HomeMy WebLinkAbout1530 Froom RanchCOUNTY OF SAN LUIS OBISPO
Facility lnformation as of 1212712017
Date run:
FA001 1 575
Run by: ' kboYle
Report#: MFRI
Page#: 1
RecordSelectionCriteria: Faciqg.'lD:
Date:by:
r#f lN GE
t I UPDATE UST INFO (sys, type, capacity, etc.
r I CLOSE FACILITY AS OF: DAIE: I I
OWNER FILE INFORMATION
Owner lD: OW0007613
Owner Name: PetSmart, lnc.
Owner DBA:
OwnerAddress: 19601 N 2TTHAVE
PHOENIX, AZ 85027
Home Phone: 623-580-6100
Work Phone: 623-587 -2912
Mailing Address: 19601 North 27th Ave
Phoenix, AZ 85027
[ ] NEW FACTLTTY RECORD
t IoWNERSHIPCHANGE: [ ] Business [ ]Property [ ]Tank
P|UPD
ATE Bl LLING INFORMATION
New Owner lD:
New Name:
New DBA:
New Address:
New Home Phone:
New Work Phone:
New Mailing Address:
Care of:New Care of:
FACILITY FILE INFORMATION
FacilitY lD: FA001 1575
FacilitY Name: PetSmart #1614
New lD:
New Name:
New Site Address:
New Phone:
New Mailing Address:
New Care of:
Phone:
Mailing Address:
Care of:
CERS ID:
GIS:
1530 Froom Ranch WY
San Luis Obispo, CA 93405
805-544-01 91
Contracted Services, 19601 N 27th Ave
Phoenix, AZ 85027
PetSmart, lnc.
1 0600660
35.25201 -120.68866
I\CCOUNTS RECEIVABLE FILE INFORMATION
Account lD: AR0023042
Mail lnvoices to: Account
Account Name: Contracted Services, Attn: Maxim Kravchuk
Account Balance as ol 1212712017: $0.00
New Account lD:
Mail lnvoices to: Owner / Facility
(Circle
UST(s)
Transfer
Program to (Circle One)
Program/Element and Description Record lD Employee lD and Name
0762 - SLO CITY-HAZARDOUS MATERIALS HANDLER 1-4 PROO169O7 EEOOOO51O - KERRY BOYLE
Last Activity: No Previous Activity
1 176 - SLO C|TY- WASTE GENERATOR (1-5 waste streams) PR0016908 EE0000510 - KERRY BOYLE
Status
Active
N
N
Last Activity:No Previous Activity
t 1 CREATE NEW F|LE FOLDER
t 1 UPDATE EXISTING FILE FOLDER LABEL
UPDATE NEXT INSPECTION DATE:Date: I I
Copy to: File Other:
Update HazMat Portal?
HAZARDOUS MATERIALS SPECIFIC:
Number of Materials
Number of Waste Streams
Number of Tanks (list
capacity/com pa rtment)Y N (rf to administrator for,I ,
Date:
=J \f .t\ a.-f
ilW mrl+n funlrlorrc $fu W,th,,tr,f/^ltfi+
Date run: 312912017 3:43:55PM
Run by: KBOYLE
oBlsPo
3t29t2017
Report #: MFR1
Page#: 1
LU IS
as of
Record Selection Criteria: Facility lD: FA001 1575
Date:
VTIIlU PDATE UST INFO (sys, type, capacity, etc.)
t 1 CLOSE FAClLlry AS OF: Date:
OWNER FILE INFORMATION
Owner lD: OW0007613
Owner Name: PetSmart, lnc.
Owner DBA:
OwnerAddress: 19601 N 27TH AVE
PHOENIX, M 85027
Home Phone: 623-580-61 00
Work Phone: 623-587 -2912
Mailing Address: 19601 North 27th Ave
Phoenix, AZ 85027
449-tl+ Requestedbv:
NFORMATION C+IANGE
[ ] NEW FACILITY RECORD
t IOWNERSHIPCHANGE; [ ]Business [ ]Property [ ]Tank
[ ]UPDATE BILLING INFORMATION
New Owner lD:
New Name:
New DBA:
New Address:
New Home Phone:
New Work Phone:
New Mailing Address:
Care of:New Care of:
FACILITY FILE INFORMATION
FacilitY lD: FA001 1575
FacilitY Name: PetSmart #1614
New lD:
New Name:
New Site Address:
New Phone:
New Mailing Address:
New Care of:
Phone:
Mailing Address:
1530 Froom Ranch WY
San Luis Obispo, CA 93405
805-544-01 91
Contracted Services, 19601 N 27th Ave
Phoenix, M 85027
Petsmart, lnc.
1 0600660
35.25201 -120.68866
Care of:
CERS ID:
GIS:
ACCOUNTS RECEIVABLE FILE INFORMATION
Account lD: AR0023042
Mail lnvoices 1e; Account
Account Name: Contracted Services
Account Balance as of 312912017: $0.00
Program/Element and Description Record lD
New Account lD:
Mail lnvoices to: Owner / Facility / Account
(Circle One)
UST(s)
Transfer
Program to (Circle One)
0762 - SLO CIry-HAZARDOUS MATERIALS HANDLER 1-4
Last Activity: No Previous Activity
1176 - SLO CITY- WASTE GENERATOR (1-5 waste streams)
PR0016907
PR001 6908
Employee lD and Name
EEOOOO5IO - KERRY BOYLE
EEOOOO5IO - KERRY BOYLE
Status
Active
Active
Linked
YN
YN
A
A
Last Activity: No Previous Activity
t I CREATE NEW FILE FOLDER
t 1 UPDATE EXISTING FILE FOLDER LABEL
UPDATE NEXT INSPECTION DATE:Date:
-
J ,,--J-
Copy to: File Other:
Update HazMat Portal? Y N (lf yes, forward to portal administrator for update)
HAZARDOUS MATERIALS SPECIFIC
Number of Materials
Number of Waste Streams
Number of Tanks (list
ca pacity/co m pa rtment)
PE
Comments:
Entered Date:
COUNTY OF SAN LUIS OBISPO
Facility lnformation as of 111212015
't Report #: MFRI
Page #: 1)Run by: kboyle
Date run: 1/1
Record Selection Criteria: Facility lD: FA000
NEW FACILITY RECORDuested by:
lBusiness [ ]Property [ ]Tank
t 1 UPDATE UST INFO (sys, type, capacity, etc.) Tj"{TPDATE BILLING INFORMATION
t j TEMpoRARtLy tNAclvATE AS oF: Date'. t I t I closE FAclLlrY AS oF: Date: t t
OWNER FILE
Owner lD:
Owner Name:
Owner DBA:
Owner Address:
INFORMATION
New Owner lD:
New Name:
New DBA:
New Address:
Home Phone: Not SPecified
Work Phone: Not Specified
Mailing Address:
Care of:
FACI LITY FILE INFORMATION
Facility lD:
Facility Name:
Phone:
Mailing Address:
Care of:
CERS ID:
Location Code:
BOS District:
New Home Phone:
New Work Phone:
New Mailing Address:
New Care of:
New lD:
New Name:
New Site Address:
New Phone:
New Mailing Address:
New Care of:
APN:
SIC Code:
ACGOUNTS RECEIVABLE FILE INFORMATION
Account lD:
Mail lnvoices to:
Account Name:
Program/Element and Description
New
Record lD Employee lD and Name
Facility / Account
One)
Status
Transfer
Program to (Circle One)
Activate/lnactvat
USr(s)
Linked
to: Owner
t I CREATE NEW FILE FOLDER
I 1 UPDATE EXISTING FILE FOLDER LABEL
UPDATE NEXT INSPECTION DATE: Date:
Copy to: File Other:
HAZARDOUS MATERIALS SPECIFIC:
Number of Materials
Number of Waste Streams
Number of Tanks (list
capacity/compartment)
,PE7 zfuul\'- 49"
Entered
Comme
Date:
nts:
rhl\515
,rio \[Qull\-
TK\b{iDK
nG-zp4zI ' a) ,N'l-l ez3
."-BJH
California Environmental Reporti ng (cERs)Business Owner Operator
art #1614 CERS ID
Froom Ranch Way 10500660
Luis O cA 93405
Status
on 2/24/2OL9 by Ashley Campbel/ of Petsmart (Phoenix, AZ)
was Not Applicable; Processed on 4/17 /2OL9 by Kerry Boyle for San Luis Obispo County Environmental Health
art, lnc Beginning Date
Dun & Bradstreet
Ending Date
Phone Business Phone Business Fax
623) s80-6100 (805) 544-0191 5lC Code
5149
Primary NAICS
453910
:acility/site Mailing Address
:ontracted Services, 19601 N 27th Ave
)hoenix, AZ85027
Emergency Contact
)wner
)etsmart, lnc.
