Laserfiche WebLink
Waste Tire Ivey & Inspection Re4Wt <br /> State of SURVEY REQUIRED <br /> .m D <br /> CIWMedWast(New Manag) Form - Page 2 <br /> Californiama Integrated Waste Management Board <br /> Inspection <br /> Part C Facility Information BLUE OR BLACK INK PEN <br /> Sttsiness"Ftrcfil ' <br /> Inspecttq.p staff, <br /> TPID- I I ( u Inspection -� <br /> Site Suffix: J I y3 - �' Report <br /> Number: <br /> SWIS mInspection Number on the associated Survey form(Page 1) <br /> Number: L1� Photos Taken 0 Yes @ No <br /> r LY _x �11,tri�a �t((✓ 1 Pv'}-�i f (1 C t , r` ,^ - _ -� C:U <br /> Name -- - --- !I.— -- -- Ii- <br /> city State ZIP Code <br /> 'ess Type (Fill if applicable) Permitted Regattatory Status (Pili nn�;, <br /> Q PRC §42823.5-Cement Manufact!firing Plant with written verification that the facility qualifies for exemption Permitted Q Exempt <br /> usiness Types(Fill if applicable) <br /> O PRC§42808-Permitted Solid Waste Facility(Landfill,Transfer Station) <br /> O Excluded O Unpermitted <br /> Q 14 CCR§18420(a)(2)-Agricultural<5,000 tires incapable of holding water&used for bumpers or ballast Facility Type(Fill ore) <br /> 0 14 CCR§18420(a)(4)-Tire retreading facility with no more than 3,000 waste tires on premises Q Major WTF (>5,000 Tires) <br /> Q 14 CCR§ 18420(a)(6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days <br /> �+ 14 CCR§18420(a)(7)&(e)-Tire dealer storing no more than 1,500 waste_ tires for 90 days 0 Minor WTF (500-4,999 Tires) <br /> Part D - Inspection of Waste Tire Facility <br /> V A , WASTE TIRE STORAGE STANDARDS u -- <br /> ta,1!k� ,,� i 0D 'g46' �_.e ,..-�' <br /> I O Q PRC§42824-Major Waste Tire Facility Permit 0 (a)Signs 0 (b) Site Allendant 0 (c)Access <br /> Q Q PRC§42834-Minor Waste Tire Facility Permit O 11 CCR§17353(a)-Hector Control <br /> O O PRC§42850(a)-Complies with Terms of Permit <br /> 0 (I) Impermeable Barrier 0 (2)Approved VectorPlan <br /> 14 Cd,R§11354-Storage of Waste Tires Outdoors <br /> Q O 1 14 CCR§18420(a)-Applicable for Permit 0 (a)Storage Units <br /> O O 14 CCR§18423-Filing Application for Permit O (b)Fire Lanes <br /> O O 14 CCR§18432-Operations Plan O (c)Fire District Requirements <br /> Q Q 14 CCR§18433-Emergency Response Plan <br /> O (d)Drainage <br /> rdkeeping Requirement O (e)Slope/Grade <br /> 0 (f)Siting(New Facilities) <br /> Q Q 14 CCR§ 18447-Records Available 0 (g)Rim Removal <br /> a 0 14 CCR§17351-Fife Prevention Measures O (h) Protection from Pyrolytic Oil Runoff <br /> 0 (a) Communication Equipment 0 (c)Water Supply o 0 14 CCR§17356-Indoor Storage '1 <br /> O (b)Fire Equipment 0 (d) Other Requirements Facility Compliance with NFPA 231D-1989 <br /> Comments <br /> te of. toP artd rVC <br /> ✓ f <br /> 01 L` V i etde?d . o k le,- I <br /> h 1F�1 ' I �.r ccC � c <br /> > y � 1 Q. a , 1 vh , 001 <br /> 01 f ' )Y"rl f'' r()(f-) 2 Dq Ao rCCi t ma,4 l /F'f lnkl< <br /> _7)4YI Ott 3 u_( fa,fu (L( <br /> 12 <br /> INSTRUCTIONS ON BACK I Correct:* Incorrect: X Ak �A 0,0, 'S "' 15386 LC_. i L <br /> ■ White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA ■ <br />