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State of California-California En mental Protection Agency Departure f Toxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> SECTION III: FACILITY HISTORY (continued) <br /> YES NO <br /> 8. Do you have in possession, or do you know the existence of any photographs, geophysical <br /> reports, analytical test data, and/or air sampling data that may indicate the presence of NO <br /> hazardous materials and/or waste in unwarranted or unexpected areas of the facility? <br /> 9. Do you know if the facility has disposed of items such as automotive batteries, <br /> unidentified waste materials, petroleum products, drums, barrels, and/or other containers NO <br /> of hazardous wastes by dumping, burying, or landfilling at the facility? <br /> 10. Do you know if the facility has ever had former liquid/sludge containment area(s), surface NO <br /> impoundment(s), collection pond(s), and/or lagoon(s)? <br /> 11. Do you know if land-farming or bio-remediation has been used at the facility. N <br /> 12. Do you know if the facility has ever burned hazardous wastes, unidentified waste NO <br /> materials, tires, or automotive batteries at the facility? <br /> 13. Do you know if ash and/or combustion residuals have been disposed of at the facility? NO <br /> 14. Do you know if any underground storage tank(s) have been removed from the facility? YES <br /> 15. Do you know if any contaminated soil has been discovered and/or remediated at the NO <br /> facility? <br /> 16. Do you know if there have been fires and/or explosions at the facility which may have <br /> caused contamination? NO <br /> 17. Do you know if the facility has ever received complaints from any employees, neighbors, <br /> or the public about their practices for managing hazardous wastes, or any actual or NO <br /> potential releases to air, water, or soil, or other environmental issues? <br /> 18. Do you know if nearby residents have complained of any type of sicknesses or unusual NO <br /> illnesses as having been caused or suspectedly caused by or related to activities at the <br /> facility? <br /> If YES, indicate below the person and/or agency who recorded the complaint. — <br /> If YES, do you know of any evidence submitted to a physician to substantiate the claim? <br /> 19. Do you know if the facility has ever has any former areas which were used for hazardous <br /> waste or hazardous materials transfer (i.e., tank loading areas, drum transfer areas)? YES <br /> 20. Do you know of any past, threatened, or pending lawsuits or administrative proceedings <br /> concerning a release or threatened release of any hazardous substance against the facility YES <br /> by another party? <br /> -- 21. If you answered YES to any of the above questions, those areas should receive special attention during the <br /> Walk-Through-Inspection (Section V). During the Walk-Through-Inspection, you are to determine if those <br /> areas contain possible contamination which require further investigation. Attach the results of your findings <br /> with a description of the problem, the Section and Question number being addressed, and submit it with this <br /> checklist to the Department (i,e., Section III, Question 1). <br /> Please indicate total.number of pages: Page 5 of <br /> DTSC 1151 (6/94) WORKSHOP DRAFT 10 <br />