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State of California-Califomia Environmental Protection Fly Department of Toxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> SECTION II: FACILITY HISTORY <br /> Instructions: Complete this section regarding facility history hexed on reasonably available knowledge of the facility. This section will determine if past <br /> operating practices and significant historical events that occurred at the facility indicate potential areas of contamination. Current and past employees who <br /> know about the facility's past operating practices can be an asset in completing this section of the checklist Yes answers to these questions mean that careful <br /> attention most be paid to these areas and considerations when completing the facility walk-through inspection. <br /> YES NO <br /> 1. Has an environmental assessment and/or a site investigation report ever been completed for the X <br /> facility? If this assessment meets the criteria for substituting for this checklist(see Instructions),use <br /> the Signature and Certification Page to record this exemption. You need not release confidential <br /> assessments. However,if these reports indicate existing or potential contamination,you must use <br /> the information relied on by the confidential report to help reach a conclusion in this assessment. <br /> 2. To your knowledge, have areas of the facility that contain hazardous materials ever been flooded? X <br /> 3. To your knowledge, has the facility ever been damaged by an earthquake that could cause X <br /> contamination? <br /> 4. To your knowledge,has the location for the facility ever been used for industrial purposes prior to its X <br /> current use? If YES,then consider potential contamination from the type of industry that the <br /> location was formerly use for. <br /> 5. To your knowledge,has there been any disposing of hazardous chemicals or hazardous wastes in, X <br /> on,or under the property? <br /> 6. To your knowledge,has the facility ever had electrical transformers,capacitors,or hydraulic X <br /> equipment including,but not limited to elevators and auto lifts,at the facility which may have <br /> released PCBs or oil to the environment? (Not including small quantities of fluorescent light <br /> ballasts and capacitors if these materials were not disposed of or dismantled at the facility). <br /> If YES,was the equipment ever tested for the presence of PCBs? <br /> 7. To your knowledge,has testing of any groundwater wells on the property ever revealed possible X <br /> contamination? <br /> 8. Do you have in your possession,or do you know of the existence of any photographs,geophysical X <br /> reports,analytical test data,and/or air sampling data that indicates the possible presence of <br /> hazardous materials and/or waste in unwarranted or unexpected areas of the facility? <br /> 9. To your knowledge, has the facility ever had liquid/sludge containment area(s),surface X <br /> impoundment(s),collection pond(s),and/or lagoon(s)? <br /> 10. To your knowledge, have land-farming or bioremediation been used at the facility? X <br /> NOTES: <br /> 1.E2C 1988-89 report-cleanup performed under DTSC oversight. <br /> 4.Two buildings- 1848-Sigma built bldg-open lot before, 1856-Likaclosed. <br /> 6. Wells drilled-since closed-installed for 1989 Phase I-found nothing after 3 yrs of sampling. <br /> 8.Phase I report. <br /> DTSC 1151(9195) Please indicate total number of pages 2 of 6 <br />