HomeMy WebLinkAboutHAZARDOUS WASTE ,~E OF CALIFORNIA-ENVIRONMENTAL PRO ['ION AGENCY PETE WILSON, Governor
CHECKLIST AND INITIAL VERIFICATION INSPECT REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
FACILITY NAME: JP~c;~_ Or-li~t~'~ ,,qr~/~/ Ero,/ EPA ID NUMBER: ('/TD 98'3ro, 7..r/._?
PHYSICAL ADDRESS: o;~, /? ',~-"' 5f. d~-k~r.~/"r/a9 ff~. 73.~/
FACILITY CONTACT-NAME: .O. C, G/~c%.. PHONE: ~o3- ) _z~ 7-/P'2 ,Y
SIC CODE(S): got( INSPECTION DATE: ~,,. ,~/; /7?o-' Local #
NOTIFIED UNIT COUNT: PBR~ CA ~ CESW 02 CESQT ~ TOTAL 2~.
CORRECT UNIT COUNT: PBR~ CA ~ CESW _fl CESQT ~ TOTAL Q.
This checklist and inspection report identify violations'of state law regarding onsite treaters of hazardous waste,
operating under an onsite permitting tier. This inspection verifies the information provided on form DTSC 1772. It also
covers generator requirements, although a separate checklist may be used for those requirements. A checkmark indicates
violation of the law, which are explained in more detail on the attached note sheets. The governing laws are the Health and
Safety Code CHSC) and Title 22 of the California Code of Regulations (22 CCR).
Generator Standards:
Each inspection agency may use their own generator inspection checklist or protocols, which are summarized below. A full
evaluation of each item or document is not condU~cted during the Verification Inspection, unless serious deficiencies are suspected.
NO
~/ 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.tg/x Meet container management standards (storage time limits, closed, labelled, compatibility,
inspected weekly, in good condition, with ignitables/reactives 50. feet from property line).
4. A//7 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. f)6., All wastes are properly identified.
Treatment Items-Facility Wide: (Facility must submit a revised Form 1772 to correct errors or omissions.)
6. cge, 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. O ~- The submitted plot plan/map adequately shows the location of all regulated units.
9. 0 ~. There are records documenting compliance with sewer agency pretreatment standards and
industrial waste discharge requirements, where applicable.
10./y/TGenerator 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.g/,qrThe generator has an annual waste minimization certification. (PBR submit with renewals.)
Onsite Checklist (A) Page 1 of [ August 2, 1994
,STATE OF CALIFORI. IIA-ENVIRONId, ENTAL PROTECTION AGENCY PETE
REGION 1-10151 C~y~u Way, S~ ~
~~, CA 95327
CII~K~T A~ ~ITIAI, V~IFICATION INSP~C'I'ION R~RT FOR
~il by ~ule, Cuu~lio~U~ ~u~hur~d, aud Cuudilio~fly ~
UNIT SII~T
Complete otu~ unit sheet for each unit either listed in the not~c~ion Or Met~t~ d.ring the it~pection.
Unit November: ~ lJdt Name: ~'/~ ~Cc~ ~e~ 7
Not~ed ~v~ Count: Ta~ / Coutaiue~ /
Cor~l ~vi~ Count: Tau~ ~ Coaia~ea~ ~ ·
Far all Uuils:
NO
_ 12.O& All hazardous wastes treated are generated m~ite.
c/ 13. The unit nolification information is accurate aa to the number of lank(s) or container(s).
14. The eatimatr, xl notification monlhi¥ lrealment ¥olunic ia appropriate for the indicatexl tier.
15. Th~ waste identificaliou/evalualiou i-~ appropriate for thc tier indicated.
16. Tile wa:ilee, trr. am{a) giwn on the notification form are appropriate for the tier.
17. 'fha treatment pr~ce..ss(e~) given on the notification form are appropria~ for the tier.
18. Thg re.siduala nmuagemen& information on the form is corce, ct and documented for the unit.
19. The indicalxal basis for hal needing a federal per, ail on the nolificalion form is corrr, cl.
~ 20. There are wa'tiles operalh~g ismlruclioas and a record of the dales, volumes, ceaid,al
management, and types of wastes treated in file unit.
.~. 21. -There is a written il~pection ~hednle (containers-weekly and tanks-daily).
~ 22 There ia a writlen i~,qpection log of the inspections conduclxal.
