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• <br />• <br />PERMIT BY RULE <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE COLLECTION FACILITY <br />INSPECTION CHECKLIST <br />F. FACILITY CLEAN-UP: YES NO COMMENT <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 />49. A written report was submitted to the CUPA/ or DTSC <br />(if no CUPA) within 15 days if an incident of <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 identify 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 />Lead Inspector: IV( VU V1 -4Vjf v� 1VVV WWt Other Inspector: <br />XkL <br />Signature: Signature: <br />Print Name: 1 N i ' uk Print Name: <br />Title: I rk _ N i Title: c ldr <br />Agency: Agency: J� <br />Phone Number: ' Phone Number: % <br />Facility Representative: <br />Your signatur ck wledges receipt of this report and does not imply agreement with the findings. <br />Signature: Print Name: � <br />s�P <br />Title: Date: <br />THHWCF Checklist (3/10) <br />