Laserfiche WebLink
,dMkL Ah <br /> 1W qw <br /> COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES <br /> ROOM 610,COURTHOUSE <br /> 222 EAST WEBER AVENUE <br /> k � <br /> STOCKTON, CALIFORNIA 95202 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> -' FAX(209)944-9015 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAM TELEPHONE NUMBER <br /> tia <br /> BUSINESS ADDRESS (Facility Bein nspec <br /> FIRE DISTRICT INSPE TIO ATE ARRIVAL TIME DEPARTURE TIME INSPECTION TYPE <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY INSPECTION YES NO <br /> 1. Business HMMP/Inventory On Site 7.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, a 10.Plant Operations Appear Safe <br /> are Hazardous Waste Manifests On Site? ff� 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 13. Soil and Facility Appear Non-Contaminated <br /> COMMENTS (Items marked"NO"above must be explained in this section) <br /> HEADQUARTERS <br /> P.O.BOX 600 <br /> LOO I.CA 9524 <br /> - (209)368-0128 <br /> i111111111�A! FAX(209)369-6160 <br /> PACKAGING WAREHOUSE: <br /> 1195 N.GERTRUDE <br /> JACK GARIBALDI STOCKTON,CA 95215 <br /> (209)948-8112 <br /> Plant Manager FAX(209)948-1915 <br /> email:JACKGARIBALDICMSN.COM 1203 REPORT AVE. <br /> STOCKTON,CA 95205 <br /> (209)939-1753 <br /> CONTRAC7PACKAGING,WAREHOUSING•fOGIS71CS FAX(209)939-9827 <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 RESULTS <br /> Business Representative(Print Name and Title) Bumess epresentativ (Signature) <br /> Name of Inspector Agency Firlv <br /> o. (If Appropriate) WHITE COPY: OES REV 9/02 <br /> PINK COPY: BUSINESS <br />