Laserfiche WebLink
State of CalifomiaCalifomia Envirorunental Protection Abyy *./ Department of Toxic substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> SECTION II: FACILITY HISTORY YES NO <br /> 11. To your knowledge,has the facility ever burned hazardous wastes, unidentified waste materials, X <br /> tires,or automotive batteries at the facility? <br /> 12. To your knowledge,has ash and/or combustion residuals been disposed of at the facility? X <br /> 13. To your knowledge, have any underground storage tank(s)been removed,abandoned,or taken out of X <br /> service from the facility? Tanks removed,abandoned,or taken out of service under the oversight of <br /> a responsible agency need not be considered if the agency addressed potential contamination at the <br /> tank location. <br /> 14. To your knowledge,has any contaminated soil been discovered and/or remediated at the facility X <br /> without oversight by an appropriate regulatory agency? <br /> 15. To your knowledge,have there been fires and/or explosions at the facility which may have caused a X <br /> release of hazardous waste or materials? <br /> 16. To your knowledge, has the facility ever received complaints from any employees,neighbors,or the X <br /> public about the facility's practices for managing hazardous wastes,or any actual or potential <br /> releases to air,water,or soil,or other environmental issues? <br /> 17. To your knowledge, have nearby residents complained to a governmental agency of any type of X <br /> illnesses or unusual illnesses as having been caused or suspectedly caused by or related to activities <br /> at the facility? (Note:this item does not require questioning the facility's neighbors). If YES, <br /> indicate below the person and/or agency who recorded the complaint. <br /> If Yes,to your knowledge,has any evidence been submitted to a physician to substantiate the claim? <br /> 18. To your knowledge,are there any areas at the facility which were formerly used for hazardous waste X <br /> or hazardous materials transfer(e.g. tank loading areas,drum transfer areas)? <br /> 19. To your knowledge,are there,or have there been lawsuits or administrative proceedings concerning X <br /> an actual,alleged, or threatened release of any hazardous substance against the facility by another <br /> party? Only actions concluded by settlement or litigation need be considered. <br /> NOTES: <br /> 14. Soil removed as part of 1989 Phase 1. <br /> DTSC 1151(9195) Please indicate total number of pages 3 of 6 <br />