HomeMy WebLinkAboutHAZARDOUS WASTE ~TATE-OF CALIFORNIA~CALIFORNIA ENVIRONMEI~ ~ ROTECTION AGENCY PETE WILSON, Governor
400 P STREET, 4TH FLOOR
P.O. BOX 8O6
SACRAMENTO CA 95812-0806
(916) 323-5871 ,. March 28, 1996
EPA ID= CAL000079902
SAN JOAQUIN IMAGING I~DICJ~ ASSOCIATES
GREG HENDERSON For facility located at:
1709 27TH ST 1709 27TH ST
B/~KERSFIELD, CA 93301 BAKERSFIELD, CA 93301
Dear Onsite Treatment Facility:
The Department of Toxic Substances Control (DTSC) has received
your letter notifying DTSC of your closure request to operate
under permit by rule, and/or conditional authorization, and/or
conditional exemptiOn. We have reviewed.your letter and have.
approved your closure.
DTSC considers your treatment activities to be closed as of
12/31/94 and no longer subject to the conditions of Permit by Rule,
Conditional Authorizationor Conditional Exemption.
DTSC has revised its database records to reflect your new status
and has notified the Board of Equalization of'the change.
If you have any questions or need further information, please
contact the appropriate regional office or the Tiered Permitting
Compliance Section at the letterhead address or phone number.
Sincerely,
Sangat Kals, Chief
Tiered Permitting Compliance section
'state Regulatory Program Division
Hazardous Waste Management Program
cc: ASTRID JOHNSON MR STEVE MCCALLEY DTSC REGION 1 KERN COUNTY
STATE REGULATORY PROGRAM ENV HEALTH SERVICES DEPT
1515 TOLLHOUSE 2700 M ST #300
CLOVIS, CA 93611 ~ BAKERSFIELD, CA 93301
STATE BOARD OF EQUALIZATION
STEPHEN R. RUDD, ADMINISTRATOR
ENVIRONMENTAL FEES DIVISION
P.O. BOX 942879
SACRAMENT0, CA 94279-0001
+-TP101A
Tiered Permitting System Screen 1 of 2
~ ~ Onsite Notifier Information '
EPA ID: CAL000079902 Initial Date: 033193 Init/Amend/Renew: I (I/A/R)
Amended Date : Renewal Date:
I. Conditionally Exempt, Small Quantity Treater Units
2 Conditionally Exempt, Specified Wastestream Units
Conditionally Authorized Units
Permit by Rule Units
Commercial Laundry
· - Conditionally Exempt - Limited (~c~_
TotaI Fee Attached: Check No: ~.5/[~
II. BOE:
Company Name: SAN JOAQUIN IMAGING MEDICAL ASSOCIATES
Address 1:1709 27TH ST
City: BAKERSFIELD CA ZIP: 93301
County: KERN Region' 1
Contact First: GREG Last: HENDERSON
Phone: 805/324-3787 Ext:
+ Enter the data and press ENTER to go to screen 2 ~
+-F2=Cncl F4=Ina-aF5=Unit-F6=Hist ......... F8=Next-F9=DVal--Entr=Acpt+
~. t TIERED PERMI~ZNG COMPLIANCE (TPC).~./"~'.:. :? '"' .... ':"~'/"~':-.....,, "~, :'
& PROGRAM DATA MANAGEMENT (PDM) BECTION~S'?g~' '?"':" '
~ ~Q~STING ~~
.. ~STING WZ~D~W~
~ZSZONS
. ~QUESTING DEL~ION (~IT(~))
'
.. ~QUESTING'~DITION OF (~ZT(S))
, REQUESTING ~SPONSE
~- .. REQUESTING REF~D/WITH 'RESPONSE
OTHER
_._ AMENDED BILLING:
YES NO
ACTION TO ]~E TAKEN BY PDM
II
.. OK 'FOR WITHDRAWAL DATE OF WITHDRAWAL
OK FOR DENIAL DATE OF DENIAL
--- DELETE TIER(S)
.... DEUETE U IT(S) / /,
., FILE/AWAITING CLOSURE ,DOCUMENTS (CERTS)
uJ,~ z)~DONSE FROM FACILITY -'SEND TO REGION
i ~ECEIYED BY:
March 1, 1996 I Hazar~0u$ Wast0 Uana~emer.,t
~. Clyde West O~a~r~[~r. O~ .~,~,,,* ....
Dep~ment of To~c Subst~ces s~asr~c~s C0~T~0L
400 P St. 4th Floor
P.O. Box 806
Sa~r~nento,.Ca 95812-0806
~: S~ JOAQ~ ~G~G
~DIC~ ASSOC~TES, ~C.
!709'27~ ST.
B~F~LD, CA 93301
De~ ~. West:
T~s coruscation is to se~e notice that San Joaquin Imaging Medic~ '
as0ciates fo~ly ended business on June 30, 1994. No ~her Profession~ ~diolo¢c
nor Tec~c~ ~diolo~ se~ices were rendered-t~ough t~s location after that date.
Therefore, there should be no ch~ges in reg~ds to to~c substance control ~er that
date.
Please inform Ms. Carol Bailey from the Board of Legalization regarding this
matter. She again called me last week because apparently you did not receive our first
communication.
I anticipate that you will receive thi§!-noti:ce::: If there are anY other documents to.
be completed in relation to this matter Please let us know..
