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• 0 <br />PERMIT BY RULE <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE COLLECTION FACILITY <br />INSPECTION CHECKLIST <br />F. FACILITY CLEAN-UP: <br />48. Removal and/or decontamination of all contaminated <br />structures, equipment, soil and all collected materials and <br />wastes have been completed within 144 hours after <br />termination of the session. <br />[Title 22, Cal. Code Regs., section 67450.4(f)] <br />YES NO COMMENT <br />49. A written report was submitted to the CUPA/ or DTSC <br />(if no CUPA) within 15 days if an incident of f <br />noncompliance with these regulatory requirements occurred. <br />[Title 22, Cal. Code Regs., section 67450.4(I)] <br />G. VARIANCES GRANTED BY DTSC: If yes, describe. <br />This report may idents conditions observed this date that are alleged to be violations of one or more sections of <br />the California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (Title 22, Cal. Code Regs.) <br />relating to the management of hazardous waste. The violations may be described in more detail on the attached note <br />sheet. <br />Inspector(s): <br />)ector: MLAn I Opp a <br />Signature: z� - /✓PSA <br />Print Name: M w n i am A t-� nA, <br />Title: �� '-<r1.c CY Kit <br />Agency: CAV V "* yA-' P L 4E" b�PT <br />Phone Number: (Zt 1) "% 34 3`) <br />Facility Representative: <br />Other Inspector: `�G�u( Tram <br />Signature: <br />Print Name: :b) ILION <br />Title: <br />AgencynytW,_4_U <br />Phone Number: �7�l6 s —$ZS0 <br />Your signature acknowledges receipt of this report and does not imply agreement with the findings. <br />Signature: �A�_ -, <br />Title: M, A-�,,eA (eW j4,k AIA",5 t ar- <br />THHWCF Checklist (3/10) <br />Print Name: KI'Al bik 4.,7.4 s <br />Date: 7 Lz_11z_012_ <br />