Laserfiche WebLink
Waste TirefuIrvey & Inspection Report,, suRVEY REQUIRED <br /> ■ --�0 ,. State of California <br /> CIWMedWeNew%9. Inspection Form - Page 2 <br /> ' Califomla Integratetl Waste Management Board <br /> Part C - Facilit Information BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- F <br /> —�—/– I Inspection a671 <br /> Site Suffix: l © I (� V 1 CI� NReport <br /> umber: �/ �I <br /> SWIS I r I Inspection Number on the associated Surveyform Pae 1 <br /> Number: ��I ` I Photos Taken 0 Yes 0 No (Page <br /> ) <br /> —il <br /> Property Owner <br /> �12me I L.1l._ t -`Com <br /> Do <br /> Cai -. ��1;��Lone <br /> Phone Numucr e <br /> Exempt Business Type (Fill if applicable) Permitted Regulatory Status (Fill one) <br /> 0 PRC §42823.5-Cement Manufacturing Plant with written verification that the facility qualifies for exemption ®permitted Q Exempt <br /> Excluded Business Types(Fill if applicable) <br /> 0 PRC§42808-Permitted Solid Waste Facility(Landfill,Transfer Station) 0 Excluded 0 Unpermitted <br /> 0 14 CCR§18420(a)(2)-Agricultural<5,000 tires incapable of holding water 8 used for bumpers or ballast Facility Type(Fill one) <br /> 0 14 C CR§18420(a)(4)-Tire retreading facility with no more than 3,000 waste tires on premises 0 Major WTF (?5,000 Tires) <br /> 0 14 CCR§18420(a)(6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days <br /> 14 CCR§18420(a)(7)$(e)-Tire dealer storing no more than 1,500 waste tires for 90 clan ®Minor WTF (500-4,999 Tires) <br /> Part D - Inspection of Waste Tire Facility <br /> MMI14 ASTE TIRE STORAGE STANDARDS MM <br /> Permit Requirements 00 14 CCR§17352-Site Security <br /> 0 0 PRC§42824-Major Waste Tire Facility Permit 0 (a)Signs 0 (b)Site Attendant 0(c)Access <br /> 0 0 PRC'§42834-Minor Waste Tire Facility Permit 00 14 CCR§17353(a)-Vector Control <br /> 0 0 PRC§42850(a)-Complies with Terms of Permit O(1)Impermeable Barrier 0(2)Approved Vector Plan <br /> 00 14 CCR§17354.Storage of Waste Tires Outdoors <br /> 0 0 14 CCR§18420(a)-Applicable for Permit 0 (a)Storage Units <br /> 0 0 14 CCR§18423-Filing Application for Permit O (b)Fire Lanes <br /> 0 0 14 CCR§18432-Operations Plan 0(c)Fire District Requirements <br /> 0 0 14 CCR§18433-Emergency Response Plan 0 (d)Drainage <br /> 0 (e)Slope/Grade <br /> Recordkeeping Requirement <br /> 0(f)Siting(New Facilities) <br /> 0 0 14 CCR§18447-Records Available 0 (g)Rim Removal <br /> 0 0 14 CCR§17351-Fire Prevention Measures 0(h)Protection from Pyrolytic Oil Runoff <br /> 0 (a)Communication Equipment .0(c)Water,Supply. 0 10 1 14 CCR§17356-Indoor Storage <br /> 0 (b)Fire Equipment O(d)Other Requirements Facility Compliance with NFPA 231 D-1989 <br /> Comments <br /> - - 1,? <br /> - e371 ►- MC - <br /> � : mc_LQ•�t^ iy1Sde - <br /> INSTRUCTIONS ON.BACK Correct: Incorrect: X A Ah P LJE1! 111213 15386 <br /> ■ White Copy,CIWMB Yellow Copy Operator Pink Copy.LFA <br />