Sincerely,
P.O. Box 2301
Bakersfield, Ca 93303
ST,~TE'0~ CALIF, ORNIA-ENVIRONMENTAL PROTP-~I~N AGENCY PETE WILSON, Governor
DEPARTMENT OF TOXIC SUBSTANCES CONTROL
CI-IECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
FACILITY NAME: 5'~t ~,~,,1...,Tm,,~2'~ /'rr,o. /7.s.s~_. EPA ID NUMBER:
PHYSICAL ADDRESS: /7~-/ 2 72,4 '._~'~re~f' ~'teer~ ~r'~/~. Cfi
'FACILITY cONTACT-NAME: :~, /'/~.;0,~r.~,. PHONE: Fo 3-) -Y-ey-'37~'7
SIC CODE(S): fid/'1 INSPECTION DATE: ~ u..~/, / ~ ~" Local #
NOTIFIED UNIT COUNT: PBR CA CESW 2 CESQT __ TOTAL
CORRECT UNIT COUNT:' PBR CA CESW __ CESQT __ TOTAL
. This checklist and inspection report identify violations'of state law regarding onsite treaters of h-~rdons' waste,
operating under an onsite permitting tier. Tiffs inspection verifies the information provided on form DTSC 1772, It also
covers generator requirements, although a separate checldkst may be used for those requirements, A checkmark indicates
violation of the law, which are explained in more detaiI on the aftached note sheets, The governing laws are the Health.and
Safety Code fi{SC) and Title 22 of the California Code of Regulations (22 CCR),
Generator Standards:
Each ir~p~¢tion a~¢ncy truly us~ their own ~en~rator inspection ch~¢lelisl or proto¢ol.~, which arc sununari~ed b~Iow. /t full
evaluation of each item or document is not conducted durin~ the Verification lnspeftion, unless serious d~f¢ieneie$ are su.~pected.
NQ'
1. ContingenCy plan has-been prepared (adequately minimize releases, has alarm/communication
system, lists emergency equipment and phone numbers for emergency coordinators).
2. · Written training documents and records prepared for employees handling hazardous waste.
3. Meet container management standards (storage time limits, closed, labelled, compatibility,
inspected weekly, in good condition, with ignitables/reacti,>es 50 feet from property ii.ne).
4. Meet tank management standards (either secondary containment or integrity assessments, plus
storage time limits, labelled, compatibilitY, inspected daily, in good condition, with
ignitables/reactives 50 feet from property line).
5. All wastes are properly, identified.
Treatment Items-Facility Wide: (Facility rau~t submit a revised Form 1772 to correct errors or omissions.)
6. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new
units with unit sheets or correct tier on the unit sheet.)
7. All generator identification information on Form DTSC 1772 is correct.
8. The submitted plot plan/map adequately shows the location of all regulated units.
9. There are records documenting compliance with sewer agency pretreatment standards and
industrial waste discharge requirements, where applicable.
10. Generator has prepared/maintained source reduction documents requirements (SB 14/SB
'~ 1726). For many wastes, a checklist or plan is required only if annual hazardous waste volume
is over 5;000 kilograms (approx 11,000 pounds or 1,350 gallons). HSC 25244.15, 25244.19-.21
For CA or PBR notifierS:
11. The generator has an annual waste minimization certification. (PBR submit with renewals.)
Onsite Checklist (A) Page i of August 2, 1994
STATE OF CALiFORtlIA.EN¥1RON.I~AENTAL PROTECTION A~ENCY PETE WlL~Otl,
DEPARTMENT OF TOXIC 6U~ CE6 CONTROL
~EGION i-10tSl C~y~u Way, S~ 3 '
~a~m, CA 95827
CII~[~T A~ ~ITI~I, V~IFICATION INSpEcTIoN RE~RT FOR
~t by Rule, Cuu~tio~Uy Authored, and Coudilio~Uy ~
UNIT SIIEET
Cott~pl~t~ Ot~ ~Jl 5~Ct for c~h wdt ~jtl~r lJst~ in th~ not~c~ion Or ~ct~t~ during ti~ it~ctio~.
Unit N~ber: ~/ U~t Name:
Notified Ti~': E C ~ ~ Co~'a~ Tier:
Not~ed ~v~ Count: Ta~ Coulaiue~ /
Corot ~vi~ Count: Tau~ ~ Coata~ca~ ~
Far all Uuits:
NO
12. All hazardous wastes treated are geuerated osUSite.
13. "l'he unit notificatiois infmmation ia aCCurate as to thc number of tank{s) ur container{s}.
14. The estimated notification monthly treatment volume is appropriate for the indicatexl dar.
-- 15. Thc waste ide. utificatioul~valuatiou is appropriate for the tier indicatcxl.
16. The wasltestrr, am{s) given on thc notification form are appropriate for the tier.
.... 17. Thc tre. atmcui proce_s.s(es)-~ivea on rile notification form arc appropriate for the tier.
- 18. Thc residuals n~anagcmcnt information on thc form is cos-re, ct asld documentr-M for thc unit.
19. The indicated basks for nut needing a federal pennis oil thc notification form is corrr, ct.
20. 'There arc wi-ilion opes-sting iustruclioas and a record of thc dates, volumes, re,4dual
managea~ent, and typ~s of wastes treat~l in rile unit.
' 2i. - Thc,'e is a written i~pectiou schedule (containers-weekly and tanks-daily).
