HomeMy WebLinkAboutSLOUNIFLOW_FS1 Admin iRC3926i Color_0164_001-t --)
Gounty of San Luis Obispo
Environmental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
l
$Hffi*nryo re
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
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EFW data
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BUSINESS PLAI\I
Business plan is complete, current, & available during inspection (HSC 25503.5, Titte 19 CCR2729)
Inventory of hazardous materials is compleib (HSC 25504, Titte 19 CCR2729)
Site layout/facility maps are accurate (HSC 25504, Title 19 CCR2729')
TRAININGPLAN
Facifity has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
66265.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCx-273L & 22
ccR s 66265.s3ts4)
Facility is operated and maintained to prevent/minimize/mitigate lire, explosiono or release of
hazardous materials/waste constituents to the environment. Maintains all required or appropriate
equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.3I-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CF.R 112.5(b))
SPCC Plan is maintained on site or nearest field office. (HSC 25270)
ADDRESS: 36fii Sacranerlt() !)r:.tve
PHONE:
F E:
CITY FIRE
AGENCYn EHSn ee DEPT
Reinspection
Other
Certif :Leatlon
Result Code: _70 _80 _90
Action Gode: _32 _37 _33 _31
ne
M,onl"tor
Complaint
PROGRAMS INSPEGTED::{)ElBusiness Plan XEIfHW Generator g.ffi,usr n ncr ncnnnp
REINSPECTION REQUIRED:Fnruo ! YES ! Business Plan FW&!#^,,l'd %g?46oo,!cnune
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining corppliance with adopted codes. GRANTED BY (NAME/TITLE):
Go to to ro comply witlr BP0l-8P03, TR01 and ER01
INSPECTOR:
llararclErur-* lrial l.a"ts nd:l.nator
FACILITYREP
nun decimal minGPS Coordinates: Latitude: _deg _min_decimal min Longitude:_deg__
fl , Ksai'y g$y
FACILITY NAM E UiliI:TUD PAl{CitL SUITVICE ADDRESS 3601 $ACRA}IEN1'O DRI.VE, S" L. O"
HAZARDOUS WASTE GENERATOR
EPA ID
NT]MBER:
Tieredpermit: LlcBsw Ljcrser nca nrnn
Treatment Equipment:Antifreeze:l{E-Others: U3-I f llr.er$
Darnaged@
Lbs or gals
(average)Total generated/month:
wastJt: xx dvents;Tx
YES NO COS N/AwEE.n-vIoL. #
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EPA ID NO/PERMITS
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Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste
(Title 22CCR 566262.12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.
HAZARDOUS WASTE DETERMINATION
Hazardous waste determi:ration.'conducted (Title 22 CCR 966262.11)lown knowledge flanalysis f]other
Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR g66262.a0.(c))
DISPOSAL/TRANSPORTATION
Hazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit
or authorization from DTSC (HSC $25189.5,TitY622pinilfrun Fottt..
fu azardous tnastes @ (Title 22
Manifests and/or receipts are properly completed/retained by generator for 3 years (Iitle 22 CCR
s66263.42t 66262.23)
STORAGE AND MANACEMENT OF CONTAINERS/TAI\KS
Hryzardous wastes are accumulated on site as follows (Titte 22 CCR $66262.34)
,p m Oays if waste generated per month is greater than or equal to 100 kg (220 lbs.)
fl fgO days if waste generated per month is less than 100 kg (see note)
E ZZO Oays itwaste generated per month is less than 100 kg and transported more than 200 miles
(see note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg(13,200
lbs.)and no acutely/extremely hazardous waste over I l<gQ.2lbs.) is held on site for over 90
days.
Ilazardous waste "satellite" collection is managed properly (complete labeling/accumulation
time/55-gal or l-qt limit) (Title 22 CCR 966262.34(c))
Ignitable or reactive wastes are located l5 m (50 feet) from facility's property line (Title 22 CCR
$6626s.176)
Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUS
WASTE'' waste composition/physical state, hazardous properties, name/address of generator)
(Title 22 CCR 566262.31,66262341
Containers/tanks containing hazardous wastes are in good condition/handled to minimize release
or reaction (Title 22 CCR 566265.17Il.19l,66265.177(c|S
Conteiners/tanks/liners are compatible with waste stored or transferred (Title 22 CCR$66265.f 72)
Containers storing hazardous wastes are closed/sealed (Title 22 CCR 566265.173)
Weekly inspection of areas where hrzardous waste containers are stored is conducted
(Title 22 CCRS66265.| 74)
Daily inspection of all tank systems is conducted and documented (Title 22 CCR $66265.f 95)
Empty containers or inner liners greater lhan 5 gal has date when emptied and are managed
properly within one year of date emptied (Title 22 CCR 966261.7 (0)
RECYCLABLE WASTE
Used oil is managed as hazardous wasle until recycled (includes proper labeting, storage, etc) (HSC
$252s0.4)
Used oil filters for rccycling are managed properly (drained offree flowing liquid, stored in closed
rainproof container, labeled "drained uscd oil filters," and transferred for metal reclamation)
(Title 22 CCR$ 66266.130)
Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill of
lading for recycling, reuse, or reclamation (Title 22 CCR $66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycted (Title 22 CCR
$66266.3)
SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of hazardous waste on site.
Generator is subject to SBl4 and has prepared and retained current source reduetion documents
or is able make them available to the inspector within (5) days. (HSC S25244.19,25244.21)
Source Reduction Evaluation and Plan contains the following live elements:
certification, ampunts of wastes generated, process description, block diagrams, and
implementation schedule of selected source reduction meesure$. (HSC 925244.f9), i .t'i, ,' ,/jj, . I r i''( \ /,, r,l\.t,;
\ t./\, | (.-/
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FAC;LITyNAME: tr]N].TEl) trTARCIiI' -)ra,VICE DATE: 10/tf /2013 '-)
;NSpECTOR; Kerr:y BoyS-e
UNDERGkOUND STORAGE TANK (UST) INSPECTION
CHSCYES
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El
cos N/A REQUIREMENT
Site has a permit to operate.
