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State of California-California Environmental Protection Agency Department of Toxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> 13 . ADDRESS OF FACILITY CONTACT PERSON: <br /> STREET: 6755 CE Dixon Street <br /> CITY: Stockton <br /> STATE : California ZIP CODE: 95206 <br /> SECTION II : FACILITY HISTORY <br /> Instructions: Complete this section regarding facility history based on reasonably available knowledge of the facility . This section will determine if <br /> past operating practices and significant historical events that occurred at the facility indicate potential areas of contamination. Current and past <br /> employees who know about the facility's past operating practices can be an asset in completing this section of the checklist. Yes answers to these <br /> questions mean that careful attention must be paid to these areas and considerations when completing the facility walk-through inspection. <br /> I <br /> YES , NO <br /> 1 . Has an environmental assessment and/or a site investigation report ever been completed <br /> for the facility ? If this assessment meets the criteria for substituting for this checklist <br /> (see Instructions) , use the Signature and Certification Page to record this exemption . You X <br /> need not release confidential assessments . However , if these reports indicate existing or <br /> potential contamination , you must use the information relied on by the confidential report <br /> to help reach a conclusion in this assessment . <br /> 2 . To your knowledge , have areas of the facility that contain hazardous materials ever been X <br /> flooded? <br /> 3 . To your knowledge , has the facility ever been damaged by an earthquake that could x <br /> cause contamination? <br /> 4 . To your knowledge , has the location for the facility ever been used for industrial x <br /> purposes prior to its current use? If YES , then consider potential contamination from the <br /> type of industry that the location was formerly used for. <br /> 5 . To your knowledge , has there been any disposing of hazardous chemicals or hazardous x <br /> wastes in , on , or under the property? <br /> 6 . To your knowledge , has the facility ever had electrical transformers , capacitors , or <br /> hydraulic equipment including , but not limited to elevators and auto lifts , at the facility <br /> which may have released PCBs or oil to the environment? (Not including small quantities <br /> of fluorescent light ballasts and capacitors if these materials were not disposed of or X <br /> dismantled at the facility) <br /> If YES , was the equipment ever tested for the presence of PCBs ? <br /> T To your knowledge , has testing of any groundwater wells on the property ever revealed x <br /> possible contamination? <br /> 8 . Do you have in your possession , or do you know of the existence of any photographs , <br /> geophysical reports , analytical test data , and/or air sampling data that indicates the X <br /> possible presence of hazardous materials and/or waste in unwarranted or unexpected <br /> areas of the facility?- <br /> 9 . To your knowledge , has the facility ever had liquid/sludge containment area(s) , surface x <br /> irnpoundment(s) , collection pond(s) , and/or lagoon(s) ? <br /> DTSC 1151 (06/99) Please indicate total number of pages Zof! <br />