22 'l'h~rc is a writlcu ia.spcctioa log of rile inspections conductr, xl.
23. If thc unit has boca cio:sod, thc generator has notified DTSC a~ld lhe local agency of Ihe
For each CA or PBR unit:
24. Thc generator has secoudary contaimuent for treatment ia contaiuers.
For each PBR unit:
25. Thcs'¢ is a waste analysks plan and waste analysis recorcts.
2~5. There is a ciosm'~ plats for the unit.
Unit Cmmuenls/Obs~-vatiotus: (lf ~ha' Ls' a unit tha~ wa,~ not includ~i uts th~ notiffication fonn, the viobxtion ~ operming
wid~o~ a p~tmit..tlSC ~l(u).)
Ot~site Checklist (B) Page- .'ur February I0, 1994
~TAT~,E 0F~ CALIFORNIA-ENViRONMENTAL PRO~ON AGENCY PETE WILSON, Governor
DEISARTMENT OF TOXIC SUBSTANCES CONTROL · --
CHECKLIST AND iNITIAL VERIFICATION INSPEC'rION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditio aally Exempt Notifiers
UNIT SHEET
Complete one unit sheet for each unit either listed in the notificatfi ~n or identified during the inspection..
Unit Number: ~ Unit Name: .2
Notified Tier: EL-- .~ Correct Tier: ~
Notified Device Count: Tanks Containers ~
Correct Device Count: Tanks ~ Containers ~
For each Unit:
NO
12. All hazardous wastes treated .are generated onsite.
13. The unit notification is accurate as to the number of tank(s) and/or container(s).
14. The estimated notification monthly treatment volume is ap~propriate for the indicated tier.
15. The waste identification/evaluation is appropriate for the tier indicated.
16. The
wastestream(s) given on the .notification form are appropriate for the tier.
17. The treatment process(es) given on the 'notification form are appropriate for the tier. '
18. The residuals management information on the form is correct and documented for the 'unit.
19. The indicated basis for not needing a federal permit on ~e notification form is correct.
20. There are written operating instructions and a record of Ithe dates, volumes, residual
management, and typis of wastes treated in the unit.
21. There is a written inspection schedule (containers-weekly ~and' tanks-daily).
22 There is a written inspection log maintained of the inspections conducted.
. 23. If the unit has been closed, the generator has notified DTS~ and. the local agency of the
· closure..
For each CA or PBR-unit:
24. The generator has secondary containment for treatment in containers.
For each PBR unit: 25. There is a waste analysis plan
26. There are waste analysis records.
27. There is a closure plan for the unit.
Unit Comments/Observations: (If this is a unit that was not included on ~he notification form, the violation is operating
without a permit-HSC 25201(a). Also note if the activity is currently ineligible for '
onstte authorization.)
Onsite Checklist (B) Page of August 2, 1994
SYATE.~ 0F ~ALIFORNIA-ENVIRO NMENTAL: : . PROT~i~IT~O N AGENCY PETE wILSON,
Governor
DEP:ARTMENT OF TOXIC SUBSTANCES CONTROL
CI{ECKLIST AND INITIAL VERIFICATION INSPECTION'REPORT FOR
Permit by Rule, Conditionally Authorized, 'and Conditionally Exempt Notifiers
SIGNATURE SHEET
Onsite Recycling: Only answer,if this facility recycles more than 100 kilograms/month of hazardous waste onsite.
NO 28. The appropriate local agency has been notified. HSC 25143.10
29. Activities claimed under the onsite recycling exemption are appropriate. HSC 25143.2 et sec.
Releases: If there has been a release, provide the following information: number of releases, date(s), type(s) and quantity of
materials/waste, and the cause(s).. Use unit sheet or attach ndditional pages.
YES'
30. Within the last three years; were there any unauthorized or accidental releases to the
environment of hazardous waste or hazardous waste constituents from onsite treatment units?
31. Within the last three years, were there any unauthorized or accidental releases
to the environment of hazardous waste or hazardous waste constituents from any location at
this facility?
For purposes of a Tiered Permitting inspection, an unauthorized and/or accidental
release to the environment does not include spills containedwithin containment systems.
This report may identify conditions observed this date that are alleged to be violations of one or
more. sections at the California Health and Safety Code (HSC) or the California Code of Regulations,
Title 22 (22 CCR) relating to the management of hazardous waste. The violations may be described in
more detail on the attached note sheets. If any violations are noted, the facility is required to the submit
a signed Certification of Return to Compliance within 60 days, unless otherwise specified. (A
certification form is provided.) If any corrections are needed to the initial notification, the facility will
submit a revised notification within 30 days to the Department of Toxic Substances Control with a copy
to the local enforcement agency.
Inspector(s):
Lead Inspector: Other Inspector:
Signature: Signature:
Print Name: Print Name:
Title: Title:
Agency: Agency:
Phone Number: Phone Number:
Facility Representative:
Your signature acknowledges receipt of this report and does not imply agreement with the findings.
Signature: Print Name:
Title: Date:
Onsite Checklist (C) Page ~ of August 2, 1994
STAT,-E OF CAlIFORNIA-ENVIRONMENTAL ION AGENCY PETE WILSON, Governor
DEPARTMENT OF TOXIC SUBSTANCES CONTROL
CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
NOTE SHEET
This sheet includes inspector, observations and expands upon the violations identified on the checklist (by number).' In some
cases, it indicates how the facility should correct the violations. It, also includes the names of any others participating in this inspection.