6231 s87-29r2
19601 North 27th Ave
)hoenix, Az85027
ry Emergency Contact
Loss Prevention Manager
Phone 24-Hour Phone Pager Number
Silling Contact
:ontracted Services, Attn: Maxim Kravchuk
6231587-2912 mkravchuk@petsmart.com
19601 N. 27th Ave
)hoenix, A285027
re Manager
Phone
544-0191
Weis
67s-s805
24-Hour Phone Pager Number
:nvironmental Contact
VIAXIM KRAVCHUK
623l, 587-29L2
19601 N. 27th Avenue
)hoenix, A285027
mkravchuk@ petsmart.com
of Signer Signer Title
COMPLIANCE® AFFAIR SPECIALIST
Document Preparer
ASHLEY CAMPBELLCAMPBELL
lnformation
Property Owner
rish Hills Plaza West, LLC
thone
,80s) s43-0300
Vlailing Address
ft \ lUl4 t) s2*S-'\Ao"/+' t
me or all of the following fields may be required by your local regulator(s).
Fields
Assessor Parcel Number (APN)
053-510-014
Number of Employees
37
Facility lD
Printed on4/L7/2019 2:15 PM
\
I
Environmdh,u,'o''t Services
(805t 781-5544
2156 Sierra Wav Ste B
San Luts Qbispo. CA 934A1
ehs(Oco,s/o, ca,us
slocountv.oov/ehs
Fire Department
2160 Santa Barbara Avenue, San LLris 0bisFo CA 1)3401 -5240
805 78 r /380
sioclty orq
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA}
Regulated Facility lnspection Form
COUNTY
bSANLUTS
OBISPO
Phone: (805) 544-0191-Establishment Name: PetSmart #LGt4
Zip:93405City: SAN LUIS OBISPOSitC AddrESS: 1-530 FROOM RANCH WY
Serial N umb er: D A7 822317 Date: L010612025CERS lD: 10600660Establishment lD: FA0011575
Aqencv
UEHS ECity Fire
lnspection Tvpe
X Routine: Other D Change of Ownership
o Reinspection fI Chargeable
O Complaint
I Secondary Containment Testing
ECaIARP trTPEEHW Generator OUST NASTPrograms lnspected:OHazmat
BTPENASTOCaIARPUHazmatOHW Generator trUSTReinspection Required:
PR0016908Permit Number:
PERMISS/ON fO /NSPECT tnspections may invalve obtaining photographs, reviewing and copying records, and determinin
camplianee with adopted codes.
lnspected By: Matheson Bliss Date: 10/06/2025
Received By: TreY Ponce Signature
Granted By: TreY Ponce Title:Ops Lead
SUMMARY OF FINDINGS
F No violations of underground storage tanlt, hazardous materials, or hazardous waste laws/regulations were discovered
appreciates your efforts to comply with all the laws and regulations applicable to your facility.SLO CUPA greatly
Violations were observed/discovered as listed below. All violations must be corrected by implementing the conective
action listed by each violation. lf you disagree with any of the violations or corrective aclions required, please inform the
CUPA in writing.
. ALL VIOLAnANS MUSI BE CORRECTED WlTHlht 30 DAyS OR AS SPECIFIED CUPA musf be informed in writing with a cefttfication
that comptiance has been achieved. A fatse statement that compliance has been achieved is a violation of the law and punishable by a
fine of up to $70,000 for each violation. Your faciltty may be reinspected any trme during narmal bustness hours.
. You may request a meeting with the Program Aianager to discuss the inspection findings and/or the pro@sed corrective actions The
rssuance of thrs Summary of Viotations tloes not preclude the CUPA from taking administrative, civil, or criminal action.
STATE M E Nr.
-O
F C oM P LIAN-q E
Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
this inspection form.
n
Datelltle.Signature of Owner/Operator
Ensure all employees handling hazardous/universal waste or managing hazardous waste storage area are trained upon hire and
annually for proper management and emergency response procedures,
, Environmental Health Services
j(805) 781-5544
lP.O.Box 1489
r2156 Siena Way Ste. B
lSan Luis Obispo, CA 93406
]
-)
ctty o[ san luls oBlspo
FIRE DEPARTTiETT
2160 Sdta garbaE Avduo ' Sa l-ub Oblspo, CA 93'101'5240 ' {805) 781-?380
"Courtesy & Service"
Date'. 0912512024
GERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time.
COUNTY
bSAN LUIS
OBISPO
Facility Name: PetSmart #1614 Agency
trEHS
trCITY FIRE
lnspection Type
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinl
Site Address: 1530 Froom Ranch V\|/
San Luis Obispo, CA 93405
Phone: (805)544-0191
Facility lD: FA0011575 CERS lD: 10600660
Serial Number: DAGACAPSS
PROGRAMS INSPEGTED:DHazmat trHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:EHazmat trHW Generator trUST trAGT trCalARP trTPE
pERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES
tr
tr
tr
tr
tr
tr
tr
NO
u
tr
tr
u
tr
tr
tr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505,
25508(aXl); 19 CCR 26sl)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(a)(1), 25506,
25508(aXl ), 19 CCR 2652, 26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(a)(2), 25508(aX1), 19 CCR
26s21
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 25508(aX1), 1gCCR
2659, 22CCR66265.1 6)
Training documentation is maintained on site for current personnel (HSC 25505(a)(4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSc 2550s(a)(3), 25508(aX1), lgccR 2658, 22ccR 6626s.s2-.54)
Secondary containment is installed and sufficiently impervious to discharges. [CHSC 25270.4.5;40 CFR
112.8(cX2)l
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinancel
GPS Coordinates: Latitude: 35.25201 00000 GPS Goordinates: Longtitude: -120.6886600000
N/A VIOL. #
tr BP01
BPO2
BPO3
TROl
TRO2
EROl
ERO3
FEOl
tr
tr
tr
tr
tr
tr
trtr
INSPECTOR: MATHESON BLISS FACILITY REP: Jason lli
YES NO N/AtrDtr
FACILITY NAME: PetSmart # +
vtol. #
GTOl
GTO3
GTO4
GTO5
GTO6
ADDRESS: 1 lFroom Ranch WY
San Luis Obispo, CA 93405
HAZARDOUS WASTE GEN ERATOR
EPA ID NO/PERMITS
Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardous waste (22
CCR 66262.12) lf not, Call (800) 618-6942 to obtain your CAL EPA lD number
HAZARDOUS WASTE DETERMINATION
Hazardous waste determination conducted (22 CCR 66262.111
Down knowledge tranalysis trother
Hazardous waste analysis/test records are kept for at least 3 years(22 CCR 66252.40.(c))
DISPOSAUTRANSPORTATION
Hazardous wastes disposed of at an authorized location (HSC 251 89.5, 25201(al, 22 CCR 66262.121
Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped with a
manifest (HSC 25160. 25163(a); 22 CCR 66262.20,66263.41 )
tr
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Emilkrun Dother
GTOT Manifests and/or receipts are properly completed/retained by generator for 3 years (22 ccR 66262.23,
GTOS
66262.40(a))
STORAGE AND MANAGEMENT OF GONTAINERS/TANKS
Hazardous wastes are accumulated on site as follows: ( HSC 25123.3 (bxly(dy(hxl); 22 CCR 66262.34(d))
tr90 days if waste generated per month is greater than or equal to 1000 kg. (2200 lbs.)
tr180 days if waste generated per month is less than 1 000 kg (see note)
tr270 days if waste generated per month is less than 1000 kg and transported more than 200 miles (see
note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000k9(13,200 lbs) and no
acutely/extremely hazardous waste over lkg(2.2|bs.) is held on site for over 90 days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation timdSS'gal
or 1-qt limit) (22 ccR 66262.34(e))
lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line (22 GCR 66262.34(aXl ),
6626s.176)
Containers of hazardous waste are properly labeled (includes appropriate date,"HAZARDOUS WASTE,"
waste composition/physical state, hazardous properties, name/address of generator) (22 CCR 66262.31,
66262.34(f))
Containersi/tanks containing hazardous wastes are in good conditiory'handled to minimize the release
or reaction (22 CCR 66262.34; 22 CCR 66265.171-.1 79, 66265.1 77(c))
Containers/tanks/liners are compatible with waste stored or transferred (22 CCR 66262.34,66265.172)
Containers storing hazardous wastes are closed/sealed (22 CCR 66262.34,66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted (22 CCR
66262.34,66265.1741
Daily inspection of all tank systems is conducted and documented (22 CCR 66262.34,66265.195)
Empty containers or inner liners > 5 gal has date when emptied and are properly managed within one
year of date emptied (22 CCR 66261.7(f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC
2s250.41
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) (Title 22
ccRs 56266.130)
Spent leadacid batteries are being properly stored and transferred offsite under manifest or bill of
lading for recycling, reuse, or reclamation (22 CCR 66266'81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (22 CCR 66266.2)
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 25244.191.211.22;22 CCR 67100.7/.8)
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of
wastes generated, process description, block diagrams, and implementationschedule of selected
source reduction measures. (HSC 25244.191.21,22 CCR 67100.5/7/'8)
Hazwaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite' (22CCR
66262.34(aX4), 66265.51 -.54)
Employees trained upon hire, annually; training records maintained at facility as required (22 CCR
66262.3a(aXa), 65265.1 6)
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materialdwaste constituents to the environment. Maintains all required or appropriate
equipment including an alarm and communications system (22 CCR 56265.31'.37)
GTO9
GTlO
GT11
GT12
GT13
GT14
GT15
GT16
GT17
GT18
GT19
GT2O
GT21
GT22
GT23
GT24
GT25
ERO2
suM. "Anv oF oBSERVATloNgvloLA 'cNS
No violations of underground storage tank, hazardous materials, or hazardous waste laws/regulations were discovered.
