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S A N�1 U A Q U I N Environmental Health Department —COU NTY— San Joaquin County Environmental Health Department HAZARDOUS MATERIALS PROGRAM This survey Conn is intended to Identify businesses which need to comply with iha hazardous materials emergency planning antl reporting requirements of aha California Haal[h antl Safety Cotla (HSC) Chapter 6.95. This Chapter requires businesses which handle hazardous materials to prepare emergency plana for their ampbyaea to use in an emergency. Businesses must submit this infgnnaiign,along with an annual Inventory of their hazardous materials,online[o the California Environmental Rapartin9 System (GFRs)found at-care.caYeoa.ce.gov for use in protecflng amarganry responders antl the general public. In San Joaquin County, the Environmental Health Department (EHD) hes bean authorized to administer this program as the Cartlflatl Unlflatl Program Agency or CUPA. Should you have any questions about the CUPA progrem or this form,please contact EHD at(209)468-3420. Please oonaitlar the following guidelines when completing the questions on page t: Quastlon t: The(HSC)section 25602(p)tleflnes a"Hazardous Material"as any matadal that,because of Its quantity,concentration,or physical chemical charegtartstics, poses a significant present or potential hazard to human health antl safety or[o the a mant If released iota the workplace or [ha environment "Hazardous Materials" inGuda but are not limited to, hazartlousnsubstencss, hazardous waste,and any material that a handler or the administering agency has a reasonable basis for balievin9 that if would be Injurious to the haatth antl safety of persons or harmful fo the environment if released Into the workplace or the environment. This includes. but is nM limited [o, fuels, petroleum products, palnffi, propane, oxygen, ammonia, chlorine, pesticides, fertilizers, and used oil If a business ganarefae env amoum of hazardous waste they must enroll In the EHD Hazardous Waste Generator Program. Answer"Yes" If you use a material that meets the definition above in any quantity at least once in the year. If you are unsure, contact the EHD ai(209)468-3420 for assistance: If you answer"No"and at a later date your business,or a tenant on your property, begins handling hazardous materials,you mus[inform the EHD within 30 days. Question 2- If you answer"Yes",you must meat the requirements of HSC Chapter 6.96. Tha EHD will ba contacting you to provide essisffinca. These requirements must be mat prior to Issuance of a cartlflceta of occupancy. If you answer"No", our oPflca may conduct en Inspacfion after you begin operations to vaHty your ezamption. Tha HSC establishes soma modified requirements or program exemptions for certain uses of hazardous materials. If you answered "Yes" to questions 2 and 2, a tlatarmination must be made if your business maaffi one of the exemptions listed. Check the appropriate boxes on page 2 and submit the hazardous materials informafion online at pers.caleoa Please contact the EHD to datertnfne if your business meats[he exemptions. Howavay even if ane mpUon Is mat for the Business Plan program,you may still ba a hazardous waste generator and will need to report in caleoa ra.gov as a hazardous waste generator. - A. Ratsil Ezemotbn-Products packaged for direct distribution to the 9enarel ublic are exam t from the p p program. This axemp0on may not apply if any of the following conditions exist 2.Tha quantity handled creates an unacceptable public hazard 2.Tha materiel is being used tlirachy by the business as pert of its operation In addition to being sold to the ganarel public 3.Tha 9enarel public doesn't have ready access to the product as stored by the business(e.g.In a warehouse). B. Modified Fartn Examotion-Farms,as stated in Question 2B on page 2. t tlifi tl i ffi. The definition of a farm in [ha law doesn't include businesses providing cemmarGal past con Vol services, fertilizer application a rvices, product processing saMcas, or packing shad services for fanners. Farms qualifying for the mption are s[III required M submit an annual chemical inventory, site map, and other raquiremenffi online to calaoa.ca.gov antl pay a fee to the San Joaquin County Environmental Health Department(EHD). Please contact the EHD at (209) 468-3420 for assistance. Businesses operating a gommardal business in adtlttlon to a fano a defined must comply wiM the requirements of the Hazardous Materials Program for those materials assoGetad with the commercial business. Quastlon 3: The Fadarel and State govarnmanffi have defined approximately 366 chemicals as an"Acutely Hazardous Material"(AHM). The most common AHM used in [ha county include: Chlorine, Ammonia, Sulfuric Acitl, Methyl Bromide, Acrolein, Sulfur Dioxide, Formaldehyde,Nitric Acid,Vinyl Acetate Monomer, Hydrogen Peroxide,and many types of Pas[icitlas. Answer"Yes" If you use any of these specific chemicals in any quantity at any one rima of[ha year: Contact the EHD if you're unsure for assistance. Question 4: Answer Wes"if the boundary of your property or fatality is or will be within 1,000 feat of the boundary of a school(z-tz)