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-San Joaquin County Hazardous Material t 1990 Worksheet JAN 13 1990 - � Businesses completing Hazardous Materials Management Plans (HMMPs) pi2fj 1N-afe rre'1quiredr pete and submit the attached 1990 HMMP. Businesses completing HMMPs after J&ffi'r%VOTLHM'9WTI{ a'use this worksheet to determine if submittal of updates is necessary. Please compare the 1990 HMMP format with your current HMMP. If you answer "yes" to any of the following questions, you are then required to submit the sections of the HMMP which are no longer accurate to OES by January 31, 1990. Section 1: LS4 Has your business name or address changed?-------------- Have emergency notification personnel and/or telephone numbers changed?—Has the nature of your business changed?---------------- Did you neglect to document your Dun and Bradstreet number?——————— — Did you forget to sign your previous HMMP?————————————— - Section 2. Have your emergency procedures changed?——————————————— Have you reassigned emergency responsibilities for employees?—————— —— Section 3: Have you reassigned an evacuation leader? —— ———————————— Have you changed shift hours and number of employees per shift?—————— — Have you changed evacuation routes and evacuation assembly areas?————— — Zr Has the area surrounding your business changed (i.e. new developments)?— — — — Section 4: Have you reassigned a spill control leader?—————————————— — Have you added, deleted, or changed your safety equipment, spill control equipment, or monitoring equipment?----------------- Have you designated or changed a clean-up company which can assist you - during a hazardous materials incident?----------------- Have you changed your written spill and leak procedures?—————————— Section 55: n sWx Does your facility diagram or topographical map need to be updated?—— — — — y/ Y Section 66. Has your employee safety and training program changed?———— —— — —— Chemical Inventory: A completed chemical inventory must be submitted to OES every year. Please complete the inventory form and submit with this worksheet. Return the forms to OES by January 31, 1990. Certification: I swear under penalty of perjury that the above information is accurate to the best of my knowl- edge. Print Name: - M N 14YL-02 Job Title: Signature: Date: — I —� 0 Business Name: r?tiIAOO^ Celt C'h Z2 Telephone Number: Site Address: 4111 L'x'12 cN 112 ^� 1