| SA N,-J Q A Q U IN    							Environmental Health Department
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<br />       				San Joaquin County Environmental Health Department
<br />      					HAZARDOUS MATERIALS PROGRAM
<br />      	This survey form is intended to identify businesses which need to comply with the hazardous materials emergency planning and
<br />      	reporting requirements of the California Health and Safety Code (HSC) Chapter 6.95. This Chapter requires businesses which
<br />      	handle hazardous matedats to prepare emergency plans for their employees to use in an emergency. Businesses must submit this
<br />      	information, along with an annual inventory of their hazardous materials, online to the California Environmental Reporting System
<br />      	(CERS)found at cers.calepa.cs.00v for use In protecting emergency responders and the general public. In San Joaquin County,
<br />     	the Environmental Health Department (EHD) has been authorized to administer this program as the Certified Unified Program
<br />     	Agency or CUPA. Should you have any questions about the CUPA program or this form,please contact EHD at(209)468-3420,
<br />     	Please consider the following guidelines when compieling the questions on page 1:
<br />     	Question 1:
<br />     	The(HSC)section 25501(p)defines a"Hazardous Mate,ial"as any material that,because of its quantity,concentration,or physical
<br />     	or chemical characteristics, poses a significant present or potential hazard to human health and safety or to the environment if
<br />     	released into the workplace or the environment.  "Hazardous Materials" include but are not limited to, hazardous substances,
<br />     	hazardous waste, and any material that a handler or the administering agency has a reasonable basis for believing that it would be
<br />     	injurious to the health and safety of persons or harmful to the environment if released into the workplace or the environment. This
<br />     	includes, but is not limited to, fuels, petroleum products, paints, propane, oxygen, ammonia, chlorine, pesticides, fertilizers, and
<br />     	used oil. If a business generates any amount of hazardous waste they must enroll in the EHD Hazardous Waste Generator Program.
<br />     	Answer"Yes" if you use a material that meets the definition above in any quantity at least once in the year.  If you are unsure,
<br />     	contact the EHD at(209)468-3420 for assistance. If you answer"No"and at a later date your business,or a tenant on your property,
<br />     	begins handling hazardous materials, you must inform the EHD within 30 days.
<br />     	Question 2:
<br />     	If you answer`Yes", you rn-st meet the requirements of HSC Chapter 6.95. The EHD will be contacting you to provide assistance,
<br />     	These requirements must be met prior to issuance of a certificate of occupancy.  If you answer"No", our office may conduct an
<br />     	inspection after you begin operations to verify your exemption.
<br />     	The HSC establishes some modified requirements or program exemptions for certain uses of hazardous materials. If you answered
<br />     	"Yes" to questions 1 and 2, a determination must be made if your business meets one of the exemptions listed.  Check the
<br />     	appropriate boxes on page 1 and submit the hazardous materials information online at cers.calepa.ca.gov. Please contact the E1-ID
<br />     	to determine if you-business meets the exemptions.  However, even if an exemption is met for the Business Plan program, yo.:
<br />     	may still be a hazardous waste generator and will need to report in cers.calepa.ca.gov as a hazardous waste generator.
<br />       		A.  Retail Exemption—Products packaged for direct distribution to the general public are exempt from the program. This
<br />   			exemption may riot apply V any of the following conditions exist:
<br />				t.The quantity handled creates an unacceptable public hazard
<br />				23he material is being used directly by the business as part of its operation In addition to being sold to    the
<br />    				general public
<br />				3.The general public doesn't have ready access to the product as stored by the business(e.g. in a warehouse).
<br />      		B.  Modified Farm Exemption—Farms, as stated in Question 2B on page 1, must meet modified program requirements.
<br />   			The oeriniticn of a farm in the lana doesn't include businesses providing commercial pest control services, fertilizer
<br />   			application services, product processing services, or packing shed services for farmers.  Farms qualifying for the
<br />   			exemption are still required to suomit an annual chemical inventory, site map, and other requirements online to
<br />   			cers.calepa.ca.gov and pay a fee to the San Joaquin County Environmental Health Department(EHD). Please contact
<br />   			the EHD at (209) 468-3420 for assistance, Businesses operating a commercial business in addition to a farm as
<br />   			defined must comply with the requirements of the Hazardous Materials Program for those materials associated with
<br />   			the commercial business.
<br />      	uestion 3
<br />    	The Federal and State governments have defined approximately 366 chemicals as an "Acutely Hazardous Material' (AHM). The
<br />    	most common AHI.11 used in the county include: Chorine, Ammonia, Sulfuric Acid, Methyl Bromide, Acrolein, Sulfur Dioxide,
<br />    	Formaldehyde, Nitric Acid,Vinyl Acetate Monomer, Hydrogen Peroxide, and many types of Pesticides.
<br />    	Answer"Yes" if you use any of these specific chemicals in any quantity at any one time of the year. Contact the EHD if you're
<br />    	unsure for assistance.
<br />    	Question 4:
<br />    	Arswer"Yes"if the boundary of your property or facility is or will be within 1,000 feet of the boundary of a school. (x-1r,.
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