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ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY • Waste ire Survey and Inspection Report 304 E WEBER AVE 3RD , - r••• STOCKTON CA 95202-2708 State of California (209) 468-3420 CIWMB-54(10/03) �7 PART A—General Information/Survey Page_of t� ' INSPECTION I SITE VISiT H . ,f, z;.3* .:�. ,.., Type(Check one) /Routine ❑ Re-inspection ❑ Complaint ❑ Observation ❑ CIWMB Referral ❑CHP Referral ❑Other Facility SWIS: Inspected by: Time In: Date: Regulatory tatus: File No. TPID: ❑County/City 6/2-3/1'6'r ❑ Permitted y Excluded❑ Exempt❑ Unpermitted Code: Hauler ID: Time Out.. T tat ime: O erational Status: Local: El 'Active❑Closed❑Inactive❑Planned Business/Facility Name: Tire Count: ype: -j ' Passenger❑Altered ❑Truck❑ OTR Address: Phone: torage Type: L,= �e� U v Outdoor❑Indoor I]Container Owner: Inspector(Please Pnnt) u iness Rep: wr• .,r_�=�15 Title: Facility Type:(check one) Role of Business: [CheA all that apply) ❑ Major WTF(,5,000 tires) ❑ Minor WTF(>500 tires) ❑Waste Tire Location (<500 tires) Generator ❑ Hauler ❑ End-use Business Type:(Check all that apply) ❑Tire Dealer ❑ Retreader ❑ Dismantler ❑Auto Repair ❑Auto Body ❑Car Dealer ❑Collection ❑ Gas Station ❑Trucking Fleet ❑ Shredder ❑ Crumb Rubber ROther: 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. ❑ 14 CCR§18420(a)(7)&(e)-Tire dealer storing no more than 1,500 waste tires for less than 90 days. If excluded from permit,complete Parts B and D. If not excluded from permit requirements complete Parts B,C,and D. PART B — Inspection of Waste Tire Dealer, Generator, Hauler and End-Use Facilit od V A 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. ❑ ❑ ❑ 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. ❑ ❑ 14 CCR§ 18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators. PART C — Inspection of Waste Tire Facility V A I C WASTE TIRE STORAGE STANDARDS V, A C WASTE TIRE STORAGE'STANDARDS A „ � 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 ❑ ❑ ❑ 14 CCR§18432-Operations Plan ❑ (b)Fire Lanes ❑(c)Fire District Requirements ❑ ❑ ❑ 14 CCR§ 18433-Emergency Response Plan ❑ (d)Drainage ❑ ❑ ❑ 14 CCR§ 18447-Records Available ❑ (e)Slope/Grade ❑ (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 __77d 0 (d)Other Requirements Facility compliance with NFPA 231 D-1989