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072690: a <br /> Waste Tire■ =iii:. Survey & Inspection Report SURVEY REQ <br /> UIRED <br /> �i . Slate of Gllrornla W Inspection Form - Page 2 <br /> CNVMe (New OYO/) <br /> • II a Integrated Waste Management Board <br /> Part C-Faculty Information _ _ BLUE OR BLACK INK PEN <br /> Business Profile Inspection Details <br /> TPID- �j ` Inspection �r^ <br /> Site Suffix: 1 { a 3 (fl a I o r Report I a I — r J (0 & <br /> Number: <br /> SWIS Inspection Number on the associated Survey form(Page 1) <br /> Number: Photos Taken 0 Yes 0 No <br /> Property Owner <br /> �- �yg -��g`1 3151 S• tJ q9 <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 0 Permitted 0 Exempt <br /> Excluded Business Types(Fill if applicable) <br /> 0 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 8 used for bumpers or ballast Facility 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 /> ®14 CCR§18420(a)(6)-Auto dismantler storing no more than 1,500 waste tires for less than 90 days <br /> JQ 14 CCR§18420 a 7 & e -Tire dealer storing no more than 1,500 waste tires for 90 days 0 Minor WTF (500-4,999 Tires) <br /> Part D-Inspection of Waste Tire Facility <br /> V I A I WASTE TIRE STORAGE STANDARDS V ' A <br /> Permit Requirements _ 0 0 14 CCR§17352.Site Security <br /> 0 0 PRC§42824-Major Waste Tire Facility Permit 0(a)Signs 0(b)Site Attendant (c)Access <br /> 0 0 PRC§42834-Minor Waste Tire Facility Permit 00 14 CCR g 17353(a)-Vector Control <br /> RC§42850(a)-Comptes with Terms of Permit 0(1)Impermeable Barrier 0(2)Approved Vector Plan <br /> P <br /> 0 0 0 0 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 0(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 /> O(e)Slope/Grade <br /> Recordkeeping Requirement 0(f)Siting(New Facilities) <br /> 0 0 14 CCR§18447-Records Available 0(g)Rim Removal <br /> 01 0 1 14 CCR§17351-Fire Prevention Measures 0(h)Protection from Pyrolytic Oil Runoff <br /> O(a)Communication Equipment 0(c)Water Supply 0 0 1 14 CCR§17356-Indoor Storage <br /> 0(b)Fire Equipment 0(d)Other Requirements <br /> cFacility Compliance with NFPA 231 D-1989 <br /> Comments. <br /> brD V-A i�t f/(. IYKck- •t�fe- CA" s 01� Vie, K)", w + lae. pk�-� <br /> 3 fiD a a V Ate- 6&-Ace- VeAd-o✓ryy- <br /> 0-bz @ V —-_TiU��, �h�2 �-h rS 6pyet, <br /> Allo violalyaxs noted <br /> INSTRUCTIONS ON BACK I Correct:* incorrect: 46 I tr X AIMI AIMP L E 12 U3 15386 <br /> ■ White Copy:CfWMB Yellow Copy Operator Pink Copy:LEA ® ■ <br />