Laserfiche WebLink
)9 q! N. <br />C�SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br />G <br />Q ? HAZARDOUS MATERIALS DIVISION <br />222 EAST WEBER AVENUE, ROOM 610A, STOCKTON, CA 95202 <br />(209)468-3969 <br />LI.F O.RN INSPECTION FORM <br />BUSINESS NAME <br />/J� <br />PHONE NUMBER <br />BUSINESS ADDRESS <br />dsy6 <br />ZIP CODE <br />, '52 yj <br />FIRE DISTRICT <br />INSPECTION DATE <br />ARRIVALTIME <br />DEPARTURE TIME <br />INSPECTION TYPE <br />A. INFORMATION CURRENT <br />YES <br />I NO <br />1,B. STORAGE/HANDLING INFORMATION <br />YES <br />NO <br />PLAN AVAILABLE ON SITE <br />WASTE GENERATOR <br />SECTION 1: NOTIFICATION <br />M.S.D.S. AVAILABLE ON-SITE <br />SECTION 2: EMERGENCY PROCEDURES <br />SECONDARY CONTAINMENT NOTED <br />SECTION 3: EVACUATION PROCEDURES <br />SAFETY HAZARDS <br />SECTION 4: LEAK & SPILL CONTROL <br />CHEMICALS PROPERLY STORED <br />SECTION 5: FACILITY MAP <br />CHEMICALS PROPERLY LABELED <br />SECTION 6: TRAINING PROGRAM & RECORDSCHEMICALS <br />PROPERLY HANDLED <br />SECTION 7: INVENTORY 114 <br />C. COMMENTS AND RECOMMENDATIONS: <br />iiiTr>a cY �iV d - i'.dJri.�n X64- SOdO <br />'/,•f6i"�9 �/rg/c../ �.iv�/v4t.:!d e,.t /%'^-Fi�.. <br />ZsC <br />D. REFERRALS <br />S J.C. AGRICULTURE S.J.C. ENVIRONMENTAL ❑ CAL OSHA LOCAL S.J.C. AIR OTHER <br />COMMISSIONER HEALTH FIRE DEPT. POLLUTION C. D. <br />E. COMPLIANCE VERIFICATION <br />FOLLOW-UP INSPECTION DATE: <br />MAIL IN REVW40NSQWE <br />�E <br />BUSINESS REPRESENTATIVE: (PRINT NAME) <br />BUSINE SREPRESENTATIV ( ( G D) <br />C <br />TITLE: <br />INSPECTOR WHITECOPYO.ES <br />Y PIWCO COPY: FILE <br />PINK COPY: BUSINESS <br />O.E.S-H.. Mat 10(11/95) ' / L.-- HN INV: REV. NOV IM <br />/Ae <br />