Laserfiche WebLink
op4`?'•^!. c COUNTY OF SAN JOAQUIN <br /> /. ��•�,a� OFFICE OF EMERGENCY SERVICES <br /> Q ?.� 2101 E. Earhart Avenue, Suite 300 <br /> " ` ` Stockton,California 95206 <br /> Telephone:(209)953-6200 <br /> c4�iFa'g�'�P Fax:(209)953-6268 <br /> HAZARDOUS MATERIALS PROGRAM INSPECTION FORM <br /> BUSINESS NAME ADDRESS(Facility Being Inspected) J <br /> -s� �u✓� r ,�01 s c. 7`�� <br /> ACC UNT# START DATE(New Bus) INSPE lQ DATE ARRIVAL TIME DEPA TURE TIME INSPEC R NAM <br /> �� <br /> 1 .2- b 4 Z /'O /��v /Sao �0 2- <br /> INSPECTION <br /> INSPECTION RESULTS <br /> DOCUMENT REVIEW YES NO FACILITY WALK THROUGH YES NO <br /> 1.HMMPIMap On Hand and Easily Accessible 6. Facility Map Complete and Accurate <br /> 2.Business Identification Page Complete&Ac rate 7. Presence of Non-Listed Regulated C micals <br /> 3.Business HMMP Complete and Accura 8. Employees Familiar with H0111 M <br /> 4.Chemical Description Pages Co ete and Accurate 9. Hazardous Materials Zte Properly Labelled <br /> 5.Training Records Availabl _ 110. Conditions that w uld hinder implementation of <br /> Emergency Plan or increase risk of release are absent <br /> EXPLANATION OF FINDINGSS AND COMME TS <br /> Q G[ CC C�l,Q CcL✓r �� <� c$'!' L5�0 C� dr.Gsa , <br /> F <br /> t- c- if cqrr� � e_� 004 <br /> TRUCK SALES <br /> 2546 Turnpike Road ; <br /> Stockton,CA 95206 1 <br /> Nathan Davidson <br /> Chairman o11he Board <br /> TRUCK PARTS & 1016 South Wilson Way <br /> E a U I P M E N T I N C. Stockton,CA 95205 <br /> Phone 209.466.7021 <br /> Toll Free 1•B00.545.2263 <br /> F 209 946 4617 <br /> • Moble 209.993.1573 <br /> E-mail:ndavidson@acmeequip.com 4 <br /> www.acmeequip.com <br /> INSPECTION FOLLOW UP INFORMATION <br /> Corrective Actions Additional <br /> To Be Submitted,By: Referrals/Notes: <br /> CKNOW EDGE T OF REVI W AND RECEIPT OF INSPECTION RESULTS <br /> Busine a attve rint Na a and Title) Business Represent tine(" nature) <br /> WHITE COPY: OES <br /> PINK COPY: BUSINESS <br /> o � �Gzr rug/ rS a-i;} REV 2r <br />