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STATE OF CALIFORNIA. Asbestos Containing Waste Disposal CALIFORNIA INIEGRAr'D WASIECIWM . <br /> 5;t"�'' Inspection Report Addendum <br /> MANAGEMENT BOARC <br /> —� ThspeCUOn re rt forth be used In unction con with the I de I rn R CIWM •58 <br /> Enforcement Agency: GV } rxtUU tl^ :l tom\ tn�l l(1�1/�1A/X'�. �0 ,�? _ _ Page/of L <br /> --� — J- <br /> FACtLITY:FILE NUMBER ( PROGRAM CODE INSPECTION DATE TIME IN INSPECTION TIME <br /> STATE=S MM iM1 YY <br /> TIME OUT -------- --- <br /> -------- <br /> FACLITYIOPERATIONNAME OPERATOR OW <br /> .F CIC V\14k If �C REC/IYED BY // - OWNER <br /> _ (U iyz <br /> FACILITY.LOCATION II ADDRESS t ALSO PRESENT <br /> / T <br /> -- C/ . c 1 1 <br /> INSP INSPECTOR SIGNATURE <br /> THE ABOVE OPER FACILITY WAS INSPECTED FOR COMPLUW TH APPLICABL S OF DIVISION 30 F IC RESOURCES CODE(PRC)AND TITLE 14 CALIFORNIA CODE OF REGULATIONS(CCR). <br /> THE STANDARDS BELOW ARE CONSIDERED IN COMPLIANCE UNLESS OT ERWISE MARKED WITH ONE OF THE FOLLOWING. V=VIOLATION A=AREA OF CONCERN NA=NOT APPLICABLE <br /> PERMITS _ - --- - _ NA <br /> PRC 44002-OPERATOR AUTHORIZED BY SWFP <br /> PRC 44004-SIGNIFICANT CHANGE <br /> PRC 44014(b)-OPERATOR COMPLIES WITH TERMS AND CONDITIONS <br /> 18213(b)-PERMIT REVIEW APPLICATION - <br /> 18222-REPORT OF DISPOSAL SITE INFORMATION <br /> C ld 3At,STANDARI _ - - - - <br /> -_-: .- <br /> 117897.16-GENERAL STANDARDS <br /> DESION AND OPERATING:REQUIREMENTS <br /> 17897.18(a)-DESIGNATED AC_W_DISPOSAL AREA <br /> !17897.18(b)-SITE CONTROL PROGRAM ---- -------- ----- --------------- --------- — <br /> _ - - - - <br /> 17897.18(C)-ACW NOT DISPOSED WITH REFUSE <br /> 17897.18(d)-CONTROL OF VISIBLE EMMISSIONS <br /> 17897.18(e)-MAINTAIN INTEGRITY OF CONTAINERS AND/OR PACKAGING <br /> 17897.18(17-NO COMPACTION PRIOR TO COVER <br /> 17897.18(9)-COVER ------.--- - - -- --._- <br /> 897.18(h) COVER FREQUENCY <br /> f3i3fTtQNAI REQUIREMENTS <br /> 17897.19(a)_EPA ID NUMBER <br /> 17897.19(b)(1)-ADDITIONAL SITE SECURITY__ <br /> 17897.19(b)(1)(A)_CONTINUOS SURVEILLANCE SYSTEM -- — ---- '� <br /> 17897.19(b)(1)(B)-WARNING SIGN(S) <br /> -- ---- -- - -- — <br /> 17.897.20 OPERATOR INSPECTION REQUIREMENTS <br /> RECORD KEEPING — - — -- --- -- -- -- -- ! <br /> 17897.19(b)(2) DISPOSAL SITE RECORD <br /> 17897.19(b)(2)(A)-LAND DISPOSAL RESTRICTIONS <br /> 17897.19(b)(2)(B)-OPERATING RECORD <br /> 17897.19(b)(3)-FINANCIAL RESPONSIBILITY <br /> 17897.19(c)(1)-CONTINGENCY PLAN <br /> 17897.19(c)(2)-PERSONNEL TRAINING <br /> EXI±AYATION.iiE lfl E ::::......................r:.- :.;.::.::::::::::: <br /> .. .NT3....::.: <br /> 17897.21(b)-SUBMIT PLAN FOR APPROVAL TO EA <br /> 17897.21(c}(d) PLAN PREPARATION AND RESCHEDULED STARTING DATE <br /> £.g5tJRE/4Nt POS'i:CLOSURE <br /> 17897 24 COMPLIANCE WITH CLOSURE/POST CLOSURE REQUIREMENTS i <br /> - I <br /> t�THEt <br /> T <br /> IF THIS BOX IS CHECKED,REFER TO DISPOSAL SITE INSPECTION REPORT(CIWMB•52)FOR ADDITIONAL INFORMATION <br /> COMMENTS(USESWIS-03FORjADDRK)NAL_SPA�CE) - -- — ---- - -- - - -- ' <br /> L-..G`/1�1��'L.__.�v`*//_��`'� --�C1� 1�—•. �� Lv/H�_ fiVfi'� Lij� __—_ —_ <br /> r� �-�'��� - O ✓e J'5 <br /> W a / / K.f <br /> C <br /> I - <br /> DISTRIBUTION: White-CIWMB Pink-LEA Yellow-Operator 97 91149 <br />