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:al-EPA DEPARTMENT OF TOXIC SUBSI.+WCES CONTROL GREY DAVIS,Governor <br /> 3AN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br /> _NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.WEBER AVENUE, 3RD FLOOR <br /> iTOCKTON,CA 95202 °+ .o •" <br /> CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br /> Permit by Rule,Conditionally Authorized, and Conditionally Exempt Notifiers <br /> FACILITY NAME: <br /> n.�a c- I t t nl s EPA ID NUMBER: <br /> PHYSICAL ADDRESS: PHO �96 - ?,6FACILITY CONTACT-NAME• l# <br /> SIC CODE(S): INSPECTION DATE: P t7 <br /> CA CESW_ CESQT CEL_, TOTAL <br /> NOTIFIED UNIT COUNT: PBR_ CA= CESW_ CESQT CEL_ TOTAL <br /> CORRECT UNIT COUNT: PBR <br /> This checklist and inspection report identify violations of state law regarding onsite treaters of hazardous waste, <br /> operating under an onsite is <br /> ion <br /> fies the information provided on form DTSC 1772. it also covers <br /> generator requirements,although gh aseparat ermittintier. hcheckl checklist betused for those requirements, A checkmark indicates violation of <br /> the law,which are explained in more detail on the attached note sheets.The governing laws are the Health and Safety Code <br /> (HSC)and Title 22 of the California Code of Regulations(22 CCR). <br /> Generator Standards: <br /> ll <br /> Each inspection agency may use their own generator inspection checklist or protocols, which are summarized below. A fii <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 /> , in good condition,with ignitables/reactives 50 feet from property line). <br /> inspected weekly <br /> _ s (either secondary containment or integrity assessments, plus <br /> 4. Meet tank management standard <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 units <br /> with unit sheets or correct tier on the unit sheet.) <br /> _ 7. All generator identification information on Form DTSC 1772 is correct. <br /> _ g. 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 /> _ <br /> industrial waste discharge requirements,where applicable. <br /> For CA or PBR notifiers: <br /> 10. The generator has an annual waste minimization certification. (PBR submit with renewals. <br /> Rev 3/5/02 <br /> Onsite Checklist(A) <br /> Page 1 of Lk <br />