Permit is kept on the premises.
Change of ownership is reported to the permitting agency
within 30 days.
ccR
TITLE 23
25284 2712
2528a@)
25284.1(a)(5)(D)2637(bX1 XB)
:
zoJz
UT13
ur14
UT15
(aX25284
, ,rn ^ Contractor trained properly. Contractor has ICC Certification
and Class A,C-10,C34,C36, or C61 license?
n UT17 , UST system leak response plan
UT18 ,Facility maintains evidence of Financial Responsibility 25292
25286
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UT2O
/u t--t ,,r,,o UST System information forms (Form A&B) are on file,u accurate and entered into database.
!
n UT22
n
n
!
Facility has BOE number. lf not call 916-324-2166 to
obtain.
Testi rmed as required.containment
Uf21 ' testing,Certification n Designated Chapter 6.7ELD
Overspill containers pass liquid tightness test, with no leak
, thlough dlain valve ,Contajnep- wilhgru! sumpg are, !es!ed,
UT23 : Overspill Container drain functional or alternative available.
Secondary containment & overspill containers are liquid/
debris free.
Leak Monitoring Console has proper leak detection and
overfill notification programming. Continuous alarm history is
maintained.
UT26 Audible and visual alarms functioning properly
UT28 UDC has approved operational leak detection equipped with
, pump shut down.
UT29 Leak detection sensors are properly secured at lowest point
in sumps
Pumping system shuts off when leak is detected or when the
Annual piping integrity test detects 0.1 gph. NA if yes on UT
30
Line leak detector detects 3.0 gph and is certified annually.2528a.1@)@)(c)
UT33 Overfill prevention system installed and operational
UT34 Emergency Shut Off switch (ESO) is functioning properly
No liquid leaks visible.
Shear Valves are in place and functioning.
Secondary Piping is open at the turbine and transition
sumps.
Fuel filters managed properly.
: only)
UT40 r
Monitoring Wells are maintained properly. CA Well
Standards; County Well Ordinance
UT41 Documentation of hazardous and restricted waste disposal
25284.2
2637,2638,
2715
2635(bXl XC),
2665
2635(bXl XC),
, 2655
I ioat (olt+1,
: 263s(bX1)
(2XB)
,2636(fX1)
2636(fX1) &
(s)
2632,2634,
2636,2641(a)
2636
2636(fX4)
2630(
2632,
2635
:tr'n UT24
UT25 25292.1
n UT3O
n
UT31
UT32
UT35
UT36
UT37
UT38
2632
tr
tr
D
tr
n
:\
:89.5(a25
25299
2632
zain
2636
2632
fi[e22
66262.23
66263.42
rMo nitoring system checked daily (Emergency generatorsUT39!
n
2636(fX6)
wi
UT42 Site has no permit to construcVmodify UST system (Local
Ordinance 8.14.013)
25284,25284.1,
25285.1,
25292.1
in
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PVOl Operations not compliant with permit conditions
2712(s)
.\
FACILITY NAME msr:rrn ]tatlclii. finRvlr.:u
UST FORM-PAGE 2
{,/fi ,JTf--,'
DATE L0 / 1112afi
':t
YES NO cos REQUIREMENT CHSC CCR
TITLE23
,Q'..{1.......-.--
W
uT43 Annual Monitor Certification Testing is performed as required.
Provide reportwithln 30 days.2638,2715
E UT44 Designated Operator performing duties as required.2716
F'n UT45 Designated Operator reporls maintalned onsite as required.2715
p"n n UT46 Facility employees are properly trained.2715
{E UT47 Secondary contalnment testing performed wihln the required
three-year lnterval. Provide report wlthin 30 days.2637
nq u V UT48 $econdary Containment Testing - Facilfi ie greaterthan 1500 fi
to a drinking waternoll: Piping passecl testing.
25290.1,25290.2,
25291
\uf u UT49 Secondary Containment Testing - Facility is greater than 1500 fi
to a drinking water well: Tank sump or UDC pasesd testlng.
25290.1,252W.2,
25291
A UTSO Secondary Contalnment Testing - Facility ls greater than 1500 ft
to a drinking water well: Tank annular spac€ passod testing.
25290.1,25290.2,
25251
n/H w UT5.I Secondary Containment Testing - Facility is less than 1500 ft to
a ddnking waterruelh Piping passed tiesting.
25290.1,23290.2,
25291
fi {UT52 Secondary Gontainment Testing - Facilfi is less &an 1500 ft to
a drinklng water unll: Tank sump or UDC passed testing.
25290.1, 25290.2,
23291
\tr tr/UTs3 Secondary Containment Testing - Facility is less lhan 1500 ft to
a ddnking $rater wsll: Tank annular passed testing.
26290.1,25290.2,
25291
\u fi UT54
Contnuously-monitored systems (VPH) operating prcperly and
as designed. Tank annular and sumps under vacuum or liquid
lllled. secondarv olplns under vacuum.
25290.1
\{UT55 Pmduc-t-tight lid components of sptems installed afier July I,
2004 eeal comec{ly {sump lids, splll bucket gaskets}.25290.1
E/\UT56
No Red Tags affxed to ffll pipe dudng this inspec'tlon. Red Tag #,
amount of fuel in the tank, and reason for Red Tag is rcoorded. .
lfneu Tas numb€r flAmount of fud ln tank. E Violation tvpe
252U,252U.1,
25285.1,25292.1 2717.1
,fi tr \
\UT57 ELD testing perbrmed as rcqulred. Provide repott wl$in 60
dsys.
252W.1,25290.2,
25292.4,25292.6 2637
\u n \uT58 Slngle walled plPlNG sltes - Monttly 0.2 gph lntegrity tests
documented on site.
28/,3
i\tr f UT59
Slngle walled TANK sltes - Monthly 0.2 gph intsgdty test rcporb
on slte documenting passing result wtth tuel at 10% of hlghest
operating level.
26,'3
tr b)u uT60
Single rralled and hybrid slbs - Cathodic protec{ion syitem
checked by a conoslon specialistwithin six months of
lnstalllreoalr and everv thrce vears treroaffer.
