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HomeMy WebLinkAbout3610 Sacramento 2_RedactedEnvironments) Health bervice .Os-6544 CICy Of SdTI 1UI3 061S}70 I P.O.BuxBax 1489 Mk 2156 Sierra Way Ste. B \ "Courtesy Service"xazvn.rxo "Courtesy &Service" San Luis Obispo CA 90406 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL' INSPECTION FORM Date: 11/08/2024 Time Facility Name: H5 DATA CENTERS Agency Inspection Type ❑EHS ©Routine Site Address: 3610 SACRAMENTO DR ®CITY FIRE ❑Reinspection SAN LUIS OBISPO, CA 93401 ` ❑Chargeable Reinspection ❑Change of Ownership Phone: (805)286-0831 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0017599 CERS ID: ❑Chargeable Secondary Containment Testing Serial Number: DA3KUVLYK PROGRAMS INSPECTED: 99Hazmat OHWGenerator DUST MGT OCaARP OTPE REINSPECTION REQUIRED: NHazmat ❑HWGenerstor OUST OAGT OCalimp OTPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. M IQ IA VIOL. # BUSINESS PLAN ❑ ® ❑ 1311301 Business plan complete, current, available during Inspection and submitted electronically (HSC 25605, 25ta)(I (1); 19 CCR 2651) ❑ ❑ 0 131302 Inventoryof hazardous materials is complete and submitted electronically (NBC 25501 25506, 2660119 CCR 2652, 2654) ❑ ❑ IS B1003 Site layout/facility maps are accurate and submitted electronically (HSC 25505(a)(2), 25508(a)(1), 19 CCR 26521 TRAINING PLAN ❑ ❑ OO TR01 Facility has appropriatetraining program, submitted electronically (HBO 25505(a)(4),25508(a)(1), 191 2659, 22CCR66266.16) ❑ Cl 0 TR02 Training documentation is maintained on siteforcumentpersonnel(HSC 25505(a)(4),22CCR66265.16) ❑ ❑ 71 ER01 Emergency responselcordingency plan complete. current. submitted electronically, maintained onsite (HSC 25506(a)(3), 255081aN1), 1912668, 22CCR 66265.52-54) ❑ ❑ 9 ER03 secondary containment is installed and suHklently impervious to discharges.[125270A.5: 40 CFR 112.8(c)(2)1 GENERAL EH VIOLATIONS ❑ ❑ © FEo1 Environmental Health fees paid. [CBPC 1T200, Local Ordinance) GPS Coordinates: Latitude: GPS Coordinates: Longtituds: INSPECTOR: MATHESON BLISS FACILITY REP: Keith Meyers FACILITY NAME: H5 DATACCENTERS ADPzESS: 3610 SACRAMENTO DR ♦..bVEGROUND STORAGE TANK (hST) SAN LUIS OBISPO, CA 93401 YES NO NIA VIOL. # 19 AT01 A Prevention control and countermeasure (spec) plan has been prepared and implemented at facility (Note: An SPCC Plan Is required for single tanks 1,320 gallons or greater or tanks/conlainere with a cumulative capacity of greater than 1,320 gallons of oil products; for farms, nurseries, construction sites: single tanks greater than 20,000 gallons or tanks with a cumulative capacity of greater than 100,000 gallons. (HSC 25270.4.61REF. 40 CFR 112.1, 112.3(d), 112.6) ❑ ❑ 91 AT20 SPCC plan has been reviewed andor evaluated within the last 5 years and completion of the review has been documented (HSC 25270.4.5(a)/REF. 40 CFR 112.6(b)) ❑ ❑ © AM SPCC plan has been amended for changes (HSC 25270.4.5(a)IREF. 40 CFR 112.5(a)) ❑ ❑ ❑p AT02 The Spill Prevention Control and Countermeasure Plan Is maintained on site or at the nearest field office. (HSC 25270.4.61REF. 40 CFR 112.3(e)(1)) OO ❑ ❑ A703 Secondary containment for the entire contents of the largest single lank, plus sufficient freeboard to allow for precipitation, has been Installed and is sufficiently impervious to contain discharges. (HSC 25270.4.5IREF. 40 CFR 412.7(c ), 112.8(cH2)) ❑ ❑ OO AT22 Secondary containment drainage restrained by valverepositive means and normally kept closed (HSC 25270.4.5/REF. 40 CFR 112.8(b)(2), 112.8(c)(3)) ❑ ❑ ❑x AM Drainage of any uncontaminated rainwater from secondary containment Is documented and recorded. (HSC 25270.4.6; 40 CFR 112.8(c)(3)(iv)) ❑x ❑ ❑ AT07 Liquid level sensing device is present and tested regularly. (HSC 252TO.4.6/REF.40 CFR 112.8(c)(8)(v)) OO ❑ ❑ AT06 The master flow valve that will prevent direct outward flow of the fall content to the environment is securely locked In the closed position when in non -operating or nonstandby status. (HSC 25270.4.5/REF.40 CFR 112.7(g)) ❑ ❑ ❑x AT09 The master Row valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are inspected and tested regularly, documented, and records are maintained for three years. (HSC 25270.4.61REF.40 CFR 112.8(d)(4)) ❑x ❑ ❑ AT10 Each aboveground tank is tested for integrity (fi applicable) on a regular schedule and whenever material repairs are made. (HSC 25270,4.5/REF.40 CFR 112.8(c)(6)) ❑ ❑ El AT11 Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to prevent vehicular departure before complete disconnect of Flexible or fixed transfer lines. (HSC 26270.4.6/REF.40 CFR 112.7(h)(2),112.8(d)(6p 99 ❑ ❑ AT12 Guard posts or other approved means are being provided to protect storage tanks and connected piping, valves, fittings, and dispensers from vehicular damage. (HSC 25270.4.5/REF.40 CFR 112.7(a)(1), 112.7g); CA FIRE CODE 5704.2.9.7.4) ❑ ❑ ❑a AT13 Visual Inspections of tanks, valves, piping, and appurtenances storing petroleum products are being conducted and documented regularly, and maintained for three years. (HSC 26270.4.5/REF.40 CFR 112.7( a), 112.6(d)(4)) 0 ❑ ❑ AT14 There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC 25270.4.SIREF.40 CFR 112.8(c)(10)) ❑a ❑ ❑ AT15 Facility lighting is commensurate with the type and location of the facility, giving consideration to the discovery of spills occurring during hours of darkness both by operating pamonnel and nonoperating personnel (i.e. general public, local police/fire) (HSC 25270.4.6IREF.40 CPR 112.7(g)) 19 ❑ ❑ AT16 FFacility Is fully fenced and locked when facility is unattended. (HSC 25270.4.6/REF.40 CFR 112.7(g)) ❑ ❑ Al AT17 Facility has documented spill history and corrective actions taken. (HSC 25270.4.SMEF.40 CFR 112.7) ❑ ❑ 19 AT18 Spill prevention briefings for operating personnel covering the SPCC Plan are conducted and documented annually to assure adequate understanding of the SPCC Plan. (HSC 25270A.SIREF.40 CPR 112.7(n) 19 ❑ 0 AT19 Spill control equipment Is maintained on site. (HSC 25270.4.SIREF.40 CFR 112.7(c)) SUMM' RY OF OBSERVATIONSVIO' `iTIONS ❑ No violations of underground s .,age 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. All 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 th CUPA in wrtina 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 violation. 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 anryor the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action. FACILITY NAME: H5 DATA CENTERS ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL, NO CORRECTIVE ACTION REQUIRED 3P01 IMMEDIATELY TAKE NECESSARY ACTION TO ENSURE THAT THE BUSINESS PLAN IS COMPLETE, SUBMITTED ELECTRONICALLY AND AVAILABLE (VISIT CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM - "CERS" haps9cers.calepa.ca.gov). IMPLEMENT A PROCEDURE TO ENSURE THAT THE PLAN IS UPDATED AS REQUIRED BY HEALTH AND SAFETY CODE SECTIONS 25505. 25508(ayf) AND CALIFORNIA CODE OF REGULATIONS SECTION 2651. FAILURE TO CORRECT THIS VIOLATION BY THE DATE SPECIFIED /N THIS REPORT MAY RESULT IN CIVIL AND/OR CRIMINAL PENALTIES OF UP TO $2,000 PER DAY PER VIOLATION, AND/OR THE PENALTIES DESCRIBED /N THE CA HEALTH 8 SAFETY CODE SECTION 25515, Prepare and submit a Hazardous Materials Business Plan through CERS (cers.calepa.ca.gov) by 112/25. Include Business Ownerloperator information, chemical inventory, facility site map, emergency response and employee training plan. AT01 Demonstrate SPCC Plan has been prepared and regular visual inspections of the tanks/piping are being documented. INSPECTION COMMENTS: Items marked N/a not reviewed during inspection. Initial inspection after ownership change and addition of two diesel generators. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: Keith Meyers DATE: 11OBCO24 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE �iCertification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. (Signature of Owner/Operator: Title: Date: Env mnmental Heath 4�. V 8 POBox 1489 2156 Sierra WI%k a v Ste B $an L AS O , CA 93406 city of san Luis oi3)spo sc smm Suna soapednow s" Iml M-TMQ Courtesy & Se"ice" CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 11108/2024 Time: AgencyInspection Type Facility Name: CENTURYLINK-SLO-SNLOCAOT ❑EHS ❑@Routine @CITY FIRE ❑Reinspection Site Address: 3610 SACRAMENT@ DR ❑Chargeable Reinspection SAN LUIS OBISPO, CA 93401 ❑Change of Ownership ❑Complaint Phone: (720)888-1000 []Secondary Containment Testing Facility ID: FA0005342 CERS ID: 10438174 ❑Chargeable Secondary Containment Testing Serial Number: DALLC44TL PROGRAMS INSPECTED: ®Fiazmat OHWGenemtor OUST OAGT OCaAW OTPE REINSPECTION REQUIRED: OHazmat OHW Generator OUST MGT OCBIARP ❑TPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. YES NO NIA VIOL. # BUSINESS PLAN ❑ ❑ OO Sp01 Business plan complete,current, avallable during inspection and submitted electronically(HSC 25506, 25508(aHl); 19 CCR 2651) ❑ ❑ OO BP02 Inventory of hazardous materials Is complete and submitted electronically (HSC 25505(a)(1), 2006, 25508(a)(1), 19 CCR 2652.2654) ❑ ❑ O BP03 Site layout( facility maps are accurate and submitted electronically (HSC 25505(a)(2), 26608(a)(1), 19 CCR 2652) TRAINING PLAN ❑ ❑ © TR01 Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 26508(a)(1), 19CCR 2659, 22CCR66265.16) ❑ ❑ © TR02 Training documerriabon is maintained on site for current personnel (HSC 25505(a)(4), 22CCR66265.16) EMERGENCY RESPONSE PLAN ❑ ❑ © ER01 Emergency responselcontingency, plan complete, current, submitted electronically, maintained onsite (HSC 25505(a)(3), 255011(a)(1), 19CCR 2658, 22CCR 66265.62-.541 ❑ ❑ © ER03 Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5; 40 CFR 112.9(c)(2)1 GENERAL EH VIOLATIONS ❑ ❑ OO FE01 Environmental Healm fees "to. ICBM 17200, Local Ordinance) GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez SUMMO$Y OF OBSERVATIONSVIOL ATIONS ® No violation of undergrounds, Ige tank, hazardous materials, or hazardou, rite lawsrreguletions were dlscovemd. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. O Violations were observeNdiscovered 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 corrective actions required, please Inform th CUPA in writing ALL VIOLATIONS MUST BE CORRECTED WITHIN 00 DAYS OR AS SPECIFIED CUPA most 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 violation. 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 Violations does not preclude the CUPA from taking administrative, civil, or criminal action. FACILITYNAME: CENTURYLINK-SLO-SNLOCAOT ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: Observed hazardous waste manifest dated 10/1624 for waste refrigerant and small quantity of corrosives. The HMBP program will now be the responsibility of H5 Datacenters. Paperwork has been submitted to remove this facility from the program. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: Bob Fernandez DATE: 1110812024 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: Environmental Hear erviceVk (805)T81489 city o� sera Lws oslspoO PO8Si 1489 2156 Sierra Way StaO +sDS=wa=r� ..•==�-•tip sp ca nna-,to e�sl ra,-,m San Luis Obieoo. CA93400 �nL011Yte]y &.tie wire" CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 10/25/2023 Time: Facility Name: CENTURYLINK-SLO-SNLOCAOT Agency Inspection Type ❑EHS ❑Routine Site Address: 3610 SACRAMENTO DR ®CITY FIRE ®Reinspection SAN LUIS OBISPO, CA 93401 ❑Chargeable Reinspection ❑Change of Ownership Phone: (720)888-1000 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005342 CERS ID: 10438174 ❑Chargeable Secondary Containment Serial Number: DAWQ9Y8DS Testing PROGRAMS INSPECTED: ®Hazmat OHW Generator OUST MGT ocamp OTPE REINSPECTION REQUIRED: ®Hazmat OHWGerlemlor DUST MGT ocalARP ❑TPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. & NQ NiA VIOL 0 BUSINESS PLAN ❑ ❑ ® BP01 Business plan complete, current, available during Inspection and submitted electronically (HSC 25606, 25608(a) (1);19 OCR 2651) ❑ ❑ © BP02 Inventory of hazardous materials is complete and submitted electronically (HSC 25505(a)(1), 25506, 26508(a)(i), 19 CCR 2652, 2654) ❑ ❑ ® OP03 Site layout/ facility maps are accurate and submitted electronically (HSC 25605(a)(2), 25508(a)(1), 19 CCR 2652) TRAINING PLAN ❑ ❑ OO TR01 Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 26508(a h), 19CCR 2659, 22CCR66265.16) ❑ ❑ ❑O TR02 Training documentation is maintainetl on site for current personnel (HSC 25505(a)(4),22CCR66266.16) EMERGENCY RESPONSE PLAN ❑ ❑ OO ER01 Emergency responselcordingency plan complete,current, submitted electronically, maintained onsite(HSC 26505(a)(3), 26608(a)(1), 19CCR 2658, 22CCR 66265.52-54) ❑ ❑ ❑a ER03 Secondary containment is Installed and sufficiently impervious W discharges. [CHSC 26270A.5; 40 CFR 112.8(c) (2)] GENERAL EH VIOLATIONS ❑ ❑ ® FE01 Environmental Health fees paid [CBPC 17200, Local Ordinance] GPS Coordinates; Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: MATHESON BLISS FACILITY REP: SUMMARY OF OBSERVATIONSVIOLATIONS -U lio violations of undergrounc rage lank, hazardous materials, or hazard( Baste lawsfregulations were discovered. SLO CUPA greatly appreciates your efforts to comply with all the issue and regulations applicable to your facility. El Violations were observeNtliscovered 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 corrective actions required, please inform the CUPA 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 $26,000 for each violation. Yourfacllitymay be reinspected any time during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings andfor the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action FACILITYNAME: CENTURYLINK-SLO-SNLOCAOT ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: Observed the nine compressed refrigerant gas cylinders and otherl-gallon to 5-gallon containers of presumed hazardous waste stored outside on pallet during inspection of new aboveground diesel generator tanks at the back of the facility. Immediately properly recover and dispose of/recycle wastes through a licensed hauler. Failure to properly dispose of wastes under manifest by 192&23 will result in a Notice of Violation Office Hearing anNor additional enforcement action including, but not limited to, Administrative Enforcement Order. Immediately activate a temporary EPA ID number to properly dispose of the wastes The following is currently in violation: Health and Safety Code (HSC) section: 25189.6, 25201(a); California Code of Regulations (CCR) Title 22 66262.12: Hazardous wastes disposed of at an unauthorized location. HSC 25123.3(b)(1)/(d)/(h)(1); 22 CCR 6626234(d): Hazardous waste are improperly accumulated on site, greater than 180 days. 22 CCR 6626212 Generator does not have an active EPA ID number to store or dispose of hazardous waste. HSC 25189r. (e) A person who intentionally or negligently treats or stores, or causes the treatment or storage of, a hazardous waste at a point that is not authorized according to this chapter shall be liable for a civil penalty not to exceed seventy thousand dollars ($70,000) for each separate violation or, for continuing violations, for each day that the violation continues. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: DATE: 1d252023 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title- Date: Environmental Health .,arvices te0517e1EMM O� tan OBI8p0 P O Boa 148 489 21W Una Run 2156 Sierra Way Ste. "Courtesy �asy &Srvice" e San Luis Obispo, CA 93406 CERTIFIED UNIFIED PROGRAM AGENCY(CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 01/062023 Time: Agency Insoaetion Type Facility Name: CENTURYLINK-SLO-SNLOCAOT ❑EHS ®Routine SiteAddress: 3610 SACRAMENTO DR ®CITY FIRE ❑Reinspection SAN LUIS OBISPO, CA 93401 ❑Chargeable action Ownership ❑Change of Owwnership Phone: (720)888-1000 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005342 CERS ID: 10438174 ❑Chargeable Secondary Containment Testing Serial Number: DAROCN19K PROGRAMS INSPECTED: ®Hannat OHWGenerator OUST DAGT OCalARP OTPE REINSPECTION REQUIRED: I OHezmat OHW Generator OUST OAGT OCalARP OTPE PERMISSION TO INSPECT: Inspections may Involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. X$ N2 WA VIOL. # BUSINESS PLAN 10 ❑ ❑ 81501 Business plan complete,current, available during inspection and submitted electronically(HSC 26605, 25508(ap1); 19 CCR 2661) ® ❑ ❑ BPD2 Inventory of hazardous materials is complete and submitted electronically(HSC 25505(a)(1), 266es, 26508(a)(1).19 CCR 2662, 2654) El ❑ ❑ BP03 Site layout) facility maps are accurate and submitted electronically(HSC 25505(a)(2), 25508(a)(1), 19 CCR 2652) TRAINING PLAN El ❑ ❑ TR01 Facility has appropriate training program, submitted electronically (HSC 25506(a)(4),25508(a)(1), 19CCR 2659, 22CCR66265.16) ❑ ❑ IN TR02 Training documentation is maintained on site for current personnel(HSC 25505(a)(4),22CCR66265.16) EMERGENCY RESPONSE PLAN 0 ❑ ❑ ERO1 Emergency response'eon ingency plan complete, current, submitted electronically, maintained ons)le (HSC 26505(a)(3), 25508(a)(1), 19CCR 2658, 22CCR 116211 ❑ ❑ IN ER03 Secondary containment is installed and sufficiently Impervious to discharges. (CHSC 26270A.5; 40 CFR 112.8(cN2)] GENERAL EH VIOLATIONS 0 ❑ ❑ FE01 Environmental Health gees paid. ICBPC 17201), Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez SW a RY OF OBSERVATIONSVIOLATIONS rx No violations of undergrounds age tank, hazardous materials, orhazardou. ,ste laws/regulations were discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. Violations were observeddiscovered 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 corrective actions required, please inform th CUPA in writing ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing with 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 violation. Your facility maybe reinspected anytime during normal business hours. You may request a meeting with the Program Managerto discuss the inspection findings andor the proposed corrective actions. The Issuance of this Summary of Violations dam not preclude the CUPA from taldng administrative, civil, or criminal action. FACILITY NAME: CENTURYLINK- SLO- SNLOCAOT ADDRESS: 3310 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: Observed nine cylinders of dichlorotri0uoroethane(R-123, refrigerant) gas stored under AC units with foot rings of cylinders rusting through. Per facility representative, AC units have not been used in a long period of time. Properly recover refigerant and dispose of cylinders. Send a copy of the mansfest/receipt once completed to mbliss@slocity.org. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: Bob Fernandez DATE: OVOW023 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: MkEnvironmental Hi.-4yjfB,g F no 919, waw-S L t8051>91-5594 City of 8dn LU1S oBiSpu P00 Box 51781459 4°srw,M.a ,nam,..cAsvwsaa•Run maxo 21 eR Sara Way Ste R \ "Courtesy&Servtc¢" San 101 soo. CA 93406 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 11/1812021 Time: Facility Name: CENTURVLINK-SLO-SN Agency Inspection TypeLOCAOT ❑EHS ®Routine ®CITY FIRE ❑Reinspection Site Address: 3810 SACRAMENTO DR DChargeable Reinspection SAN LUIS OBISPO, CA 93401 DChange of Ownership Phone: (720)888-1000 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005342 DChargeable Secondary Containment Testin( Serial Number: DAPWN69KK PROGRAMS INSPECTED: mHazmet OHWGenomWf DUST DAGT DCeIARP Ori REINSPECTION REQUIRED: ®Hazmat OHWGenerator OUST DAGT OCalARP i PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. y.LS NO WA VIOL, # BUSINESS PLAN ❑ Al ❑ BPOt Business plan complete, current, available during inspection and submitted electronically (Hi 26505, 26508(a)(i); 19 CCR 2651) 9 ❑ ❑ 131302 Inventory of hazardous materials is complete and submitted electronically (HSC 25505(a)(1), 26606, 266(1 111L 19 CCR 2652, 2654) A ❑ ❑ all SIN layout/ facility maps are accurate and submitted electronicalty(Hi 25605(a)(2),25508(a)(1), 19 CCR 2652) TRAINING PLAN A ❑ ❑ Ti Facility has appropriate training program, submitted electronically(HSC 25505(a)(4),25508(a)(1), 19CCR 2659, 22CCR66265.16) ❑ ❑ Z Ti Training documentation is maintained on she for current personnel(HSC 25506(a)(4),22CCR66365.16) EMERGENCY RESPONSE PLAN 0 ❑ ❑ i Emergency response/contingency plan compleN,current, submitted electronically, maintained onsiN (Hi 2550fila)(3).25508(a)(1U, 19CCR MS. 22CCR 66265.52-.50) 19 ❑ ❑ ER03 Secondary containment is installed and sufficiently impervious to discharges.[CHSC 25270A.5; 40 CFR 112.8(c)(2)] GENERAL EH VIOLATIONS 171 ❑ ❑ FE01 Environmental Health fees paid. [CRPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez SUMMARY OF OBSERVATIONSVIO' `,TIONS ❑ No violations of underground age tank, hazardous materials, or hazardoL. vaste lawslregulations were discovered. SILO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. 0 Violations were observedldiscovered 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 corrective actions required, please inform th CUPA 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 violation. Your facility maybe reinspected any time during normal business hours. You may request a meeting with the Program Managerto discuss the inspection findings andlor the proposed corrective actions. The issuance of this Summary of Violations daft not preclude the CUPA from taking administrative, civil, or criminal action. FACILITYNAME: CENTURYLINK-SLO-SNLOCAOT ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED BP01 IMMEDUITELY TAKE NECESSARY ACTION TO ENSURE THAT THE BUSINESS PLAN IS COMPLETE, SUBMITTED ELECTRONICALLY (EZSUBMITSLOGOV.ORG OR CERS) AND AVAILABLE. IMPLEMENT A PROCEDURE TO ENSURE THAT THE PLAN IS UPDATED AS REQUIRED BY HEALTH AND SAFETY CODE SECTIONS 25505, 25508(sX1) AND CALIFORNIA CODE OF REGULATIONS SECTION 2651. FAILURE TO CORRECT THIS VIOLATION BY THE DATE SPECIFIED IN THIS REPORT MAY RESULT IN CIVIL AND/OR CRIMINAL PENALTIES OF UP TO $2,000 PER DAY PER VIOLATION, ANDA)R THE PENALTIES DESCRIBED IN THE CA HEALTH & SAFETY CODE SECTION 25515. Revise and resubmit Hazardous Materials Business Plan through CERS by 12N812021. Revise primary emergency contact Information (John Sharp no longer at facility), revise chemical inventory and site map for hydrogen (no longer stored at facility). INSPECTION COMMENTS: Items marked WA not reviewed during inspection. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: Bob Fernandez DATE: 11118/2021 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: lokEnvironmental HeaRh • .res f8051 ]81-5544 city of son Luis os(spoO p.O.Bnz 1489 �"" RE soe mmrwT 2156 Sierra Way SR. B am e,m.a pnue'em Lux omo%cu sm,-am• Hem-nn San Luia Obispo, CA 93406 "Courtesy & Service° CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 10/2112019 Time: Facility Name: CENTURYLINK- SLO- SN Agency Inspection TypeLOCAOT ❑EHS ®Routine Site Address: 3610 SACRAMENTO DR ®CITY FIRE ❑Reinspection SAN LUIS OBISPO, CA 93401 ❑Chargeable Reinspection ❑Change of Ownership Phone: (720)888-1000 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005342 ❑Chargeable Secondary Containment Serial Number: DAKVlMZ01 Testing PROGRAMS INSPECTED: ©Hazmat OHW Generetor OUST OAGT OCalARP DTPE REINSPECTION REQUIRED: OHavnat OHW Generator OUST OAGT OCaMP DTPE PERMISSION TO INSPECT: Inspections may Involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAME/TITLE): Name: John Sharp Title: Lead Opepee�raattions Technician = NQ N/A VIOL.# BUSINESS PLAN © ❑ ❑ BP01 Business plan complete, current available during inspection and submitted electronically( HSC 25505, Militia) (1); 19 CCR 2651) 91 ❑ ❑ BP02 linentory of hazardous materials Is complete and submilted electronically(HSC 25506(a)(1), 25506,25508(a)(1), 19 CCR 2652, 2654) III ❑ ❑ BP03 Site layouu facility maps am accurate and submitted electronically(HSC 25W5(aH2),25508(a)(1I, 19 CCR 2652) © ❑ ❑ TR01 TRAINING PLAN Facility has appropriate training program, submitted electronically(HSC 25505(a)(4), 25508(aNi), 19CCR 2659, 22CCR66265.16) OO ❑ ❑ TR02 Training documentation is maintained on site for current personnel( HSC 26605(a)(4), 22CCR68286.16) EMERGENCY RESPONSE PLAN Al ❑ ❑ ER01 Emergency response/contingency plan complete, current, submitted slectronbally, maintained onsite,(HSC 25505(a)(3), 25508(aKt), 19CCR 2658, 22CCR 66265.52-54) 19 ❑ ❑ ER03 Secondary containment is installed and sufficiently Impandous to discharges. [CHSC 26270.4.6; 40 CFR 112.8(c) (2)] GENERAL EH VIOLATIONS 0 ❑ ❑ FE01 Environmental Health fees paid. [CBPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: KERRY BOYLE FACILITY REP: John Sharp SUMMARY OF OBSERVATIONS'VIOLATIONS ® No violations of underground s Be tank, hazardous materials, or hazardou ste laws/regulations were discovered SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. D Violations were obsemed/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 corrective actions required, please inform the CUPA 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 violation. 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 artier the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action. FACILITY NAME: CENTURYLINK - SLO - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: HMBP is rsrent and has been updated for CY 2019 via the CERS database. Good employee training program in place. INSPECTED BY: KERRY BOYLE NAME OF FACILITY REP: John Sharp DATE: 10/2tr2019 SIGNATURE OF FACILITY REP: v STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date County of San Luis Obispo City 4 ii Environmental Health Services sAn Us onus o / P.O. Box 1489 JOY 1 l7 eT✓v P.O. Box a Wa 2156 Sierra Way Fire DepaSame rt (806)baraA Avenue 00 - San Luis O6lspq CA 93406 San Luis Obispo Avenue see Lula Obispo CA 014014240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data HAZARDOUS MATERIALS INSPECTION FORM entry by: Datet�(/`/ / Times j FACILITY NAME: AGENCY ❑ ENS ❑ AG DEPT ?CITY FIRE y INSPECTION TYPE outine ❑ Reinspection ❑ Complaint ❑ Other Result Code: 70 _80 _90 Action Code: _32 _37 _33 _31 ADDRESS: PHONE: PROGRAMS INSPECTED: eminess plan I ❑ xW Genemwr El UST ❑ AGT I]CAIARP REINSPECTION REQUIRED: NO []YE S �usiness Plan ❑ HW Generator ElUST ❑ AGT DCAIARP PERMISSION TO INSPECT: Ins ewrminin eom Ilene with adopted tions may involve obtaining photographs, reviewing and copying records, and codes. GRANTED BY NAMEMTLE : BUSINESS PLAN Yq5 NO COS N/A BPOI Business plan is complete, current, & eve0eble during inspection (t[SC 25503.5, Title 19 CCR 2729) ,VYJyy��Jll ❑ ❑ ❑ BP02 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) _ nj' (� ❑ ❑ ❑ BP03 Site layout/facility maps are accurate (11SC 25504, Title 19 CCR 2729) TRAINING PLAN TROT Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) ❑ ❑ ❑ TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN ❑ ❑ ❑ ER01 Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR § 66265.53/54) —I/ ❑ ER02 Facility is operated and maintained to p vveothumimize/miligate fire, explosion, or release of li hazardous materiols/waste constituents to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31- .43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ i- ATM SPCC Plan is reviewed and certified by a registered engineer within last 5 yre. (40 CFR 112.5(b)) ❑ ❑ ❑ {.'I`1i'^ AT02 SPCC Plan is maintained on site or nearest neld office. (HSC 25270) COMMENTS, Gp tohtlpl/www.ilopablic0eallfiurg/enviloammtaOeallNAezardous_makdak.him, to obtain forsis to comply with GPO;-BP03, TROT and ER01 INSPECTOR:i FACILITY RGP: Environmental Heal' rvi e 18061781-6544 CIR7 OfeSdTl IU1S ODIS�JO Pn.BOY 1489PRE DEPARENENT 2156 Siena Way Ste. 6 auraue"Ras maa� $an Luis Obisos. CA 93406 ne"Courtesy &Se"icice" CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) - HAZARDOUS MATERIAL INSPECTION FORM Date: 0427/2018 Time: Facility Name:QWAgent; Inspection TypeEST COMMUNICATIONS CORP OEHS ©Routine Site Address: 3610 SACRAMENTO DR ®CITY FIRE OReinspection SAN LUIS OBISPO, CA 93401 ❑Chargeable Reinspection ❑Change of Ownership Phone: (720)578-2006 ❑Complaint DSecondary Containment Testing Facility ID: FA0005342 DChargeable Secondary Containment Testin, Serial Number: DAUBRYFOB PROGRAMS INSPECTED: I RHazmat OHWGenerator OUST oAGT OG31ARP OTPE REINSPECTION REQUIRED: I OHazmat I OHWGenerator I OUST I OAG-r I OCeIARP I OTPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAME/TITLE): Name: John harp Title: Lead Operations Technician CtVV Wa n YES NO N/A BUSINE, 0 ❑ ❑ BP01 Business I /,' C 25503.5, T10919 CCR 2729) © ❑ ❑ BP02 Inventory /I,ptll6lyrl MR 2729) © ❑ ❑ 1311303 Site layou9) © ❑ ❑ TR0Facility ha /y yylB /�,/(/V//✓4,, MR 862 19 ❑ ❑ TR02 Training l �g '-- 'Jj'L/A �, 0 IITitIe 199CCR 2]32822 2I MERI` /ry1 t1 0 ❑ ❑ ER01 EmF' e�rgen maintained on site(HSC 2ssI Tit © ❑ ❑ ER02 Facility is re, explosion, or release of hazaMou d7° YYYbbb ains all required or approprii letem (Title 19 CCR 27318 22 CCR 6624 © ❑ ❑ ER03 Seconds _ _ _ discharges. [CHSC2barv...v... ............ ,. GENERAL EH VIOLATIONS 19 ❑ ❑ FFA1 Environmental Hearn fees paid [CBPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: KERRY BOYLE FACILITY REP: John Sharp SUMMARY OF OBSERVATIONSNIOI "TIONS ® No violations of underg id storage tank, hazardous materials, or ha Sous waste laws/negulations were discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to yet facility. D Violations were observerYdiscovered 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 corrective actions required, please inform the CUPA in writina. ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be Informed in writing w certification that compliance has been achieved A false statement that compliance has been achieved is a violatior of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation Yourfacilitymay be reinspected any time during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings andlor the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action FACILITY NAME: QWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL, NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: HMBP will be updated for Calendar Year 2018. Facility in good order, no violations noted. INSPECTED BY: KERRY BOYLE NAME OF FACILITY REP: John Sharp DATE: 04/272018 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: County of San Luis Obispo My Or j II Environmental Health Services SAn WIS OBISPO P.O. Box 1489 21%Sierra Way Fire Department (806) 781-7380 San Luis Obispo, CA 93406 2160 Santa Barbara Avenue San Luis Obispo CA 934014i240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data HAZARDOUS MATERIALS INSPECTION FORM entry by: Date: "1 1 t, /' Times. I (, FACILITY NAME: / AGENCY ❑ EHS ❑,AG DEPT -1 CITY FIRE 1% IN CIN TTYPE Routine ❑ Reinspection ❑ Complaint ❑ Other Result Code: _70 _80 _90 Action Code: _32 37 _33 31 III ADDRESS: % 4 ( PHONE: ' PROGRAMS INSPECTED: 7 Business Plan ❑ HW Generator ❑UST ❑AGT ❑CAIARP REINSPECTIONREQUIRED: ©-NO ❑YES i f7 Business Plan T ❑Hw Generator ❑UST ❑AGT ❑CALARP PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying recounts, and etenninin corofiance with adopted codes. GRANTED BY NAMEITITLE : BUSINESS PLAN YES NO COS N/A i ❑ ❑ ❑ ❑ BP01 Business plan is complete, current, & available during inspection (HSC 25S03.5, Tide 19 CCR 2729) ,❑ ❑ ❑ ❑ BP02 Inventory of hazardous materials is complete(RSC 25504, Title 19 CCR 2729) ❑' ❑ ❑ ❑ BING Site layout/facility maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN ❑ ❑ TR01 Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) ❑ ❑ TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN Q ❑ E1101 Contingency plan is complete, updated, and maintained on site LRSC 25504, Title 19 CCR 2731 & 22 CCR § 66265.53/54) ❑' ❑ ❑ ER02 Facility is operated and maintained to preventhadmimize/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 (Tide 19 CCR 2731 & 22 CCR 66265.31- .43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑. ❑ ❑ Q- AT01 SPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR 112.5(b)) ❑ ❑ ❑ AT02 SPCC Plan is maintained on site or nearest field office. (BSC 25270) COMMENTS Gob M1itp:/Iwsw¢alopublichnids..omJenvironmemelhralllWezerdous mmerials.him,to ehminfimms mcomply withBPol43P0J, TROT Rd El INSPECTOR: I \ . 'v' fWVV 1 1 i". ill II, ' " FACILITY REP: — .___ ,_ Environmental Heal.., cervices (805) 781-5544 a P.O.Box 1489 S l US OMSPO 2156 Siena Way Ste. 8 Fire Department (805) 7847380 San Luis Obispo. CA 93406 2160 Santa Barbara Avenue -- San Luis Otrispo CA 93401;52A0 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 10/07/2016 Time: Facility Name: QWEST COMMUNICATIONS CORP v AgencInspection Type ❑EHS ©Routine Site Address: 3610 SACRAMENTO DR ©CITY FIRE ❑Reinspection SAN LUIS OBISPO, CA 93401 ❑Chargeable Reinspection ❑Change of Ownership Phone: (720)578-2006 ❑Complaint OSecondary Containment Testing Facility ID: FA0005342 ❑Chargeable Secondary Containment Testin, Serial Number: DAJX60Z4P PROGRAMS INSPECTED: ©Hazmat oliwcenerator OUST OAGT OCnARP OTPE REINSPECTION REQUIRED: OHazmat OI1w Generator OUST DAGT 0CeIARP OTPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAMEITITLE): Name: John Sharp Title: Lead Operation Tech _4; - "'-v* YES NO [VIA BUSINESS PLAN 0 ❑ ❑ BP01 Business plan is complete,current, available during Inspecton(HSC 26503.6, Title 19 CCR 2729) © ❑ ❑ OP02 Inventory of hazardous materials is complete (HSC 26604, Title 19 CCR 2729) 19 ❑ ❑ BP03 site Iayoutlfacility maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN © ❑ ❑ TR01 Facility has appropriate training program (Title 19 CCR V32 4 22 CCR 66265.16) © ❑ ❑ TR02 Training documentation Is maintained on site for current personnel (Title 19 CCR 2732 s 22 CCR) 66266.16 EMERGENCY RESPONSE PLAN © ❑ ❑ ER01 Emergency responselconlingency plan is complete, updated, and maintained on site (HSC 25604, Title 19 CCR 2731 3 22 CCR 9 66265.531M) 09 ❑ ❑ ER02 Facility is operated and maintained to preventaniniminamitigate fire, explosion, or release of hazardous matey alshvaste consi tuents to the environment. Maintains all required or appropriate equipment including an alarm and communications system (This 19 CCR 27313 22 CCR 66266.31-37, 66267.34 (d)(2), 40CFR 1265.31) 09 ❑ ❑ ER03 secondary containment is installed and suRiciendy impemlous to discharges. [CHSC 25270.4.6; 40 CFR 112.6(c)(2)] GENERAL EH VIOLATIONS 97 ❑ ❑ FE01 Environmental Healthlees paid.[CBPC 1720o, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longthude:-120.6408330000 INSPECTOR: KERRY BOYLE FACILITY REP: John Sharp SUMMARY OF OBSERVATIONSIVIOL-ATIONS pp No violations of undergi A storage tank, hazardous materials, or her lous waste lawa/regulations were discovered. SLO CUPA greatly appreciates your efforts to comply with a„ One laws and regulations applicable to yoi facility. D Violations were observeddiscovered 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 arcorrective actions required, please Inform the CUPA in writina. ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing w certification that compliance has been achieved A false statement that compliance has been achieved is a violatior of the law and punishable by a fine of not less than$2,000 or more than$25,000 for each violation. Yourfacilitymay be reinspected any time during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings andor the proposed corrective actions. The issuance of this Summary of Violations do" not preclude the CUPA from taking administrative, civil, or criminal action FACILITY NAME: OWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS AOL_ NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: Hazardous Materials Business Plan will be updated and submitted electronically via"E Z Submit Ponar. Facility well managed, and good employee training program. One diesel generator on site with less than 1,320 gallon capacity so no need to submit Spill Prevention Control and Countermeasure. INSPECTED BY: KERRY BOYLE NAME OF FACILITY REP: John Sharp DATE: 10/07/2016 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: EnV ronn autal Health Services (805) P.O.BQX ox 146 14B9 2150 Sierra Way Fire Department (805) 78W380 San Luis Obispo. CA UM 2160 Santa Barbara Avenue Son Luis Q0j6po CA 9340Y5240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 07/20/2015 Time: Facility Name: QWEST COMMUNICATIONS CORP Apencv Inspection Type ❑EHS ©Routine Site Address: 3610ENTO DR BCITY FIRE ❑Reinspection SAN LUIS OBISPO, CA CA 934 93401 ❑Chargeable Reinspecdon❑Change of Ownership Phone: (720)578-2006 ❑Complaint []Secondary Containment Testing Facility ID: FA0005342 ❑Chargeable Secondary Containment Testinc Serial Number: DAP6HTPY2 PROGRAMS INSPECTED: I®Hazmat I DHWGenemtor I DUST OAGT OCaIARP 13TPE REINSPECTION REQUIRED: 1131-1azmat I DHWGenemtor I DUST I OAGT I DCaIARP D E PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAMEITITLE): Name: Patrick Taylor Title: Lead Operations Technician /v YES N2 WA BUSINESS PLAN ® ❑ ❑ BP01 Business plan is complete, current, available during inspection (HSC 25503.5, Tide 19 CCR 2729) ® ❑ ❑ 1311202 Inventory of hazardous materials is complete (HSC 26604, Title 19 CCR 2729) ® ❑ ❑ BP03 Site Iayou ffacllily maps are accurate (HSC 25504, Tide 19 CCR 2729) TRAINING PLAN ® ❑ ❑ TR01 Facility has appropriate training program (Title 19 CCR 2732322 CCR 66265.16) ❑ ❑ TR02 Training documentation is maintained on site for current personnel (Tide 19 CCR 2732 a 22 CCR) 66265.16 EMERGENCY RESPONSE PLAN ® ❑ ❑ ER01 Emergency response/contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 a 22 CCR § 66265.53154) © ❑ ❑ ER02 Facility is operated and maintained to prevent/minimizelmltlgato fire, explosion, or release of hazardous maledalslwaste constituents to the environment Maintains all required or appropriate equipment Including an alarm and communications system (Title 19 CCR 27319 22 CCR 66265.31-�7, 66267.34 (d)(2), 40CFR 1 265.31) Al ❑ ❑ ER03 Secondary containment is installed and sufficiently impervious to discharges. [CHSC 26270A.5; " CFR It 2.8(c)(2)] GENERAL EH VIOLATIONS Al ❑ ❑ FE01 Environmental Health fees paid. [CBPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: KERRY BOYLE FACILITY REP: Patrick Taylor SUMMARY OF OBSERVATIONS/VIOt ATIONS O No violations of underf `+nd storage tank, hazardous materials, or h idous waste lawt/regulations were discovered. SLO CUP4 ,; Batty appreciates your efforts to comply with A the laws and regulations applicable to yoc facility. Violations were observecildiscovered as listed below. All violations must be corrected by implementing the correctl% action listed by each violation. If you disagree with any of the violations or corrective actions required, please infon the CUPA in writino. ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be Informed in writing wi 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 S2,DD0 or more than $25,000 for each violation. 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 andlor the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action. FACILITY NAME: Q`NEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL, NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: Annual inspection, good employee training program and record keeping. No changes to chemical inventory. Hazardous Materials Business Plan has been updated and submitted electronically via E Z Submit Portal No violations noted during facility inspection. INSPECTED BY: KERRY BOYLE NAME OF FACILITY REP: Patrick Taylor DATE: 07/202015 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title: Date: City yr &M WIS OBISO Fire Day p m rn (8051 78t7380 2160 Santa Barbara Avenue San We Obisoo CA 93401-5240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 1112212013 Time: 3:00 pm Facility Name: QWEST COMMUNICATIONS CORP p1Y1" ❑EHS """"""in II@Rougne ®CITY FIRE ❑Reinspection Site Address: 3610 SACRAMENTO DR ❑Chargeable Reinspection SAN LUIS OBISPO, CA 93401 ❑Change of Ownership ❑Complaint Phone: (720)578-2006 ❑Secondary Containment Testing Facility ID: FA0005342 ❑Chargeable Secondary Containment Testing Serial Number: DAKPICBSA PROGRAMS INSPECTED: Mittel 01,19vGenerator ❑UST OAGT Mal OTPE REINSPECTION REQUIRED: OHavnat OHW Generator OUST CIAGT Ell OTPE PERMISSION TO INSPECT: Inspections may Involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. YU NQ -WA BUSINESS PLAN © ❑ ❑ BP01 Business plan is complete, current, a callable during Inspectbntill 25503.5, Me 19 MR 2722) 19 ❑ ❑ BP02 Inventory of hazardous materials is complete(H5C 25504, Title 19 MR 2729) ® ❑ ❑ BP03 Site layout/facility maps are accurate (HSC 25504, Title 19 MR 2r28) TRAINING PLAN ® ❑ ❑ TR01 Facility has appropriate training program (Title 19 CCR 2732 a 22 MR 66266.16) ® ❑ ❑ TR02 Training documentation is maintained on site for current personnel (TRW 19 MR 2732 & 22 MR) 66MAS EMERGENCY RESPONSE PLAN ® ❑ ❑ ER01 Contlngency plan is complete, updated, and maintained on site MSC 255K Title 19 OCR 2731 a 22 MR § 66265.52154) 09 ❑ ❑ ER02 Facility is operated and maintained to prevendminimtrehni6gate fire, explosion, or release of hazardous materialsNan to constituents to Me environment. Maintains all required or appropriate equipment including an alarm and communlcatlom system (Title 19 MR 273%22 MR 66266.31-37, 66267.34 (d)(2), 40CFR 1 265.31) ❑ ❑ © ER03 Secondary containment is imtalled and sufficiently Impervious W discharges. ICHSC 25270.4.6; 10 CFR 112.8(cH2)] GENERAL EH VIOLATIONS ❑ ❑ ® FE01 Environmental Health tees paid [CBPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude:-120.6408330000 INSPECTOR: KERRY BOYLE FACILITY REP: -} SUMMARY OF OBSERVATIONS/VIO1 AMONS ❑, No violations of undergr d storage tank, hazardous materials, or ha. ous 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 observecildiscovered 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 corrective actions required, please inform the CUPA 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 violation. 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 andlor the proposed corrective actions. The issuance of this Summary of Vlolations does not preclude the CUPA from taking administrative, civil, or criminal action FACILITY NAME: OWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR SAN LUIS OBISPO, CA 93401 VIOLATIONS VIOL. NO CORRECTIVE ACTION REQUIRED INSPECTION COMMENTS: WILL CONFIRM THAT HAZMAT BUSINESS PLAN HAS BEEN SUBMITTED VIA CERS. ALL ELSE OK. INSPECTED BY: KERRY BOYLE NAME OF FACILITY REP: DATE: t V2212013 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE ification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on inspection form. ature of Owner/Operator: Title: Date: County of San Luis Obispo City 01 !' A. Environmental health Services Sm US OBiC�' O (005) ox148d 7LU g u.n 7 Vll J j��' P.O. Boa 1d09 Fire San Luisierra way 216 Santa Barb ra A enue 00 t San Luis Obispo, CA 93406 San Obispo Avenue San Luis Obispo CA 934014i240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data HAZARDOUS MATERIALS INSPECTION FORM entry by: Date: HAZARDOUS ' �.' , rxs-7 � P9mr.10 `+ FACILITY NAME: i AGENCY EXS ❑ AG DEPT I ION TYPE ye Routine ❑ Complaint ❑. Reinspec n ❑ Other Gfi ~ ADDRESS: n : ,�, A, fl CITY FIRE V Result Code: _70 Action Code: _80 _90 _ �' r � PRONE: _32 _37 _33 _31 PROGRAMS INSPECTED:rippl4ausines" nPlan ❑ NW Generator ❑ U3T ❑ AST ❑cALAnP REINSPECTION REQUIRED: P 0 ❑ YESs Plan ❑ NW Generator ❑ UST ❑ AST ❑CALARP PERMISSION TO INSPECT: inspections may Involve obtaining photographs, reviewing and copying records, and etermining compliance with adopted codes. GRANTED BY NAMEfrITLE : BUSINESS PLAN YES NO COS N/A ❑ ❑ ❑ ❑ RPOI Business plan Is cumpls ty current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) ❑ ❑ ❑ BP02 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) `❑ `❑ ❑ ❑ ❑ BP03 Site layeutlfacility maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN y ❑ ❑ ❑ ❑ TR01 Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) P ❑ ❑ ❑ TR02 , Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN �❑ ❑ ❑ ❑ ER01 Contingency plan is complete, updated, and maintained on site (DSC 25504, Tide 19 CCR 2731 & 22 CCR Q 66265.53/54) ❑ ❑ ❑ ❑ ER02 Facility is operated and maintained to prevenbminimin/mitigate fire, explosion, or release of hazardous materialsrwaste constituents to the environment. Mniotains all required or appropriate equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 6626531- .43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ ❑ ❑ ATOI SPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR 1123(b)) ❑ ❑ ❑ , ,❑ AT02 SPCC Plan is maintained on site or nearest field office. (HSC 25270) nnaaaecv re rmnm.nw.w,aim„hfchmhh nos/rnvimnmrntelhealt dons matenelstom to obtain forms Otiosely with BPo1-131)03, TROT and ER91 Y GPS Coordinates: INSPECTOR: 1 s , ,t MA41 t, i Vl"y" _{ FACILITY REP: I County of San Luis Obispo City 01 yj�♦ Environmental Health Services L+�f> �/ tlC /yZIC Tyra' (805)781.55" 7A1 8 ka J OB SPO mle . P.O. Box i"ll 2156 Sierra Way Fire Department (805) 781.7380 San Luis Obispo, CA 91406 2160 Sane Barbara Avenue San Luis Obispo CA 9MOl-5240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data HAZARDOUS MATERIALS INSPECTION FORM entry by: Date: /, ���� Tim ' O MiYII FACILITY NAME: AGENCY ❑ EHS ❑ AG DEPT . CITY FIRE INSPECTION TYPE U1 Routine `❑ Complaint Result Code _70 Action Code: _3247_33 ❑ ❑ Retrospection Other !404) _80 _90 _31 ADDRESS: i 2( PHONE: PROGRAMS INSPECTED; Buslnes;Plan ❑ HW Generator ❑ BST I X,.JTj❑GAIARP REINSPECTION REQUIRED: JN0 ElYES ElBusiness Plan ❑ 11W Generator ❑ UST P PERMISSION TO INSPECT: Inspections may involve obtaining photographs:, reviewing and espying records, and etermtnin com Itance with adopted codes. GRANTED BY NAMEITITLE : NO COS "o o o Bob, ❑ ❑ ❑ BP02 ❑ ❑ ❑ BP03 kEl ❑ ❑ ❑ Fuel 1-10 0 ❑ TR 12 ❑ ❑ ❑ ER01 L� ❑ ER02 ❑ ❑ ❑ 0 ATot ❑ ❑ ❑ AT02 COMMENTS Oo 1a h0d(/uwalSIM INSPECTOR: 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 layout/facility maps are accurate (HSC. 25504, Title 19 CCR 2729) TRAINING PLAN Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265,16) Training documentation is maintained on site for current personnel (Tide 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR § 66265.53/54) 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 (Tide 19 CCR 2731 & 22 CCR 66265.31- A3) 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) :health.oripenamhMm1v10m10✓hamrtlou�mvted4ls:hM, to96min ktms m comply with BRI-BP01 Int01 vie ER01 County of San Luis Obispo City Of a 44 Environmental health Services C 1.