COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

i i Pre-Inspection Health and Safety Assessment Facili Name: R & B LOUISE LLC ET AL — FA#: FA0022826 FR#: PR0539909 Location: 500 E LOUISE AVE Business Type, COMMERCIAL PROPERTY Date: Mar 13 2015 Initiall Com leted B : E Manzo he or fter Instructions: Fill Substhis eauent InsD ctio sP Re view facility ble file aninitial chemctal inventory nlformati n, along with the information on this The inspection. form, to become familiar with potential hazardous substances and/or conditions at the facility and any control or precautionary measures that should betaken prior to conducting the inspection activity. alta/Haza dslete form as needed.Sign and date below. Chemical Hazards ❑ Ox en Deficiency: ® Carcino ens: ® Noise: ® Corrosives: ❑ Excavations: ® Flammables: I@ Climbing, ❑ Gases: ❑ Ex losion: ❑ Metals: 0 Heav E ui ment. ® Oxidizers: ® Heat or Cold Stress: ❑ PCBs: ❑ Other: ❑ Ex losives: Personal Protective E ui ment Biolo 1 a Hazards ® Hard Hat ❑ CPC-T vek ❑ Do s ® Safet Vest ❑ CPC-Other: ❑ Snakes ® Protective Boots ❑ APR Res irator ® Insects ® Go les/Glasses ❑ SCBA Res irator ® Poisonous Plants ® I Hearin Protection ❑ Other: ❑ Other: By signing below, I am declaring that I have reviewed the health and safety information for this facility prior to my inspection and that I have performed, and will perform during the inspection, the following actions: I have reviewed this form and the facility file for information on the business type of operation,compliance history, prior releases and res onse, and other health and safely related information. I have reviewed the properties and hazards associated with the chemicals in the chemical inventory submitted by the facilit . I have searched out and evaluated information on the properties of the chemicals at the facility, using the Internet an other resources,for chemicals I am not familiar with at this time. I have reviewed the facility information with my supervisor if I could not determine the most appropriate health and safety recautions needed for this facilit11. I have gained an awareness of the potential hazards at the facildetermined the appropriate health and safety ity and have recautions needed to perlolLi m ins ection. Before beginning the inspection, I will review the facility's health and safety information and rules with the owner/manager and wear thea ro riate ersonal rotective a ui ment. During the inspection, I will observe the labeling and condition of hazardous materials containers and conveyances,the posting of placards and warning signage, and the actions of the facility employees and guests to identify any potential unsafe conditions that may arise durin the ins ecttiione Staff Signature Date Staff Signature an - ?)-1' San Joaquin County Environmental Health Department 1868 E. Hazelton Avenue; Stockton,CA95205;209.468.3420 r ; eAssessment EHD 48- 06-12-2013