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000720 — �� Cal-cupaforum guidance i PEPUM1T NO, ASTItTIFICATION&ENGINEERING DATE CAPACITY ASSESS NT EXEMPTION NOTIFICATION CONTENTS SI=NDARY CONTAINMENT TYPE YEAR INSTALLED • U/L APPROVED(Y/N) BUSINESS NAME nnn �^A TANK ID(if¢pplicablc) (.•` �.J INSPECTOR /n� DATE OF REQUEST 1 ,ADDRESS L4 Ci 5 lam, PX�ZCf 1f r✓ I CITY/zlp 0115,Z I certify that the abovegro d used oil/waste antifreeze tank meets the requirements of the Califomia Code of Regulation(CCR) I for exemption from the Prbfrssional Engineering Assessment[reference Title 22 CCR section 66265.1920)]. Owner/Operator Signpns Print Name:1. A-Mb l late_�-ZS- The Local Fire�Man,usage,and design approval are attached,OR The Local Fire Marshal has reviewed this abovnf,9rrmance with applicable regulations. Fire Marshal ApprPrint Nam DattiQj 2f1'aThe hazardous Ma (HIVID) o tionally approves the installation of the sed oil/waste asitifreeze aboveground storage tank as long as you comply with thefollowing terms and conditions- T FRMS AND CONni'ITONS I 1 The aboveground tank, installed after July 1, 1991, must contain used oil or waste antifreeze only (a non- RCRA waste)as de med m HSC section 25250 l and has no connected ping. 2. The local Firc Marshal approved and/or permitted the installation,usage, and design per municipal codes and i the tank operator Tet�oh'iandle ' documentation supporting this requirement. 3 The primary tankWM ded with greater than 100%secondary containment. 4 If the tank systemd to precipitation,the secondary containment must,in,addition to the requirement of item 3 above,beab a 25 year,24 hour rainfall event, with no intrusion or flooding problems. TheHMD strongly ad the tank.system be completely covered to prevent such problems,following all local building and zoniments. 5 The facility must have a written leak detection program and daily inspection logs kLt as required in 22 CCR sections 66265.194-195 for review by HMD inspectors. Ensure that appropriate controls and practices are in- place at all times to prevent spills, leaks,or overflows from occurring. The secondary containment should be kept empty and dry, except when there is a leak or spill, at which time the secondary containment must be hours.thoroughly cleaned ut within 24 hos. The cause of a leak or spill would need to be determined and j corrective actions n(refer 22 CCR section 66265 196). 6. The tank must be in ed and maintained on a non-permeable surface,i.e. concrete(in good repair)or scaled asphalt(in good co - on). 7 The operator needs revise their Business Plan site map,if applicable. 8 The facility should in a photocopy of this notification onsite to show to an inspector during facility j inspections. Provided you do not char a the configuration of the tank this exemption is good for 3 years from the date of request for exemption above. In the futuro, if you make any changes or modifications to the tank system, submit a description of the proposed changes in writing to the HMD 30 days before making the changes to ensure compliance with applicable regulations. Attached is a fact sheet developed by the 14MD for your information regarding the j regulation of hazardous waste tank systems. This approval doesiMZ erupt your facility from compliance with additional requirements that may be enforced by other local,State,or Fedoagcncies with regards to storage of hazardous materials in a tattle system. i HMD Supervisor's Signa Date Sigmed 17 t00/NQ 'M `INI1; 010 HIT Nt 6N YVA ZO:tl NIB OIOZ/N/10