23. If the unit has been clo:/cd, thc generator has nolified I)T$C ami lhe local agency of Ihe
closure.
For each CA or PBR uuil:
24. The generator has secoudary containment for Irealmeul ia conlainers.
For each PBR null: 25. Th~'e ia a w~te analy$~ plan and was~ ~Mysia r~m'~.
26~ There ia a ci~m~ plan for the unit.
whho~ a pcttnit..il~C ~201 (a).)
Oasite Checklist (B) Page / of ,~. February I0, 1994
STATE OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY PETE WILSON, Governor
D'E'PAR'~'~CES CONTROL
CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
UNIT SHEET
Complete one unit sheet for each unit either listed in the notification or identified during the inspection.
Unit Number: ~ Unit Name: ~Sf'/~
Notified Tier: £ ES ~ Correct Tier:
Notified Device Count: Tanks / Containers /
Correct Device Count: Tanks ~ Containers ~ ,
For each Unit:
NO
12. All hazardous wastes treated are generated onsite.
v/- 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 appropriate 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 the notification form is correct.
t/ 20. There are written operating instructions and a record of the dates, volumes, residual
management, and types 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 DTSC 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 onsite authorization.)
Onsite Checklist (B) Page ~ of o2. August 2, 1994
ENCY PETE WILSON, Governor
CI-[ECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
SIGNATURE SHEET
Onsite Recycling: Only anxwer jf this facility recycles more than lO0 kilograms/month o[ h. azardous waste onsite.
NQ
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 additional 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 contained within 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
subnfit 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: /')~f~0 ~ ~'~ Signature:
Print Name'~Qa~,,20 x', -f/~v~,~ ~a Print Name:
Title: ~2,e,),~,,_~ .5'~&o(~-(v ~f~ 'Lb 3 Title:
Agency: D,~/. ~,;_ .fv~.~4o_,~ C'o~¢~? Agency:
Phone NuMber: .2o v) 3 77~7_~o Phone Number:
Facility Representative:
Your signature acknowledges receipt of this report and does not imply agreement with the findings.
Signature:
Title: ,~ fl. aV~ 5'~/. Date: ,r~o~-'/r-?;'-''--'
Onsite Checklist (C) Page / of / August 2, 1994
STA:rE OF C~LIFORNIA-ENVIRONMENTAL PRiTION 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 e~ands 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.
STATE OF CAtJFORNIA-Et, NIE¢INMI AGENCY
~ ·., '~ P.cl'E WILSON.
DEPARTMENT OF TOXIC 8UgSTANC~S CONTROL
C~C~T ~ ~~ ~CATIO~ ~BPECTION ~PORT FOR
Pe~t by Rule, Condition~ly Auto.ed, ~d Condifion~ly Exempt Notifiers
NO~
~ xheet ~c!~ i~pe~o~ ob~io~ ~ ~ upon th~ viol~ia~ id~ified on the ~e~t ~ ~er). In ~ome
c~. it i~ic~ how ~e faciIi~ ~ouM cn~e~ ~e via~io~. It a~o ind~ the ~ o~ ~ othe~ pani~ating ~ th~ i~pe~ion.
Onsite Checklist' (D) Page <,7 or ~2,... August 2, t99~.
~TATE C~'~. CA~FORNIA-ENVIRONMENTAL PRO bON AGENCY ' PETE WILSON, Governor
D~g.~.TMENT OF TOXIC SUBSTANCES CONTROL
T~D PE~I~G
CERT~CATION OF ~~ TO, COOL--CE
For Pe~t by Rule, Condition~ly Author~ed, ~d Condition~ly Exempt Noti~rs
In the matter of the Violation cited on · 1-95
As Identified in the Inspection Report dated '~.
Conducted by: DEPARTMENT TO×TC ~IIR.RTAMC17R c~M'-r']~t3T. (agency(s))
I certify under penalty of law that:
1. Respondent has corrected the violations specified in the notice of violation
cited above.
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 file this certification on behalf of the Responden_t.
5. I am aware that there are significant penalties for submitting false information, .i
including the possibility of f'me and imprisonment for knowing violations.
OC GLASCO XRAY SUPERVISOR
Name (Print or Type) Title
Signature Date Signed
pACIFIC ~-'-.?
