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-V <br /> %WoolCOUNTY OF SAN JOAQUIN <br /> c...y. <br /> OFFICE OF EMERGENCY SERVICES <br /> 2101 E. Earhart Avenue,Suite 300 <br /> m ` Stockton,California 95206 <br /> Telephone:(209)953-6200 <br /> • �aTic'o'ai+�p• Fax:(209)953-6268 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM S <br /> BUSINESS NAME ADDRESS(Facility Being Inspected) _ <br /> AT&T MOBILITY O U1' • r� <br /> ACCOUNT# START DATE(New Bus) INSP ION DATE ARRIVAL TIME DEPARTURE TIME INSPECTO NAME <br /> `2— 3 /7 Wit0 5 LJ 1i�+� ROBERT LOPEZ <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY WALK THROUGH YES NO <br /> 1.HMMP/Map On Hand and Easily Accessible V 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 /> o ca.irc� <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective Actions Additional <br /> Submitted By: 14 . Referrals/Notes: <br /> AN�OWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULTS <br /> Business Represe tive(Prinj Name a Title) Business a es ve(S' ture) <br /> WHITE COPY: OES <br /> J o a af PINK COPY: BUSINESS <br /> REV am <br />