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Cal -EPA •DEPARTMENT OF TOXICS ANCES CONTROL aGRAY DAVIS, Governor <br />SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br />ENVIRONMENTAL HEALTHDIVISION <br />304 E. WEBER AVE. <br />t ... <br />STOCKTON,1 <br />e <br />CHECKLIST , INITIAL VERIFICATION INSPECTION REPORT • ;r <br />Permit 1 Rule, ConditionallyAuthorized, and Conditionally Exempt1 <br />SIGNATURE <br />Onsite Recycling: Only answer if this facility recycles more than 100 kiloerams/month of hazardous waste onsite. <br />NO <br />_ 27. The appropriate local agency has been notified. HSC 25143.10 <br />_ 28. Activities claimed under the onsite recycling exemption are appropriate. HSC 25143.2 et sec. <br />Releases: <br />YES <br />_ 29. Within the last three years, were there any unauthorized or accidental releases to the <br />environment of hazardous waste or hazardous waste constituents from onsite treatment units? <br />_ 30. Within the last three years, were there any unauthorized or accidental releases to the <br />environment of hazardous waste or hazardous waste constituents from any location at this <br />facility? <br />For purposes of a Tiered Permitting inspection, a release to the environment is unauthorized or <br />accidental and does not include spills contained within containment systems. <br />Source Reduction: <br />31. Generator was subject to SB 14 OR SB 1796 and failed to prepare and retain current source <br />reduction documents, as applicable, and make them available to the inspector within (5) days. A <br />checklist or plan is required gMl if annual hazardous waste volume is overr 5, 000 kilograms (approximately 11, 000 <br />pounds or 1, 350 gallons). <br />_ 32. Source Reduction Evaluation Review and Plan failed to contain, at a minimum, the following <br />five required elements: certification, amounts of wastes generated, process description, block <br />diagrams, and implementation schedule of selected source reduction measures. <br />This report may identify conditions observed this date that are alleged to be violations of one or more sections of the <br />California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management <br />of hazardous waste. The violations may be described in more detail on the attached note sheets. If any violations are noted, the <br />facility is required to the submit a signed Certification of Return to Compliance within 30 days, unless otherwise specked. (A <br />certification form is provided.) If any corrections are needed to the initial notification, the facility will submit a revised <br />notification within 30 days to the Department of Toxic Substances Control with a copy to the local enforcement agency. DTSC <br />or the local enforcement agency may reinspect, at any time, to verify compliance with this Notice to Comply. <br />Inspector(s): <br />Lead Inspector: Other Inspector: <br />Signature: Signature: <br />Print Name: f ' ®a, r Print Name: y <br />Title: 10 Title: <br />Agency: S A, _ -1; — E H 0 Agency: <br />Phone Number: T- 314 Phone Number: AAA —1, <br />Facility Representative: <br />Your signat acknowledges r ceipt of this report and does not imply agreement with the findings. <br />Signature: Print Name: -- <br />Title: Date: <br />Onsite Checklist (C) Page3 of 5 February 10, 1999 <br />