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GREY DAVIS,Govemor <br /> ;aI-EPA DEPARTMENT OF TOXIC SUB- ,ANCES CONTROL <br /> SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E. WEBER AVENUE, 3RD FLOOR O:. <br /> STOCKTON, CA 95202 <br /> CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR <br /> Permit by Rule,Conditionally Authorized, and Conditionally Exempt Notifiers <br /> 61(L5 EPA ID NUMBER: <br /> FACILITY NAME: <br /> PHYSICAL ADDRESS:L-_7;'qO Vja.Shtmo)tWl IFYVP px0 r� 5gou x 5b l L <br /> FACILITY CONTACT-NAME: LINSPECTION DATE: Local# <br /> SIC CODE(S): <br /> NOTIFIED UNIT COUNT: PBR_ CA_ CESW S CESQT_ CEL_ TOTAL <br /> CELTOTAL <br /> CORRECT UNIT COUNT: PBR_ CA— CESW O CESQT _ <br /> This checklist and inspection report identify violations of state law regarding onsite treaters of hazardous waste, <br /> is <br /> ion <br /> fies the information <br /> generator reon form DTSC 1772. It also covers <br /> quirements,although agseparat 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: generator inspection checklist or protocols, which are summarized below. A f dl <br /> Each inspection agency may use their own g P <br /> evaluation of each item or document is not conducted during the Verification Inspection, unless serious deficiencies are suspecte . <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 /> torage tie liits, <br /> 3. Meet container management <br /> condition,with igni ables/reacclosed, labelled, <br /> tives50 feetfrom property line). <br /> inspected weekly,, in good <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 /> (. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new units <br /> _ <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 ds documenting <br /> requirements,ting c compliance <br /> with <br /> sewer ageency pretreatment standards and <br /> industrial wasted <br /> For CA or PBR notifiers: <br /> 10. The generator has an annual waste minimization certification. (PBR submit with renewals. <br /> 3 <br /> Onsite Checklist (A) Page 1 of Rev 3/5/0: <br />