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Cal-EPA DEPARTMENT OF TOXIC SUBSTANUts UUNiKUL <br /> SAN JOAQUIN COUNTY PUBLs..HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. WEBER AVENUE, 3RD FLOOR 1 P.O. BOX 388 <br /> STOCKTON, CA 96201-0388 <br /> CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br /> Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br /> FACILITY NAME: 'e>c1 ro EPA ID NUMBER: ,-.A-�r[Ro G <br /> PHYSICAL ADDRESS: c jj r <br /> jr. <br /> FACILITY CONTACT-NAME: PHONE: RWO <br /> SIC CODE(S): INSPECTION ATE: - Local # <br /> NOTIFIED UNIT COUNT: PBR _ CA I CESW _ CESQT _ TOTAL <br /> CORRECT UNIT COUNT: PBR _ CA -I— CESW _ CESQT _ TOTAL <br /> This checklist and inspection report identify violations of state law regarding onsite treaters of hazardous waste, <br /> operating under an onsite permitting tier. This inspection verifies the information provided on form DTSC 1772. It also <br /> covers generator requirements, although a separate checklist may be used for those requirements. A checkmark indicates <br /> violation of the law, which are explained in more detail on the attached note sheets. The governing laws are the Health and <br /> Safety Code (HSC) and Title 22 of the California Code of Regulations (22 CCR). <br /> Generator Standards: <br /> Each inspection agency may use their own generator inspection checklist or protocols, which are summarized below. A full <br /> evaluation of each item or document is not conducted during the Verification Inspection, unless serious deficiencies are suspected. <br /> NO/ <br /> ,✓ 1. Contingency plan has been prepared (adequately minimize releases, has alarm/communication <br /> system, lists emergency equipment and phone numbers for emergency coordinators). <br /> _ 2. Written training documents and records prepared for employees handling hazardous waste. <br /> _ 3. Meet container management standards (storage time limits, closed, labelled, compatibility, <br /> inspected weekly, in good condition, with ignitables/reactives 50 feet from property line). <br /> _ 4. Meet tank management standards (either secondary containment or integrity assessments, plus <br /> storage time limits, labelled, compatibility, inspected daily, in good condition, with <br /> ignitables/reactives 50 feet from property line). <br /> 5. All wastes are properly identified. <br /> Treatment Items-Facility Wide: (Facility must submit a revised Form 1772 to correct errors or omissions.) <br /> _ 6. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new <br /> units with unit sheets or correct tier on the unit sheet.) <br /> _ 7. All generator identification information on Form DTSC 1772 is correct. <br /> _ 8. The submitted plot plan/map adequately shows the location of all regulated units. <br /> _ 9. There are records documenting compliance with sewer agency pretreatment standards and <br /> industrial waste discharge requirements, where applicable. <br /> For CA or PBR notifers: <br /> 10. The generator has an annual waste minimization certification. (PBR submit with renewals.) <br /> Onsite Checklist (A) Page 1 of -5- June 5, 1995 <br />