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RECEIVED <br />oP41"�. COUNTY OFSANJOA UIN ^1{ <br />Q APR a � x.,11 <br />OFFICE OF EMERGENCY SERVICES <br />b - 2101 E. Earhart Avenue, Suite 300 SAN JOAQUIN COUNTY <br />_ Stockton, California 95206 JFFICE OF EMERGENCY SERVICES <br />r; `P Telephone: (209) 953-6200 <br />Fax: (209) 953-6268 <br />HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br />BUSINESS NAME <br />A>�7� (FaciTt Being Inspected) <br />AT&T-------- -- - <br />MOBILITY ' 4j <br />ACCOUNT k STARTA�ew � <br />INSPE [ON DATE ARRIVAL ITNIE DEPA TURF TISIE INSPE R NALIE <br />�� <br />"' c:^/f /� �" <br />DOCUMENT REVIEW <br />INSPECTION RESULTS <br />YES NO FACILITY WALK THROUGH <br />1. HMMP/Map On Hand and Easily Accessible <br />S 5. Facility Map Complete and Accurate <br />2. Business Identification Paye Complete & Accurate L 6. Employees Familiar with HMMP <br />3. Business HMMP Complete and Accurate <br />Training Records Available <br />I. Chemical Description Pages Complete and Accurate <br />tr ` 8. Unsafe Conditions Observed (see details below) <br />EXPLANATION OF FINDINGS AND CO;vI:V <br />tENTSS <br />IION FOLLOW UP INFORJL%-I'IO:N <br />t �-lrrrrti� � :A�tit>ns 4EI� <br />k) Be Submitte(I Bv: f� - Additional <br />iReferrals/Vote: <br />kChNOtVi.F;UGI:JIEVTO kRECF"IPTOFINSPF.('llt)\itl�Il I` <br />31SI11e5$ Representati%e (Print Name and Title) -- <br />( Blhll4. .�. T�ri1l_11� l 1 71i (51,1;;;Ilifl'I <br />YES NO <br />WHITE COPY ()FS <br />PINK COPT' Bt:iINI—, <br />kt:, .I i <br />MAR 2 RECD <br />Ll- <br />WHITE <br />./ <br />