,,, O~, i~ ~OPAEL)I,,.. ?,:\FDICAL GROUP
AO ""F;'
2,,~.1 STREET CAD983637513
............ ,
Company Name
DTSC-RETCOMP.CRT (8/94) . "
PACIFIC ORTHOPEDIC
MEDICAL GROUP .',~,.,,.q~.~..~ / ., -=~' u . ~..~.
2619 F Street ,
Bakersfield, California 93301
ADDRESS CORRECTION REQUESTED
DAVID L. SHUMATE
DTSC
1515 TOLLHOUSE ROAD
CLOVIS CA. 93611
STATE ~~ . , ,
FILE T~PE ..,, ,
STATE OF ~ALIFORNIA--ENVIRO iN AGENCY PETE WILSON. Governor
~EPARTMENT OF TOXIC SUBSTANCES CONTROL ~
400 P Street, 4th Floor
P.O. Box 806
Sacramento, CA 95812-0806
(916) 323-5871
01/10/94
EPA ID: CAD983637513
PACIFIC ORTHOPAEDIC MEDICAL GROUP For facility located at:
ROBERT TAYLOR
2619 F. STREET 2619 F. STREET
BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301
Authorization Date: 01/10/94
Dear Conditionally Authorized 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 Waste.streams (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 must 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 aim 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: CAD983637513
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,
~ Michael S. Homer, Chief
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: CAD983637513
ENCLOSURE 1
U,~ts authoriz~ to operme at O~.v/oau/o~-
UNDER CONDITIONAL AUTHORIZATION:
UNDER CONDITIONAL EXEMPTION:
A B
92 0 49
ONSITE HAZARDOUS WASTE TREATMENT NOTIFICATION FOILM
FACILITY SPECIFIC NOTIFICATION -
For U~ by Hazardous W~tc Generators Pcrforminll Treatment [] taiti~
- ; . ? under Conditiona! Exemption and Conditional Authorization, f=l Revi~
and by Pcrmi~ By Rul~ Facilifi~
Please refer to the attached ln~truction~ before completing thief otto. You may notify for more than one t~rmitting tier by uMng thi
notification form, D TSC 1772. You mu~t attach a separate unit specifc notifcation form for each unit at thit location. There ar,
di2~erent unit specifc notifcation forrn~ for each of the four categories and an additional notifcation form for transportable treatmen
units O'I'U'$). You only have to submit forms for the tier(s) that cover your unit{S). Discard or recycle the other unused forms.
Number each page of your completed n~t~cation paclcage and indicate the total number of page~ at the top of each page at the
'Page ~ of ~ '. .Put your EPA IZ) Number. on each page. Plea.~e provide all of the information requited;, all fiel~ mu~t b,
completed ~cept thoxe that state 'if different' or 'if available'. Pteme type the information provMe, d on thix form and arc
attachments.
The notification will not be considered complete .without payment of the appropriate fee for each tier under which you are operating
(Pteas¢ note that the fee ix per TIER not per UNIT. For example, if you operate 5 units but they art all Conditionally,4uthorize. d
you only o~.': '.,t. o140, NOT5 ~ $1,140. If you operate any Permit by Rule units and any unit~ under ConditiOr. ui ..tianoHz~uio,
you owe $2,280.) Chtckx shouM be made payable to the Department .of Toxic Substance.~ Control and be ,tapled to the top of thi.
form. Please write your EPA ID Number on the check. Fill in the check number in the box above.
I. NOTIFICATION CATEGORIES
IMicat¢ the number of units you operate in each tier. ThH will al~o ~e the number of unit specific notifcation form~ you mu~t attac, h
Canditionalb/ F_ztmpt ~ Quantity 'Treatment operationt may not operate uttit~ under any other ti~'.
Number of units and attached unit specific notifications Fee per Tie
{not/~r uz..
