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RECEIVED <br />• oP4�!K. COUNTY OF SAN JOAQUIN 2011 <br />OFFICE OF EMERGENCY SERVICES <br />2 J <br />a 2101 E. Earhart Avenue, Suite 300 SAN <br />OAQUIN �FFlCEOFE COUNTY <br />Stockton, California 95206 MERGENCySERVICE' <br />• �. P Telephone: (209) 953-6200 <br />F O R�� Fax: (209) 953-6268 <br />HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br />BUSINESS NA�1E <br />AT&T 140BILITY .ADDRESS (Facility Being Inspected / <br />s <br />le <br />ACCOUNT tt START DATE (New Bus) INSPE ION ATE ARRIVAL TIME IDEPARTURE T�IN1E JINSPEil�\.��tEn r <br />/O ROBERT i.0:`Z <br />INSPECTION RESULTS <br />DOCUMENT REVIEW YES NO FACILITY WALK THROUGH <br />YES NO <br />1. HMMP/Map On Hand and Easily Accessible 5. Facility Map Complete anHAccurate y� <br />2. Business Identification Page Complete & Accurate <br />6. Employees Familiar with <br />3. Business HMMP Complete and Accurate 7. Training Records Available <br />4. Chemical Description Pages Complete and Accurate <br />is 8. Unsafe Conditions Observed (see details below) � <br />EXPLANATION OF FINDINGS AND CObIMENTS <br />_t I <br />I \'A'ECTION FOLLOW UP INF'ORMLTEM <br />'orrective Actions Additional <br />('�� Re Submitted 13v: i-/ Referrals/Notes: <br />�l l.��111L.I:U(;E�IENTOFREII1) RECEIPT OFINSPECTION RF.SULTS, <br />3usiu Rrpriii �ntative (Pant NtI'll .,nd I idel <br />Ru,inrss Rcprc,,zni rSattire) <br />WHITE COPY <br />()FS <br />PINK COPY <br />REV .t <br />(�,I�R ? 5 REC'd <br />