Onsite Checklist (D) Page of August 2, 1994
"' $~i'A'I'=[ OF CAI~IFORNIA-ENVIRONMENTAL PRO=~ON AGENCY ' '
~ c -' '~ PETE WILSON, Governor
DEPARTMENT OF TOXIC SUBSTANCES CONTROL
TIERED PERMITTING ~
CERTn*ICATION OF RETURN TO COMPLIANCE
For Pet:mit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
In the matter of the Violation cited on '
As Identified in the Inspection Report dated
Conducted by: ,(agency(s))
I certify under penalty of law that:
1. Respondent has corrected the violations specified in the notice of violation
cited above.
2. I have personally examined any documentation attached to the certification to
establish that the violations have been corrected.
3. Based on my examination of the attached documentation and inquiry of the
individuals who prepared or obtained it, I believe that the information is true,
accurate, and complete.
4. ~ I am authorized to fil_e this certification on behalf of the Respondent.
5. I am aware that there are significant penalties for submitting false information,
including the possibility of frae and imprisonment for knowing violations.
Name (Print or. Type) Title
Signature Date Signed
Company Name EPA ID. Number
DT$C-R~TCOMP.CRT (8/94)
FIL~.TYPE
OTHER
'. S~'ATE O~I~;CAL FORN A--ENVIRONMENTAL PRO{ AGENCY
PETE
WILSON,
Governor
ix DEPARTMENT OF TOXIC SUBSTANCES CONTROL
400 P Street, 4th Floor ' ~,~
~ P.O. Box 806
Sacramento, cA 95812-0806
(9]6) 323-587]
12/28/93
EPA ID: CAL000079902
SAN JOAQUIN IMAGING MEDICAL ASSOCIATES .ForfacilitYlocated at:
GREG HENDERSON ,.
1709 27TH STREET 1709 27TH STREET
BAKERSFIELD¢ CA 93301 BAKERSFIELD, CA 93301
Authorization Date: 12/28/93
Dear Conditionally Authodzed and/or Conditionally Exempt Facility:
ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR
CONDITIONAL EXEMPTION
The Department of Toxic Substances Control (DTSC) has received your facility specific notification (form
DTSC 1772) and forms for Conditional Authorization and/or Conditional Exemption for Specified Wastestreams (form
DTSC 1772B and/or 1772C). Your notifications are administratively complete, but have not been reviewed for technical
adequacy. A technical review of your notifications will be conducted when an inspection is perfOrmed. At any time,
you may be inspected and will be subject to penalty if violations of laws or regulations are found.
The Department acknowledges receipt of your completed notificatiOn for the treatment unit(s) listed on the last
page of this letter. These units operating under Conditional Authorization or Conditional Exemption are authorized by
California law without additional Department action, pursuant to Health and Safety Code sections 25200.3 and 25201.5..
Your authorization to operate continues until you notify DTSC that you have stopped treating waste and have fully
closed the unit(s). You will be charged annual fees calculated on a calendar year basis for each year you. operate and
have not notified DTSC that the units have been closed.
You must notify the DTSC 60 days before first treating hazardous wastes in any new unit. You mus(also
notify the DTSC whenever any of the information you provided in these notifications changes. To revise information,
mail a cover letter to the above address explaining the changes, attach only the pages of your notification package that
have changed, and re-sign and date at the signature space on page 3 of form 1772.
Your status to operate under Conditional Authorization and/or Conditional Exemption is contingent upon the
accuracy of information submitted by you in the notifications mentioned above, and your compliance with all applicable
requirements in the Health and Safety Code. Any .misrepresentation or any failure to fully disclose all relevant facts
shall render your authorization to operate null and void.
You are also required to properly close any treatment unit. Additional guidance on closure will be issued and
distributed to all authorized onsite facilities later this year.
Page 2 EPA ID: CAL000079902
If you have any questions regarding this letter, or.have questions on operating requirements for your facility,
please contact the nearest DTSC regional office, or this office at the letterhead address or phone number.
Sincerely,
Onsite Hazardous Waste Treatment unit
Permit Streamlining Branch
Hazardous Waste Management Program
Enclosure
cc: SUSAN LANEY.
DTSC REGION 1
SURVEILLANCE & ENFORCEMENT BR.
10151 CROYDON WAY, SUITE 3
SACRAMENTO, CA 95827
STEVE MCCALLEY
KERN COUNTY
ENVIRON. HEALTH SERVICES DEPT
2700 M. STREET, SUITE 300
BAKERSFIELD, CA 93301
Page 3' EPA ID: CAL000079902
ENCLOSURE 1 I
Un/ts author/zed to operate at th/.v/ocat/ot~-
UNDER CONDITIONAL AUTHORIZATION:
UNDER CONDITIONAL EXEMPTION:
B 1
State of C.allforma - C~lif¢~-~ ~-Envi~onmentnl~l. ection Agency,. -~-'~' ~ ' -~'~
- - ~~ of To~ ~m C~
ONSITE T ATME NOTI CATION FODI
FACILI~ SPECIFIC NO~FICA~ON
For Um by Ha~rdom W~te Genemto~ Pe~omng Tr~tment ~ti~
Under Conditional Exemption ~d Conditional Au~oh~tion, ~ Revi~
~d by Pe~t By Rule Faciliti~
P~&~e refer to the atta&ed l~tru~io~ before completing thix fo~. You m~ ~t~for more t~n o~ pe~itting tier ~ ~ing
not~cation fo~, D~C 1772. You m~t ~tach a xeparate unit xpec~c ~t~cation fo~ for each unit ~ th~ ~c~ion. ~ere are
d~erent unit xpec~c ~t~cation fo~ for ~ach of the four categoriex a~ an ~ditio~l ~t~c~ion fo~ for tra~po~ tre~ment
units ~). You only ~ve to ~ubmit fo~ for the tier(x) that cov~ your unit(xJ. D~card or re~c~ t~ ot~r un~ fo~.