„ US mispo @�� P.O. 7015044 .7A/ a7 Vl7 JP.O. Box 1409 San LuisO Way Fire Same Barb raA Avenue 00 San Luis Obispo CA 93406 San Santa Barbara Avenue San Wis Obispo CA 930013240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data /�u HAZARDOUS MATERIALS INSPECTION FORM entry by: Date: /;i; . TIMA FACILITY NAME: AGENCY kEj ERE ❑ AG DEPT ❑ CITY FIRE INSPECTION TYPE Routine ❑ Complaint Result Code: Action Code: _32 Reinspection ❑ Other 70 80 90 _37 _33 _31 ADDRESS: PHONE: PROGRAMS INSPECTED: usiness Plan HP2 Generator ❑ uST ❑ AGT ❑CAI RP REINSPECTION REQUIRED: NO ❑ YES ❑ Business Plan ❑ Hill Generator ❑ UST ❑ AGT ❑CAIARp PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and Wetermining compliance with adopted codes. GRANTED BY NAMEITITLE : BUSINESS PLAN NO COS N/A ❑ BPOI Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) ❑ ❑ ❑ BP02 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) ❑ ❑ ❑ B103 Site layout/facility maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN (Ej TROT Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) TR02 Training documentation is maintained an site for current personnel (Title 19 CCR 2732&22 CCR 66265.16) 1 EMERGENCY RESPONSE PLAN IV I ERAI Contingency plan is complete, updated, and maintained an site (HSC 25504, Title 19 CCR 2731 & 22 ❑ ER02 CCR § 66265.53/54) Facility is operated and maintained to prevent/mini mizelmitigale tire, explosion, 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 6626531- .43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ ❑ AT01 SPCC Plan is reviewed and certified by a registered engineer within last 5 yet. (40 CFR 112.5(b)) ❑ ❑ ❑ AT02 SPCC Plan Is maintained an site or nearest field office. (HSC 25270) COMME)`fP8 to htry://www.sl:"ishmlih.otg/eaviroomentalhmllWhomrdous' mclurialshlm to cousin lmms to comply war anI-HP03, TR01 still BR01 �,Oio GPS Coordinates: Latitude: _deg - uniin decimal min Longitude: deg "go 6eimal min INSPECTOR: �._ I /� I. N FACILITY REP: Environmental Hlth city qeaServices 11' P.O.)Box 109 San g ��F� a. S OBIS i 2156 SIem Way San Lob Okd pw, CA 93405 Flm Department (905) 791.7380 2160 Santa Barbera Avenue San Luis Oblapm CA 934014ig40 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW dot Date: entry by: Time:%� i>fj77i`i 1 FACILITY NAME: AGENCY ❑ EHS sr`}t1'' CITY FIRE -,\\ INSPECTION TYPE Routine Reinspectlon ❑ Complaint ❑ Other "1 ADDRESS-, - , �( f 1 iti' PHONE: f,A 5�l— PROGRAMS INSPECTED: Business; Plan ❑ fiw Generator ❑ UST ❑ AOT ❑GALARP REINSPECTION REQUIRED: NO [I YES ❑Business Plan Her Generator ❑ulrr ❑AGT ❑GWip BUSINESS PLAN YE NO N/A C ❑ ❑ BPol Business plan is complete, current, & available during impaction (I16C 25503.5, Title 19 CCR 2729) G / ❑ ❑ BPo2 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) ❑ ❑ BPo3 She layout/facility maps are accurate (HSC 25504, Tilde 19 CCR 2729) Ej,/ ❑ TROT TRAINING PLAN Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) Ej ❑ ❑ TRO2 Training dvaumentatim is maintained an site for current Personnel (Title 19 CCR 2732 & 22 CCR 652(5.16( EMERGENCY RESPONSE PLAN ❑ ❑ EROI Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 / CCR t 6s © ❑ ❑ EA02 explosion, car oper3/54) of hazardus;peteredsodmaintainedto mtibe emiirmam/mitigate ifire,s orlappo entsto the inquirei2731&tlor lium;s synlLstem Tide 19 CCR CCR662iate equipment including an alarm and c;mmunimrtium xyxnm (Title 19 CCR 27J1 & 22 CCR 66265J1..43) equipment an its and ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ ❑ ATOI SPCC Plan Is reviewed and certified by a registered engineer within last 5 ym. (40 CFR 112.5(b)) ❑ ❑ AT02 SPCC Plan is maintained on site or nearest field office. (HSC 25270) :OMMBNTS Ont;hop://www.sbpubli<lleellh.org/environmen1e16ealWhvaNvus matmab.hoot,to;buin lmna wconply wilhBPo1-BPot, TROI and ER01 CPS Comedienne: Latitude: _deg min declmW min Longitude: d min decimal min INSPECTOR: FACILITY REP C"\OOCUTAR-I\Roprd.LOCALS-1\Templc.lotus.notes.data\t Inspection Form 1.doc 24-Jan-06 Environmental Health Services P.O. 10921569Iem WaWay (1)) San Luis Obispo, CA 93W CERTIFIED UNIFIED PROGRA HAZARDOUS MATERIALS IN Til A-o, Ih'. nl City Of sAn tuts OLi pis its Fire Department (805) 781 1380 21W Santa Barbara Avenue San Luis Obispo CA 93401-524C 1 M AGENCY (CUPA) [VJK' SPECTION FORM EFW data entry by: cgj FACILITY NAME: AGENCY ❑ EHS fA CITY FIRE 7[ `�Q - I PECTION TYPE Routine Reinspection ❑ Complain ❑ Other ADDRESS: PHONE: PROGRAMS INSPECTED: K.BushisesPhon ❑ Irv✓ Gertteamr I []WTI ❑ AGT I OCAIARP REINSPECTION REQUIRED: NO ❑ YES Business Plan ❑ Rw Generam, WE ❑ MIT ❑CALARP BUSINESS PLAN YES NO N/A rl Spot Business plan Is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) BP02 Inventory of hazardous; materials is complete (HSC 25504, Title 19 CCR 2729) •L�ti✓ ❑ ❑ BPo3 Site lay tat/facility maps an accurate (HSC 25504, Title 19 CCR 2729) ❑ ❑ TR01 TRAINING PLAN Facility has appropriate training program (Tide 19 CCR 2732 & 22 CCR 66265.16) n�/ V ❑ ❑ TRO2 Training documentation is maintained on site for current personnel (Tide 19 CCR 2732 & 22 CCR 66265.16) / D ❑ ❑ ER01 EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC 25506, Title 19 CCR 2731 & 22 CCR 0 66265,53154) ❑ ❑ ER02 Facility is operated and maintained to preventimh,imize/nd igate Bra, explosion, or release of hazardous materials/waste constituents to the environment. Maintains all required or appropriate equipment Including an signs and communications system (Tide 19 CCR 2731 & 22 CCR 6626531-.0.T ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ AT01 SPCC Plan is reviewed and certified by a registered engineer within lag 5 yrs. (60 CFR 112.5(b)) ❑ ❑ AT02 SPCC Plan is maintained on site or nearest field office. (HSC 25270) COMMnENI'3 Go to hup://www.alopubii<fiedlh.org/mvuoynme�talhealN/harsNo�maredals.hrm, mobmiz tome w comply wirh BPol-BPo3, TROtW Seat (A7 LY1�L'-7�' / U GPS Coordinates: Latitude: ._deg_._ decimal min Longitude: —deg min dceimal min 1011 INSPECTOR: " FACILITY REP: ./I< C \DOCU4 11Repra:LOCALS—YSemp':c. lotus notes. d, _ 1 Inspection Form /0e l.doc 24Jan-06 Environmental Health Services itiy .^ IBox 149 i 2156 Sierra Way San Luis Obispo, CA 93406 city off - sAn tuts Owpo noble Fire Department (805) 781-7380 2160 Santa Barbara Avenue San Luis Obispo CA 93401-5240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) OI HAZARDOUS MATERIALS INSPECTION FORM EFW data Date: /O/ 1; f entry by: Time: 9 " FACILITYNAME: AGENCY ❑ EHS ICITY FIRE 7j IMPPECTION TYPE Routine Relnspectlon ❑ Other El w ADDRESS: PHONE: PROGRAMS INSPECTED: Business Plan ❑ HW Generator ❑ UST ❑ AST ❑CAIARP REINSPECTION REQUIRED: NO ❑ YES X Business Plan ❑ tw Generator ❑ UST AST ❑CAIMP BUSINESS PLAN YES NO N/A BP01 Bardeess plan is complelq curreul, & available during inspection (HSC 25503.5, Title 19 CCR 2729) ❑ BPO2 Inventory of hazardous materials is complete (HSC 25$04, Title 19 CCR 2729) ❑ ❑ BP03 Site layout/facility maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN TROI Facility hoe appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) TRM Training documentation Is maintained on site for current personnel (Tide 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN �-,/ Lh ❑ ER01 Contingency plan is complete, updated, and maintained on silt (HSC 25504. Title 19 CCR 2731 & 22 CCR ¢ 66265SN54) �" ER02 Facility is operated and maintained to preventlmidMzdmidgme fire, explosion, or release of hazardous materials/wasle constituents to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Tide 19 CCR 2731 & 22 CCR 66265.31..43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ❑ �. AT01 SPCC Plan Is reviewed and certified by a registered engineer within last 5 yes. (40 CFR 112.5(b)) El ❑ AT02 SPCC Plan Is maintained on site or reactor field office. (HSC 25270) COMMENT$ GoWhttp://www.slopubhchea]M.OrgimviwnmcntalhealtN aurdous nunnals.b,toubninfarmswcoW]y%iffiBMI-BM3,MOIandn0i CPS Coordinates: Latitude: _deg min decimal min mteadecimN min INSPECTOR: FACILITYREP:.