Laserfiche WebLink
882270S0002 <br /> € , Waste Tire Survey & Inspection Report <br /> m <br /> State e1Califomla SURV Y QUIRED ■ <br /> cerate Walt :=92> Inspection Form - Page 2 <br /> Galironda <br /> integrated Wafh Nanaafmfn!board <br /> Part C-Facilily Information BLUE OR BLACK.INK PEN' <br /> Business Profile Inspection Details <br /> I TPID- I I- Inspection _ <br /> Site Suffix: Q q R g / Report I ' , 0 jY g <br /> Number: V v <br /> SWIS F1 inspection Number on the associated Survey form(Page 1) <br /> NumberEEI Photos Taken Q Yes No <br /> Property Owner - -- <br /> ams J Phone Rumbe—r —J'Ma&V Address city State I node <br /> Exempt Business Type (Fill if applicable) Permitted Regulatory Status(Fill one) <br /> Q PRC§42823.5-Cement Manufacturing Plant with written verification.that the facility qualifies for-exemption O permitted"� Q Exempt <br /> Excluded Business Types(Fill if applicable) <br /> Q PRC§42808-Permitted Solid Waste Facility(Landfill,Transfer Station) Excluded Q Unpermid6d <br /> Q 14 CCR§18420(a)(2)-.Agricultural<5,000 bras incapable of holding water&used for bumpers or ballast Facility Type(FRI one) <br /> i 14 CCR§18420(a)(4)-Tire retreading facility with no more than 3,000 waste fires on premises Q Major WTF (?5,000 Tires) <br /> Q 14 CC R§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 Ao more than.1,500 waste tires for 90 days Q Minor WTF (500-4,999 Tires) <br /> Part D-Inspection of Waste Tire Facility <br /> V WASTE TIRE STORAGE STAND R V A <br /> Permit Requirements 100 14 CCR§'17352-Site Security <br /> Q Q PRC§42824-Major Waste Tire Facility Permit 0(a)Signs 0(b)Site Attendant _2_(.)Access <br /> Q Q PRC§42834-Minor Waste Tire Facility Permit Q Q 14 CCR§17353(a)-Vector Control <br /> Q Q PRC§42850(a)-Complies with Terns of Permit 0(1)Impermeable Barrier 0(2)Approved Vector Plan <br /> p Q 14 CCR§17354-Storage of Waste Tires Outdoors <br /> Q Q 14 CCR§18420(a)-Applicable for Permit 0(a)Storage Units, <br /> Q Q 14 CCR§118423.Filing Application for Permit 0(b)Fire Lanes. <br /> Q Q 14 CCR§18432-Operations Plan 0(c)Fire District Requirements <br /> Q Q 14 CCR§18433:Emergency Response Plan 0(d)Drainage <br /> 0(e)Slope/Grade <br /> Recordkeeping Requirement 0(f)Siting.(New Facilities) <br /> 01 Q 14 CCR§18447.-Records Available 0(g)Rim Removal <br /> 01 Q 14 CCR-§17351-Fire Prevention Measures 0(h)Protection from Pyrolytic Oil Runoff <br /> 0(a)Communication,Equipment 0(c)Water Supply 00 14 CCR§17366.Indoor Storage <br /> 0(b)Fire Equipment 0(d)Other Requirements Facility Compliance with NFPA 231D-1989 <br /> Comments /y-1 t <br /> 0 1 -'O/i4-r7_V-3 D! C117't cs-a,n S ova r%_J . <br /> 15386 <br /> INSTRUCTIONS ON BACK I&JAIMIP[LIE1 111913 <br /> White Copy.CIWMB Yellow Copy.Operator Pink Copy LEA <br />