Number each page of your complet~ ~t~cation pac~ge a~ i~icate the total numb~ of pag~ ~ t~ top of each page ~ the
'Page ~ of ~'. Put your EPA ~ Number on each page. Pleme provide all of the infomation requestS; all fie~ m~t b,
completed ~cept those that state '~ d~erent' or '~ avai~ble'. Ple~e ~ th~ info~ation prov~ on thix fo~ a~ any
attachmentx.
~e not,cation will not be co~Mered complete without p~,ment of the appropriate fee for each tier u~ which you are operating.
(Pleme note that the fee ix per ~ER not per UNI~ For ~ample, ~you operate 5 unitx but th~ are all Co~itionally Authorized,
you only owe $1,1~, NOT5 t~ $1,1~. ~you operate any Pe~it by Rule unitx a~ any units u~ Co~itional Authorization
you owe ~2,2~.~ Chec~ shouM be m~e p~able to the Depa~ment of Toxic Substanc~ Control a~ be stapl~ to the top of th~
fo~. Ple~e ~ite your EPA ~ Numb~ on the chec~ Eill in the &e& number in the box above.
I. NOT,CATION CATEGO~S
l~icate ~he n~ber of units you operate in each tier. ~ix will a~o be the number of unit xpec~c n~fo~ you m~t ~tach.
N~ of ~ ~d atm~ unit s~fic notifi~tio~ . /~ ~ ~~' ~F~ ~r Tier
C. Conditio~ly Au~ofi~ '~ DTSC 17~~~~;' / ....
. ' ~ . ~_....~A~/' ~ /
D. Pe~tbyRule . (Fo~DTSC 1772D) ~ _ /$l,l~
~ ~ T.o~ Numar of U~ To~ F~ At~¢h~ $
H. GE~TOR ~E~CATION. O~' ~
EPA ID NUMBER CA~ ~ ~ ~ ~ ~ ~ ~ ~ ~ BOE NUMBER (if available) H__H~
N~E(Comp~yorF<ili~) SAN GOAQUXN Xm&~n~ HEDXCAL ASSOCXATES
PHYSIC~L~A~ON q709 27~h' ST
BAKERSFIELD , CALIF.
Fo~ DTSC U~
C[~ CA - ZIP (93301 . ~%o.
COU~ KERN
CONTA~ PKRSON Greg Henderson PHON~ NUMBER( 805 ) 3 74
~i~ N.~) (~ Na~)
EPA
MAILING ADDRESS, IF DIFFERENT: '
· COMPANY NAME(DBA) SAN JOAQUIN IMAGING MEDICAL ASSOCIATES
STREET~ 1709 27th Street
Bakersfield
CITY . STATE CA ZIP 9 3 3 0.1
COUNTRY . ,
(only comple,,' if tug USA)
CONTACT PERSON Greg Henderson PHONE NUMBER( 8 0 5 ) 3 2 4-.3 7 8 7
(Firsl Name) (I..msl Name)
HI. TYPE OF CO]~flaANY: STANDARD INDUSTRIAL CLASSWICATION (SIC) CODE:
Use either one or two SIC codes (a four digit number)' that best describe your company's products, services; or industrial activity.
Example: ..7.384 ~ 3672 Printed circuit boards
First: ::]--3-'8-4 Photcfini~_ ~ nfL_Lab Second:
IV. PRIOR PERJVlIT STATUS: Che& yes or no to each question:
YES NO ..
[] ~ 1. Did you file a PBR Notice of Intent to Operate (DTSC Form 8462) in 1992 for this location?
["'] ~ 2. Doy0u now have or have you ever held a state or federal hu:,-rdous waste facility full permit or interim
status for any of these treatment units?
["-1 ~ 3. Do you now have or have you ever held a state or federal full permit or interim status for any other
hazardous waste activities at this location?
[--] 4. Have you ever held a variance issued by the Department of ToXic Substances Control for the treatment you
[~ are now notifying for at this location?
{~] :5.' Has this location ever been inspected by the state or any local agency as a hazardous waste generator?
V. PRIOR ENFORCEMENT HISTORY: No~ r~luir~d from generator~ only notifying a~ corditio~dly ~m~rnpt.
YES NO
['-] U Within the last three years, has this facility been the subject of any convictions, judgments, settlements, or final
orders 'resulting from aa action by any local, state, or federal environmental, hazardous wast~ or public health
enforcement agency?
(For the purposes of this form, a notice of violation does not constitute an order and need not be'reported unless
it was 0or corrected and became a final order.)
