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EHD Program Facility Records by Street Name
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1900 - Hazardous Materials Program
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PR0542546
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COMPLIANCE INFO
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Entry Properties
Last modified
10/9/2019 10:38:08 AM
Creation date
6/10/2018 12:53:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0542546
PE
1921
FACILITY_ID
FA0024466
FACILITY_NAME
Restaurant Technologies, Inc. (#021)
STREET_NUMBER
3840
STREET_NAME
METRO
STREET_TYPE
DR
City
STOCKTON
Zip
95206
CURRENT_STATUS
01
SITE_LOCATION
3840 METRO DR
QC Status
Approved
Scanner
SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\M\METRO\3840\PR0542546\COMPLIANCE INFO 2018 - PRESENT .PDF
QuestysFileName
COMPLIANCE INFO 2018 - PRESENT
QuestysRecordDate
2/12/2018 7:58:37 PM
QuestysRecordID
3789773
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Pre-Inspection <br /> Health and Safety Assessment <br /> Facilit Name: GC! MkI p to i FA#: FAOO A10 C4 <br /> Location: 3ef d ! �7 rc5 �� s�za t,K�f vac 9'S. 3 PR#: PRO A1'A <br /> Business 7 e: '0C5A_"r_ 01_1 <br /> initial/ Com leted By: Robert Lopez Date: Z_ P. / <br /> Instructions: Fill out this form as best as possible before the initial inspection and complete the remaining information during or after <br /> the inspection. Subsequent Inspections: Review facility file and chemical inventory information, along with the information on this <br /> form, to become familiar with potential hazardous substances and/or conditions at the facility and any control or precautionary <br /> measures that should be taken prior to conducting the inspection activity. Update/complete form as needed. Sign and date below. <br /> Chemical Hazards Physical Hazards <br /> ❑ Carcina ens: ❑ I Oxygen Deficiency: <br /> ❑ Corrosives: ❑ Noise: <br /> ❑ Flammables: ❑ Excavations: <br /> Gases: ❑ Climbing: <br /> ❑ Metals: ❑ Explosion: <br /> ❑ Oxidizers: ❑ Heav Equipment: <br /> ❑ PCBs: ❑ Heat Stress: <br /> ❑ I Explosives: ❑ Cold Stress: <br /> ❑ 1 Other: ❑ Other: <br /> Biological Hazards Personal Protective Equipment <br /> ❑ Dos X Hard Hat ❑ CPC-T vek <br /> ❑ Snakes X Safety Vest ❑ CPC—Other: <br /> ❑ Insects X Protective Boots ❑ APR Respirator <br /> ❑ Poisonous Plants X Goq.g les/Glasses ❑ SCBA Respirator <br /> ❑ Other: X Hearing Protection ❑ Other: <br /> By signing below, I am declaring that I have reviewed the health and safety information for this facility prior to my <br /> inspection and that I have performed, and will perform during the inspection, the following actions: <br /> have reviewed this form and the facility file for information on the business type of operation, compliance history, prior <br /> releases and response, and other health and safety related information. <br /> I have reviewed the properties and hazards associated with the chemicals in the chemical inventory submitted by the <br /> facility. <br /> I have searched out and evaluated information on the properties of the chemicals at the facility, using the internet and <br /> other resources, for chemicals I am not familiar with at this time. <br /> I have reviewed the facility information with my supervisor if I could not determine the most appropriate health and safety <br /> precautions needed for this facilit . <br /> have gained an awareness of the potential hazards at the facility and have determined the appropriate health and safety <br /> precautions needed to perform my inspection. <br /> Before beginning the inspection, I will review the facility's health and safety information and rules with the owner/manager <br /> and wear the appropriate personal protective equipment. <br /> During the inspection, I will observe the labeling and condition of hazardous materials containers and conveyances, the <br /> posting of placards and warning signage, and the actions of the facility employees and guests to identify any potential <br /> unsafe conditions t t may arise during the ins ection. <br /> Staff gnature Date Staff Signature Date <br /> Robert Lopez dAr Z & t k <br /> San Joaquin County Environmental Health Department; 1868 E. Hazelton Avenue; Stockton, CA 95205; 209.468.3420 <br /> EHE 48- 06-12-2013 Pre-Inspection Health&Safety Assessment <br />
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