SLO CUpA grealy appreciates your efforts to comply with all the laws and regulations applicable to your facility'
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please inform th
CUPA in writinq
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA MUSt bE iNfOTMEd iN WTitiNg With A
certification that compliance has been achieved. A false statement that compliance has been achieved is a violation of
the law and punishabie by a fine of not less than 92,000 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 GUPA from taking administrative, civil, or
criminal action.
FACILITY NAME: PetSmart #1614 ADDRESS: '1530 Froom Ranch WY
San Luis ObisPo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION COMMENTS:
Items marked N/A not reviewed during inspection. Hazardous waste storage area in well-maintained
condition today. Thank You.
INSPECTED BY: MATHESON BLISS
DATE: ogl25t2o24
NAME OF FACILITY REP: Jason lli
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of perjury that this facility has complied with the co rrective actions listed on
is inspection form.
Signatu re of Owner/Operator:-Title Date:_
COUNTY.6SAN LUIS
OBISPO
Environmental He,
(805) 781-5544
f\
I_ .ervrces
,-\
)crty 01 slll Luls oBlspo
FIRE DEPARII'IENT
2160 Silta BarbaEAvfluo'gan Lub obbpo,CA 93401-5240 t (805) 701-?380
"Courtesy & SerYice"
Date: 03/03/2023
GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: PetSmart #1614 Aoencv lnsoection TyoetrEHS trRoutine
BCITY FIRE trReinspection
trChargeable ReinsPection
trChange of OwnershiP
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinl
SiteAddress: 1530 Froom Ranch \M/
San Luis Obispo, CA 93405
Phone: (805)544-0191
Facility lD: FA0011575 CERS lD: 10600660
Serial Number: DAC1Q0NE0
PROGRAMS INSPECTED:trHazmat EIHW Generator trUST trAGT trCa|ARP trTPE
REINSPECTION REQUIRED:trHazmat EHWGenerator trUST trAGT UCaIARP trTPE
pERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES
tr
tr
tr
tr
tr
tr
tr
NO
tr
tr
tr
tr
tr
tr
tr
Nla vroL. #
tr BP01
BPO2
BPO3
TROl
TRO2
EROl
ERO3
tr
E
tr
B
tr
tr
BUSINESS PLAN
Business plan complete, current, available during inspection and submifted electronically (HSC 25505,
25508(axl); 19 ccR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl ), 25506'
25508(axl), 19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aX1), 19 CCR
26521
TRAINING PLAN
Facility has appropriate training program, submifted electronically (HSC 25505(a)(4), 25508(aXl), 19CCR
2659, 22CCR66265.1 6)
Training documentation is maintained on site for current personnel (HSC 25505(a)(4)' 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSC 25505(a)(3), 25508(aX1), l9CCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270'4.5;40 CFR
112.8(cX2)l
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinance]trtrtrFE01
GPS Goordinates: Latitude: 35.25201 00000 GPS Coordinates: Longtitude:
INSPECTOR: MATHESON BLISS FACILITY REP: Lori Shaw
-120.6886600000
YEs N9 NIAtrtrtr
FACILITY NAME: PetSmart #1F'-4
vtoL. #
GTOl
GTO3
GTO4
GTOS
GTO6
GTOT
GTOS
GTO9
GTIO
GTl1
GT12
GTl3
GTl4
GT15
GTI6
GTl7
GT18
GT19
GT2O
GT21
Gf22
GT23
GT24
GT25
ERO2
ADDRES$, \1530 Froom Ranch \A/Y
San Luis Obispo, CA 93405
HAZARDOUS WASTE GENERATOR
EPA ID NO/PERMITS
Generator has an EPA lD number to treat, store, dispose, transpoft or transfer hazardous waste (22
CCR 66262.12) lf not, Call (800) 6186942 to obtain your CAL EPA lD number
HAZARDOUS WASTE DETERMINATION
Hazardous waste determination conducted (22 CCR 66262.11)
Bown knowledge tranalysis trother
Hazardous waste analysis/test records are kept for at least 3 years(22 CGR 66262.40.(c))
D IS P OSA UTRA NS P ORTATIO N
Hazardous wastes disposed of at an authorized location (HSC 25189.5, 25201(a1,22CCR66262.121
Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped with a
manifest (HSC 25160. 25163(a); 22 CCR 66262.20,66263.41)
Emilkrunfu trother
Manifests and/or receipts are properly completed/retained by generator for 3 years (22 CCR 66262'23,
66262.40(a))
STORAGE AND MANAGEMENT OF CONTAINERS/TANKS
Hazardous wastes are accumulated on site as follows: ( HSC 25123.3 (bxly(dy(hxl); 22 CCR 66262.34(d))
tr90 days if waste generated per month is greater than or equal to 1000 kg' (2200 lbs.)
trl80 days if waste generated per month is less than 1000 kg (see note)
8270 days if waste generated per month is less than 1000 kg and transported more than 200 miles (see
note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000k9(13'200 lbs) and no
acutely/extremely hazardous waste over 1kg(2.2lbs.) 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) (22 CCR 66262.34{e}}
lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line (22 CGR 66262.34(a)(1),
66265.176)
Gontainers of hazardous waste are properly labeled (includes appropriate daIe"'HAZARDOUS WASTE"'
waste composition/physical state, hazardous properties, namey'address of generator) (22 GCR 66262.31'
66262.34(fl)
Containe-riitanks containing hazardous wastes are in good conditiory'handled to minimize the release
or reaction (22 CCR 66262.34;22 CCR 66265.171-.179,66265'177(c))
Containersltanks/liners are compatible with waste stored or transferred (22 CCR 66262.34,66265.172)
Gontainers storing hazardous wastes are closed/sealed (22 GGR 66262.34, 66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted (22CCR
66262.34,66265.174)
Daily inspection of all tank systems is conducted and documented (22 CGR 66262.34,66265.195)
Empty containers or inner liners > 5 gal has date when emptied and are properly managed within one
year of date emptied (22 CCR 66261.7(f))
RECYCLABLE WASTE
ttseO olt is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC
25250.41
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
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 (22 CCR 66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (22 CCR 66266'2)
SOURCE REDUGTION:For facilities generating >12,000 kg./yr. of hazardous waste on site.
Generator is subiect to SB14 and has prepared and retained current source reduction documents or is
able make them available to the inspector within (5) days. (HSC 25244.191.211'22;22 CCR 67100.7/.8)
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of
wastes generated, process description, block diagrams, and implementationschedule of selected
sou rce reduction measures. IHSC 25244.1 I I 21' 22 CCR 671 00'5/7/.8)
Haanyaste Gontingency Plan prepared, current, submitted to the CUPA, maintained onsite. (22CCR
66262.34(aXa), 66265.51 -.54)
Employees trained upon hire, annually; training records maintained at facility as required (22 CCR
66262.34(aX4), 66265.1 6)
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment Maintains all required or appropriate
equipment including an alailn and communications system (22 CCR 66265.31-.37)
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suMr- )RY oF oBSERVATIONSVIC','STIONS
No violations of undergrouhd crortg€ tank, hazardous materials, or hazardo-- waste laws/regulations were discovered.
SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
tr Violations were observedldiscovered as listed below. All violations must be corrected by implementing the corrective
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please inform th
CUPA in writinc
ALL VTOLATIONS 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 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.