]-'] Ifyou answered Yes, check this box and attach a listing of convictions, judgments, settlements, or orders and a copy
of the cover sheet from each document.' (See the Instructions for more information)
DTSC 1772 (1/93)
: EPA ID '~ - :
, ,7 - Page 3 o
' VI. ATTACHBIENTS:
1. A plot plan/map detailing the location(s) of the covered unit(s) in relation to the facility boundaries.
~ 2. A unit specific notification form for each unit to be covered at this location.
VII; CERTIFICATIONS: This form must be signed by an authorized corporate officer or any other person in the company who
has operational control and performs decision-making functions that govern operation of the facility (per title 22, California
Code of Regulations (CCR) section 66270.11). All three copie~ rnuxt have original $igrumtz~.
Wa.ste Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the
degree I have determined to be economically .practicable and that I have selected the practicable method of treatment, storage, or
disposal currently available to me which minimizes the present and future threat to human health and the environment.
Tiered Permitting (~ertificatlon I certify that the trait or units described in these documents meet the eligibility and operating
requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary containment
requirements. I understand that if any of the units operate under Permit by Rule or Conditional Authorization, I will also be required
to provide required financial assurances by January 1, 1994, and conduct a Phase I environmental assessment by January I, 1995.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry
of the person or persons Who manage the system, or those directly responsible for gathering the information, the information is, to
the best of my knowledge and belief, true, accurate, and complete.
I am aware that there are substantial penalties for submitting false information, including the possibility of frees and imprisonment
for knowing violations.
Name (Pri(nt or T~) Title
Date Signed
OPERATING REQUIREMENTS:
Please note that generato~ treating hazardous waxte onsite are required to comply with a number of operating requirements which
differ depending on the tier(s} under which one OPerates. These operating requirements are set forth in the statutes and regulations,
some of which are referenced in the 77errSpeci. fic Factsheets.
SUBMISSION PROCEDURES:
You must submit two copies of this completed notification by certified mail, return receipt requested, to:
Department of Toxic Substances Control
Form 1772
Onxite Hazardous Waste Treatment Unit
400 P Street, 4th Floor (walk in only)
P.O. Box 806 ·
Sacramento, CA 95812-0806.
You must abo submit.one cot/of the notification and attachments to the local regulatory agency in your jurisdiction as listed in th~
instruction materials. You must also retain a col:~y ax part of your operating record.
All three forms must have original signatures, not photocopies.
779 (!/0'~ r~.~ ~
· CONDITIONALLY EXEMPT - SPECIFIED WASTESTREAMS
'UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Safety Code Section 25201.5(c))
. uwr Ft tnvrr m mmBER
NUMBER OFTREATMENT DEVICES: Tank(s) 2[ Container(s)
Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. A~sign your Own unique number to each
unit. The number can be sequential (I, 2, 3) or uxing any system you choose.
Enter the estimated monthly total volume of hazardous waste treated by this unit. This should be the maximum or highest amount
treated in any month. Indicate in the narrative (Sec'lion II) if your operations have seasonal variations.
I. WASTESTREAMS AND TREATMENT PROCESSES:
Estimated Monthly Total Volume Treated: pounds and/or /~O gallons
The following are the eligible wastestreams and treatment processes. Please check all applicable boxes:
[-'] 1. Treats resins mixed in accordance with the manufacturer's instructions.
[-'] 2. Treat containers of 1 I0 gallons or less capacity that contained hazardous waste by rinsing or physical processes,
such as crushing, shredding, grinding, or puncturing.
[--I 3. . Drying special wastes, as classified by the department pursuant to title 22, CCR, section 66261.124, by pressing
or by passive or heat-aided evaporation to remove water.
l'"] 4. Magnetic separation or screening to remove components from special waste, as classified by the department pursuant
to title 22, CCR, section 66261.124.
['-I 5. Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demi~eralize water.
(Tkis waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.)
[-1 6. Neutralize acidic or alkaline (base) wastes from the food processing industry..
~_~7. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator
(at the same location) in any calendar month.
8. Gravity separation of the following, including the use of flocculants and demulsifiers if
I~ a. The settling of solids from the waste where the resulting aqueous/liquid stream is not baTardous.
[~] b. The separation of oil/water mixtures and separation sludges, if the average oil recovered per month is less
than 25 barrels (42 gallons per barrel).
["] 9. Neutralizing acidic or alkaline (base) material by a state certified laboratory or a laboratory operated by an
educational institution. (To be eligible for conditional exempti6n, this waste cannot contain more than 10 percent
acid or base by weight.)
CO~IONALLY EX~ . SPEC~D WA~E~A~.~
UNIT SPECIFIC NO~FICA~ON
(pu~t to H~I~ ~d Safety C~e S~tion ~201.5(c))
BASIS FOR NOT ~ED~G A ~DE~L PE~I~: (confinu~)
3. %e w~te is tr~t~ M elemenm~ neut~li~tiOn ~u, ~ de~ in 40 CFR PaH 260.10, ~d di<~g~ m a
PO~/~we~g agency or =der ~ NPDES ~t. 40 CFR 264. l(g)(6) ~d ~ CFR 270.2.
4. ~e w~te is tr~t~ ~ a totally enclo~ tr~tment facility ~ de~ M ~ CFR Pm 2~. 10; ~ CFR 2~. l(g)(5).
5. ~e comply gene~t~ no mor~ ~ 1~ kg (approxi~tely 27 gallons) of harardo~ w~ ~ a ~len~ ~nfi
~d is eligible ~ a f~e~l conditionally exempt s~ll q~tity gene~tor. ~ CFR 260.10 ~d ~ CFR 261.5.
