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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&REG 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 tr tr fl tr tr tr tr tr tr D tr tr D il tr tr tr tr tr tr tr fI D tr n tr tr tr tr tr n D n tr D tr tr E tr tr tr tr tr tr tr tr n tr I n D tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr 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) tr tr tr tr tr tr tr E 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 E tr tr tr tr tr tr tr E tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr tr 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) tr tr tr n 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 u 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 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 tr tr tr tr tr D tr tr tr tr tr tr tr tr tr tr tr tr tr tr E 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 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: -deg D. Kerry lloy f, ls nof receiv:ed an Aclnlnj.s lve C{tat:{on Longitude: . ,-l:. t.,' INSPECTOR: (sos5'7s1-7383 decimal min F'ACILITY REP: &i mln be 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