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ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY Waste Tire Survey and Inspection Report 304 E WEBER AVE 3� FL STOCKTON CA 95202-2708 State of California (209) 468-3420 CIWMB-54(10/03) PART A—General Information/Survey Page of Z� _ FT INSPECTION ISITE VISITI? N'' xtts ., Type(Check one) Routine ❑ Re-inspection ❑ Complaint ❑ Observation ❑ CIWMB Referral ❑CHP Referral ❑ Other: Facility SWIS: Inspected by: Time In: Dat Regulatory Sta s: File No. ❑ County/City �; ❑Permitted Excluded ❑ Exempt❑ Unpermitted TPID 0.71 Sy-cf Code: Hauler ID: Time Out: T tal ime: Op rational Status: ❑ State Active❑Closed❑ Inactive❑Planned Local: lne s/Facility Name: Tire Count: Type: Bus �' ❑Passenger❑Altered ❑Truck❑ OTR Phone: Storage Iype: Address: c'� �� y+ 11-q 7 Z Q ffputdoor❑Indoor Container Owner• Inspec r(Please Print): I , u Business Rep: 12 - � ' g1"rvr ► � ;�-.K-�l Title: Role o BUSInesS:(Check all that apply) Facility Type:(Check one) ❑ Major WTF(>5,000 tires) ❑ Minor WTF(,500 tires) ❑Waste Tire Location (<500 tires) Generator ❑ Hauler ❑ End-use Busin ss Type:(Check all that apply) ❑ [O/Fire Dealer 171 Retreader Dismantler ❑Auto Repair [I Auto Body ❑Car Dealer ❑Collection ❑ Gas Station ❑ Trucking Fleet ❑ Shredder ❑ Crumb Rubber El 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. 14 CCR§ 18420(a)(7)&(e)-Tire dealer storing no more than 1,500 waste tires for less than 90 days. If excluded from permd,complete Parts B 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 Facility RC 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. ❑ ❑ I ❑ 1 14 CCR§ 18460.2 -Manifest System Requirements for Registered Waste Tire Haulers. ❑ ❑ 1 ❑ 1 14 CCR§ 18461 -Manifest System Requirements for Waste Tire End-Use Facilities. ❑ ❑ 1 ❑ 1 14 CCR§ 18462-Manifest System Requirements for Tire Dealers or Waste Tire Generators. PART C —Inspection of Waste Tire Facility V A C WASTE TIRE STORAGE STANDARDS V A C WASTE TIRE STORAGE STANDARDS Permits Requirements [ I [ [ 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 ❑ E] ❑ PRC§42850(a)-Complies with Terms of Permit [ [ [ 14 CCR§17353(a) Vector Control ❑ ❑ ❑ 14 CCR§ 18420(a) -Applicable for Permit ❑ (1) Impermeable Barrier LJ (2) Approved Vector Plan ❑ ❑ ❑ 14 CCR§ 18423 -Filing Application for Permit E: [ [ 14 CCR§17354-Storage of Waste Tires Outdoors Recordkeeping Requirements El (a)Storage Units ❑ (b)Fire Lanes ❑ ❑ ❑ 14 CCR§ 18432-Operations Plan ❑ (c)Fire District Requirements ❑ ❑ ❑ 14 CCR§ 18433-Emergency Response Plan ❑ (d) Drainage ❑ (e)Slope/Grade ❑ ❑ ❑ 14 CCR§ 18447-Records Available ❑ (f)Siting(New Facilities) [ ❑ [ 14 CCR§17351 -Fire Prevention Measures ❑ (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