6. ~e w~te is tr~t~ ~ ~ accumulation ~ or ~n~Mer wi~ ~ ~ys for over 1~ kg/mon~ gene~to~ ~d
180 or 270 ~YS for gene~to~ of 1~ to 1~ kg/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), ~d ~e Pr~mble
to the March 24, 1986 F~e~l Register.
7. R<yclable ~tefials are r<laim~ to r<over <ono~lly si~fi~t a~=ts of silver or offer pr<io~ ~uls.
40 CFR 261.6(a)(2)(iv), 40 CFR 264. l(g)(2), ~d 40 CFR 2~.70.
8. Empty ~nminer ~sing ~d/or tr~tment. 40 CFR 261.7.
V. TRANSPORTABLE TREATMENT UNIT: Check Yes or No. Please refer to the Instructions for more information.
YES (~
['-] Is this unit a Transportable Treatment Unit?
If you answered y~, you must also complete and attach Form 1772E to this page.
The Tier-Specific Factsheets contain a summary of the operating requirements for this category.
Please review those requirements carefully before completing or submitting this notification package.
DTSC 1772B (1/93} D,,,, ~
~? ,-,. EPA ID N~'~BER. ~ Page 0f/:
CONDITIONALLY EXE~fPT - SPECIFIED WASTEgrREAMS
UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Safety Code Section 25201,5(c))
II. NARRATIVE DESCRI-I:rrlONS: Provide a brief description of the specific waste treated and the treatment process used.
1. SPECIFIC WASTE TYPES TREATED: Spent photographic fixer solution
con~ainlng silver.'
2. TREATMENT PROCESS(ES) USED: Silver reclaimer that uses a
electrolytic processor method, uses a pollution abateman
cartridge that uses an ion exchange.
Ill. RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all residuals from this treatment unit.
YES NO
·
[--] 1. Do you discharge non-hazardous aqueous waste to a publicly owned treatment works (POTW)/sewer?
['"] ~ 2. Do you discharge non-hazardous aqueous waste under an NPDES permit?
[~ ["'] 3. Do you have your residual hazardous waste hauled offsite by a registered hazardous waste hauler?
[~' you do, where is the waste sent? Check all that apply.
a. Offsite recycling
[-'! b. Thermal treatment
[-] c. Disposal to land
i--] d. Further treatment
['-] [~ 4. Do you dispose of non-hazardous solid waste residues at an offsite location?
[-'i [~ 5. Other method of disposal. Specify:
IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT:
In order to demonstrate eligibility for one of the onsite treatment tiers, facilities are required to provide the basis for determining that
a hazardous waste permit is not required under the federal Resource Conservation and Recovery Act (RCRA) and the federal
regulations adopted under RCRA ('Iitle 40, Code of Federal Regulations (CFR)).
Choose the reason(s) that describe the operation of your onsite treatment units: ..
i-'] I. The hazardous waste being treated is not a ha?ardous waste under federal law although it is regulated as a hazardous
waste under California state law. '
['"] 2. The waste is treated in wastewater treatment units (tanks), as d~fined in 40 CFR Part 260.10, and discharged to a
publicly owned treatment works (POTW)/sewering agency or under an NPDES permit. 40 CFR 264. l(g)(6) and
40 CFR 270.2.
COiNDIT~ONALLY EXE~ SPECIFIED~ESTREAIVIS
UNYF SPECIFIC N(Yl-H:ICATION
(pursuant to Health and Safety Code Section 25201.5(c))
NUMBER OF TREATMENT DEVICES: ~ 'Tank(s) 20 Container(s)
Each unit mu. ct be clearly idenlified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each
unit. The number can be sequential (I, 2, 3) or u.~ing any system .vo, choose.
Enter the estimated monthly total volume of hazardous waste treated ~rv this unit. This should be the maximum or highext amount
treated in any month. Indicate in the narrative (Section II) if your or>erations have seasonal variations.
I. WA~'ESTREAMS AND TREATMENT PRocESSES:
Estimated Monthly Total Volmne Treated: potmds and/or gallons ?
The following are the eligible wastestrearns and treatment processes. Please check all applicable boxer:
[-'] 1. Treats resins mixed in accordance with the manufacturer's instructions.
[-'] 2. , Treat containers of 110 gallons or less capacity t~ contained ha?ardous waste by rinsing or physical processes;
suet as crushing, shredding, grinding, or puncturing.
[--'! 3. Drying special wastesl as classified by the department pursuant to title 22, CCR, section 66261.124, by pressing
or by passive or heat-aided evaporation to remove water.
' ['-] 4. Magnetic separation or SCreening to remove components from special waste, as classified by the department pursuant
to title 22, CCR, section 66261.124.
I-'! 5. Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demineralize water.
(This waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.)
7. Neutralize acidic or alkaline (base) wastes from the food processing in~lustry.
Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator
(at the same location) in any calendar month. '
8. Gravity separation of the following, including the use of flocculants and demulsifi'ers if
[-"l a. The settling of solids from the waste where the resulting aqueous/liquid stream is not hazardous. ,
[~] b. The sepa~tion of oil/water mixtures and separation sludges, if the average oil recovered per month is less
than 25 barrels (42 gallons per barrel).
