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State of California-California.Environmental Protection Agency Department of Toxic Subshanccs Control <br /> TIERED PERMITTING PIIASE IENVIRONMENTAL ASSESS;•'IF.NT CHECKLIS.0 <br /> 10. To your knowledge,have Iaud fartning or bioretnedaation been used at the facility? X <br /> 11. To your knowledge,has the facility ever burned hazardous wastes,unidentified waste X <br /> materials,tires,or automotive batteries at the facilit ? <br /> 12. To your knowledge,have ash and/or combustion residuals been disposed of at the X <br /> facility? <br /> 13. To your knowledge,have any underground storage tanks)been removed,abandoned,or <br /> taken outof service from the facility? '1•ank8 removed,abandoned,or taken out of service g <br /> under the oversight of a responsible agency need not be considered if the agoncy <br /> addressed potential contamination at the tank location. <br /> 14. To your knowledge,has any contaminated soil been discovered and/or remediated at the X <br /> facility without oversight by an aom-opiJate regulatory agency? <br /> 15. To your knowledge,have there been fres and/or explosions at the faoillty which may <br /> have caused a release of hazardous waste or materials? <br /> 16. To your knowledge,has the facility ever received complaints from any employees, <br /> neighbors,or the public about the facility's practices for managing hazardous wastes,or X <br /> anv actual or potential releases to air water or soil or other enviremnental issues? <br /> 17. To your knowledge,have nearby residents complained to a governmental agency of any <br /> X <br /> type of illnesses or unusual illnesses as having been caused or suspectedly caused by or <br /> related to activities at the facility? (Note:this item does not require questioning the <br /> :Facility's neighbors) If'YES,indicate below thcperson and/or agency who recorded the <br /> complaint. <br /> If YES,to your knowledge,has any evidence been submitted to a physician to <br /> substantiate the claim? <br /> 18. `1'o your knowledge,are there any areas at the facility which were formerly used for <br /> hazardous waste or hazardous materials transfer(e.g.tank loading areas,drum transfer X <br /> areas)? <br /> 19. To your knowledge,are there,or have there been lawsuits or administrative proceedings <br /> concerning an actual,alleged,or threatened release of any hazardous substance against X <br /> the facility by another party? Only actions concluded by settlement or litigation need be <br /> considered. <br /> DTSC 1151(06N9) Please indicate totnl nurn[wof pages_ of <br />