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Cal-EPA DEPARTMENT OF TOXIC SUB'-4NCES CONTROL GRAY DAVIS,Govemor <br /> 14W J <br /> SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E.WEBER AVE. <br /> STOCKTON,CA 95202 s, <br /> ODM,. <br /> CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br /> Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br /> SIGNATURE SHEET <br /> Onsite Recycling: Only answer ifthis facility recycles more than 100 kilograms/month of hazardous waste onsite. <br /> NO <br /> 27. The appropriate local agency has been notified. HSC 25143.10 <br /> _ 28. Activities claimed under the onsite recycling exemption are appropriate. HSC 25143.2 et sec. <br /> Releases: <br /> YES <br /> _ 29. Within the last three years,were there any unauthorized or accidental releases to the <br /> environment of hazardous waste or hazardous waste constituents from onsite treatment units? <br /> _ 30. Within the last three years,were there any unauthorized or accidental releases to the <br /> environment of hazardous waste or hazardous waste constituents from any location at this <br /> facility? <br /> Forpurposes ofa Tiered Permitting inspection, a release to the environment is unauthorized or <br /> accidental and does not include spills contained within containment systems. <br /> Source Reduction: <br /> 31. Generator was subject to SB 14 OR SB 1796 and failed to prepare and retain current source <br /> reduction documents, as applicable, and make them available to the inspector within(5) days. A <br /> checklist or plan is required only if annual hazardous waste volume is overr 5,000 kilograms(approximately 11,000 <br /> pounds or 1,350 gallons). <br /> _ 32. Source Reduction Evaluation Review and Plan failed to contain, at a minimum, the following <br /> five required elements: certification, amounts of wastes generated,process description,block <br /> diagrams, and implementation schedule of selected source reduction measures. <br /> This report may identify conditions observed this date that are alleged to be violations of one or more sections of the <br /> California Health and Safety Code(HSC)or the California Code of Regulations,Title 22(22 CCR)relating to the management of <br /> hazardous waste. The violations may be described in more detail on the attached note sheets. If any violations are noted,the <br /> facility is required to the submit a signed Certification of Return to Compliance within 30 days,unless otherwise specified. (A <br /> certification form is provided.)If any corrections are needed to the initial notification,the facility will submit a revised <br /> notification within 30 days to the Department of Toxic Substances Control with a copy to the local enforcement agency.DTSC or <br /> the local enforcement agency may reinspect,at any time,to verify compliance with this Notice to Comply. <br /> Inspector(s): <br /> Lead Inspector: In <br /> : � Other spec <br /> r��ltr. tor: <br /> Signature: . fZ Signature: <br /> Print Name: L7G-A , Ti.GksoA Print Name: L ce 0 <br /> Title:,I?„4,silc ad CNa,r.NN.i 140 Nealy 'S?eci.I�lsf J Title: "— Za,,. ;r 5S, Sfi,, c�J S-11 <br /> Agency LN7M9NIN MI GNJIHNM�MM/k{ xt�a(' Agency: , TSC <br /> Phone Number: Zo9-y68-3yy0 Phone Number: Sitf—SVO -3F.7S <br /> Facility Repr entative: <br /> Your Signa ac ledges receipt of this report and does not imply agreement with the findings. <br /> } Signature. J 'r Print Name: yl✓C F• !'UNN0/C <br /> f Title: S t T 45 t o s>— .Y Date: /o/9 l-i <br /> Onsite Checklist (C) Page of February 10, 1999 <br />