Laserfiche WebLink
Waste Tire S ey & Inspection Rei SURVEY REQUIRED <br /> State of California <br /> CIWMed182 WasteManag) Inspection Form - Page 2 <br /> California Integrated Waste Management Board <br /> Part C - Facility Information BLUE OR BLACK INK PEN <br /> Inspection Details <br /> TPID- � I I Inspection <br /> Site Suffix: W Report <br /> Number: - <br /> SWIS Inspection Number on the associated Survey form(Page 1) <br /> Number: m Photos Taken (1� Yes O No <br /> 'l,eme Phone Number Mailing Address City State ZIP Code <br /> 0 PRC §42823.5-Cement Manufacturing Plant with written verification that the facility qualifies for exemption O permitted Q Exempt <br /> Ex sines T es FIII tf a pl)ca le) <br /> 0 PRC§42808-Permitted Solid Waste Facility(Landfill,Transfer Station) Q Excluded Unpermitted <br /> Q 14 CCR§18420(a)(2)-Agricultural<5,000 tires incapable of holding water&used for bumpers or ballast <br /> Q 14 CCR§18420(a)(4)-Tire retreading facility with no more than 3,000 waste tires on premises Major WTF (>5,000 Tires) <br /> Q 14 CCR§18420(a)(6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days <br /> Q 14 CCR§ 18420(a)(7)&(e)-Tire dealer storing no more than 1,500 waste tires for 90 days (�Minor WTF (500-4,999 Tires) <br /> Part D - Inspection of Waste Tire Facility <br /> V A WASTE TIRE STORAGE STANDARDS V A <br /> Permit Requirements 00 14 CCR§17352-Site Security <br /> 0 Q PRC§42824-Major Waste Tire Facility Permit 0 (a)Signs Q (b)Site Attendant 0 (c)Access <br /> (# O PRC§42834-Minor Waste Tire Facility Permitlor Control <br /> O O PRC§42850(a)-Complies with Terms of Permit O (1)Impermeable Barrier Q (2)Approved Vector Plan <br /> Q O 14 CC of Waste Tires Outdoors. <br /> O O 14 CCR§18420(a)-Applicable for Permit Q (a)Storage Units <br /> O 0 14 CCR§18423-Filing Application for Permit O (b)Fire Lanes <br /> O 0 14 CCR§18432-Operations Plan O (c) Fire District Requirements <br /> O Q 14 CCR§18433-Emergency Response Plan O (d)Drainage <br /> O (e)Slope/Grade <br /> O (f)Siting(New Facilities) <br /> O 0 14 CCR§18447-Records Available Q (g) Rim Removal <br /> O (h)Protection from Pyrolytic Oil Runoff <br /> O (a)Communication Equipment Q (c)Water Supply <br /> O (b)Fire Equipment Q (d)Other Requirements Facility Compliance with NFPA 231D-1989 <br /> Comments <br /> 4_!l `s 12 �-r. J, <br /> r� r <br /> If <br /> r <br /> I _ SJ�� ' l_/ 1..:! (.bNe f-E= �.� r- ?-�, �r ✓-�`� �.- C� r �L <br /> INSTRUCTIONS ON BACK Correct: Incorrect: Xjl�, 15386 X R M P j 2 3 <br /> White Copy:CIWMB Yellow Copy:Operator Pink Copy:LEA <br />