2635
n rt \UT61 Single rvalled and hybrid sites - Compliant cafpdic protec{ion
.sllstem: running onlinuously;60-day lnspection log on site.m98,2712
a/n u \{6,Single walled and hybrid sftes - Compllant lntedor lining
inspoc{on performad and certification rcport on site. Requlred
1O vrs afier llnlno and sverv 5 vrs *rercafler.
2663
fr tr u ,t\Has report been provided wlth in the rcquired dme period?2997,2694,
2W.1
w'tA tr PVo1 Operations are compliant wiffi permit conditions.2528g,2528/'.1,
28285.1,25292.1
,FN,EI FEOl Environmental Health fees are paid.GBPC 17200 LocalOd.
Environmental Health Senices
(805) 781€544
P.O. Box 1tO9
2156 Stcrrr Way
Sen Luis Obispo, CA 9t4ll6
ffiispo
,- - ',,
clty-ot
san uts
Flru Dspilttnent (805) 78t -7380
2160 Santa Bartara Awnuc
San Lulr Oblrpo CA 93/O1-52'O
CERTIFIED UNIEIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM.i ,, ."'t
oate$.\ ){'' ',r'''
YES NO
BUSINESS i'LAN
Business plan is complete, curren4 & available during inspection (HSC 25503.5, Title 19 CCn,n2g)
Inventory of hazardous materials is complete (IISC 255M, Title 19 CCR2729)
Site layouUfecility mapo arc accurate (IISC 25504, Title 19 CCn n29)
TRAINING PLAN
Facility has approprlate naintng program (Title 19 CCR n32 & 22 CCR 66265.f6)
Training documentadon is maintsined on site for current personnel (Tltle 19 CCR2732 & 22 CCR
66265.t61
EMERGEI\CY RESFONSE PLAN
Conffngency plan is complete, updated, and maintained on site (HSC 255114, Title 19 CCR 2731 & 22
ccR $ 6626s.s3/54)
Facility is operated and maintained to prevenUminimize/mitigate fire' explosion, or release of.
hazirdous matcrlelVwaste constituents to the environmenl Maintalns all requircd or appropriaG
equipment including an alarm end communications system (TlOe 19 CCR 273f & 22 CCR5625531-.4i)
ABOVEGROTJI\D PETROLEUM STORAGE TANK ACT
SPCC Plan is reviewed and ccrdfied by a register,ed engineer within lsst 5 yrs. (40 CFR f f2.5(b)) ,
SPCC Plan is maintained on site or nearcst tield ofrice. (IISC 25,n0D
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FACIUTY NAME:AGENCY
EHS
CITV FIRE
I Bualner Plan EInwco#tot p usr EJ rcr ElSrr-mpPROGRAMS INSPECTED:
E Buslnecr Plan E Xw GGnsrator E usr EIrcr Ec*mpREINSPECTION REQUIFED:,F "o D YEs
,.11),t
COMMENTS Cotohttp://www to obtain forms to comply with BP0I-BP03, TROI EROI
l
Coordinates:deg
FACILITY REP:c
mrn
INSPECTOR:
1\R 1 \Temp\c.lotus.notes.data\1 -lnspeclion Form Page l.doc 24-Jan-06
mtn
Environmental lleelth Services
(8t}t) 78r€s44
P.O. Box 1tO3
2136 Sicrrr Wry
Sen Luls Oblspo, CA 934116
\
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:...::,j:,,:i:,.ir,,,
sat'itrilsontspo -lFItr Dcp.lttlcnt (8O5) 781,7380
2100 Srntr Biltm Avrnuq
Sen Lult Ob'lrpo CA 93t|of -52'tO
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
1)
Date: f
Time:
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BUSINESS PL\II
Bttsincrs plen ls comphte, crrrrrent, & rvellabh dtiring incpccdon (HSC 2t5lt35, fitle 19 CCR2:129,
tnvcutorx of hazrrdous mrterialc is oomphrc (HSc 2550+ fioe 19 ccn n?,l)
Slte byoul/frcillty mrps trl rccurete (llSC 255114, Tlttc l9 CCR 2T29l
TRAINING PII\I{
Frcill$ hrs spproprlrte Fehtng prngran (TlOc 19 CCR Zt32 & 22 CCR 66265.ff)
Tnlning documcntedon b mrintrlncd m dte for currcnt pcrsonnel (fiOc f9 CCR 2732 & Z! CCR
ffi;255.151
EMERGEF{CT RESFONSE PLAN
Condngcncy plrn ls cuttplct€, @rtc4 and nrqlnttilncd on dtc (Illfc 2!i504, n& f9 CCR tlSl & t2ccrf 66'r5ss3l5/ll
Frdlty b opcnred rnd mrinteincd to prcrcntrbrinlmlzg/rnldgrte firl, cAlodonn or nlcese of
hrzirdon mererirldwsstc eoffllircnts to the cnvlnonment ltilalntelnc dl r:quircd or eppruprlate
cqutpmmt lncluding en ehrm end conrmurilcrtlom systcm (Tltlc 19 CCT, t/3l & Zl CCn,6526531-.,f3)
ABOVEGROTTND PETROLET'M STORAGE TANK ACT
SPICC Phn b rcviewcd end ccrtified by a regbtercd cngirccr wlthin lest 5 yrs (40 CFR ff15(b))
SFCC Plm is nrlntalned on ritc or ncercct ticH oftEcc. (IISC 25210)
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entry by:
Routlne
Relnspectlon
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PROGRAIIS INSPEGTED:Phn pfiwactrcrrtor ptsr-El rcr / Ecn-enp
REINSPECTION REOUIRED:p-6 NYES E Burln*r Phn E nwccmrnor E usr Elrcr Elmr.mp
GH Cmrdinsics: Iltitudq dc8 Din---dcdndmtl
ro obtain fomu to BPOI TROI ardER0l
INSPECTOR:
\Temp\c.lotu8.not6s.dala\1 _lnspeclion
rnln
FACILITYREP:
FACILITY NAME DATE:
RGRUUND STORAGE TAN
. REQUIREMENT
UT13 Site has a permit to operate.