['"! 9. Neutralizing acidic or alkaline (base) material by a state certified laboratory or a laboratory operated by an
educational institution. (To be eligible for conditional exemption, this waste cannot contain more than 10 percent
acid or base by weight.)
DTSC 1772B (1/93) Page 9
. ~ CO~ON~LY E~ . ~C~D W~
~ SPEC~IC NO~ICA~ON
~ ~t ~H~ ~d Saf~ ~e ~fion ~1.5(c))
W. B~ FOR N~ ~~G A ~E~ ~~: (~nfinu~
~ 3. ~e ~e is ~t~ m elemn~ neut~i~fion ~i~, ~ de~ M ~ ~ P~ ~. 10, ~d ~g~ ~
PO~/~e~g ag~cy or ~der ~ NPDES ~t. ~ CFR ~. l(g)(6) ~ ~ CFR 270.2.
~ 4. ~e ~ is tmt~ m a to~ly ~clo~ t~tment f~i~ty ~ de~ M ~ ~ P~ ~. 10; ~ C~ ~. 1~)(5).
~ 5. ~e ~y g~emt~ no m~ ~ 1~ kg (app~x~tely 27 gMlo~) of ~o~ ~ ~ n ~en~ mn~
~d ~ ~$ble ~ a f~e~ ~n~fio~ly exempt s~l q~ti~ g~emtor. ~' ~ 2~.10 ~d ~ CFR 261.5.
~ 6. ~e ~ is ~ m ~ ~m~fi~ ~ or ~n~er ~in ~ ~ys for ov~ 1~ kg/~n~ g~em~m ~d
180 or 270 ~ys for g~emtp~ of 1~ to I~ kg/mon~. 40 CFR 262;34, ~ ~ 270. l(e)(2)(i), ~d ~e P~ble
. ~ ~e Mmh 24, 1986 F~e~ Register.
7.. R~yc~le ~te~s ~ ~1~ to ~ver ~no~ly si~fi~t ~ of silver or o~er pr~io~ ~s.
~ C~ 261..6(a)(2)(iv), 40 C~ 2~.1~)(2), ~d ~ CFR 2~.70.
~ 8. ~W ~er ~g ~d/or ~t. ~ CFR 261.7.
~ 9. ~r S~i~:
V. TRANSPORTABLE TREATMENT UNIT: Check Yes or No. Please refer to the Instructions for more information.
['"] ' Is this umt a Transportable Treatment Unit?
If you answered yes, you must also complete and attach Form 1772E to this page.
The Tier-SpecifiC Factsheets contain a summary of the operating requirements for this category. .
Please review those requirements carefully before completing or submitting this notification package. ."
DTSC 1772B (1/93) .Page 11
. . CONDri'IONALLY EXEMPT - SPECWIED WA AMS
UNIT SPECIFIC NOTIFICATION.
(pursuant to Health and Safety Code Section 25201.$(c))
H. NARRATIVE DESCRIFFIONS: Provide a brief description of the specific waste treated and the treatment process used.
1. SPECIFIC WASTE TYPES TREATED: Spent photographic fixer solution
containing silver.
2. TREATMENT pROCESS(ES) USED: Silver reclaimer that uses a
electrolytic processor method, uses a pollution".'abateman
cartridge that uses an ion exchange.
III. RESIDUAL MANAGEMENT: Check ¥~ or No to each q~-.~tion as it appli~ to all resM~l~ from thi~ treatment unit.
YES/ NO
~/ [--] 1. Do you di~ha~e non-~---rdous ~u~us w~te to a publicly owned U~aUnem work~ (POTW)/~wer?
~ ~ 2. Do you dish.ge non-hazardo~ m]u~ous waie under ~ NPDES
~/~ 3. Do you have your ~id,,-I h.,-rdo~ w~te hauled offsile by a ~Dsm~d haz~do~ vamm hauler?
Offsim ~cycling
D b. Thermal
~] c. Di~o~l ~o land
D d. Further i~aim~ui
D ~/ 4. Do you dispose of non-hazardous solid waste residue~s ai an offsile {ocalion?
[-] ~ $. Other method of di~o~d. Sp~ify:
IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT:
In order to demonstrate eligibility for one of the onsite tremment tiers, facilities are required to provide the basis for determining that
a hazardous waste permit is not required under the federal Resource Conservation and Recovery Act (RCRA) and the federal
regulations adopted under RCRA (~tle 40, Code of Federal Regulations (CFR)).
Choose the reason(s) that describe the operation of your onsite treatment units: '
[~! 1. The ha~rdous waste being treated is not a h~:,ardous waste under federal law although it is regulated as a hazardous
waste under California state law.
[-] 2. The waste is treated in wastewater treatmeat units (tanks), as defined ia 40 CFR Part 260.10, and discharged to a
publicly owned treatment works (POTW)/sewering agency or under an NPDES permit. 40 CFR 264. l(g)(6) and
40 CFR 270.2.
DTSC 1772B (1/93) Page 10
?
SAN ;lNG MEDICAL ASSOCIATES
P, O. BOX 2447 (805) 324-3787
BAKERSFIELD, CA 93303 90-1891/1222
, March 31 ]9 93
PAY Department of Toxic Substances Control
TO THE
I $, 100.00
ORDER
OF
One hundred and ************************************************** DOLLARS
california Republic Bank
STOCKO, o F,c
EPA# CAL000079902
FOR