Laserfiche WebLink
�. <br /> Waste Tire S*vey & Inspection Rert <br /> SURVEY REQUIRED <br /> State of California <br /> CIWMB 2(New teMan Management <br /> Inspection Form - Page 2 - _-- ---- -- -__-' <br /> California Integrated Waste Management Board <br /> Part C Facility Information BLUE OR BLACK INK PEN <br /> –" zii.,v n: dw�r `ra w W i w"" w xF w z e a <br /> t:S�tStr1 �5„ w �,” � 1111 II I! rt <br /> TPID- - — .�nInspectReport ion _. _ m <br /> Site Suffix: ! U � � [-61—{� Number: i � �` `��}_ "��t� <br /> SWIS i Inspection Number on the associated Survey form(Page 1) <br /> Number: Photos Taken O Yes 0 No <br /> Property <br /> 01 <br /> Fliorrc Number Mall Address Cit State Ti, Codr, <br /> F. glirpy SP�_Irtr-_•ss Type (Fill if applicabie) Petr a .., <br /> „', _ ,,�„.�..il,_ <br /> O PRC §42823.5 Cement Manufacturing Plant with written verification that the facility qualifies for exemption O Permitted 0 Exempt <br /> Excluded Business Types(Fill if applicable) <br /> O PRC§42808-Permitted Solid Waste Facility(Landfill,Transfer Station) Excluded 0 Unpermitted <br /> 0 14 CCR§18420(a)(2)-Agricultural<5,000 tires incapable of holding water&used for bumpers or ballast FacFiity Type(Fill one) <br /> 0 14 CCR§18420(a)(4)-Tire retreading facility with no more than 3,000 waste tires on premises 0 Major WTF (?5,000 Tires) <br /> Q 14 CC R§18420(a)(6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days <br /> 114 CCR§18420(a)(7)&(e)-Tire dealer storing no more than 1,500 waste tires for 90 days O Minor WTF (500-4,999 Tires) <br /> Part D- Inspection of Waste Tire Facility <br /> ASTEmTIII:,STGO/kGE S,,.AIVI�aRDS, - <br /> 00a`§1113 2-Site Se"curlt;9 <br /> O O PRC§42824-Major Waste Tire Facility Permit 0 (a)Signs 0 (b)Site Attendant 0 (c)Access <br /> Q O PRC§42834-Minor Waste Tire Facility Permit 0a R§1 r'S•.s(a)-'Vector Control <br /> O O PRC§42850(a)-Complies with Terms of Permit 0 (1) Impermeable Barrier 0 (2)Approved Vector Plan <br /> 0 0 14 CCR§17354-Storage of Waste Tires Outdoors <br /> O O 14 CCR§18420(a)-Applicable for Permit <br /> 0 (a)Storage Units <br /> O O 14 CCR§18423-Filing Application for Permit 0 (b) Fire Lanes <br /> 0 O 14 CCR§18432-Operations Plan (c)Fire District Requirements <br /> O O 14 CCR§18433-Emergency Response Plan 0 (d)Drainage <br /> O (e)Slope/Grade <br /> 0 (f)Siting(New Facilities) <br /> O O 14 CCR§18447-Records Available 0 (g) Rim Removal <br /> ” w ^' wr t <br /> ri �vr lc (h) Protection from Pyrolytic Oil Runoff <br /> 0 (a)Communication Equipment 0 (c)Water Supply <br /> 0 (b)Fire Equipment - 0 (d) Other Requirements Facility Compliance with NFPA 231D-1989 <br /> Comments <br /> /r 1 <br /> L lOtf,/� yr /� ✓°+;�'hL t° Z ���` 1 ��",✓ -ft v AJ L_u. <br /> r <br /> tol <br /> INSTRUCTIONS ON BACK Corropy:CIWMB ect: l Incorrect: _ h� Y 15386 <br /> ■ <br /> White C -- - Yelltoo - : ® ■ <br /> Yellow Copy:Operator Pink Copy:LEA <br />