(r)l
NO
tr
n
YES
p
F,
cos N/A
!UT14 Permit is kept on the premises.
CHSC
25284(a)(1)
ccR
TITLE 23
2712n
n
25284
UT15 i
Change of ownership is reported to the permitting agency
within 30 days.25284(c)
n
tr n
UT16 : Contractor trained properly. Contractor has ICC Certification
: and ClassA,C-10,C34,C36, orC61 license?25284.1(a)(5XD)2637(bX1 XB)
2632
2637.2638,
2715
2635(b)(1XC),
2665
2635(b)(1XC),
265_5
2631(dX4),
2635(bX1 )
2634
2632(cX2XB)
, 2636(fX1)
26s6(fx1) &
(s)
2632.2634,
2636,2641(a)
2636
c'
FN
UT1un
UT17 ' UST system leak response plan.
8 I Facility maintains evidence of Financial Responsibility.25292I
n
r rr.ro , UST System information forms (Form A&B) are on file,
accurate and entered into database.25286
!UT20 , Facility has BOE number. lf not call 916-324-2166 to
obtain
Testing ggfformed as required.
Uf 21 testinqr MAnnual Certification.
Operato'tt'
!Secondary containment
fl ELD I Designated Chapter 6.7
r Overspill containers pass liquid tightness test, with no leak
through dlain vatve, _Contajners wilhoqt sumps are.. lested,
Overspill Container drain functional or alternative available.
Secondary containment & overspill containers are liquid/
debris free.
Leak Monitoring Console has proper leak detection and
overfill notification programming. Continuous alarm history is
maintained.
Audible and visual alarms functioning properly
UDC has approved operational leak detection equipped with
pump shut down.
Leak detection sensors are properly secured at lowest point
in sumps and tank annular spaces, at time of inspection.
Pumping system shuts off when leak
monitor is disconnected or fails.
detected or when the
Annual piping integrity test detects 0.1 gph. NA if yes on UT
30
Line leak detector detects 3.0 gph and is bertified annually.
Overfill prevention system installed and operational.
25284.2
F{
UT25
UT24
UT25
UT26
UT29
25292.
n UT28
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UT32
UT33
2528a.1@)@)(c)
2636(fX4)
2630(d),
2632,2636(f).
2635
2632
2632
2632
Title 22
66262.23
66263.42
n
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n UT34 Emergency Shut Off switch (ESO) is functioning properly
n
n
tr
tr
!
UT35
UT36
UT37
UT38
UT39
UT4O
No liquid leaks visible.
Shear Valves are in place and functioning.
Secondary Piping is open at the turbine and transition
sumps.
Fuel filters managed properly
Monitoring system checked daily (Emergency generators
only)
Monitoring Wells are maintained properly. CA Well
Standards; County Well Ordinance
2632
2636
25 189.5(a)
25299
2636(fX6)
UT4 Documentation of hazardous and restricted waste disposal
ur42 Site has no permit to construcUmodify UST system (Local
Ordinance 8.14.013)
1
PVOl
25284,2s284j,
25285.1,
25292.1
!,,1,if ',
I'T J('*i i
!Operations not compliant with permit conditions
2712(g)
I FACILITY NAME ADDRESS
.J
US WASTE GENERATOR
EPA ID
NI]MBER:
Tiered Permit:
Treatment Equipment:
Total generated/month:
Waste oil:
Antifreeze:
I-bs or gals
(average)
Solvents:
Others:
YES NO COS N/AF"E-E E-
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GTOl
GTO3
GTO4
GTO5
GTO6
GTOT
GTOs
GTO9
GTlO
GTIl
GT12
GTT3
GTI4
GTl5
GTT6
GTl7
GTIS
GTT9
GT2O
GT2T
GT22
GT?3
(Title
Diiily
EPA ID NOIPERMITS
Generator has an EPA ID number to treat, store, dispose, tran$port or transfer hazardous waste
(Title 22CCR 566262.12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.
HAZARDOUS WASTE DETERMINATION
Hagardous waste determipafionjconducted (Title 22 CCR 966262.f f)pSw"knowledge trf,analysis floitrer
Hazardous waste analysis/te$t records are kept for at least 3 years (Title 22 CCR g66262.40.(c))
DISPOSAL/TRANSPORTATION \
Hazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit
Manifests end/or recbipts are properly completed/retained by generator for 3 years (Title 22 CCR
s66263.42t 66262.23)
STORAGE AND MANAGEMENT OF CONTAINERS/TA]\IKS
Hlgardous wastes are accurirulated on bite as follows (Title 22 CCR 966262.34)
E SO days if waste generated per month is greater than or equal to 100 kg (220 lbs.)
fl f SO days if waste generated per month is less than 100 kg (see note)
3 ZZOdays if waste generated per month is less then 100 kg and transported more than 200 miles
(see note)
Note: ABpties gnly if hazardous wabte accumulated on site never exceeds 6000 kg(13,200
Ibs.)and no acuteli/extremely hazhrdous waste over I kg (2.2 tbs.) is held on site for over 90
days.
Hazardous .wlste (satellite" collection is managed properly (complete labeling/accumulation
tim€/S5-gal or l-qt limit) (Tttle 22 CCR $662623a(c))
Ignitable or reactive wastes are located l 5 m (50 feet) from facility's property line (Title 22 CCR
$6626s.t76)
Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARI)OUS
WASTE'" waste composition/physical state, hazardous profertiesg name/address of generator)
(Title 22 CCR $66262.3 l, 66262.341
Containers/tanks containing hazardous wastes ere in good condition/handled to minimize release
orreactiqn(Title22ccR$66265.l7ll.lgl,66265.l77(c)\
Containers/tanks/liners are compatible with waste stored or transferred (Title 22 CCRS66265.172)
Containers storing hazardous rryastes are closed/sealed (Title 22 CCR $66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted
E
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inspection of all tank systems is conducted and documented (Title 22 CCR S66265.195)
Empty containers or inner liners grealer lhan 5 gal has date when emptied and are mandged
properly within one year of date emplied (Title 22 CCR 966261.7 (f))
RECYCLABLE WASTE
Used oil is managed as hazardous wasle until recycled (includes proper labeling storage, etc) (HSC
$2s2s0.4)
Used oil lilters for recycling are managed proferly (drained offree flowing llquid, stored in closed
rainproof container, labeled odrained used oil filters," and transferred for metal reclamation)
(Title 22 CCR$ 66266.130) '
Spent lead.acid batteries are being properly stored and transferred offsite under manifest or bill of
lading for recycling, reuse, or rqclamption (Title 22 CCR $66266.81)
Solvents/other recyclable materials-'are managed as hazardous wastes until recycled (Title 22 CCR
$66266.3) ::
SOURCE REDUCTION: ,For i.acilities generating >12,000 kg./yr. of hazardous wsste on site.
