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STATE OF CAUFOMM - Asbestos Containing Waste Disposal CALIFORNIA INTEGRlTEO WASTE <br /> "" ( 7) Inspection Report Addendum MANAGEMENT BOARC <br /> A <br /> ---s Th sped.on ort form' be used in conjunction with the I tgrte I on R CIWMBlS� <br /> Enforcement Agency: — G/! j L�0 0 LA 1-V\ r r_1.1�\i l��J 1(L�t/\Vv+P 1!\iTi, ' �N(? � \tet? .`� Page/of <br /> FACILITY FILE NUMBER PROGRAM'CODE r INSPECTION DATE:: TIME IN INSPECTION TIME <br /> 6ZL4 STATE=S ! MM DID YY <br /> ?LFt`1 TIME OUT - --- <br /> -------- - <br /> FAC11f1 OPERATION NAME REC D BY <br /> OPERATOR OWNER , <br /> wq If 1- y\C - <br /> FACILffY.LOCATION I ADDRESS ALSO PRESENT <br /> C ✓ -�-� _-. = - ` l vt ��`''1_L�GI.- _ _ �!�T��fG� - - - -/,.�I 1 c l��+c .i_ , ��1�. <br /> INSPECT INSPECTOR SIGNATURE <br /> THE ABOVE OPERON/FACILITY WAS INSPECTED FOR COMPLIAN H APPLICABL S OF DIVISION LIC RESOURCES CODE(PRC)AND TITLE 14 CALIFORNIA CODE OF REGULATIONS(CCR). <br /> _-..------------- <br /> THE STANDARDS BELOW ARE CONSIDERED IN COMPLIANCE UNLESS OTFTERWISE MARKED WITH ONE OF THE FOLLOWING: V=VIOLATION A=AREA OF CONCERN NA=NOT APPLICABLE <br /> PERMITS -- - - - --- - - — -- - --- - Y A Nfi:i <br /> ---- - --- <br /> PRC 44002-OPERATOR AUTHORIZED BY SWFP <br /> PRC 44004-SIGNIFICANT CHANGE <br /> PRC 44014(b)-OPERATOR COMPLIES WITH TERMS AND CONDITIONS <br /> 18213(b)-PERMIT REVIEW APPLICATION <br /> _,18222-REPORT OF DISPOSAL SITE INFORMATION <br /> GENERAL STANDARDS - - - <br /> 17897.16-GENERAL STANDARDS <br /> DESIGN AND OPERATING REQUIREMENTS <br /> 17897.18(a)-DESIGNATED ACW DISPOSAL AREA <br /> 17897.18(b)-SITE CONTROL PROGRAM -- - <br /> 17897.18(c)-ACW NOT DISPOSED WITH REFUSE <br /> 17897.18(d)--CONTROL OF VISIBLE EMMISSIONS <br /> 17897.18(e)-MAINTAIN INTEGRITY OF CONTAINERS AND/OR PACKAGING <br /> 17897.18(17---N— COMPACTION PRIOR TO COVER <br /> 17897.18(g)-COVER _------_.-- _ --- <br /> 7897.18(h) COVER FREQUENCY -- <br /> DDITtONAL REQUIREMENTS <br /> 17897.19(a)-EPA ID NUMBER <br /> 17897.19(b)(1)-ADDITIONAL SITE SECURITY i <br /> --- -- - ------------ --- .--- - ----------- -- - - --- <br /> 17897.19(b)(1)(A)-CONTINUOS SURVEILLANCE SYSTEM j <br /> 17897.19(b)(1)(B)_WARNING SIGN(S) -- -- ---- --- -- -- - <br /> 17-897.20-OPERATOR INSPECTION REQUIREMENTS <br /> RECORD KEEPING ---- - - - — - - - --- _ , <br /> - ------=--- -� --- - -- - ----_- -= _- ---- <br /> 17897.19(b)(2)-DISPOSAL SITE RECORD <br /> 17897.19(b)(2)(A)-LAND DISPOSAL RESTRICTIONS <br /> 17897.19(b)(2)(B)-OPERATING RECORD - ---- <br /> 17897.19(b)(3)-FINANCIAL RESPONSIBILITY <br /> 17897.19(c)(1)-CONTINGENCY PLAN <br /> 17897.19(c)(2)-PERSONNEL TRAINING <br /> EXCAYATION<;RE4UIREMENTS <br /> 17897.21(b) SUBMIT PLAN FOR APPROVAL TO EA - " <br /> 17897.21(c}(d) PLAN PREPARATION AND RESCHEDULED STARTING DATE _ <br /> CLOSURE AND POST GL®St1FtE <br /> 7897.24 COMPLIANCE WITH CLOSURE/POST CLOSURE REQUIREMENTS --� <br /> OTHER-- �.-- <br /> - -- --- -- -- - ------ <br /> IF <br /> -IF THIS BOX IS CHECKED,REFER TO DISPOSAL SITE INSPECTION REPORT(CIWMB-52)FOR ADDITIONAL INFORMATION <br /> COMMEJNTS,(USE SWISI FOR ADDITIONAL SPACE) <br /> ._—_C.._�/9_ - v--_ ___�-�_.�ea�'.9�__-!_"'-"f!G•i._sl.�'__-�_� ��G✓W�H^ ft/!I<.__-- '. <br /> W <br /> R , — ---- -- - t CCC 1 <br /> DISTRIBUTION: White-CIWMB Pink-LEA Yellow-Operator 97 91149 <br />