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Cal-EPA DEPARTMENT OF TOXIC SUh__wANCES CONTROL GREY DAVIS,Governor <br /> SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.WEBER AVENUE, 3RD FLOOR <br /> STOCKTON,CA 95202 <br /> CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br /> Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notitiers <br /> l <br /> FACILITY NAME: G� A nz, 1 P1- EPA ID NUMBER: CSL ODD() �- <br /> PHYSICAL ADDRESS: a&tzyl OA ED_dlDr <br /> FACILITY CONTACT-NAME: 410 <br /> PHONE: 7d1 .H3Z 51 (P <br /> SIC CODE(S): INSP CTION DATE: Z-q d LI -j-JZ-6q Local# <br /> NOTIFIED UNIT COUNT: PBR_ CA_ CESW_ CESQT CEL_ TOTAL <br /> CORRECT UNIT COUNT: PBR_ CA. CESW_ CESQT_ CEL_ TOTAL <br /> This checklist and inspection report identify violations of state law regarding onsite treaters of hazardous waste, <br /> operating under an onsite permitting tier. This inspection verities the information provided on form DTSC 1772. It also covers <br /> generator requirements, although a separate checklist may be used for those requirements. A checkmark indicates violation of <br /> the law,which are explained in more detail on the attached note sheets.The governing laws are the Health and Safety Code <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 inspection checklist or protocols, which are summarized below. A full <br /> evaluation of each item or document is not conducted during the Verification Inspection, unless serious deficiencies are suspected. <br /> NO <br /> / I. Contingency plan has been prepared (adequately minimize releases,has alarnJcorrununication <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 /> _ 3. Meet container management standards (storage time limits, closed, labelled, compatibility, <br /> inspected weekly,in good condition,with igaitables/reactives 50 feet from property line). <br /> _Z 4. Meet tank management standards (either secondary containment or integrity assessments,plus <br /> storage time limits, labelled,compatibility, inspected daily, in good condition,with <br /> ignitables/reactives 50 feet from property line). <br /> 5. All wastes are properly identified. <br /> Treatment Items-Facility Wide: (Facility must submit a revised Form 1772 to correct errors or omissions) <br /> _✓ 6. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new units <br /> with unit sheets or correct tier on the unit sheet.) <br /> _✓ 7. All generator identification information on Form DTSC 1772 is correct. <br /> 8. The submitted plot plan/map adequately shows the location of all regulated units. <br /> _ 9. There are records documenting compliance with sewer agency pretreatment standards and <br /> industrial waste discharge requirements,where applicable. <br /> For CA or PBR notifiers: <br /> 10. The generator has an annual waste minimization certification. (PBR submit with renewals.) <br /> Onsite Checklist(A) <br /> Page I of y Rev 3/5/0 <br />