FACILITY NAME: PetSmart #1614 ADDRESS: 1530 Froom Ranch \Aff
San Luis Obispo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
INSPECTED BY: MATHESON BLISS
DATE: ou03t2023
NAME OF FACILITY REP: LoriShaw
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of periury that this facility has complied with the corrective actions listed on
inspection form
Signature of Owner/Operator:-Title:- Date:-
COUNTY
b SAN LUIS
OBISPO
I
Environmental Heall.
(805) 781-5544
P.O.Box 1489
2156 Sierra Way Ste. B
San Luis Obisoo. CA 93406
/"\
crty o[ $an Luls oBlspo
FIRE OEPARTMENT
2'160 Santa Earba6Avsu6'San Luls Obispo, CA 93401-52,10'(805) 78t'?380
"Courtesy & Service"
L'-
Date:0112712022
GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
trClTY FIRE trReinspection
trChargeable ReinsPection
trChange of OwnershiP
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Facility Name: PetSmart #1614 trEHS
Testi
Phone: (805)544-0191
Site Address: 1530 Froom Ranch \A/Y
San Luis Obispo, CA 93405
lnsoection Tvoe
trRoutine
Facility lD: FA0011575
SerialNumber: DATD703J4
trAGT trCalARP trTPEtrHWGeneratortrUSTPROGRAMS INSPECTED:trHazmat
trCa|ARP trTPEtrHW Generator trUST trAGTREINSPECTION REQUIRED:trHazmat
PERMISSION TO TNSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES NOtrtr
utr
trtr
trtr
trtr
trtr
trtr
BUSINESS PLAN
Business plan complete, current, available during inspection and submifted electronically (HSC 25505, 25508(a)
(1); 19 GCR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506, 25508(aX1),
19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aX1), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4), 25508(aX1)' l9CCR 2659,
22CCR6626s.16)
Training documentation is maintained on site for current personnel (HSG 25505(aX4), 22CCR66265'16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite (HSC
25505(aX3), 25508(aXl), 1gCCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR 112.8(c)
(2)t
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Goordinates: Latitude: 35.25201 00000 GPS Coordinates: Longtitude: -120.6886600000
N/A VIOL. #
EI BP01
tr BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
tr
tr
tr
tr
trtrtrFE01
INSPECTOR: MATHESON BLISS FACILITY REP: Lori Shaw
FACILITY NAME: PetSmart #16/ "'r
l
vtoL. #
GTOl
GTO3
GTO4
GTOS
GTO6
GTO8
GTO9
GTlO
GT11
GT12
GT13
GT14
GT15
GT16
GT17
GT18
GTl9
GT2O
GT21
Gf22
GT23
GT24
GT25
ERO2
ADDRESS;. 1530 Froom Ranch \AfY
-)an Luis Obispo, CA 93405
YES NO N/Atrtrtr
HAZARDOUS WASTE G EN ERATOR
EPA ID NO/PERMITS
Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardous waste (22 CCR
66262.121lf not, Call (800) 618-6942 to obtain your CAL EPA lD number
HAZARDOUS WASTE DETERMINATION
H azardous waste determ i nati on condu cted (22 CC R 66262. 1 1 )
trown knowledge tranalysis trother
Hazardous waste analysis/test records are kept for at least 3 yeats(22 CCR 66262.40.(c))
D IS P OSA UTRA N S P O RTATIO N
Hazardous wastes disposed of at an authorized location (HSC 25189.5, 25201(a1,22 CCR 66262.121
Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped with a manifest (HSC
25160, 25163(a); 22 GCR 66262.20, 66263.41)
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D
tr
tr
trmilkrun Eother Lori Shaw
GT07 Manifests ancUor receipts are properly completed/retained by generator for 3 years (22 CCR 66262.23,
66262.40(a))
STORAGE AND MANAGEMENT OF GONTAINERS/TANKS
Hazardous wastes are accumulated on site as fotlows: ( HSC 25123.3 (bX1y(dy(hxf ); 22 CCR 66262.34(d))
tr90 days if waste generated per month is greater than or equal to 1000 kg' (2200 lbs.)
tr180 days if waste generated per month is less than 1000 kg (see note)
8270 days if waste generated per month is less than'1000 kg and transported more than 200 miles (see note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000k9(13,200 lbs) and no
acutefy/extremely hazardous waste over 1kg(2.2|bs.) is held on site for over 90 days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation timdS5gal or 1-qt
limit) (22 ccR 66262.34(e))
lgnitabte or reactive wastes are located 15 m (50 feet) from facility's property line (22 CGR 66262.34(a)(1),
66265.176)
Containers of hazardous waste are properly labeled (includes appropriate daIe,"HAZARDOUS WASTE"'waste
composition/physical state, hazardous properties, name/address of generator) (22 CCR 66262.31,66262.34(f))
Gontainers/tanks containing hazardous wastes are in good conditiory'handled to minimize the release or reaction
(22 CC R 66262.3 4; 22 CCR 66265.17 1 -.179, 65265. 1 77(c))
Containers/tanks/liners are compatible with waste stored or transferred (22 CCR 66262.34,66265.1721
Containers storing hazardous wastes are closed/sealed(22 CCR 66262.34, 66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted (22 CCR 66262'34,
66265.174)
Daily inspection of all tank systems is conducted and documented (22 GGR 66262.34,66265.195)
Empty containers or inner liners > 5 gal has date when emptied and are properly managed within one year of
date emptied (22 CCR 66261.7(0)
RECYCLABLE WASTE
Used oil is manaSed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC 25250.41
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) (litle 22 CCRS 66266.130)
Spent leacl-acid bafteries are being properly stored and transferred offsite under manifest or bill of lading for
recycling, reuse, or reclamation (22 CCR 66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (22 CCR 66266'2)
SOURCE REDUCTIONIFoT facilities generating >12,000 kg.fyr. of hazardous waste on site.
Generator is subject to SB14 and has prepared and retained current source reduction documenls or is able mak(
them available to the inspectorwithin (5) days. (HSC 25244.191.211.22;22 GCR 67100.7/8)
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes
generated, process description, block diagrams, and implementationschedule of selected source reduction
measures. (HSC 25244.1 9 1.21, 22 CCR 671 00.5/7/A)
Haalaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite. (22CCR 66262.34(a)(4),
66265.51-.54)
Employees trained upon hire, annually; training records maintained at facility as required (22 CCR 66262.34(aX4)
66265.16)
Facility is operated and maintained to prevenUminimize/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 (22 CCR 66265.31-.37)
suMM )RY OF OBSERVATIONSVIOI ITIONStr No violations of underground s..riage tank, hazardous materials, or hazardou> c{aste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf 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 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.
FACILITY NAME: PetSmart #1614 ADDRESS: 1530 Froom Ranch \4ff
San Luis Obispo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Facility generates small quantities of hazardous waste and will moved to the "Conditionally Exempt Small
Quantity Generator" tier. Facility will be sent a form annually in Spring (ApriUMay) requesting copies of
hazardous waste manifests from previous year to be sent to inspector in lieu of a site visit.
INSPECTED BY: MATHESON BLISS
DATE: 01t27t2022
NAME OF FACILITY REP: LOri ShAW
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
cation: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
this inspection form
Signature of Owner/Operato Title:- Date
COUNTY
bSAN LUIS
OBISPO
-\
crty o[ san lurs onrspo
FIRE OEPAR]TEIIT
2150 Sata BarbaaAvsuo'8a Lub Obbpo, CA 93401-52,t0'{8lE}781-7380
"Cotrtesy & Serttice"
Date: 1211112019
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
trEHS trRoutine
trClTY FIRE trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Facility Name: PetSmart #1614 lnsoection Tvpe
Phone: (805)544-0191
SiteAddress: 1530 Froom Ranch \A/Y
San Luis Obispo, CA 93405
Facility lD: FA0011575
Serial Number: DAOWBWGTH
trAGT trCalARP trTPEPROGRAMS INSPEGTED:trHazmat trHW Generator trUST
trCalARP trTPEtrHazmattrHWGeneratortrUSTtrAGTREINSPECTION REQUIRED:
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Matthew J. Morales Title: Assistant Manager
gfisM/b*4e
YES NO N/Atrtrtr vtoL. #
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO3
trtrtrFE01
GPS Coordinates: Latitude: 35.25201 00000
BUSINESS PLAN
Business plan complete, current, available during inspection and submifted electronically (HSC 25505, 25508(a)
(1); 19 CGR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 2550s(axl), 25506, 25508(a)(1),
19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aX1), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4), 25508(aXl), 1gCCR 2659,
22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(aX4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite (HSC
25505(aX3), 25508(aXl), 19CCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR 112.8(c)
(2)l
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinancel
tr
tr
tr
tr
tr
tr
GPS Goordinates: Longtitude: -120.6886600000
INSPECTOR: KERRY BOYLE FACILITY REP: Matthew J. Morales
FAGILITY NAME: PetSmart#16'-^) ADDRESS:
' '\30 Froom Ranch V1l/
.ran Luis Obispo, CA 93405
HAZARDOUS WASTE GENERATOR
YES NO N/Atrtrtr vtol. #
GTOl
EPA ID NO/PERMITS
Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardous waste (22 CCR
66262.121lf not, Call (800) 618-6942 to obtain your CAL EPA lD number
HAZARDOUS WASTE DETERMINATION
Hazardous waste determination conducted (22 CCR 66262.11)
trown knowledge tranalysis trother
Hazardous waste analysis/test records are kept for at least 3 years(22 GCR 66262.40.(c))
D I S P OSA UTRA N S P ORTATIO N
Hazardous wastes disposed of at an authorized location (HSC 25189.5, 22 CCR 66262.121
Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped with a manifest (HSC
25160, 25163(a); 22 CCR 66262.20,66263.41)trmilkrun trother
Manifests and/or receipts are properly completed/retained by generator for 3 years (22 CCR 66262.23,
66262.a0(a))
STORAGE AND MANAGEMENT OF CONTAINERSTTANKS
Hazardous wastes are accumulated on site as follows: ( HSC 25123.3 (hXt)/(bXl); 22 CCR 66262.34)
D90 days if waste generated per month is greater than or equal to 1000 kg. (2200 lbs.)