Generator is subject to SB14 and has prepared and retained current source reduction documents
or is able make them availableto the inspector within (5) days. (HSC 525244.19,25244.21)
Source Reduction Evdu.tion and Plan contsins the following five elements:
certification, am9unts !f wastes generated, process description, block diagrams, ahg
implementation schedtle-of selected source reduction measures. (IISC $25244.f9)
I
County of San Luis Obispo
I
CltVPl
san ufls g"t*o6f$Environmental Health Services
(805) 781 -s544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:
ifr::d,'
AGENCYn EHSn nc DEPT
E, ctrv nRe
{
NAME:F
Complaint n Otner
Result Code:
Action Code:
-i-
70 80 9032 37 33 31
Reinspection
ON TYPE
Routine
PROGRAMS INSPECTED:Planpfeusin"""Generator F{ut'n acr !cemne
REINSPECTION REQUIRED:d*o r YES I Business Plan n Hw Generator n usr n ecr !cnlnnn
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes. GRANTED BY (NAME/TITLE):
Date:
Time:
YES
D"
W"
BPOT
BPO2
BPO3
TROI
TRO2
EROI
ERO2
T01
ATO2
COS N/ANDnnnn
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)
Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)
Site layout/facility maps are accurate (HSC 25504, Title t9 CCR2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16\
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
66265.16)
EMERGENCY RESPONSE PLAN
Contingency pfan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273l &22
ccR $ 6626s.53ts4)
Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment. Maintains all required or appropriate
equipment including an alarm and communications system (Title l9 CCR 2731 & 22 CCR 66265.31-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR 112.5(b))
SPCC Plan is maintained on site or nearest field office. (HSC 25270)
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COMMENTS Go to http://www.slopublichealth.org/environmentalhealth/hazardous materials.htm, to obtain to comply with BPOl -BPO3. TROI and ERO
INSPECTOR:FACILITY REP
mrnGPS Coordinates: Latitude: _deg _min_decimal min Longitude:_deg__mln
r FACILITY NAME
a
DATE
RGROUND STORAGE TAN
J REQUIREMENT
\SPECTOR
s INbPECTION
CHSC
NOYES cos N/A
ccR
TITLE 23
n UT13 I Site has a permit to operate
!UT14 Permit is kept on the Premises
urls . ;llfril5.T:fi:ership
is reported to the permitting asencv
Contractor trained properly. Contractor has ICC Certification
and Class A,C-10,C34,C36, or C61 license?
UT17 UST system leak response plan.
UT18 !Facility maintains evidence of Financial Responsibility
tr r rr.ro , UST System information forms (Form A&B) are on file,
accurate and entered into database.
tr
n
n
n
!
Ur20 : 5;,"ji[1
has BoE number' lf not call e16-324-2166 to
ur21 testing,
Testing as required Secondary containment
Certification. n flO ! Designated
n UT22 Overspill containers pass liquid tightness test, with no leak
through drain valve. Containers without sumps are tested
UT23 Overspill Container drain functional or alternative available
UT24 Secondary containment & overspill containers are liquid/
debris free.
Leak Monitoring Console has proper leak detection and
overfill notification programming. Continuous alarm history is
maintained.
UT26 Audible and visual alarms functioning properly
UDC has approved operational leak detection equipped with
pump shut down.
Leak detection sensors are properly secured at lowest point
in sumps and tank annular spaces, at time of inspection.
n UT3O i Pumping system shuts off when leak is detected or when the
monitor is disconnected or fails.
Annual piping integrity test detects 0.1 gph. NA if yes on UT
Line leak detector detects 3.0 gph and is certified annually
tr UT34 Emergency Shut Off switch (ESO) is functioning properly
No liquid leaks visible.
Shear Valves are in plgce and functioning.
Secondary Piping is open at the turbine and transition
sumps.
Fuel filters managed properly.
Monitoring system checked daily (Emergency generators
only)
Monitoring Wells are maintained properly. CA Well
Standards; County Well Ordinance
n UT41 Documentation of hazardous and restricted waste disposal
25284(a)(
!25284 2712
25284(c)
25284.1(a)(5XD)2637(bX1XB)
2632
25292
Chapter 6.7 2637,2638,
2715
n
!UT16
25284.2 2635(bX1XC),
2665
tr
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!
tfl !
2635(bX1 XC),
2655
2631 (dX4),
2635(bX1 )
tr
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UT25 25292.1 2634
2632(cX2XB)
,26 1)
n UT28
UT29
2528a.1@)()(C)
2636(f)(1) &
(s)
2632,2634,
2636,2641(a)
2636
2636(fX4)
2630(d),
2632,2636(f)
2635
2632
2632
2632
2636
2636(fX6)
2632
Title
66262.23
66263.42
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30UT31
UT32
UT33 : Overfill prevention system installed and operational
u
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UT35
UT36
UT37
UT42
UT38 89.5(a251
UT39
UT4O
io.Site has no permit to construcVmodify UST system (Local
Ordinance 8.14.013)25299
25284,25284.1,
25285.1,
25292.1
,
1
1
I
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PVOl Operations not compliant with permit conditions
2712(s)
FACILITY
EPA.ID
NUMBER:
ADDRESS
HAZARDOUS WASTE GENERATOR
r rtrlr t trr b#tr tl$ f;.
