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state of California-California Enviroriacntal Protection Agency Department of Toxic Substances Control TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST SECTION V: FACILITY WALK-THROUGH-INSPECTION Instructions: This section of the checklist requires the owner and/or operator of the facility to conduct a walk-through- inspection of the facility in order to identify possible environmental problems, environmental warning signs or potential exposure to people, animals, or plants. Some of the problems that may be discovered during this inspection may include abandoned'storage tanks, spill areas, surface impoundments, etc. Some of the environmental warning signs include stains, discolored vegetation, and/or unnatural terrain. During the inspection, were any of the following present: YES NO 1. Does the facility have vent pipes, fill pipes, and/or access ways that may indicate the presence NO of an underground storage tank? 2. Does the facility have stains and/or discoloration of the soil, flooring, drains and/or walls at NO the facility which may indicate a release? 3. Does the facility have areas of soil at the facility that appear disturbed without reason? NO 4. Does the facility have areas at the facility where the terrain appears unnatural, such as NO unexplained mounds or depression? 5. Does the facility have unusual smells or odors emanating from the soil, floor, drains, and/or NO walls at the facility? 6. Does the facility have dead, abnormal, or distressed-appearing vegetation or conspicuous NO absence of vegetation at the facility that is not directly explainable by a deliberate action and/or lack of water at the site? 7. Does the facility have areas of the ground surface of the site that have low lying spots or NO sloping areas where water can collect, pool, or run off? 8. Were any piping or secondary containment systems observed to be damaged or leaking? NO 9. Is there evidence or signs of structural instability? NO If YES, then attach a description of the structural instability and its location at the facility. 10. Is the facility unsecure due to improper fencing, absence of guards, or alarms. NO 11. Where does rain and/or wash water drain to at the facility (circle all that apply)? aStorm drain b Sewer C. Drainage ditch d. Open land Other LANDSCAPING Indicate below the drainage direction and pattern before the rain and/or wash water leaves the facility (i.e. North, towards the sewer in the street). NORTH TO STORM DRAIN 12. If you answered YES to any of the above questions, it may indicate potential contamination or it may indicate that there is an environmentally sensitive area near the facility and that the area could be impacted by any operation. You should examine these areas carefully to determine if further investigation is required to verify if contamination exists. Attach the results of the findings with a description of the problem, the Section and Question number being addressed, and submit it with this checklist to the Department (ie. Section V, Question 1). Please indicate total number of pages: Page 7 of DTSC 1151 (6/94) WORKSHOP DRAFT 12