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`ft..' COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES <br /> 2101 E. Earhart Avenue,Suite 300 <br /> Stockton,California 95206 <br /> Telephone:(209)953-6200 <br /> Fax: (209)953-6268 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAME ADDRESS(Facility Being Inspected) <br /> AT&T MOBILITY Zp l f� `2 Cj.1 jel" <br /> ACCO10 6!1 <br /> UNT# ISTART DATE(New Bus) INSPE I0ND TE ARRIVAL TIME DEPARTURE TI IN ECTOR NAME f <br /> 12782-1 z3 , ! d �� ROBERT LOPEZ <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 v <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 /> J l/e—C— G!?A d !3 c J -�' Q <br /> ot4l <br /> INSPEC'T'ION FOLLOW UP INFORMATION <br /> Corrective Actions Additional <br /> Submitted By: 4 t&12-a `� Referrals/Notes: <br /> FLAKWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULTS <br /> usiness Representative(Print ame and Title) Business Re resenta v (Signature) <br /> WHITE COPY: OES <br /> Qi PINK COPY: BUSINESS <br /> REV 4110 <br />