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California Integrated Waste State of California Management Board CIWMB 501 (Rev.9/02) WASTE TIRE FACILITY OPERATION PLAN California Code of Regulations(CCR),Title 14, §18432 requires that an Operation Plan be submitted as part of a waste tire facility permit application. For ease of reference,the applicable CCR section numbers are indicated where appropriate on this form. I. GENERAL INFORMATION(please print or type) SWIS#: Facility Name: Facility Mailing Address: City: County: State: Zip: Phone: II. FACILITY OPERATION DESCRIPTION(attach additional pages if necessary) Days and hours of operation: Days and hours open to public: How will waste tires be received? ❑ Self Haul ❑ Common Carrier ❑ Public ❑ Other: ❑ Outdoors(Complete Sections I,II,III,V,and VI) How will waste tires be stored? and/or ❑ Indoors(Complete Sections I,II,IV,V,and VI) Describe storage method(s): Describe on-site processing(e.g.,shredding,buffing,milling,baling,product manufacturing,etc.): Haul Destinations/Sites: You will be permitted for the maximum quantity of waste tires that you intend to store during the five year permit period, not to exceed the amount that can be stored in compliance with 14 CCR, Division 7, Chapter 3,Article 5.5,sections 17350 through 17356. Financial Assurances shall be based on the permiYed uanti . + Maximum quantity of waste tires to be stored: III. OUTDOOR STORAGE REQUIREMENTS A. FIRE PREVENTION MEASURES-§17351 On-Site Emergency Communications: ❑ Phone: arE] Radio: ea-code/numbertype/channel,band,or net On-Site Emergency Equipment: ❑ One,dry chemical fire extinguisher Weight: ❑ One,2'/z gallon water extinguisher ❑ One,pike pole at least 10 feet in length ❑ One round point and one square point shovel Describe additional equipment on-site. Any local fire authority requirements? Attach any local fire authority agreement/approval.