurate I/ <br /> 3.Bus ID Page/HMMP Complete and Accurate 9.Employees Familiar with HMMP ✓ <br /> 4.If Business is a Hazardous Waste Generator, / 10.Plant Operations Appear Safe <br /> are Hazardous Waste Manifests On Site? V 11.Hazardous Materials Being Properly Handled by Employees (/ <br /> 5. Material Safety Data Sheets (MSDS) On Site 7 12.Hazardous Materials Properly Stored and Labeled <br /> 6.Current Training Records On Hand I V, 13. Soil and Facility Appear Non-Contaminated <br /> COMMENTS (Items marked"NO"above must be explained in this section) <br /> REFERRALS ❑SJ Ag ❑SJ Env HIth ❑OSHA ❑Fire ❑DA ❑ <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective Actions Must be Delivered to OES By Follow Up Inspection Date OES Inspector Name Performing Follow Up <br /> ACKNOWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULTS <br /> Bus' ess Representative(Print Name and Title) Business Represe lve(Signature <br /> Q� d5 !Jl Z- 11vIS1RgYJ � <br /> Name of Inspector Agency Fire Co. ( f Appropriate) WHrr Y: OES REV 9/02 <br /> PINK COPY: BUSINESS <br />