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SA N�J O A O U I N E^virommenfal Haamh DePartr.ent COUNTY San Joaquin Gounty Envlronmenlal Health Department HAZARDOUS MATERIALS PROGRAM TNs aurvay form is Intended[o identify businesses which need to c mply with ina Hazardous materials a argancy plannMg and ' reporting requirements of[he California Haaltn and Safety Coda (HSC) Cnaptar 6.95. This Chapter req Wres businesses which handle nazardoua materials to prepare emergency plans for their employees to use in en emergency. Businesses must submit this ' information,along witn a ual inventory of their hazardous materials,onllne to the California Environmental Reporting System (CERS)found at pars calepa cagov for use in protecting emergency respontlers and[he general public. In San Joaquin County, the Environmental Haal[h Department (EHD) has been authorized [o administer[hfs program as the Certlflad UniFled Program ' Agency or CUPA. Should you nava any questions about the CUPA program or this form,please contact EHD at(209)468-3420. Plaasa wnsitler the following guidelines when comple[Ing the questions on page 1: Ouastlon '1: Tha(HSG)section 25501(p)tlaflnas a"Hazardous Material"as any material Mai,because of lis quantity,concen[retioq or physical or chemical cherectedstica, poses a significant present or potential hazard to human health and safety or[o<ha environment If releeead Into [ha workplace or Ma a ant "HazeMOus Materials' 'ncluda but a no[ limited to, hazardous subs[ancea, hazardous weals,and any matadal that a h ndlar or the atlmin istering agency has a re nable basis for believing tha<If would ba injurious to the health and safety of persons or harmful to[ha a ant if released nto the workplace or the anvlronmant THis Includes, but is no[limited to, fuels, petroleum products, paints,r�propana, oxygen, a chlorine, pesticides, fertilizers, and sad oil. If a business generates env am unt of nazaMoua este[hay must enroll in the EHD Hazardous Wastes Generator Program. Answer"Yes" If you u matadal ina[ meats the definition above In any quantity at least once In the year. If you a Ontact the EHD at(209)468-3420 for asalatanca. If you answer"No"and at a later data your business,or a tenant on your property, beglna nantlling Hazardous materials,you must Inform Ma EHD within 30 days. Question 2- If you a r"Yea",you must meet the requlremants of HSC Chap[ar 8.95. Tha EHD will ba contacting you to provide assistance. Tnase requlremants mus[ba mat prior to is of a certificate of occupancy. If you answer"No'",our office may conduct an Inspection after you ba91n oParaflons to verify yourr exemption. Tha HSC establishes some modified requlremants or program exemptions for certain uses of hazardous materials. If you answered "Yes" to questions 1 antl 2. a daterminaflon mus[ be made If your business meets o of Ma a mp[lons listed. Cnack the appropriate boxes on page 1 antl submit Ma hazardous materials Information online a[cars calapa Plaasa contact Ma EHD to determine if your businasa meets the a mptions. However. even If an exemption is maf Tor ina Business Plan program, you may still ba a Hazardous waste generator and will need to report{n c calcoa v as a hazardous waste generator. A. Retail Exammtlon-Products packaged for direct distribution to the general public are exempt from the program. THis ax merlon may not apply if any of tna following conditions axis[: e 'LTha quantlfy Handled creates an unacceptable public Hazard 2.The matadal is being used directly by the business as part of Its operation in atldition to being sold to the ganerel public 3.Tha general public doesn't have reedy access[O tna protluct as stpretl by[he business(e.g�in a warehouse). B. Modiflad Farm Exammibn-Farms,es stated in Question 26 on page 1,mus[meat motliflad o Oulremanis. Tha daflnitlon of a farm in tna law d2ea^[include businesses providing co roial pas[controlrs rvices,fertilizer eppllcatlon services. protluc[processing sarvlcas. or packing shad sarvlcas 4or farmers. Farms qualityln9 for the exemption a a still required to submit en annual chemical in antory, site map, end other requlremants onllne fo caleoa and pay a faa to[ha San Joaquin County Envlronmantal Health Department(EHD). Plaese contact thesEHD a[ (209)466-3420 for assistance. Businesses operating a commercial business in addition tq a farm as defined mus[comply with the requlremants of the Hazardous Materials Program for those materials associated with ina commercial business. Ouastion 3: Tha Fatlerel and Sate governments nava tlaflned approximately 366 chemicals a n"Acutely Hazardous Material"(AHM). Tha oat c n AHM used in the c unty include: CHlorina, Ammonia, Sulfuric Acid, Methyl Bromide, Acrolain, Sulfur Dloxida, Formaldehyde, Nitric Acid,Vinyl Acetate Monomer,Hydrogen Peroxide,and many types of Pesticides. Answer"Yes" If you a any of tneae speclFlc cnamicals in any quantity at any one[Imes of tna year. Contact[he EHD If you're unsure for assis[anca.sa OuastiOn 4: Answer"Yes"if the boundary of your property or facility is or will ba within '1,000 faa[of[nes bcuntlary of a school.(K-12)