tr180 days if waste generated per month is less than 1 000 kg (see note)
tr270 days if waste generated per month is less than 1000 kg and transported more than 200 miles (see note)
Note: Applies only if hazardous waste accumulated on site never exceeds 6000k9(13,200 lbs) and no
acutely/extremely hazardous waste over'lkg(2.2|bs.) is held on site for over 90 days.
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation timd55-gal or l-qt
limit) (22 CCR 66262.34(e))
lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line(22 CCR 66262.34(aX1),
66265.1 76)
Containers of hazardous waste are properly labeled (includes appropriate daIe,"HAZARDOUS WASTE," waste
composition/physical state, hazardous properties, namdaddress of generator) (22 CCR 66262.31, 66262.34(f))
Containers/tanks containing hazardous wastes are in good conditiory'handled to minimize the release or reaction
(22 CCR 66262.34;22 CCR 66265.171-|179, 66265.177(c))
Containers/tanks/liners are compatible with waste stored or transferred (22 CCR 66262.34,66265.1721
Containers storing hazardous wastes are closed/sealed (22 CCR 66262.34, 66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted (22 CCR 66262.34,
66265.1 74)
Daily inspection of all tank systems is conducted and documented (22 CGR 66262.34, 66265.195)
Empty containers or inner liners > 5 gal has date when emptied and are properly managed within one year of
date emptied (22 CCR 66261.7(f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC 25250.41
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) (lille22 CCRS 66266.130)
Spent leadacid batteries are being properly stored and transferred offsite under manifest or bill of lading for
recycling, reuse, or reclamation (22 CCR 66266.81)
Solvents/other recyctable materials are managed as hazardous wastes until recycled (22 CCR 66266.2)
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 mak(
them available to the inspector within (5) days. (HSC 25244.19/.211.22;22 CCR 67100.7/8)
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes
generated, process description, block diagrams, and implementationschedule of selected source reduction
measures. (HSC 25244.1 9 1.21, 22 CCR 671 00.7/.8)
Haanvaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite. (22CCR 66262.34(a)(4),
66265.51-.54)
Employees trained upon hire, annually; training records maintained at facility as required (22 CCR 66262.34(aX4)
66265.16)
Facility is operated and maintained to prevenUminimize/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 (22 CCR 66265.31-.37)
tr
tr
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tr
tr
tr
tr
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tr
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tr
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GTO3
GTO4
GTOS
GTO6
GTOT
GTOS
GTO9
GTlO
GT11
GT12
GT{3
GTI4
GT15
GTl6
GT17
GT{8
GT{9
GT2O
GT21
GT22
GT23
GT24
GT25
ERO2
SUMM
-]Y
OF OBSERVATIONSVIOI. IIONS
tr No violations of underground 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.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf 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 $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: PetSmart #1614 ADDRESS: 1530 Froom Ranch V1/Y
San Luis Obispo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Hazardous waste is properly managed with good employee training prograny'record keeping and
documentation of hazwaste disposal.
INSPECTED BY: KERRY BOYLE
DATE: '12/1112019
NAME OF FACILITY REP: Matthew J. Morales
SIGNATURE OF FACILITY REP:
i,Ue"Jlft*Ie
STATEMENT OF COMPLIANCE
: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
inspection form.
ignature of Owner/Ope Title:- Date:
. -,
clty-ot
sAn llfis
)
Gounty of San Luis ObisPo sryo rc\Environmental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED T]NIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:
Date:f alr lxnr7
FACILITY NAME I tr v l{-llv -rAV'
A t$caoqREsS: /f,1
EHS
AG DEPT
CITY FIRE
Complaint I Otner
Result Code: _70 _80 -90Action Gode: 32 37 33 31
Routine Reinspection
fl usr fl acr Icnnne/eusiness Plan HW GeneratorPROGRAMS INSPECTED:
! ncr IcnlnneHW Generator n usrfl Business Plan! NO IYESREINSPECTION REQUIRED
TO INSPECT: lnspections may involve obtaining photographs'ng and copying records, and
rmlnt com with codes. GRANTED BY
Time:
YPSyn,
ffip
hf,trpfll
kz"
/rA'
bii{Y ERot
NOtrnn
cpstrtrn
n
BPOl
BPO2
BPO3
TROl
TRO2
ERO2
ATOl
ATO2
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCK^2729)
Inventory of hazardous materials is complete (HSC 25504' Title 19 CCR2729)
Site tayout/facility maps are accurate (HSC 25504, Title 19 CCR2729)
TRAINING PI,AN
Facility has appropriate training program (Title 19 CCK-2732 & 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 CCR273I & 22
ccR s 6626s.s3ts4)
Facility is operated and maintained to prevent/minimize/mitigate Iire, 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-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SPCC Plan is reviewed and certi{ied 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)
NZfru nrn
to to obtain forms to comply with BP0l -BP03, TR0l and ER01
-l
INSPECTOR:
min decimal min
FACILITY REP:
GPS Coordinates: Latitude:
-deg
Lonsitude: des min decimal min
COUNTY
bSAN LUIS
OBISPO
'-\
)
Environmental Health -€rvices
t(805) 781-5544
rP.O.Box 1489
;2156 Sierra Way Ste. B
jSan Luis Obisoo. CA 93406
'-)
ctty o[ san lurs oBrspo
FIRE DEPARTIIETIT
2160 Sdta 8a.baa Av6uo' Sm Lub Obbpo, CA 93401-52,10 ' (805) 781-7380
"Courtesy & Service"
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:Date: 1110712018
Facility Name: PetSmart #1614 Aqencv
trEHS
trctw FtRE
lnsoection Tvpe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
SiteAddress: 1530 Froom Ranch \M/
San Luis Obispo, CA 93405
Phone: (805)544-0191
Facility lD: FA0011575
Serial Number: DABUZOYI4 Testing
PROGRAMS INSPECTED:EHazmat trHW Generator trUST NAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHW Generator trUST trAGT trCalARP trTPE
PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Lori Shaw Title: Manager
YES NOtrtr
trtr
trtr
trtr
trEl
tru
trtr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505, 25508(a)
(1); 19 CCR 2651)
tnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506, 25508(a)(1)'
19 CCR 2652,26541
Site layouU facility maps are accurate and submifted electronically (HSC 25505(a)(2), 25508(aX1), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 25508(aXl), 19CCR 2659,
22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(a)(4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite (HSG
25505(a)(3), 25508(a)(1), 19CCR 2658, 22ccR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR 112.8(c)
(2)l
GENERAL EH VIOLATIONS
tr n tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Goordinates: Latitude: 35.25201 00000 GPS Goordinates: Lonstitude: -120.6886600000
N/A VIOL. #
tr BP01
E BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
tr
tr
tr
tr
INSPECTOR: KERRY BOYLE FACILITY REP: Lori Shaw
FACILITY NAME: PetSmart#16- -', ADDRESS' rp30 Froom Ranch WY
san Luis Obispo, CA 93405
HAZARDOUS WASTE GEN ERATOR
YES
B
tr
tr
tr
tr
tr
tr
N/A
tr
tr
tr
tr
tr
tr
tr
vrol. #
GTOl
GTO3
GTO4
GTO5
GTO6
GTOS
GTO9
GTlO
GT11
GT12
GT13
GT,I4
GT15
GT16
GT17
GT18
GT19
GT2O
GT2'I
GT22
GT23
GT24
GT25
ERO2
NO
tr
tr
tr
tr
D
tr
tr
EPA ID NO/PERMITS
Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardous waste (22 CCR
66262.12) lf riot, Call (800) 618-6942 to obtain your CAL EPA lD number
HAZARDOUS WASTE DETERMINATION
Hazardous waste determi nation condu cted (22 CCR 66262.1 1 )
trown knowledge tranalysis trother
Hazardous waste analysis/test records are kept for at least 3 years(22 CCR 66262'40.(c))
D IS POSA UTRANS PORTATIO N
Hazardous wastes disposed of at an authorized location (HSC 25189.5, 22 CCR 66262'12)
Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped with a manifest (HSC
tr
tr
tr
n
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
EI
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
D
tr
tr
tr
tr
tr
D
tr
tr
tr
tr
2s160, 25163(a); 22 GCR 66262.20,66263.41)
trmilkrun Eother
GT07 Manifests and/or receipts are properly completed/retained by generator for 3 years (22 ccR 66262.23,
66262.40(a))
STORAGE AND MANAGEMENT OF CONTAINERS/TANKS
Hazardous wastes are accumulated on site as follows: ( HSC 25123.3 (hX1)/(bXl); 22 CCR 66262.341
tr90 days if waste generated per month is greater than or equal to 100 kg. (220 lbs.)