[� / ✓ C:\DOCII �1\Repr \kOCALS-1\Temp\c.lotus.r.ates.data\l Inspection Form 134 1.doc 24Jan-06 Environmental Health Services ci t y .0 (8o5)7s1-5544 san Us owpo � P.O. Box 1488 2156 Sierra Way San Luis OMrpo,CA 93J06 Fire Department (805) 781-7380 2160 Santa Barbara izt 2 San Luis Obisp r CA Avenue 23401 5240 7 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW data Date: I `( - " - entry by: m�e. rr)"2n — It a; l FACILITYNAME: _ AGENCY ENS ❑ AG DEPT 12 CITY FIRE INSPECTION TYPE <. Routlne ❑ Reinspectlon ❑ Complaint ❑ Other ADDRESS: '� Lt> PHONE: PROGRAMS INSPECTED E] Business Plan ❑ HIS Generator ❑ USr ❑ AGT ❑CAIARP REINSPECTION REQUIRED: RNO ❑ YES ❑ Business Plan ❑ HW demander ❑ UST ❑ AGT I]CAtARP ERMISSION TO INSPECT: Inspections may Involve obtaining photographs, reviewing and alternating Compliance with adopted codes. GRANTED BY NAMEITITLE : Copying Favorite, and BUSINESS PLAN YES NO NO ❑ N/A ❑ BPo1 Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) J ❑ ❑ BP02 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) Me ❑ ❑ BPO3 Site Iayoutlfaell ty maps are accurate (HSC 25504, Title 19 CCR 2729) TRAINING PLAN �' ❑ TROI Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) 0 ❑ ❑ TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN d❑ ❑ EROl Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR 166265.53154) 0 ❑ ❑ ER02 Facility is operated and maintained to prevmUminimize/midgate gee, explosion, 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 66265.31. .Cl) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ / AT01 SPCC Plan Is reviewed andcertilied by a registered engineer within last 5 yes. (40 CUR 112.5did ❑ AT02 SPCC Plan Is maintained on site or nearest field stave. (HSC 25270) COMMENTS Coordinates: nl/ INSPECTOR: vi.>r1,��(�, FACILFLYREP:_T C:\DOCUME-1\Repro\LOCALS. l\Temp\C.lotu8.note8.data\7_Inspectlon Form Page 1.doc 20-Jul-04 dP SUMMARY OR OBSERVATIONS/VIOLATIONS No violations of underground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requirements were discovered. SLO CUPA greatly appreciates your effort; to comply with all the laws and regulations applicable to your facility. Violations were observed(discovered ns listed below. All violations must becorrecled 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 200 DAYS ORAS SPECIFIED. CUPA must be informed in writing certifying 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 mere than $25,000 for each violation. Your facility maybe reinspected anytime during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. The issuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as a result of the violations noted or that have not been corrected within the time specified. VIOLATIONS NUMBER MINOR MAJOR CORRECTIVE AMON REQUIRED COMMENTS: y ) t V'0 Iq,p*$(:Q Inspected 6y: '; :i: Facility Rep Name: Date: �__i — (�c'j' Signature: lyt�yf 01DOCUMENTUetfp\FORMSinspeIXion formACUPA inspection forms.doc 10-Sep-01 .,. Division of Enviromn,..• sl Health - ' y (e05)7814i544 P.O. aea 1469 2156 Sierre Way,San Luis Obispo, CA 93406 1/17�D SM k" 2lspoTJ a7Q� Department of AericultureM[emuremenl Standards 4805)781-5910 Fire Department (8051 781-73M 2156 Sierra Way Suite A •San Luis Obispo, CA 93401 2160 Santa Barbara Avenue San Luis Obispo CA NOI-5240 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW data Date: 2 — 3 —0 + entry by: Time: 0,0)r?0 — 1000 PROGRAM RECORD ID NUMBERS: AGENCY ❑ DEH ❑ AG DEPT 91 CITY FIRE ❑ CITY UTILITIES INSPECTION TYPE 9 Routine ❑ Reinspection ❑ Complaint ❑ Other FACILITY NAME: Owe5f Ld»+ ADDRESS: (p <10 PHONE: PROGRAMS INSPECTED IR Business Plan ❑ HW Generator ❑ UST ❑ AGT REINSPECTION REQUIRED: M NO ❑ YES ❑ Business Plan ❑ HW Generator ❑ UST ❑ ACT 'PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and pleterminina compliance with adopted codes. GRANTED BY NAMEITITLE: BUSINESS PLAN Y NO N/A BPOl Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) 11102 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729) ❑ BP03 Site layouttfacility maps are accurate (HSC 25504, Title 19 CCR 2729) C1 ❑ ❑ TROI TRAINING PLAN Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) M02 Training documentation is maintained on site for current personnel (Tide 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN ❑ ❑ ER01 Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR 166265,53/54) ER02 Facility is operated and maintained to preventnninimize/mitigale 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 19 CCR 2731 & 22 CCR 6626531. 43) ABOVEGROUND PETROLEUM STORAGE TANK ACT ❑ ATO1 SPCC Plan is prepared and certified by a registered engineer within last 3 yrs. (HSC 25270) ❑ AT02 SPCC Plan is maintained on site or nearest field office. (HSC 25270) COMMENTS "N O to p lg, fq s h". A INSPECTOR: YYaM I Q "C ^' FACILITY Qw@ } cr SUMMARY OR OBSERVATIONS/VIOLATIONS No violations of underground tank, 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 as in writing. ALL VIOLATIONS MUST BE CORRECTED WITHIN 20 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 of the law and punishable by a fine of not less than$2,000 or more than $25,000 for each violation. Your facility maybe reinspected any 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 falling administrative, civil, or criminal action as a result of the violations noted or that have not been corrected within the time specified. VIOLATIONS NUMBER MINOR MAJOR CORRECTIVE AMON REQUIRED 9,v74✓L <; YK � .✓l,a-15 M cQ— wet!_ Vlb Uldl¢4-4doc COMMENTS: Inspected By: n Facility Rep Name: Date: 0Signature: U6! ,/# mpm 1127 my 0'1DOCUMENTWeffpIFORMSIInspection forms\CUPA inspection fonns.doc 10-Sep-01 ` Division of Environr �(al Health FireMpar' ,'(M781.7380 (805)78L5544 2I60Sauta_ .bara Avenue k I I P.O. Box 1489 San 1,1113 Mena CA 9. I.5240 2156 Sierra Way• San Luis Obispo, CA 93406 O. e._J�y, (ey or..._a Department of Aericulture/Massurement Udlilka Department -'.(805)781-7315 Standards (805) 781-5910 879 Morro Street • San Luis Obispo, CA 93401 2156 Sierra Way Suite A *San Luis Obispo, CA 93401 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) EFW data Date: / / �3 HAZARDOUS MATERIALS INSPECTION FORM e t _T ry by: ENCY INS: CTION TYPE DEH loutine AG DEPT Reinspection .CITY FIRE ❑ Complaint CITY UTILITIES ❑ Other PROGRAMS INSPECTED• ZR eusine® Plan I ❑ BW Gainers r ❑ UST ❑ AGT ❑ Tiered Permitting REINSPECTION REQUIRED: O ❑ YES El Business Plan ❑ HW Ceeerator ❑ UST ❑ AGT ❑ Tered Permining ERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAMEITIT'LE): BUSINESS PLAN Y. $/ N jLu1�P❑ ❑ DPW Business plan is complete, current, & available during Inspection (BSC §25503.5, Tide 19 CCR §2729) ❑ ❑ BP02 GtvenWty of hazardous materials is complete (HSC §25504, Title 19 CCR §2729) ❑ ❑ BP03 Site IayouuPucilhy, maps are accurate (BSC §25504, Title 19 CCR§ 2729) TRAINING PLAN TR01 Facility has appropriate training program (Title 19 CCR §2732 & 22 CCR §66265.16) YE] ❑ TR02 Training documentation is maintained on site for current personnel (Title 19 CCR §2732 & 22 CCR §66265.16) ❑ ❑ ER01 EMERGENCY RESPONSE PLAN Contingency plan Is complete, updated, and maintained on site (RSC §25504, Title 19 CCR §2731 & 22 CCR §66265.53/54) ❑ ❑ ER02 Facility is operated and maintained to prevent/minimize/mitigate pre, explosion, or release of hazardous waste to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR §2731 & 22 CCR §66265.31- A3) COMMENTS: {'6 A:\CUPA inspection torms.doc 19-Sep-02 FACILITY DATE' ISPECTOR: HAZARDOUS WASTE GENERATOR lI' EPAIDNUMBER: /v Tiered Permit: ❑CESW Treatment Equipment: /7 Lbs or gals /1 Total generated/month: NU (average) ❑CESQT ❑CA ❑PBR Wasteoil: Solvents: Antifreeze: Others: YES NO N/ VIOL. # EPA ED NO/PERMITS ❑ ❑ 0 GTOI Gerwrator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title 22CCR §66262.12) If Not, Call (800) 618.6942 to obtain your CAL EPA ID number. HAZARDOUS WASTE DETERMINATION ❑ ❑ GT03 Hazardous waste determination conducted (Title 22 CCR §66262.I1) ❑own knowledge []analysis []other ❑ ❑ GT04 Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR §66262.40.