COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

Waste ire Survey and Inspection Repox r city/county Mailing Address State of California – j� ` llcs 14 "`� Phone Number CIWMB-54(10/03) PART A-General Information/Survey Page ) of-2, INSPECTION/SITE VISI;C Type(check one) ❑ Routine ff Re-inspection ❑ Complaint ❑ Observation ❑ CIWMB Referral ❑CHP Referral ❑Other: Facility SWIS: Inspected by: Time In: Date: Regulatory Statu File No. TPID: i 3 1-7 / - ElCounty/City El xcluded ElExempt E]Unpermitted Code: Hauler ID: State Time Out: Total Time: Operational Status: ❑ Local: D Active❑Closed❑ Inactive❑Planned Business/Facility Name: Tire Count: T,�yy,pe-�e- �'— L assenger[]Altered❑Truck❑OTR Address: Phone: Storage Type: �' (��? —(J 7SS�, D 6utdoor❑ Indoor El container Owner: Ins ec r(Please Print): Business Rep: Title: Facility Type:(Check one) u Role of Business:(Check all that apply) ❑ Major WTF(,5,000 tires) ❑ Minor WTF(-500 tires) ❑Waste Tire Location (,500 tires) Generator ❑ Hauler ❑ End-use Busi ess Type:(Check all that apply) Tire Dealer ❑ Retreader ❑ Dismantler ❑Auto Repair ❑Auto Body ❑Car Dealer ❑Collection ❑ 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. EZY 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 6 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 \/ 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 CWASTE TIRE STORAGE'STANDARDS V A C WASTE TIRE STORAGE STANDARDS Permits Requirements [ [ C 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 C C [ 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 [ ❑ [ 14 CCR§17351 -Fire Prevention Measures El (fl Siting(New Facilities) ❑ (g)Rim Removal ❑ (a)Communication Equipment ❑ (h)Protection from Pyrolytic Oil Runoff ❑ (b)Fire Equipment [ [ [ 14 CCR§17356 -Indoor Storage ❑ (c)Water Supply ❑ (d)Other Requirements Facility compliance with NFPA 231 D-1989