tr180 days if waste generated per month is less than 100 kg (see note)
tr270 days if waste 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 6000k9(13,200 lbs) and no
acutely/extremely hazardous waste over 1kg(2.2|bs.) is held on site for over 90 days'
Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation timey'S5-gal or 1-qt
limit) (22 CCR 66262.34(e))
lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line (22 CCR 66262.34(aX1),
66265.176)
Containers of hazardous waste are properly labeled (includes appropriate daIe,"HAZARDOUS WASTE," waste
compositiodphysical state, hazardous properties, name/address of generator) (22 CCR 66262.3'|',66262.34(f))
Containers/tanks containing hazardous wastes are in good conditiodhandled to minimize the release or reactior
(22 CCR 66262.34;22 CCR 66265.171-.179, 66265.177(c))
Containers/tanks/liners are compatible with waste stored or transferred (22 CCR 66262.34,66265.172)
Containers storing hazardous wastes are closed/sealed(22 CCR 66262.34, 66265.173)
Weekly inspection of areas where hazardous waste containers are stored is conducted (22 CCR 66262.34,
66265.1 74)
Daily inspection of all tank systems is conducted and documented (22 CCR 66262.34,66265.195)
Empty containers or inner liners > 5 gal has date when emptied and are properly managed within one year of
date emptied (22 CCR 66261.7(f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSG 25250.41
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) (Title 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 (22 CCR 66266.81)
Solvents/other recyclable materials are managed as hazardous wastes until recycled (22 CCR 66266.2)
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 makt
them available to the inspector within (5) days. (HSC 25244.191.2'11.22;22 CCR 67100.7/.8)
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes
generated, process description, block diagrams, and implementationschedule of selected source reduction
measures. (HSC 25244.191 .21 , 22 CCR 671 00.7/.8)
Hazwaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite. (22CCR 66262.34(aX4),
66265.51-.54)
Employees trained upon hire, annually; training records maintained at facility as required (22 CCR 66262.34(aX4)
66265.1 6)
Facility is operated and maintained to prevenuminimize/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 (22 CCR 66265.31-.37)
SUMM ,\.Y OF OBSERVATIONSVIOI .TIONS
tr No violations of underground 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.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
please inform the CUPA in writing
ALL VTOLATTONS 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 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.
FACILITY NAME: PetSmart #1614 ADDRESS: 1530 Froom Ranch WY
San Luis Obispo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Facility is neat and orderly. Hazardous waste is properly managed w/good waste disposal records and
employee training. No violations noted during facility inspection.
INSPECTED BY: KERRY BOYLE
DATE: 1110712018
NAME OF FACILITY REP: LoriShaw
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
inspection form.
ignature of Title:- Date:-
''-)County of San Luis Obispo
Environmental Health Services
(805) 781-5544
P.O. Box'1489
2156 Sierra Way
San Luis Obispo, CA 93406
clty fut-
lurssan oBtspo
Fire Department (805) 78'l-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPEGTION FORM
EFW data
entry by:
natez if
Time:i*!F*t'
FACILITY NAME AGENCY
El EHsn ac DEPT
,JE""Olrv rtne
Routine Reinspection
Other! Complaint
Result Gode: _70 _80 _90
Action Code: _32 _37 _33 _31
,
/\t tX
AD fffi ut
PHO
PROGRAMS INSPEGTED:n Business Plan ,ilr* Generator n usr n eer ncnmnp
REINSPECTION REQUIRED:rdlo N YES n Business Plan ,fZf uw Generatorr n usr n eer ncnmnp
PERMISSION TO INSPECT: tnspections may involve obtaining photographs, reviewing and copying records, and
Cetermining compliance with adopted codes. GRANTED BY (NAME/TITLE)
YES NOnnnnnn
un trntr n
cos N/A
trT
Go to
GPS Coordinates: Latitude
BPOI
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
ATO2
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)
lnventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)
Site layout/facility maps are accurate (HSC 25504' Title 19 CCR2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Titte 19 CCR2732 & 22 CCR
66265.16\
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273I & 22
ccR s 6626s.s3ts4)
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 19 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)
to obtain forms to with BP01-BP03, TR01 and ER01
deg mrn
FACILITY REP:
mln
INSPECTOR:
I
Environmental Health Services
'-)
ctf,y o[ san lurs oBrspo(805) 781-5544
P.O.Box 1489
2156 Sierra Way Ste. B
San Luis Obisoo. CA 93406
FIRE DEPARTI,IENT
2160 Sanla BarbaB Avsla' San Lub Oblspo, CA 93401"5240 ' (805) 781-73S0
"Cotwtesy & Service"
Date: 1212712017
CERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
COUNTY
bSANLUIS
OBISPO
Facility Name: PetSmart #1614 Aoencv
trEHS
trCITY FIRE
lnsoection Tvoe
trRoutine
ElReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinr
Site Address: 1530 Froom Ranch \A/Y
San Luis Obispo, CA 93405
Phone: (805)544-0191
Facility lD: FA0011575
Serial Number: DAGTVZF02
PROGRAMS INSPEGTED:trHazmat BHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHW Generator trUST trAGT DCaIARP trTPE
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Wynde Brown Title: Store Manager
YES NO N/Atrtrtrtrtrtrtrtrtr
BUSINESS PLAN
Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)
lnventory 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 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22
ccR) 66265.16
EMERGENGY RESPONSE PLAN
Emergency response/contingency plan is complete, updated, and maintained on site (HSC
25504, Title 19 CCR 2731 &22CCR S 66265.53/54)
Facility is operated and maintaaned to prevenUminimize/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 19 CCR 2731& 22
ccR 66265.31-.37,40CFR 1 265.31)
Secondary containment is installed and sufficiently impervious to discharges.
IcHSc 25270.4.5; 40 CFR 112.8(cX2)l
GENERAL EH VIOLATIONS
tr tr tr FE01 Environmental Health fees paid. [CBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.2520100000 GPS Coordinates: Lonqtitude: -120.6886600000
BPOl
BPO2
BPO3
TROl
TRO2
EROI
ERO2
ERO3
tr
tr
u
u
tr
tr
tr
tr
tr
tr
tr
INSPECTOR: KERRY BOYLE FACILITY REP: WYnde Brown
ADDI\oFACILITY NAME: PetSma 14
EPA ID
NUMBER:
HAZARDOUS WASTE GENERATOR
1530 Froom Ranch WY
San Luis Obispo, CA 93405
Total generated/month:Lbs or gals (average)
Waste Oil:Solvents:
Antifreeze: Others:-
YES N/A
tr
tr
tr
tr
tr
NO
tr
VIOL. # EPA ID NO/PERMITS
GT01 Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardous
waste (Title 22CCRS66262.12) lf not, Call (800) 618-6942 to obtain your GAL EPA lD number
HAZARDOUS WASTE DETERMINATION
GT03 Hazardous waste determination conducted (Title 22 CCR 566262.11)
trown knowledge tranalysis trother
cT04 Hazardous waste analysis/test records are kept for at least 3 years(Title 22 CCR S66262.40.(c))
DISPOSAL/TRANSPORTATION
cT05 Hazardous wastes disposed of at an authorized location (HSC $25189.5 , Tille 22 CCR 566262.12)
GT06 Facility utilizes a registered hazardous waste transporter, and hazardous wastes
shiooed with a manifest fiitle 22 CCR 866262.20. HSC S25160/25163(al)
tr GTOT ned by generator for 3 years
tr cros
(Title 22 cCR $66262.23, 66262.40 (a))
STORAGE AND MANAGEMENT OF GONTAINERS/TANKS
Hazardous wastes are accumulated on site as follows (Title 22 CCR 566262.34)
tr90 days if waste generated per month is greater than or equal to 100 kg. (220 lbs.)
