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State of California-California Environmental Protection Agency Department of Toxic Substances Control TIERED PERMITTING PRASE I ENVIRONMENTAL ASSESSMENT CHECKLIST 14. To your knowledge,have land-farming or bioremediation been used at the facility? X 11. To your knowledge,has the facility ever burned hazardous wastes,unidentified waste X materials,tires,or automotive batteries at the facility? 1.2. To your knowledge,have ash and/or combustion residuals been disposed of at the X facility? _. 13. To your knowledge,have any underground storage tank(s)been removed,abandoned,or taken out of service from the facility? 'Tanks removed,abandoned..or taken out of service X under the oversight of a responsible agency need not be considered if the agency addressed potential contamination at the tank location. ......... .......................... 14. To your knowledge,has any contaminated soil been discovered and/or remediated at the X facility without oversight by an appropriate regulatory agency? 15. To your knowledge,have there been fires and/or explosions at the facility which may X have caused a release of hazardous waste or materials? 16. To your knowledge,has the facility ever received complaints from any employees, neighbors,or the public about the facility's practices for managing hazardous wastes,or X any actual or potential releases to air.w:.ater,or soil,or other environmental issues? 1.7. To your knowledge,have nearby residents complained to a governmental agency of any type of illnesses or unusual illnesses as having been.caused or suspectedly caused by or related to activities at the facility? (Note:this item does not require questioning the facility's neighbors) If YES,indicate below the person and/or agency who recorded the X complaint. If YES,to your knowledge,has any evidence been submitted to a physician to substantiate the claim? 18. To your knowledge,are there any areas at the facility which were formerly used for X hazardous waste or hazardous materials transfer(e.g.tank loading areas,drum transfer areas) 19. To your knowledge,are there,or have there been lawsuits or administrative proceedings concerning an actual,alleged,or threatened release of any hazardous substance against X the facility by another party? Only actions concluded by settlement or litigation need be considered. _........................................................._......._.........................................................................._:..... .................__........_.......................................................__............._....._...................................._..._................................._._...i D SC 1151(06199) Please indicate total nutuber of pages_cif