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SAN10 A Q U I N Environmental Health Department - —COUNTY--- San Joaquin County Env�wnmanlal MaallF� �epaRmenY HAZAR�OIJS MATERIALS PROGRAM This survey form is intendetl to itlandry businesses which need to comply with[ha hazardous materials emergency planning and reporting requirements of the Califomla Health and Safety Code (HSC) Chapter 6.95. This Chapter requires businesses which handle hazardous materials to prepare emergency plans for their employees[o use in an emergency. Businesses mus[submit this Information,along with an annual inventory of their hazartlous materials,online to the California Environmental Reporting System (GFRs)found at cars.calaoa v for use in protecting emergency responders and the general public. In San Joaquin County, the Environmental Health Department (EHD) has been authorized to administer this program as the Certified Unified Program Agency or CUPA. Should you have any questions about the CUPA program or this form, please contact EHD at(209)466-3420. Plaasa consider the following guitlelinea when completing the qu¢s[ions on page 1: Quastlon 1: Tha(HSC)section 2550'1(p)defines a"Hazardous Material"as any material[hat,because of Its quantity,concentration,or physical chemical characteristics, poses a significant pressen[ or potential haaard to human health and safety or fo the environment If released Into the workplace or the environment. "Hazardous Materials" include but a not limited to, hazardous substances, hazardous waste,and any material that a handler or[he administering agency has a reasonable basis for behaving that i[would be injurious to iha health and safety of persona or harmful[o the environment If released Into the workplace or the environment. This includes, but is not limited to, fuels, petroleum products, paints, propane. oxygen. ammonia. chlorine. pesticides. fardlizers, and us¢d oil. If a business generates env am un[of hazartlous este they must enroll in the EHD Hazardous Wastes Ganeretor Program. Answer"Yes" if you use a material that meets iha definition above in any quantity at least once in the year. If you are unsure, contact the EHD at(209)468-3420 for assistance. If you answer"No"and at a later date your business.or a Tenant on your property, begins hantlling hazartlous materials,you must inform Ma EHD within 30 days. Ouastlnn 2 It you answer"Yes",you must meet[he requirements of HSC Chapter 6.95. Tha EHD will be contacting you to provide assistance. Those raqulrements must ba mat prior[o Issuance of a certificate of occupancy. If you answer"No", our office may conduct an Inspection after you begin operations to verify your exemption. Tha HSC establishes some modified requirements or program exemptions for certain uses of hazartlous materials. if you answered "Yes" [o questions 1 antl 2, a tlatarmine[ion mus[ ba made if your business meats o of the a mptions liatatl. Chock the appropriate boxes on page 1 and submit the hazardous materials Information online at cers.caleoa Please contact the EHD io determine if your business meets the exemptions. However, even if an exemption Is met for[ha Business Plan program, you may still ba a hazartlous waste generator and will need to report in cars caleoa c a hazardous waste generator. A. Ra[ail Exammtlon-Products packaged for direct tliatdbution to the general public era exempt from[ha program. This exemption may not apply if any of the following conditions axisL 'I.Tha quantity handled creates an unacceptable public hazard 2.Tha material Is being used directly by the business es part of Its operetion in atldition to being soltl to the general public 3.Tha general public doesn't have ready access to the product as stored by the business(a.g.in a warehouse). B. Mndi9ad Farts Ex®motion-Farms,a stated in Quastlon 2B on page 1, t Tha definition of a farm in the law doesn't include businesses providing c rolal past controlrs s! fertilizer application services. product processing s rvicas. or packing shad services for fanners. Farms qualifying for the exemption are still required to submit an annual chemical Inventory, site map, and other requirements online [o caleoa ov and pay a Pea to the San Joaquin County Environmental Health Department(EHD). Please contact thesEHD at (209) 466-3420 for assistance. Businesses oparetin9 a ial business in addition to a farm a defined must comply with the requirements of fhe Hazardous Materials Program for those materials associated with the commaroial business. Ouasfon 3: Tha Fadaral and States governments have defined approximately 366 chemicals as an "Acutely Hazardous Material"(AHM). Tha most common AHM usetl in Me county include: Chlorine, Ammonia, Sulfuric Acid, Methyl Bromide, Acrolaiq Sulfur Dioxide, Formaldehyde. Nitric Acid.Vinyl Ace[ata Monomer. Hydrogen Peroxide,and many types of Pasticitlas. Answer"Yes^ if you use any of these specific chemicals In any quantity a[any one time of the year. Contact the EHD if you're unsure for assistance. Question 4- Answar"Yes"if the boundary of your property or facility Is or will ba within '1,000 feat of[ha boundary of a school. pc-tz)