1l13 Lbs or gals
(average)
.r Tiered permit, [ci'stv' -fJcnsQr [cl Epnn
Treatment Equipment:
Total generated/month
Waste oil: l/
Antilieeze: , ./'----v-
Solvents:
Others:
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GTOT
GTO3
GTO4
GTO5
GTO6
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GTTO
GT11
GT12
GT13
GT14
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GTI6
GTIT
GTl8
GTl9
GT2O
GT2I
GT22
GT23
EPA ID NO/PERMITS
Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste
(TiUe 22CCR 566262.12) If Not, CaIl (800) 618-6942 to obtain your CAL EPA ID number.
HAZARDOUS WASTE DETERM INATION
Hazardous waste determination conducted (Title 22 CCR $66262.1l)
nown knowledge [analysis nother
Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR $66262.40.(c))
DISPOSAL/TRANSPORTATION
Hazardous wastes were transported andior disposed to a facility with an EPA ID NO. and permit
or aqthorization from DTSC (HSC $25189.5, Ti!)e22 CCRS66262/12) . /E{ffiil"; ffitn", l,ib.4/ti/ift'I:t
Hazardous wastes are shipped with manifest (Title22 CCft.5O6ZO?.20; I
Manifests and/or receipts are properly completed/retained by generator for 3 years (Title 22 CCR
s66263.421 66262.23)
STORAGE AND MANAGEMENT OF CONTAINERS/TANKS
Haz4adous wastes are accumulated on site as follows (Title 22 CCR $66262.34)
ffiO days if waste generated per month is greater than or equal to f 00 kg (220 lbs.)
n tSO days ifwaste generated per month is less than 100 kg (see note)
n 270 days ifwaste generated per month is less than 100 kg and transported more than 200 miles
(see note)
Note: Applies only ifhazardous waste accumulated on site never exceeds 6000 kg(13,200
lbs.)and no acutelyiextremely hazardous waste over I l<E Q.2lbs.) is held on site for over 90
days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation
time/55-gal or l-qt limit) (Title 22 CCR $6626234(c))
Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR
$6626s.176)
Containers of hazardous waste are properly labeled (includes appropriate date,"HAZLRDOUS
WASTE,' waste composition/physical stateo hazardous properties, name/address of generator)
(Title 22 CCR S66262.31, 66262.34)
Containers/tanks containing hazardous wastes are in good condition/handled to minimize release
or reaction (T itle 22 CCR $66265. l7 I I .I9 I, 66265.17 7 (c)'l
Containers/tanks/liners are compatible with waste stored or transferred (Title 22 CCR$66265.172)
Containers storing hazardous wastes are closed/sealed (Title22 CCR S66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted
(T itte 22 CCRS66265. 1 74)
Daily inspection of all tank systems is conducted and documented (Title 22 CCR S66265.195)
Empty containers or inner liners greater than 5 gal has date when emptied and are managed
properly within one year of date emptied (Title22 CCR S6626f .7 (f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC
s2s2s0.4)
Used oil filters for recycling are managed properly (drained offree flowing liquid, stored in closed
rainproof container, labeled "drained used oil filters," and transferred for metal reclamation)
(Titte 22 ccRS 66266.130)
Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill of
lading for recycling, reuse, or reclamation ("Iitle22 CCR $66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR
s66266.3)
SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of hazardous waste on site.
Generator is subject to SB14 and has prepared and retained current source reduction documents
or is able make them available to the inspector within (5) days. (HSC $25244.L9,25244.21)
Source Reduction Evaluation and Plan contains the following five elements:
certification, amounts of wastes generated, process descriptiono block diagrams, and
implementation schedule ofselected source reduction measures. (HSC $25244.19)
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I
Environmental llealth Services
(805) 781-5544
P.O. Bor lt89
2156 Slern Way
Sen Luis Obiepo, CA 9:14116
SiH,ffso**po
Fln llepartment (805) 781'7380
2160 Santa Barbare Avrnuc
San Lulr Oblepo CA93't{11-52'O
CERTIFIED T]NIFIED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIALS INSPECTION FORM
Date
EFW data
entry by:
Time:
N/A
COMMENTS Goto
NOtrntr
trtr
YES!n!
nn
n
n
tr
n
ntrtrn
Bp0r
BPO2
Bm3
TROT
TRO2
EROI
ERO2
ATOI
AT02
BUSINESS PLAN
Business plan is complete, curren! & avallable during inspection (HSC 25503.5, Tltle 19 CCR2729,
Inventory of hrzardous materials is comphtc (HSC 255M, Title 19 CCR2J29)
Site layouUfacillty maps are accurate (IISC 25504, Title 19 CCI 2I]}9)
TRAINING PLAN
Facillty hrs approprlate trainlng prograq (Tltle 19 CCR?3? & 22 CCR 66265.16)
Trolning documentadon is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
ffi25s.r5)
EMERGENCY RESPiONSE PLAN
Contingency plan is compleie, updated, and maintained on site (HSC 255M, Title 19 CCR n3l & 22
ccR $ 6625s.s3/54)
Facility is operated and maintained to prevent/minimize/mitigate firrc, explcion, or release of
hax,irdous materlalVwaste constituents to the environmenl Maintainr all rcquired or appropriate
equipment lncluding an alarm and communications system (Titte 19 CCR 273f & 22 CCR 662653f- .43)
ABOVEGROT]IYD PETRO TUTVT STORAGE TANK ACT
SPCC Plen is leviewcd and crrtified by a registered engineer within last 5 yrs. (40 CFR ff2.5(b))
SPCC Plan is maintained on sitc or nearcst Reld otrlce. (HSC 25270)
to obtain forms to comply with BPOI-8F03, TROl and EROl
FACILITY INSPECTION TYPE
nntr
4
Routlne
- vr- /PHONE:
{.c.-rne wffu
AGENCY
E ens
PROGRAMS INSPECTED:E Euslncgc Plan EI xw cenerator UST EJ rcr Ecnunp
N NO trYES E Burlners Plan E xw Grnerrtor flusr EIrcr flcunpREINSPECTION REQUIBED:
t
mlnLatitude:
FACILITYREP:
c
INSPECTOR:
ME-1 1\Temp\c.lotus.notes.data\1 -lnspection Form Page 1 .doc 24-Jan-O6
min
,rvrcesc't Environmental Heal''
(80s) 781-ss44
P.O. Box 1489
2156 Sierra Way oSan Luis Obispo, CA 93406
Department of A griculture/1\{easurement
Standards (sos) 7sr-s910
2156 Sierra Way Suite A .San Luis Obispo, CA 93401
f ire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Ohisno CA 93401-5240
Utilities Department o (805) 781-7215
rL-of San Luis
ij:
879 Moruo Street e San Luis Obispo, CA 93401
CERTIFIED UNIF'IED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORMqp7I
EFW data
entry by:Date:
Time
COMMENTS:
7d o
NOTTn
YESzdc.w
d.