(c)) DISPOSALITRANSPORTATION ❑ ❑ GT05 Hazardous wastes were transported and/or disposed te a facility with an EPA ID NO. and permit or authorization from DTSC (HSC §25189.5, Title 22 CCR §66262.12) un ther ❑ ❑ GT06 22 Hazardous wastes are shipped with manifest (Title 22 CCR ¢66262.20) Hazard (Title ❑ ❑ GT07 Manifests and/or receipts are properly compleled/relained by generter for 3 years (Title 22 CCR §66263.42/ 66262.23) STORAGE AND MANAGEMENT OF CONTAINERS/TANKS El El GT08 Hazardous wastes are accumulated on site as follows (Title 22 CCR §66262.34) ❑ 90 days if waste generated per month is greater than or equal is 100 kg (220lb&) ❑ 180 days if waste generated per month is less than 100 kg (see note) ❑ 270 days if waste generated per month is less than 100 kg and transported more than 200 miles (see role) Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg(13,200 Ibs.)arrd no acutely/extremely hazardous waste over 1 kg (2.2 lbs.) Is held on site for over 90 days. ❑ ❑ GT09 Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/55-gal or I-qt limit) (Title 22 CCR §66262.34(c)) ❑ El GTIO Ignitable or reactive wastes are located 15 no (50 feet) from facility's properly line (Title 22 CCR M El GT11 Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUS WASTE," waste compnsitlon/physical state, hazardous properties, name/address ofgenermor) (Title 22 CCR §66262.31, 66262.34) ❑ ❑ G712 Comainers/tanks containing hazardous wastes are in good cc n lilion/bandled to minimize release or reaction (Title 22 CCR §66265.171/.191, 66265.177(c)) El ElGTl3 Corlainers/tanks/liners are compatible with waste stored or transferred (Title 22 CCH§66265.172) ❑ ❑ GTl4 Containers storing hazardous wastes are closed/sealed (Title 22 CCR §66265.173) ❑ ❑ GTI5 Weekly inspection of areas where hazardous waste containers are stored is conducted Mile 22 CCR§66265.174) GT16 Daily inspection of all tank systems is conducted and documented (Title 22 CCR §66265.195) ❑ ❑ GT17 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 (D) RECYCLABLE WASTE ❑ ❑ GTIB Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC Uo ❑ ElGT19 Usedsed oilfilters for recycling an managed properly (drained of free Rowing liquid, stored in dosed rainproof container, labeled "drained used oil filters," and transferred for metal reclamation) (Title 22 % CCR$ 66266.130) ❑ ❑ "'rrrL'L"..iiLlrrr"'����-"', GT20 Spent lead -acid batteries are being properly stored and transferred offsi a under manifest or hill of lading for recycling, reuse, or reclamation (Title 22 CCR §66266.81) ❑ ❑ GT21 Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR .3) SOURCE REDUCTION: For facilities genera[ing>72,IIIk1 kg✓yr. of hazardous waste on site. SOUR D❑ E GT22 Generator is subject to SB14 and has prepared and retained current source reduction documents or is able make them available 10 the inspector within (5) days. (HSC §25244.19, 2524411) ❑. ❑ GT23 Source Reduction Evaluation and Plan contains the following five elements: certification, amounts of wastes generated, process description, block diagrams, and implementation schedule of selected source reduction measures. (HSC §25244.19) AICUPA inspection forms. doc 19-Sep-02 FACILITY NAME: ADDRESS: SUMMARY OF OBSERVATIONSNIOLATIONS Vo violations of underground storage tank, hazardous materials, or hazardous wastelawalregulatlons 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 corrective actions required, please inform the CUPA in writing. ALL VIOLATIONS MUST BE CORRECTED WITHIN 12 DAYS OR AS SPECIFIED. CUPA most be irdohpted 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 $25,000 for each violation. Your facility may be reinspected any time during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective actions. The issuance of this Summary or Violations does not preclude the CUPA from taking administrative, civil, or criminal action. VIOLATIONS NUMBER MINOR MAJOR Inspected By: Date: •..� � 5'r Facility Sign the certification below and mail this form to the CUPA inspecmrall¢r all corrective actions have been completed. Retain a copy for your records. Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on this Impeclion farm. Signature of Owner/Operator: Title: Dale: A:\CUPA inspection forms.doc 19-Sep-02 1 Division of Env iran ... 4nxaf Health Fire DePAI,orm(US) 781-73M 1 1� (805)781-55" 21ce Soma Barbara Avenue P.O. &,x 140 San Luis Obispo CA 93401-5240 `'..'. 2156Sierra Way •San Luis Obispo, CA 9340ab Imo. g 14 tl Department of Agriculture/Measurement Standards (BOS)791-5910 Utilities Department•(805)781-7215 879 Morro SMet • San Loh Obispo, CA 93401 2156 Sierra Way Suite A •San Luis Obispo, CA 9340E CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) Date: 3 /�7 /dc HAZARDOUS MATERIALS INSPECTION FORM DEH AG DEPT SITY FIRE CITY UTILITIES FFW7 datatry by: Reinspeclion Complaint Other _ PROGRAMS INSPECTED y_I Bminem Plan ❑ DW Geaerator ❑ UST ❑ ACT I ❑ Tiered Permitting REINSPECTION REQUIRED: O ❑ YES ❑ Business Plan ❑ DW Ge serater ❑ UST ❑ AGT ❑ Tiered Permitting TO INSPECT: obtaining photographs, reviewing and copying records, and determining BUSINESS PLAN YE$r NO N/A ❑ ❑ BP01 Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR 2729) ,L�JJ'' OP02 Inventory of hazardous materials; is complete (HSC 25504, Title 19 CCR 2729) BP03 Site layout/facility maps are accurate (HSC 25504, Title 19 CCR 2729) / TRAINING PLAN TR01 Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) 1S��Q✓/ TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16) EMERGENCY RESPONSE PLAN ER01 Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR § 66265.53154) ❑ ❑ ER02 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 2731 & 22 CCR 6626531. .43) COMMENTS: INSPECTOR: FACLery REI-: FACILITY NAME: ,". �) DATE: � ,SPECTOR: HAZARDOUS WASTE GENERATOR EPA ID Lbs or gals NUMBER: Total generated/month: (average) Tiered Permit: ❑CESW ❑GESQT ❑CA PBR Waste oil: Solvents: Treatment Equipment Antifreeze: Others: YES NO N/A / VIOL. N EPA ID NO/PERMITS ElyM�/ GTOI Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title 22CCR 66262.12) If Not, Call (890) 618-6942 HAZARDOUS WASTE DETERMINATION - ❑ ❑ Ej/� GTO3 Hazardous waste determination conducted (Title 22 CCR 66262.11) ❑own knowledge ❑am.Jysis ❑other ❑ ❑ GT04 Hazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR 66262.40.(c)) DISPOSAL/TRANSPORTATION ❑ ❑ GT05 Hazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit or authorization from DTSC (HSC 25189.5, Title 22 CCR 66262.12) ���///'' ❑milkrun service ❑other El El GT06 Hazardous wastes are shipped with manifest (Title 22 CCR 66262.20) ❑ ❑ GT07 Manifests and/or receipts are properly completed/remaned by generator for 3 years (Title 22 CCR 66263.42166262.23) STORAGE AND MANAGEMENT OF CONTAIN ERSIFANKS ❑ ❑ Er' CT08 Hazardous wastes are seen mutated on site as follows (Title 22 CCR 66262.34) ❑ W days if waste generated per month is greater than or equal to 100 kg (220 tax.) ❑ 180 days if waste generated per mouth is less than WO kg (see note) ❑ 270 days if waste generated per month is less than IM kg and transported mm a than 200 miles (see note) Note: Applies only if hazardous waste accumulated on sate never exceeds 6000 kg(t3200 lbs.Emd no acutely/extremely hazardous waste over 1 kg (2.2 lbs.) is held on site for over 90 days. El El GT09 Hazardous waste "satellite" collection is managed properly(complete labeling/accumulation time)55-gal or 1-ql limit) (Title 22 CCR 66262.34(c)) El El CT10 Ignitable or reactive wastes are located 15 an (50 feet) from facility's property line (Title 22 CCR ElElO �--�/ GT11 66255.176) Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUS WASTE," waste composition/physical state, hazardous properties, name/a ldress of generator) (Title 22 2 6 .34) CCR 6666rshlaR ❑ ❑ GT12 Cont p containing Hazardous wastes are In good conJifion/handled to minimize release or reaction (Title 22 CCR 66265.171/.191, 66265.177(c)) GT13 Containera/tenks/liners are compatible with waste stored or transferred (Title 22 CCR 66265.172) El ,.,�,P GT14 Containers storing hazardous wastes are closed/sealed(Title 22 CCR 66265.173) ❑ ❑ G115 Weekly inspection of areas whare hazardous waste containers are stored is conducted (Title 22 CCR 66265.174) ❑❑ ❑ G116 Daily inspection of all tank systems is conducted and documented (Title 22 CCR 66265.195) ❑ , GT17 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 (0) RECYCLABLE WASTE ❑ ❑ GT18 Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC 25250,4) El El GT19 Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closed rainproof container, labeled "drained used oil fillers," and transferred for metal reclamation) (Title 22 CCR 630) ❑ ElGT20 Spent lead -acid batteries are Transferred oteite under manifest or bill of lading for recycling, reuse, or reclamation (Title 22 CCR 66266.81) ❑ ❑ GT21 Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR 66266.3) SUMMARY OR OBSERVATIONS/VIOLATIONS ❑ No violations of underground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requiremems 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 dee 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 of the law and punishable by a fine of not lose than S2,000 or more than S25400 for each violation. 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 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. VIOLATIONS NUMBER MINOR MAJOR CORRECTIVE ACTION REQUIRED COMMENTS: l.i✓5Pt'c?id>'/ �'ar-rf'Lei C� O/V 3/7/024_/�f?�,�1 sa i 7y Cg(.-4 ON Y9 L NO Col°Y &/a5 /a/=7 _ Inspected By: ""'l '"ucr "! Facility Rep Name: DoiI/V �/W/ Dale: - —7 6104 Signature: O:\DOCUMENT\Jefrp\FORMS\Inspection forms\CUPA inspection fonos.doc 10-Sep-01