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<br />Revised 6/24/2011 gfb print again 11107(2011 gb WAData\FORMSARCHIVE\HM\HMP\HMP\dU5 FLAPI\HM LHtLxu51 SUMM VIV Hua 5Us rtly trtuea I ry m>.00e
<br />HAZARDOUS Facility tf�ft: Specialist: M Inspection Date: / 31
<br />MATE (ALS Facility Name: �t Ica I �'s tic 9/ `"/ti'r t jf c+ r e t r°
<br />Instructions:
<br />1 i. Priority Corrective Action violations must be corrected within 14 days; all other vio?afions must be corrected within 30 days (unless otherwise noted on the
<br />Notice To Comply)
<br />P
<br />2. Proof of correction must be received by EMD within 19 days for Priority Corrective ACaon violations and within 35 days for all other violations (unless
<br />/ otherwise noted on the Notice To Comply) Complete and submit the Retr'n To ComlJ7tarre Statementon the back of this checklist.
<br />Facility status is evaluated for each inspection requirement on this Checklist as follows:
<br />NVQ - No �ialation Observed • V= VK)iaoun Observed • NA= Not Applicable ® RV= Repeat V101ation
<br />FACILITY STATUS
<br />VIOLAWN AUTHORITY REQUIREMENTS NVO V NA RV
<br />�
<br />Cast
<br />c® �
<br />HM100
<br />SCC 6.96.030 Has permit for Hazardous materials storage.
<br />O
<br />❑ 0Mi
<br />� a
<br />HMt01
<br />19CCR 2729.1
<br />H&SC 25505(a)&(b) Adequate completion and submission of Hazardous Maleriats. Business Plan,
<br />0 O O
<br />®
<br />_
<br />o
<br />HMt02
<br />H&SC 25503.5(a} Hazardous Materials Business Plan is accessible.
<br />0
<br />❑ O O
<br />19GCR2729.1
<br />e
<br />¢19CCR
<br />HM103
<br />2729.2 Adequate completion, submission, and revision of the Business Activities & Owner 7 Operator Ider:5fication forms
<br />0 C7 O
<br />a
<br />s
<br />H&SC 25505 a &fh
<br />—
<br />the Chemical Inventory forms.
<br />27292 & A Adeguats completion, submission, and revision of
<br />❑ O O
<br />ro19CCR
<br />HM104
<br />H&SC 25505(a)&(b) ❑- Class 11 - Failure to submit inventory forms for: a reportable EHS, a reportable hazardous material subject to
<br />�
<br />M o.
<br />H&SC 25509 & 25510 EPCRA, and/or a reportable hazardous material that results in an economic benefit to the facility (e.g. fee category).
<br />W
<br />Co HAnnul
<br />submission of Business Activities & Owner i Operator Identificaficti,and Chemical Inventory forms when required
<br />o
<br />r-
<br />HM105
<br />t9CCR 2729:5(C} by EPCRA {'d storing > f 0,000 pounds of a hazardous material or an amount 2 the TPQ or 500 les (whichever is less) for
<br />O E30
<br />H&SC 25505(a}&(b) an tuitramely, hazardous material).
<br />x19CCR
<br />HM106
<br />2729.2 Adequate completion, submission, and revision m the Site Map.
<br />25505(a)&(b)
<br />® O O
<br />H&SC [3- Class fl - Not including location of s materials storageand handling areas.
<br />a
<br />U;
<br />®
<br />H&a"C 25509
<br />+`+
<br />HM107
<br />19CCR 2731 to complefim. submission, revision, and retention of ftp written Consolidated Contingency Plan.
<br />w ❑ O O
<br />a
<br />H&SC 2550 a
<br />®
<br />n
<br />FIM108
<br />19CCR 2729.4 -.5
<br />Adequate completion and submission of the N Ma Re
<br />❑ O O
<br />r
<br />H&SC 5(a)&(b)
<br />HMf09
<br />H&SC c) Wlal annual employee training � hazardous matte • t response implemented.
<br />❑ O O
<br />19CCR 2732
<br />--
<br />Employee trainingprogram adequate - including, but not knited ter
<br />• Methods for safe handling of Hazardous Maters. (e.g )
<br />w
<br />HM 110
<br />H&SC 25504(c) • Procedures for coordination with local emergency response organizations.