trl80 days if waste generated per month is less than 100 kg (see note)
tr270 days if waste generated per month is less than 100 kg and transported more than 200
miles (see note)
Hazardous waste "satellite" collection is managed properly (complete
labeling/accumulation time/ss-gal or 1-qt limit) (fitle22 GGR 566262.34(c))
lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title
22 CCR 566265.176)
Containers of hazardous waste are properly labeled (includes appropriate daIe,"HAZARDOUS
WASTE," waste compositiodphysical state, hazardous properties, name/address of
generator) (Title 22 CCR 566262.3'1, 66262.341
Containers/tanks containing hazardous wastes are in good conditiory'handled to
minimize the release or reaction (litle 22 CCR 566262.34 (dX2),
Gontainers/tanks/liners are compatible with waste stored or transferred (Title 22 CCRS
s66262.34 (dX2), 66265.172)
Containers storing hazardous wastes are closed/sealed (Title 22 CCR 5566262.34 (dX2), 66265.1
Weekly inspection of areas where hazardous waste containers are stored is conducted (Title
22 CCRSS66262.34 (dl(21, 66265.17 4l
Daily inspection of all tank systems is conducted and documented (Title 22 CCR 5566262.34 (dX2),
66265.195)
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 566261.7 (f))
RECYCLABLE WASTE
Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc)
lTitle 22 CCRS 66266.13, HSC 525250.4)
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) (Title 22 CCRS 66266.13)
Spent lead-acid bafteries are being properly stored and transferred offsite under manifest or
bill of lading for recycling, reuse, or reclamation (Title 22 CCR 566266.81)
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. (67100.7,67100.8, HSC
Source Reduction Evaluation and Plan contains the following five elements:certification, amounts
of wastes generated, process description, block diagrams, and implementationschedule of
selected source reduction measures. (67100.7. 671 00.8. HSC 825244.1 9)
Hazwaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite. (Title
22 CCR 566265.51-.54)
tr GT22
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr GTO9
tr GTIO
tr GT1'
tr GT12
tr GT13
tr GT14
tr GT15
tr GT16
tr GT17
tr GT18
tr GT19
tr GT2O
tr GT21
tr GT23
tr GT24
.*-r' '\
SUMtV. IY OF OBSERVATIONS/VIO--.TIONS
tr No violations of underground 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 yot
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
Dlease inform the CUPA in writino.
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. 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.
FACILITY NAME: PetSmart #1614 ADDRESS: 1530 Froom Ranch WY
San Luis Obispo, CA 93405
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Hazardous waste is securely stored inside bldg., and properly managed. Good waste disposal
documentation along with good hazwaste container labeling. No violations noted.
INSPECTED BY: KERRY BOYLE
DATE: 1227t2017
NAME OF FACILITY REP: Wvnde Brown
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Gertification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
is inspection form.
Signature of Owner/Operato Title:- Date:-
Gounty of San Luis Obispo S#,ffsoB*po JEnvironmental Health Services
(805) 781-5544
P.O. Box'1489
2156 Sierra Way
San Luis Obispo, CA 93406
Fire Department (805) 78'l-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS NSP ION FORM
nate:ilrffi
Time:'v l,+ftff!
YES NO COS N/AtrUtnnnn,nnnn,Etr
tr!dnnnFn
tr[],Enun.E'tr
nnnMnnIF
BPOl
BPO2
BPO3
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 19 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
6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273L &22
ccR $ 6626s.s31s4)
Facility is operated and maintained to prevent/minimizeimitigate 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 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)
TROl
TRO2
EROl
ERO2
ATOl
ATO2
EFW data
entry by:
FACILITY NAME:
' A - // I "r
ADDRESS: rlfj '// fAtrrft
AGENCY
f] EHS
N AG DEPT
,Z cnv rlne
Complaint n Otner
Result Code: _70 _80 _90
Action Gode: 32 37 33 31
Routine Reinspection
PH E:
!cnmner.Fl Business Plan tE^* Generator fl usr ! aerPROGRAMS INSPEGTED:
I usr n acr ncnmnpN YESt*o lfl Business Plan SlHtu GeneratorREINSPECTION REQUIRED:
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determininq compliance with adopted codes. GRANTED BY (NAME/TITLE):
Go to http materials.htm, to obtain forms to with BPO1 TR01 andERO1
INSPECTOR:FACILITY REP:
mlnGPS Coordinates: Latitude: _deg min Longitude:
Gounty of San Luis ObisPo
\
ClW-t f
san uls
i. :-,1i,,1.- rrlt r-1.:,!, li i:
Environmental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
osffipo
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:
Date: May 29' ?{}15
Time:
FACILITY NAME:
Attnt $usen Blalr
ADDRESS:
$sn Lul"s EA
I Complaint ]m Other
l"ess
Result Gode: _70 -80 -90Action Code:
-32 _37 -33 -31
Routine Reinspection
AGENCY
fl EHS
N AG DEPT
XE CITY FIRE
PHONE:
ncalnnpn usr I rcrn Business Plan n gw GeneratorPROGRAMS INSPECTE
tl acr flcnt-nnpn xw Generator fl usrI Business Plantr NO IYESREINSPECTION REQUIRED:
RMISSION TO INSPECT: lnsPections may involve obtaining photographs,reviewing and copying records, and
codes. GRANTED BYliance withn
t
YES NO COS NiAutr n nnn n nnn n r
ntrtrn
nn !!tr n
nn
n
ETntr
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
ATO2
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 layoutifacilify maps are accurate (HSC 25504' Title 19 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
6626s.16) .
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273I & 22
ccR $ 6626s.s3/s4)
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 19 CCR 273f & 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 Ptan is maintained on site or nearest fietd office. (HSC 25270)
Y'
COMMENTS Go to http://www.slopublichealth.org/environmentalhealth/hazardous-materiais,htm, to obtain forms to comply with BPO1 -BP03, TR01 and ER01
Iinvlronrueneal llea.lttr Servlcee E (805) 7 B1-5596 fcr the current totel. due ($370.CI0'f ).Faf-l-ure tc rlil)
paymdi|l.r& uo later than June l-0n 2015 - tf
GPS Coordinates:
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D. Kerry lloy
f, ls nof receiv:ed an Aclnlnj.s lve C{tat:{on
Longitude:
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INSPECTOR:
(sos5'7s1-7383
decimal min
F'ACILITY REP:
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San Luis Obispo City Fire lnspection Report
FIRE
s
Fire Department lnformation
21 60 SanLa Barbara Avenue, San Luis Obispo, CA 93401
phone: (805)783 -7780 Fax: (805) 543 - 8019 Fire DeparLmenE Emait:FDCeneral@stocity.org
Hours: Monday - Friday, 8:00 am - 5:00 Pm
Business / Occupant lnformation
lnformationlns
Business / OccupanU PETSMART lNC. (#1614) (CUPA)Address: 1530 Froom Ranch
Work Phone:
Email:Contact Name: ,
Thank you For your cooperaLion with San Luis Obispo City Fire in keeping your business and our community saFe!
Correcg Ehe cited violaEion(s) by Ehe "Reinspection Date" lisLed betow Eo avoid Further enForcement action inctuding, bul
not timited to, chargeabte ie-inspection and/or AdminisbraEive Citation. You may request a review oF Ehe ciLed violations by
Ehe Depargmeng Diiector [fire ChleF] within 5 days oF report issuance iF noLed violations do nol create an immediaLe danger
Eo healLh and saFety (SLO M.C. 1.24.090).
lF you have any questions, please contact our lnspection Line at 805/783-7775.
Date Completed: 10/06/2025 lnspected By: Bliss, Malheson
Passed: Yes Violation Count: 0
lnspection Notes: Reptace fire exginguisher aE FronE regisLers. Observed wiEh insutFicienE charge during inspection- A[[
other extinguisheis observed had adequaEe charge and were inspecLed wibhin past year.
Remove retocatable power !ap (power strip) aE last Fish lank (orange 3 outlet rpt) or demonsLrate rpt
has adequaLe amperage capaciEy tor items ptugged into iE.
