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State of California <br />CIWMB 52A <br />(Rev 9/05) <br />® .•� <br />C <br />Asbestos Containing Waste Disposal Site <br />Inspection Report Addendum <br />This Inspection report is to be used in conjunction with the Disposal Site Ins ection Re rt CIWMB <br />California Integrated Waste <br />Management Board <br />Page <br />Blore orBlack' ink Pen <br />'–a <br />P Po <br />EnforcemtaptAgency: l San Joaquin Count Environmental Health Department <br />q Y p I <br />for Oft qjM CIWMB Is&Q �Y <br />'AGILITY FILE NUMBER INSPECTION DATE (MM/DD/YYYY) <br />Received Date <br />39 -AA -0015 10/27/06 <br />I I <br />00 <br />I i <br />Ply one code) Time Inspection Time <br />QLEApfo i QCIWut6 C(tised Sites OCiFo usetl In: <br />WM6 <br />010 <br />O O <br />r .. _ Time <br />O FA Focused Qi IWMB EnforcementAgEntOCIWME, Periodic <br />Out: '�f <br />s <br />0Att hinents:On Ftle*(hiot� Sea,tt� <br />;,,> ,.v WW"T" <br />Facility Name Re By perator) <br />Forward Inc. <br />17897.18(d) - CONTROL OF VISIBLE EMISSIONS <br />17897.18(e) - MAINTAIN INTEGRITY OF CONTAINERS AND/OR PACKAGING <br />Facility Location <br />n r <br />19999 S. Austin Rd., Manteca I <br />I <br />17897.18(h) - COVER FREQUENCY <br />Inspector Inspector, ignature <br />Also Present <br />00 <br />Michael Kith <br />Garrett Backus <br />EX4�ONEpQ'ltlifiMEt�S e <` <br />�- IF THIS BOX IS CHECKED, REFER TO DISPOSAL SITE INSPECTION REPORT (CIWMB 621 FO <br />O O <br />THE ABOVE FACILITY WAS INSPECTED FOR COMPLIANCE WITH PLICABLE SECTIONS OF DIVISION 30 OF THE PUBLIC RESOURCES CODE (PRC), AND TITLE 14 AND TITLE 27 CALIFORNIA CODE OF REGULATIONS (CCR): <br />cU, NoiucRCu IN COMPUANCE UNLt.7J U <br />PERMITS" <br />PRC 44002 - OPERATOR AUTHORIZED BY SWF PERMIT <br />O.O <br />PRC 44004- SIGNIFICANT CHANGE.. .. <br />00 <br />PRC 44014(b) - OPERATOR COMPLIES WITH TERMS 8 CONDITIONS <br />00 <br />21640- PERMIT REVIEW APPLICATION <br />21600 - REPORT OF DISPOSAL SITE INFORMATION <br />GENEAiAL STANDARDS ��..,-'a <br />010 <br />O O <br />17897.15- SCHEDULES OF COMPLIANCE <br />17897.16 -GENERAL STANDARDS <br />SIGN AND OpEKA flt� EQU'7"-7 TS <br />897.18(a) DESIGNATED ACW DISPOSAL AREA <br />;97.18(b) - SITE CONTROL PROGRAM <br />O O <br />00 <br />O O <br />O O <br />17897.18(c) - ACW NOT DISPOSED WITH REFUSE <br />17897.18(d) - CONTROL OF VISIBLE EMISSIONS <br />17897.18(e) - MAINTAIN INTEGRITY OF CONTAINERS AND/OR PACKAGING <br />MOO <br />17897.18(0 - NO COMPACTION PRIOR TO COVER <br />17897.18(8) - COVER <br />17897.18(h) - COVER FREQUENCY <br />00 <br />17897.19(c)(1) - CONTINGENCY PLAN <br />00 <br />17897.19(c)(2) - PERSONNEL TRAINING <br />00 <br />EX4�ONEpQ'ltlifiMEt�S e <` <br />�- IF THIS BOX IS CHECKED, REFER TO DISPOSAL SITE INSPECTION REPORT (CIWMB 621 FO <br />MARKED WITH ONE OF THE FOLLOWING: V=VIOLATION A=AREA OF CONCERN <br />ADDITIONALREQUIREMENTS- <br />17897.19(a) - EPA ID NUMBER <br />- <br />- 00 <br />17897.19(bX )--ADDITIONAL SITE SECURITY _ - - <br />00 <br />17897.19(b)(1)(A) - CONTINUOUS SURVEILLANCE SYSTEM _ <br />00 <br />17897A9(b)(1)(B)- WARNING SIGN(S) <br />0,0 <br />17897.20.OPERATOR INSPECTION REQUIREMENTS <br />010 <br />17897.19(b)(2) - DISPOSAL SITE RECORD <br />- 010 <br />17897.19(b)(2)(A) - LAND DISPOSAL RESTRICTIONS <br />00 <br />17897.19(b)(2)(8) - OPERATING RECORD --- — - <br />00 <br />17897.19(b)(3) - FINANCIAL RESPONSIBILITY <br />00 <br />17897.19(c)(1) - CONTINGENCY PLAN <br />00 <br />17897.19(c)(2) - PERSONNEL TRAINING <br />00 <br />EX4�ONEpQ'ltlifiMEt�S e <` <br />1789721(b) - SUBMIT PLAN FOR APPROVAL TO EA <br />O O <br />17897.21(c) -(d) - PLAN PREPARATION AND RESCHEDULED STARTING DATE <br />O O <br />17897.24- COMPLIANCE WITH CLOSURE/POST CLOSUREREQUIREMENTSO <br />O <br />OTHER ° s:,4 J <br />00 <br />OO <br />R ADDITIONAL INFORMATION <br />Comments (Note: for additional or continued comments use the CIWMB 03 or attach additional pages.) <br />Conducted monthly routine inspection this date. No violation or area of concern was observed. <br />INSTRUCTIONS ON BACK t <br />-st( <br />Top - CIWMB Middle - LEA Bottom - Operator <br />