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A <br /> qO' <br /> COUNTY OF SAN JO QUIN <br /> RECEIVED <br /> i OFFICE OF EMERGENCY SERVICES <br /> ROOM 610,COURTHOUSE <br /> 222 EAST WEBER AVENUE SAN JOA[]J N COUNTY <br /> STOCKTON, CALIFORNIA 95202 OFFICE OF EMERGENCY SERA ES <br /> ,a HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> FAX(209)944-9015 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAME TELEPHONE NUMBER <br /> Orchard Supply Hardware 239-2161 <br /> BUSINESS ADDRESS (Facility Being Inspected) <br /> 189 W. Louise Avenue, Manteca, CA 95336 <br /> FIRE DISTRIC NSP TIO DATE JARRIVAL TIME DEPARTURE TIME INSPECTION TYPE <br /> 24 12 <br /> 11 <br /> G�-1 1110-00 1 K- ± I m�P <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY INSPECTION YES NO <br /> 1. Business HMMP/Inventory On Site 17. Facility Map Complete and Accurate <br /> 2. HMMPIMap Easily Accessible to Employees 8.Chemical Inventory Complete and Accurate <br /> 3. Bus ID Page/HMMP Complete and Accurate 9. Employees Familiar with HMMP <br /> 4, If Business is a Hazardous Waste Generator, 10.Plant Operations Appear Safe <br /> are Hazardous Waste Manifests On Site'? 11, Hazardous Materials Being Properly Handled by Employees <br /> 5. Material Safety Data Sheets (MSDS) On Site 12. Hazardous Materials Properly Stored and Labeled <br /> 6. Current Training Records On Hand 21 13. Soil and Facility Appear Non-Contaminated <br /> COMMENTS (Items marked"NO"above must be explained in this section) <br /> 10 <br /> tvr <br /> it, -1-r <br /> Q ,o� NLI�I�j <br /> 00" A?S V60(504 Oo 169L t,A#Pv P ou fug <br /> A -a aS�' IN CJIJ 1C auk 0A —011; Gc", ALL DAY <br /> W i 0 tji r-fL <br /> PAUL.i: MCC <br /> 1901�- fzrt--�Pttj vmws <br /> REFERRALS ❑ SJ Ag ❑ SJ Env Hlth ❑OSHA ❑Fire ❑DA ❑ <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective Actions Must be Delivered to OES By Follow Up Inspection Date OES Inspector Name Performing Follow Up <br /> ACKNOWLEDGEMENT OF REVIEW AND RECEIPT OF INSPECTION RESULT <br /> yyBess Rerse1-N <br /> Live(Print Name and Title)_ Business present 'v re <br /> j { 'N J �j"�l�Gam' <br /> N me of[ns ctor cy Fire (If Appropri OPY: OES <br /> PINK COPY: BUSINESS REV 9102 <br />