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ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY Waste 'Fire Survey and Inspection Report 304 E WEBER AVE 3' FL STOCKTON CA 95202-2708 State of California (209) 468-3420 CIWMB-54(10/03) PART A—General Information/Survey Page_of �-- 4+K INSPECTION tSITE VISIT Type(Check ore): ❑ Routine Re-inspection ❑ Complaint ❑Observation ❑ CNVMB Referral ❑CHP Referral ❑ Other: n S Inspected by: Time In: Date Regulatory Status: ❑County/City 6 2(/C, ❑ Permitted� Excluded❑ Exempt❑ Unpermitted : S-0 Code:er ID: Time Out: T tai T me: Operational Status: ❑State Active❑Closed❑ Inactive❑ Planned l: Business/Facility Name: Tire CouI e: G, 1 5—OPassenger❑Altered❑Truck El OTR Address: Phone: rage Type: L+bz-_ 7_Jz Outdoor❑Indoor❑Container t -AJ �s�_ S Owner: I- I peccr(Pi P rq: p (, Business Rep:) `3 /JCCF fig Title: I ' +— Role of Business:(check all that apply) Facility Type:(check one) ❑ Major WTF(>5.^Co ores) ❑ Minor WTF(>�cc tires) ❑ Waste Tire Location (<sco ores) ]Generator g( Hauler ❑ End-use Business Type:(check all that apply) ❑ Dismantler ❑Auto Repair El Auto Body ❑ CCar Dealer ❑Colleon �rTire Dealer ❑ Retreader ❑ Gas Station ❑ Trucking Fleet ❑ Shredder ❑ Crumb Rubber ❑ Other Describe Excluded Business Types(Check only if Applicable): ❑ 14 CCR§ 18420(a)(3)-Facilities storing less than 500 waste tires(Waste Tire Location) ❑ 14 CCR§ 18420(a)(4) -Tire retreading facility with no more than 3,000 waste tires on premises. ❑ 14 CCR§ 18420(a) (6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days. IS 14 CCR§ 18420(a)(7)&(e) Tire dealer storing no more than 1,500 waste tires for less than 90 days. If excluded Prom permit,complete Parts 8 and 0 If net exCuded from permit requirements complete Parts B.C,and D. PART B — Inspection of Waste Tire Dealer, Generator, Hauler and End Use Facility V 'k C HAULING AND MANIFESTING REQUIREMENTS ❑ ❑ ❑ PRC §42951 (a)-Waste Tire Hauler Registration and Transport of Tires. ❑ ❑ ❑ PRC§42953-Contracts with Registered Waste Tire Haulers. ❑ ❑ ❑ 14 CCR§ 18459.1 (a)(b)(c)-Tire Program ID Number from CIWMB. ❑ Cl ❑ 14 CCR§ 18459.2.1 -Submittal of Manifest Forms and Tire Trip Logs within 90 days. ❑ ❑ ❑ 14 CCR§ 18459.3 -Retention of Manifest Forms and Tire Trip Logs for 3 years. ❑ ❑ ❑ 14 CCR§ 18460 2 -Manifest System Requirements for Registered Waste Tire Haulers. ❑ ❑ ❑ 14 CCR§ 18461 -Manifest System Requirements for Waste Tire End-Use Facilities. R ❑ ❑ 14 CCR§ 18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators. PART C —Inspection of Waste Tire Facility Y A G WASTE TIRE STORAGE STANDARDS VA C WASTE TIRE STORAGE STANDARDS Permits Requirements [ [ [ 14 CCR§17352-Site Security ❑ ❑ ❑ PRC§42824—Major Waste Tire Facility Permit ❑ (a) Signs ❑ (b)Site Attendant ❑ (c)Access ❑ ❑ ❑ PRC§42834—Minor Waste Tire Facility Permit ❑ ❑ ❑ PRC§42850(a)—Complies with Terms of Permit [ [ [ 14 CCR§17353(a)-Vector Control ❑ ❑ ❑ 14 CCR§ 18420(a) —Applicable for Permit ❑ (1) Impermeable Barrier ❑ (2) Approved Vector Plan ❑ ❑ ❑ 14 CCR§ 18423 —Filing Application for Permit [ [ [ 14 CCR§17354-Storage of Waste Tires Outdoors Recordkeeping Requirements ❑(a)Storage Units El(b)Fire Lanes ❑ ❑ ❑ 14 CCR§ 18432—Operations Plan ❑ (c) Fire District Requirements ❑ ❑ ❑ 14 CCR§ 18433—Emergency Response Plan El (d)Drainage [1 (e) Slope/Grade ❑ ❑ ❑ 14 CCR§ 18447—Records Available ❑ (f)Siting(New Facilities) [ ❑ [ 14 CCR§17351 -Fire Prevention Measures ❑ (g) Rim Removal ❑ (a)Communication Equipment ❑ (h) Protection from Pyrolytic Oil Runoff ❑ (b) Fire Equipment [ [ [ 14 CCR§17356 -Indoor Storage ❑ (c)Water Supply Facility compliance with NFPA 2310-1989 ❑ (d)Other Requirements