W
{
d
N/A
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC $25503.5, Title 19 CCR $2729)
Inventory of hazardous materials is complete (HSC $25504, Title 19 CCR $2729)
Site layouUfacility maps are accurate (HSC $25504, Title 19 CCR$ 2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR 52732 & 22 CCR S66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR 52732 &
22 CCR S6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC $25504, Title 19 CCR
$2731 & 22 CCR $6626s.s3/s4)
Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release
of hazardous waste to the environment. Maintains all required or appropriate equipment
including an alarm and communications system (Title 19 CCR 92731 &?2 CCR $66265.31-
.43)
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
FACILITY ID NO:
FACILITYNAME:
d
PHONE:
AGENCY
E] DEHf] EcDEPT[] eny unn
Vctry urrlrrrns
Reinspection
ComplaintI ott""
PROGRAMS INSPECTED:PlanEdo.i'o.4r\v G"nr^to,! cat,l,np n usr fl ncr I Tiereil Permitting
E Business Plan
REINSPE9'I'ION RTJQUTREL/
'rNO
ll YES E nw Generator ! crnnp flusr !ncr I Tiereil Permitting
PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining
compliance with adopted codes. GRANTED BY (NAME/TITLE):
\[i\bGPS Coordinates: Latitude:
-deg
min-decimal min Longitude:-deg min_decimal min
Inspector Facility Representative:
A:\CUPA inspection forms 2.doc 20-Mar-03
. FAQILJTY NAME:DATE:
HAZARDOUS WASTE GENERATOR
t 07?
CA
'NSPECTO R:
I f,bsor@
(average)EPA ID NUMBER:
Tiered Permit:
Treatment
Equipment:
CESW g
YES, NOvE
dntndr
dznWT
N/An VIOL.#
GTOl
Antifreeze:o Others:
EPA ID NO/PERMITS
Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title
22CCR966262.12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.
HAZARDOUS WASTE DETERMINATION
Hazgrdous waste determination conducted (Title 22 CCR 566262.11)
Wnnknowledge [analysis nother
Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCF- S66262.40.(c))
DISPOSAL/TRANSPORTATION
Hazgpdous wastes were transported and./or disposed to a facility with an EPA ID NO. and permit or
auJfforization from DTSC (HSC $25189.5, Title 22 CCx_S66262.12)
ffrnilL.un nother
Hazardous wastes are shipped with manifest (Title22 CCR $66262.20)
Manifests and/or receipts are properly completed/retained by generator for 3 years (Title 22 CCR
s66263.421 66262.23)
STORAGE AND MANAGEMENT OF CONTAINERS/TANKS
Haz4rdous wastes are accumulated on site as follows ("Iitle 22 CCR $66262.34)
WSO auy"if waste generated per month is greater than or equal to 100 kg (220 lbs.)
! ttO Aays ifwaste generated per month is less than 100 kg (see note)
! ZZO aays if waste generated per month is less than 100 kg and transported more than 200 miles (see
note)
Note: Applies only if hazardous \ilaste accumulated on site never exceeds 6000 kg(13,200 lbs.)and no
acutely/extremely hazardous waste over I kg Q.2lbs.) is held on site for over 90 days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/55-gal
or l'qt limit) (Title 22 CCR$6626234(c))
Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCIR
96626s.176)
Containers of hazardous waste are properly labeled (includes appropriate date, "HAZATRDOUS
WASTE," waste composition/physical state, hazardous properties, name/address of generator) (Title22
ccR $66262.3 l, 66262.34)
Containers/tanks containing hazardous wastes are in good condition/handled to minimize release or
reaction ("1 itle 22 C C R $ 66265. l7 I I .19 l, 6626 5.17 7 (c))
Containers/tanks/liners are compatible with waste stored or transferred ("Iitle22 CCR$66265.172)
Containers storing hazardous wastes are closed/sealed (Title 22 CCR $66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted
(Title 22 CCR$66265. 174)
Daily inspection of all tank systems is conducted and documented (Title 22 CCR 566265.195)
Empty containers or inner liners greater than 5 gal has date when emptied and are managed properly
within one year of date emptied (Title 22 CCR $66261.7 (f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC
$2s2s0.4)
Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closed
rainproof container, labeled "drained used oil filters," and transferred for metal reclamation) (Title22
ccR$ 66266.130)
Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill of
lading for recycling, reuse, or reclamation (Title 22 CCR $66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR
s66266.3)
SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of hazardous waste on site.
Generator is sutlject to SB14 and has prepared and retained current source reduction documents or is
able make them available to the inspector within (S)'days. (HSC i25244.19,25244.21)
Source Reduction Evaluation and Plan contains the following {ive elements:
certification, amounts of wastes generated, process description, block diagrams, and implementation
schedule ofselected source reduction measures. (HSC $25244.19)
A:\CUPA inspection forms.doc 1 9-Sep-02
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GT13
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GT16
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GT18
GT19
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GT22
GT23
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FACIIAITY NAME ADD
SUMMARY OF OBSERVATIONS/VIOLATIONS
No violations ofunderground storage tank, hazardous materials, or hazardous waste laws/regulations were discovered.
SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
Violations were observed/discovered as listed below. AII violations must be corrected by implementing the corrective action listed by
each violation. If you disagree with any of the violations or corrective actions required, please inform the CLIPA in writing.
