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mal -EPA DEPARTMENT OF TOXIC SUMANCES CONTROL <br />SAN JOAQUIN COON TY <br />IDEPARTMENRTAM AGENCY <br />ENVIRONMENTAL HEALTH <br />304 E. WEBER AVENUE, 3RD FLOOR <br />STOCKTON, CA 95202 <br />GREY DAVIS, Governor <br />04 IFOn*'� <br />CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br />Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br />FACILITY NAME: EPA ID NUMBER: r AQ 0 688 t 577-5-V <br />LW <br />PHYSICAL ADDRESS: S ' S <br />FACILITY CONTACT -NAME: <br />PHONE: <br />SIC CODE(S): INSPECTION DATE: 'L�� ��Local # <br />CEL TOTAL <br />NOTIFIED UNIT COUNT: PBR __j/CA� CES W CESQT CEL TOTAL <br />CORRECT UNIT COUNT: PBR CA CES <br />This checklist and inspection report This inspectionidentify <br />tverifi s the information ions of state law �prrovided on form DTSC 1772.hazardousng onsite treaters of It also covers <br />operating under an onsite permitting tier. <br />generator requirements, although a separates th the note sheetsklist may be used for. The governing oern g la vs are the Health and Safety Code <br />the law, which are explained in more detail o <br />(HSC) and Title 22 of the California Code of Regulations (22 CCR). <br />Generator Standards: <br />Each inspection agency may use their own generator during <br />the Verification Inlspection, sonless serious deficiencies are bsuspected. <br />evaluation of each item or document is not cond�sccte � <br />NO 1N_"'�,(6 <br />— 1. Contingency plan leas been prepared (adequa munication <br />system, lists emergency equipment and phone numbers for emergency coordinators). <br />2. Written training documents and records prepared for employees handling hazardous waste. <br />Meet container management standards (storage time liits, ls/reactives 50 fee,tlfroem property line)ity, <br />inspected weekly, in good condition, with ignrtabe <br />4. Meet tank management standards (either seconda containment or integrity assessments, plus <br />storage time limits, labelled, compatibili , inspected daily, good condition, with <br />ignitables/reactives 50 feet from propert <br />5. All wastes are properly identified. <br />Treatment Items -Facility Wide: (Facility must submit a revised Form 1772 to correct rDTSCrors or o1772 mission(Add any new units <br />_ (. All units under PBR, CA, and CE are properly indicated on Form <br />with unit sheets or correct tier on the unit sheet.) <br />7. All generator identification inf <br />ormation shows the location of all regulated units. <br />_ TSC 1772 is correct. <br />g. The submitted plot plan/map quat 1 Y <br />_ 9. There are records documenting compliance with sewer <br />agency pretreatment standards and <br />industrial waste discharge requirements, where app <br />For CA or PBR notifiers: <br />inimization certification. (PBR submit with renewals. <br />10. The generator has an annual waste m <br />Onsite Checklist (A) Page 1 of S <br />Rev 3/5/C <br />