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San Joaqu County Environmental Health L_partment HAZARDOUS MATERIALS PROGRAM This survey form is intended to identify businesses wM1ich neatl to comply with the hazardous materials emergency planning end reporting requirements of[he California Health end Safety Code(HSC) Chapter 6.95. This Chapter requires busineasas which handle hazardous materials to prepare emergency plans for their employees to use in an emergency. Businesses must submit a wpy of this plan, along with an annual inventory of their hazardous materials, to public safety agencies for use in protecting emergency responders antl the general public. In San Joaquin County, tM1e Environmental Health Department (EHD) has been authorized to administer this program as tM1e Certified Unified Program Agency or CUPA. Should you have any questions about the CUPA program or this form, please contact EHD at(209)468-3420. Pleas¢consider the following guidelines when completing[h¢questions on page 1: Question 1: The (HSC) section 2550'1(p) defines a "Hazardous Material" as any material that, because of its quantity. concentration, o physical or chemical characteristics, poses a signiicani present or potential hazard to human health and safety or to the environment if released into the workplace or [he environment. "Hazartlous Materials" include but are not limited [o, hazartloua substances, M1azardous waste,and any material that a hantller or the administering agency has a reasonable basis for believing that it would be injurious to the health antl safety of persons or harmful [o the environment if released into the workplace or the environment This includes, but is no[ limited to, fuels, petroleum products, paints, propane, oxygen, chlorine, pesticides, fertilizara, and used oil. If a business generates a unt of hazardous waste they must enroll in the EHD Hazardous Waste Generator Program. Answer"Yes" if you use a material that meets[he definition above in any quantity of leas[ once in [he year. If you are unsure, contact[ha EHD at (209)468-3420 for asaistanca. If you answer "No"antl at a later data your business, or a tenant on your property,begins M1antlling hazartlous materials,you must Inform the EHD within 30 days. ' Question 2: If you answer "Yes", you must meal the requirements of HSC Chapter 6.95. Tha EHD will be contacting you to provide assistance. These requirements must be me[ prior to issuance of a certificate of occupancy. It you answer"No"". our office may conduct an inspection aR¢r you begin operations to verify your exemption. TM1¢ HSC establishes some motlifietl requirements or program exemptions For certain uses of hazardous materials. If you answered "Yes" to questions 1 and 2, a determination must be mad¢ if your business meets one of thea mptions listed. Chock the appropriate boxes on page 1. Tha EHD will contact you [o make a Rnal determination if your business meets the exemptions. A. Ra[ail Examotion—ProduIXs packaged for direct distribution[o the general public are exempt from the program. This exemption may no[apply if any of the following conditions exist 1.TM1e quantity M1andletl creates an unacceptable public hazard 2. Tha malarial is being used directly by [he business as part of iia operation in atltlition to being soltl to the 9¢^¢rel public 3. The general public doesn't have ready access to the product as stored by the business (e.9. in a warehouse). B. Motlifiatl Farrn Examotion — Farms, as stated in Question 26 on page 1, usf eat modiflatl ants. The definition of a farm to the law d,�¢sn•t Include businesses providing commercial past control services, fertilizer application services, product processing services, or packing sh¢tl services for farmers. Farms qualifying for the axempiion a a still required to submit an annual chemical in antory antl faa to the San Joaquin County Office of the Agncuttural Commissioner (OAC) along with other requirements. Please contact the OAC for further information a[(209)953-6000. Businesses operating a wmm¢rciai business in addition to a farm as definetl must comply with the requirements of the Hazardous Materials Program for those materials associatatl with the commercial business. ouestion 3: The Federal and Stale governments have d¢Rned approximately 366 chemicals as an "Acutely Hazartlous MatariaP' (AHM). The most common AHM used in the county include: Chlorine. Ammonia. Sulfuric Acid. Methyl Bromide, Acrolain, Sulfur Dioxitla, Formaltlehytla, Nitric Acid,Vinyl Acatata Monomer, Hytlro9en Peroxide,antl many types of Pesticides. Answer"Yes"if you us¢any of these specific chemicals in any quantity at any one time of the year. Contact the EHD if you're unsure for asaistanca. ouestion a: Answer"Yes"if the boundary of your property or factli[y is or will be within 1,000 feet of the bountlary of a school (oraaea k-tz)