Exil doors are alarmed and were noL tested during inspeclion. Test exits now and regularty'
Emergency exit doors shal[ open readily with 15-30tbs oF Force.
Knox box con;ains key Eo Fire sprinkler and electrical room. ConEacE inspector iFyou wish to place key
Eo store into Knox box.
Fire sprinkler sysgem reporL uploaded to TCE under 1520 Froom Ranch (Homegoods). Observed items
passing annuaI inspection.
Violations
No Viotations Found On lnspecLion
I n spssli_qn D osunenlls
Violation Documents
*please note: lF a third inspection is required due to non-compliance, a Fire-inspection Fee oF 5271 may be charged For that inspection, and
"u"iy-intp"aion
tt'ereaftdr untit compliance is obtained. Faiture to compty may resutE in a misdemeanor ciLation and an appearance by
you in cour!.
Page 'l of 1
Dale:112712022 Requesled by:
NEWFACILITY RECORD
INFORMATION CHANGE
CLOSE FACILITYAS OF: Date: I I
OWNER FILE INFORMATION
Owner lD: OW00076t3
Owner Name: PetSmart, lnc.
Owner DBA:
OwnerAddtess: 19601 N 2TTHAVE
PHOENIX,AZ 85027
Home Phone: 623-580-6100
Work Phone: 623-587 -29'12
MailingAddress: 19601 North 27th Ave
Phoenix,AZ 85027
GOUNTY OF SAN
Facil lnformation as ot 112712022 P.qe#: 1
I IOWNERSHIPCHANGE: [ ] Business [ ]Property I lTank
[ ] UPDATE BTLLTNG INFORMATION
I I UPDATE UST INFO (sys, $pe, capacity, etc.)
New Owner lD:
New Name:
New DBA:
NewAddress:
New Home Phone:
New Work Phone:
New Mailing Address:
Ne-w Care of:
run:
Care of:
lD:FA0011575
FACILITY FILE INFORMATION
Faclllty tD; FA0011575
Facility Name: PetSmart#1614
1530 Froom Ranch I/VY
San Luls Obispo, CA 93405
Phone: 805-544-019'l
Mailing Address: Contracled Services, 19601 N 27th Ave
Phoenix,AZ 85027
Care of: PetSmaft, lnc.
CERS lD: 10600660
GIS:35.25201 -120.68866
New lD:
New Name:
New Site Address:
New Phone
New Mailing Address:
New Care of:
New CERS lD:
New GIS:
ACCOUNTS RECEIVABLE FILE INFORMATION - PRIMARY FORALL BILLING AND PERMITTING CORRESPONDEN
Account Balance as of 112712O22: $0.00
Account lD: AR0023&2
Account Name: Contracted Services, Attn: Maxim Kravchuk
MailingAddress: 19601 N. 27th Ave
Phoenix,AZ 85027
Care of:
NewAccount lD:
NewAccount Name:
New MailingAddress:
New Care of:
Mail lnvoices to: Account Discount Code: Discount lnvoices?: N
LINKED PROGRAMS
0762 - SLO CITY-HAZARDOUS MATERIALS HANDLER 1'4
Last Activig: No Previous Activity
1176 - SLO Clw- WASTE GENEMTOR (1-5 waste streams)
Last Actlvity: 12111 12019 - REGUI-AR INSPECTION
PR0018907 EE0000517 - MATHESON BLISS
PR0018908 EE0000517 - MATHESON BLISS
Transfer (Circle One)
UST(s) Programto Activate/Change/l
Linked New Owner? nac{vate
YNACI
Y N A CO
lnactive
Ac,tive
t I CREATE NEW FILE FOLDER
I I UPDATE EXTSTTNG F|LE FOLDER I3BEL
UPDATE NEXT INSPECTION DATE: Date: --J-J-
Copy to: File Otherr
HMARDOUS MATERIALS SPECIFIC:
Number of Materials
Number of Waste Streams
Number of Tanks (list
capacity/compartment)
PE
Update
Comments:
Portal? Y N (lf yes, forward to CER9portaladmi n for update)
71e e(
Entered by:Dare: I tTltLL
Date run: 112712022
lD: FA0011575Faci
Page #: 1
COUNTY OF SAN LUIS PO
) Facility lnformation as of 112712022
Date:112712022 Requested by:
NEW FACILITY RECORD
INFORMATION CHANGE
CLOSE FACILITYAS OF: Date: I I
OWNER FILE INFORMATION
Owner lD: OW0007613
Owner Name: Petsmart, lnc.
Owner DBA:
OwnerAddress: '19601 N 2TTHAVE
PHOENIX, M 85027
Home Phone: 623-580-6100
Work Phone: 623-587 -2912
Mailing Address: 19601 North 27th Ave
Phoenix, M 85027
t IOWNERSHIPCHANGE: [ ] Business [ ]Property [ ]Tank
[ ] UPDATE BTLL|NG INFORMATION
[ ] UPDATE UST INFO (sys, type, capacity, etc.)
New Owner lD:
New Name:
New DBA:
NewAddress:
New Home Phone:
New Work Phone:
New Mailing Address:
New Care of:Care of:
FACI LITY FI LE INFORMATION
Facility lD: FA0011575
Facility Name: PetSmart #1614
1530 Froom Ranch \A/Y
San Luis Obispo, CA 93405
Phone: 805-544-01 91
Mailing Address: Contracted Services, '19601 N 27th Ave
Phoenix, AZ 85027
Care of: PetSmart, lnc.
CERS lD: 10600660
GIS: 35.25201 -120.68866
New lD:
New Name:
New Site Address:
New Phone:
New Mailing Address:
New Care of:
New CERS lD:
New GIS:
ACCOUNTS RECEIVABLE FILE INFORMATION . PRIMARY FORALL BILLING AND PERMITTING CORRESPONDEN
Account Balance as of 112712022: $0.00
Account lD: AR0023042
Account Name: Contracled Services, Attn: Maxim Kravchuk
Mailing Address: 19601 N. 27th Ave
Phoenix, M 85027
Care of:
NewAccount lD:
NewAccount Name:
New Mailing Address:
New Care of:
Mail lnvoices to: Account Discount Code: Discount lnvoices?: .N
LINKED PROGRAMS
0762. SLO CITY-HAZARDOUS MATERIALS HANDLER 1-4
Last Activity: No Previous Activity
1176 - SLO CITY- WASTE GENERATOR (1-5 waste streams)
Last Activity:'l2l 1 1 I2O'19 - REGULAR INSPECTION
PROO16907 EEOOOOs17. MATHESON BLISS
pR0016908 EE0000517 - MATHESON BLISS
Transfer (Circle One)
UST(s) Program to Activate/Change/l
Linked New Owner? nactvate
YNACI
Y N o cc
lnactive
Active
I 1 CREATE NEW F|LE FOLDER
I 1 UPDATE EXISTING FILE FOLDER LABEL
UPDATE NEXT INSPECTION DATE: Date: I l-
Copy to: File Other:
HAZARDOUS MATERIALS SPECIFIC:
Number of Materials
Number of Waste Streams
Number of Tanks (list
capacity/compa rtment)
PE
Update
Comments:
at Portal? Y N (lf yes, forward to CERS/portal admin update)
?vt 7Q ?e(
Entered by:
a\ L€S
Dale: I I
FIRE INSPECTION REPORT
FtRE-00345-20L7
''\rfopilhail full,l4 f,/
Responslble Party
Phone Bo5
n/e hraPn
fq4 _o tq I
05i-570-014
Next rnspection Lf; / 20L8
Arsignment Engine ComPanY 48
case P LOCC-1 447 7 L-2014
last rnspectlon 6 / 25 | 20L4
cych Biannual
Emergency Phone / a' \
Property owner IRISH HlttS PIAZA WEST ll tLC A CA ttC
281 HIGUERA ST
sLo, cA 9340L Total Unlts
Buildlng Area
Stories
Construction Type
CONTACTTYPE NAME
f#EUSTNESS
HOME
fro5 ,f4l- ots/MoBlL' -
OTHER
occlt PANCY FIRE PERMITS
Area
Load
Classes
STANDPIPES SPRINKTERS
lnstalled
Details
FDC Location
SPrlnklets?
Last Certlflcatlon
Sprinkler [ocation
Sprinkler FDC Location
ATARM CIEAN AGENT
Alarm Date
Alarm Details
Clean Agent Date
Clean Agent Detalls
Mtsc
Last Hood Test
rnox aox -flfl
Central MonitorinS
Flre Flow
Flre Lateral lnstalled?
CRITICAL TOCATIONS ACCESS
PRE.PLAN HAZARD LEGACY NOTES
IREBtC-O2856-2016 r2l27l2ot7 Page 1 of 1