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State of California-California Environmental Protection Agency Department of Toxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL:ASSESSMENT CHECKLIST <br /> SECTION III. FACILITY WALK-THROUGH INSPECTION-SPECIFIC AREAS <br /> Instructions:Listeacharea of the facility where hazardous materials are present.The listing area is divided into functional divisions for convenience. Individual units maybe grouped on the chart.but <br /> must be individually inspected_ CarefiilIy examine each of these areas during the walla through inspection to determine the presence of releases or possible releases and record the results in the <br /> appropriate column,date and initial the entry. Complete a Release Information Data Sheet for each actual and possible release found. Using your best judgement,decide if any actual or suspected <br /> releases found require father investigation aad record.the results oa the Release Information Data Sheet and inthe appropriate column onthis chart.If you need additional space,photocopy this sheet. <br /> ACTUAL OR SUSPEC'T'ED REQUIRES FURTHER <br /> HAZARDOUS MATERIAL AREA INSPECTED RELEASE INVESTIGATION <br /> LOADIN (Yes or No) (Yes or No) (Yes or No) <br /> G/1JNLOADING AREAS <br /> Loading Docks(inside and staging area for hazardous waste and products) Yes No No <br /> Loading Docks(Outside) Yes No No <br /> HAZARDOUS MATERIALS USE AREAS <br /> Bulk NaOH Area Yes No No <br /> ,iquid Dispensing Cart(LDC)Room -Cart Cleaning Operation Yes No No <br /> Cartridge filling(ROBAL) Yes(brorm outside clean room) No No <br /> Bead Production Yes(from outside clean room) No No <br /> B Labs Yes No No <br /> C Labs Yes No No <br /> Consumables Yes No No <br /> ackaging(PAL) Yes No No <br /> NaOH storage room-151 Yes No No <br /> Recycling center Yes No No <br /> Service Chase Yes No No <br /> HAZARDOUS WAS'T'E GENERATION AREAS <br /> Satellite Containers m Packing Line Yes No No <br /> Shredzilla Treatment Unit and Waste Accumulation Area in Shredzilla Room Yes No No <br /> LDC Roorn Waste storage containers Yes No No <br /> Bulk Lab Yes No No <br /> HAZARDOUS WASTE TRFATMENT/STORAGEAItEAS <br /> ShnedzilIa ,yes No No <br /> Satellite Arca Yes No No <br /> Buk Lab Yes No No <br /> Temporary staging area prior in hazardous waste shipment Yes No No <br /> IJTSC 1151{06199) Please indicate toted mmberafpages` of <br />