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ARCHIVED REPORTS XR0012588
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0012588
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Last modified
6/20/2019 5:05:37 PM
Creation date
6/20/2019 3:39:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012588
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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_> physical examination as appropriate. This examination has been designed :to <br /> comply with OSHA requirements in 29 CFR 1910.120 for hazardous waste site <br /> operations. <br /> The IT medical surveillance program examination consists of: <br /> Medical and occupational history form (detailed questionnaire for new <br /> r- employees, short questionnaire for periodic exams) <br /> • Physical examination <br /> • Complete blood count wth differential <br /> SMA( 23 <br /> Urinalysis (dipstick and microscopic) <br /> ^ Chest x-ray <br /> • Pulmonary function test (FEV/FVC) <br /> f � j <br /> • . Audiometric examination <br /> rs - Electrocardiogram for persons older than 45 years of age, or if <br /> medically indicated <br /> ©rug and alcohol screening <br /> • Visual acuity- <br /> ` The Following information is provided to the examining physician: <br /> r Description of employee's duties <br /> {'. Anticipated exposure levels <br /> • Description of the PPE to be used <br /> s 'r Information from previous medical exams. <br /> A copy of the medical examination is provided the employee at his/her <br /> request. The employee shall be informed of any medical conditions that would <br /> result in work restrictions or that would preclude him/her from working at . <br /> hazardous waste sites. . <br /> -- --- - 1�„ :: ---- ------'--- --- -- -- <br /> All subcontractor personnel who have potential for exposure to hazardous <br /> materials shall have-successfully completed an examination similar, to the <br /> D-b 1. <br /> ` -rrA:ENG:9204-APpD/031191 <br />
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