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing with a
certification that compliance has been achieved. A false statement that compliance has been achieved is a violation of the law and
punishable by a fine of not less than $2,000 or more than $25,000 for each yiolation. Your facility may be reinspected any time during
normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective actions.
The issuance of this Summary of Yiolations does not preclude the CUPA from taking administrative, civil, or criminal action.
NUMBER
VIOLATIONS
MINOR MAJOR CORRECTIYE ACTTON REQUIRED
COMMENTS:5
Inspected By:
Date:
Facility Rep Name:e
Signature:
Sign the certification below and mail this form to the CUPA inspector after all corrective actions have been completed. Retain a copy for your records.
Certification: I certify under penalty of perjury that this facility has complied with the correctiye actions listed on this
inspection form.
Signature of Owner/Operator:Title:Date:
A:\CUPA inspection forms.doc 1 9-Sep-02
l
Divlsion of Euyironme',.al Health
(80s) 78r-ss44
P.O. Box 1489
2156 Sierra Way rSqn Luis Obispo, CA 93406
Department of Agriculture/l\{easurement
Standards (sos) 78r-s9ro
2156 Sierra Way Suite A oSan Luis Obispo, CA 93401
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CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIALS INSPECTION FORM
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 9340I-5240
Utilities Department o (805) 781-7215
879 Morro Street o San Luis Obispo, CA 9340f
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FACILITY ID NO:
FACILITY NAME:
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Reinspection
Complaintn otn".
PROGRAMS INSPECTEDI Planffiin"""ffiw G"n"ruto,I usr I ncr I Tiered Permitting
REINSPECTION REQUIRED:d*on YBS I Business Plan n uw Generator n usr E ncr n tierea Permitting
PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance
with adopted codes. GRANTED BY (NAME/TITLE):
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BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCx*2729)
Inventory of hazardous materials is complete (I{SC 25504, Title 19 CCR2729)
Site layout/facility maps are accurate (HSC 25504, Title 19 CCR2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCx-2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 &22
ccR 6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR
2731 & 22 CCR S 6626s.53/54)
Facility is operated and maintained to prevenf/minimize/mitigate fire, explosion, or release of
hazardous waste to the environment, Maintains all required or appropriate equipment
including arr alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43)
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HAZARDOUS WASTE GENERATOR
EPA ID NO:C,1g7z tb b la"d':x
Tiered Permit:_ CESW _ CESQT _ CA _ PBR
Treatment Equipment:
Total generatedimo:-lbs or gals
Waste Oil:_ Solvents:_
Anti-freeze: Others:
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EPAID NO/PERMITS
Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title 22CCR
66262.r2)
Generator has a permit or authorization to conduct on-site waste treatment (fitle 22 CCR 66270.1)
HAZARDOUS WASTE DETERMINATION
Hazardous waste determination conducted (fitle22 CCR 66262.11)
[otno knowledge llanalysis [other
Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR 66262.40.(c\)
DISPO SAL/TRANPORTATION
Hazardous wastes were offered to transporter and/or disposed to a facility with an EPA ID No. and permit
or authorization from DTSC (HSC 25189.5, Title22 CCI366262.12)
lmilkrun service
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Hazardous wastes are shipped with manifest (Iitle 22 CCR 66262.20)
Manifests are properly completed/retained by generator for 3 years (fitle 22 CCR 66263,42/ 66262.23)
STORAGE AND MANAGEMENT OF CONTAINERS/TANKS
Hazardous \,vastes are accumulated on site as follows (fitle 22 CCR 66262'34)
days ifwaste generated per month is > 100 kg (220 lbs,)
< 180 days ifwaste generator per month is _ less than 1000 kg (See Note)
< 270 days if waste generator per month is _ less than I 000 kg and transported more than
200 miles (See Note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg and no acutely/extremely
hazardous waste over 1 kg is held on site for over 90 days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/55-gal or l-qt limit)
(titte 22 CCR 66262.34(c))
Ignitable or reactive wastes are located l5 m (50') from facility's property line (Iitle 22 CCR66265,1'16')
Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUS WASTE," rvaste
composition/physical state, hazardous properties, name/address of generator) (litle 22 CCR 66262.34)
Containers/tanks containing hazardous wastes are in good condition/handled to minimize release or reaction (fitle
22 CCR 66265.17 t t.r9l, 66265.17 7 (c))
Containers/tanks/liners are compatible with waste stored or transferred (fitle22 CCR66265,172\
Containers storing hazardous wastes are closed/scaled (Iitle 22 CCR 66265,173)
Weekly inspection of areas where haz. waste containers are stored is conducted/documented (Iitle 22 CCR
66265.174)
Daily inspection of all tank systems is conducted and documented (f itle 22 CCR 66265.195)
Empty containers or inner liners > 5 gal has date when emptied and managed properly within one year of date
emptied (Iitle 2 CCR 66261.7 (f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC 25250.4)
Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closed rainproof
container, labeled 'drained used oil filters," and transferred for metal reclamation) (Iitle 22 CCR 66266.130)
Spent lead-acid batteries are transferred offsite under manifestation for recycling, reuse, or reclamation (Title
22 CCR66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (Iitle 22 CCR 66266.3)
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SUMMARY OR OBSERVATIONSNIOLATIONS
No violations of underground tanko hazardous materials, inventory, and hazardous waste laws, regulations, and requirements were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective action listed by each
violation. If you disagree with any of the violations or proposed action, please inform us in writing.
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing certifying
that compliance has been achieved. A false statement that compliance has been achieved is a violation ofthe law and punishable by a fine
of not less than $2,000 or more than $25,000 for each violation. Your facility may be reinspected eny time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. The
issuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as a result of the
violations noted or that have not been corrected within the time specified.
NUMBER
VIOLATIONS
MINOR MAJOR CORRECTTVE ACTION REQUIRED
COMMENTS:,}'l 7 N w'i'T]1ie
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on(/Inspected By:
Date:/7 Facility Rep Name:
Signature: " A-iU
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