<br />❑ O O
<br />19CCR 2732 • Use of emergency response equipment and suppilles under contral of the
<br />• Emergency response plans & procedures as outlined in 19CCR 2731
<br />S
<br />n
<br />- mcludung, but not limited, to: spill praininfibri, millgatial, notification, and response.
<br />ware
<br />imptemrentfng their training an safe h d Hazardous Materials- including, but not limited to.,
<br />• Containers. tanks and totes are kept closed unless in use.
<br />HM111
<br />196CR 2732 • Containers, tanks and totes stored in a mamher to prevent rupture, leaking or structural deterioration.
<br />OA10,❑ O O
<br />x
<br />• Containers, tanks and totes are compatible with contents.
<br />°-
<br />+Storage area is maintained to separate incompatible materials.'
<br />rn
<br />:
<br />Adequate knpleurntntation and training of sniff on the facility's Consolidated Contingency Pblrl - including, but not limited
<br />o
<br />¢
<br />to: • Emergency shutoffs for chemical processes orequipment axe labeled.
<br />zy'
<br />H&SC 25503.5(a) • Emergency equipment (such as fie extinguishers• spy prevention & alarm equipment) tested & maintained as
<br />o
<br />w
<br />HMI 12
<br />19CCR 2731 necessary (e.g. fire ext3 annually).
<br />❑ O O
<br />U
<br />W
<br />19CCR 2732 + Adequate spill control and spill mifigatien materials are avallatile (e.g. absorbents, rags, or shop vac).
<br />C
<br />+ Ability to protect against f prevent any unplanned release W ale, mi. or surface water as warranted
<br />(e.g. berms, secondary containment, drain avers, socks, etc...).
<br />Hx
<br />H&SC 25124(bH3)(b) containers, tanks (fixed or portable) and totes are in condition. A hazardous material stored in da
<br />❑ O O
<br />rQ,
<br />1Va19 t3
<br />2(fj{2) containers becomes a waste after 96 hours the material is re in an appropriate container.
<br />19CCR 2731
<br />ti
<br />HM114
<br />) H&SC 25124(b)(3)Ea) Containers, tanks (fixed or portable) and totes are property labeled. Unlabeled hazardous materials must be re -lard
<br />) 22CCR 6626t.2(fXl)
<br />jW0❑ O O
<br />o
<br />®
<br />within 10 days of discovery, or the contents bene a waste,
<br />19CCR 2731
<br />cs
<br />HM115
<br />22CCR 66261.7 Containers, tanks (fixed or portable) and totes are disposed of property when empty.
<br />❑ O O
<br />19CCR 2731(c) Me irri spills in storage area. All pro mph sed to prevent discharge to air, sod or surface water.
<br />NHM116
<br />22CCR 66265.31 ❑= Class 11- inability to protect against t prevent any unplanned reuse to air, soil, of surface water.
<br />H&SC 25W3. a (e.g. lack of absorbents, rags, berms, secondary containment, drain coven, socks, etc..).
<br />a�Hlill97
<br />H&SC 25507(a) Failure to provide an immediate; verbal report of any release or threatened release of a hazardous material to
<br />O ❑ O
<br />19CCR 2703 EMU aril the California Emergency Management Agency, (Cal-EMA).
<br />Does the facility have AST(s) with aggregate capacity of> 1,320 and 510,004 s?
<br />YES NO
<br />AST
<br />H&SC 25270.3
<br />If s, arm the Iter VII APSA Fadlity Checklist. If >14,000 sallons, refer to AST Team
<br />_❑
<br />Any comments entered wi this code are observations or recommendations orgy and are not violations. This i rnatiorr Is educationat or suggested
<br />�sAdec
<br />preventative ractice but Es rat currenE4 r uired.
<br />Revised 6/24/2011 gfb print again 11107(2011 gb WAData\FORMSARCHIVE\HM\HMP\HMP\dU5 FLAPI\HM LHtLxu51 SUMM VIV Hua 5Us rtly trtuea I ry m>.00e
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