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State of California-California Environmental Protection Agency Department of Tonic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> 10 . To your knowledge , have land farming or bioremediation been used at the facility? X <br /> 11 . To your knowledge , has the facility ever burned hazardous wastes , unidentified waste X <br /> materials , tires , or automotive batteries at the facility? <br /> 12 . To your knowledge , have ash and/or combustion residuals been disposed of at the X <br /> 13 . To your knowledge , have any underground storage tank(s) been removed , abandoned , or <br /> taken out of service from the facility ? Tanks removed , abandoned , or taken out of service X <br /> under the oversight of a responsible agency need not be considered if the agency <br /> addressed potential contamination at the tank location . <br /> 14 . To your knowledge , has any contaminated soil been discovered and/or remediated at the X <br /> facility without oversight by an appropriate regulatory agency? <br /> 15 . To your knowledge , have there been fires and/or explosions at the facility which may X <br /> have caused a release of hazardous waste or materials ? <br /> 16 . To your knowledge, has the facility ever received complaints from any employees , <br /> neighbors , or the public about the facility's practices for managing hazardous wastes , or X <br /> any actual or potential releases to air, water.-or soil , or_other environmental issues? <br /> 17 . To your knowledge , have nearby residents complained to a governmental agency of any <br /> type of illnesses or unusual illnesses as having been caused or suspectedly caused by or <br /> related to activities at the facility? (Note: this item does not require questioning the <br /> facility's neighbors) If YES , indicate below the person and/or agency who recorded the X <br /> complaint. <br /> If YES , to your knowledge , has any evidence been submitted to a physician to <br /> substantiate the claim? <br /> 18 . To your knowledge , are there any areas at the facility which were formerly used for X <br /> hazardous waste or hazardous materials transfer (e .g . tank loading areas , drum transfer <br /> areas) ? <br /> 19 . To your knowledge , are there , or have there been lawsuits or administrative proceedings <br /> concerning an actual , alleged , or threatened release of any hazardous substance against X <br /> the facility by another party? Only actions concluded by settlement or litigation need be <br /> considered . <br /> DTSC 1151 (06/99) Please indicate total number of pages v04 <br />