A. Conditionally Ex~mpt-Small Q ._..u._..a~y._T.~!.ment. (Form DTSC 1772A) ' $ tO
C. Condmonally'' Auth_t.~_~' '--- . ".,(Form DTSC 1772C} $1,14-
D. . Pem~t by Rula . .~ ~' . ..... :.; ~ . ,(Form DTSC 1772D) $1,14.
Total Numar ofU-.~x ,~ ..... //' Total ,F.~ Attached $ ICXOoCO~
H. GENERATOR IDEHT1FI CAT I ON'~----Z~.-..~
EPA ID NLFMBER CAC /K D c? ~$ % (-/?~'? ~--, ~ % BOE NUbIBER (if available) H__EC
{DBA-Ehain~ B~sin~sa Aa}
[ For DTSC
CYI'Y "' '~)-,t-x~'~,',~')l:~=! i') CA ZIP <t'5~>c.~l -__
CO~A~ PERSON ~c~,fl:C~ -'~'f ~R , PHONE NUMBER(?,c')~)~-
DTSC 1'772 (!193) ~ Paga
\
~L.~ILING ADDRESS, IF
COMPANY NAME (DBA)
STREET
CITY STATE ZIP -
COUNTRY
(oniy CO.IcL4 i(~x~ USA)
CONTACT PERSOH PHONE NUMBER(~).~-~
iii. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE:
'list either ona or two SIC codes (a four digit n'.~nber) that beat de. scribe your company's product~, service, z, or industrial acti
%
Example: 7384 ph~to~ni~hi_n_~ lab_ 36_~.~ PHnted circuit board, r
,".')~i'~, ~'" '/' '~ l~,",~'
First: <'(,('3ti ,',~ ~,~t~,, 'i~t t~',,.'~?,t~_', Sccond:~
IV. PRIOR PER~flT STATUS: Check yes or no to each queation:
YES NO
[-'] [~i 1. Did you file a PBR Notice of Intent to Operate (DTSC Form 8462) ia 1992 for this location?
[~! [~ 2. Do you now have or have you cw.r held a state or. fexh:ral hazaxdoua waste facility full l~rmit or t~
status for any of thes~ treatment units?
~ [5~1 3. Do you now have or have you ever held a state or f~cleral full permit or interim status for any et
_ha:,ardon.s w'as~ activities at this location?
D [~l' 4. Have you ever held a varianc: isaued by the Department of Toxic Subatanc~ Control fei' the treatment y
a~ now notifying for at this location? - .
~ l'-] 5. Ha~ this location ever been iaspect~ by thc stata or any local agency as a hanrdous wasta gen'L"t~or?
V. PRIOR ENFORCEMENT IHSTORY: Not reci~ir~cl from generator~ only notifying a~ c~nditionally
YES NO
["'l ~ ' With_i~ the last thre~ years, has this facility been the subject of any convictiom% judgments, s~ttlements, or
orders resulting from an action by any local, crate, or federal environmental, hazardous wast$, or public heal
.enforcement agency?
(For thc purposes of this form, a notice of violation does not constitut~ aa order and n~xi not b~ reported ual~
it was not con-~cted and became a final order.}
['-] If you ax:swered Yes, chock tlxis box and at'ach a listing of convictions, judgments, settlements, 9r orders and a cop
of the cover sheet from each document. (See the Inslructiorts for men: information}
DT$C 1772 (1/93) Page
~ '!' ~EPA ID NUMBER S-lo Page 3 of ~
[] I. A plot plan/map detmiing tho location(i) of the cover~ ~i't(s) in r~lation to ~ [~ility ~~.
. 2. A ~t ~ific notifi~ion fora for ~h mt to ~ cov~r~ at ~s I~tion.
VII. CERTI~'ICATIONS: Thi~ form must be signed by an authorized corporate o2flcer or any othtr 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 thr~ copie~t tnuat hav~ original signature~.
Waste Minimiza~,ion I certify that I have a program ia place to reduce the volume, quantity, and toxicity of w~te generated to the
dcgre~ [ have determined to b~ economically practicable and that [ have selected the pract!cable method of treatment, storage, or
disposal currently available to me Which minimizes the present and future tht~at to human health and the eavironmeat.
Ti{red permilling Certification_ I ccrtif7 that the unit or units described in the..~ d~cumeats meet the eligibility and operating
r~quirements of state stamte, a and regulatioas for the indicated permitting tier, including generator and ~condary contaian~nt
requirements. I under~tand that ifaay of the units operau", under Permit by Rule or Conditional Authorization, I will also be required
to l.,rovida required fiaaracial a..~a'urances by January 1, 1994, and conduct a Pha.~ I enviroun~ntal a.t~.~meat by January 1, 1995.
I certify under.penalty of law that this document and all attachments were prepared under my direction or supervision ia ._ccordance
with a system designed to a..~'ure 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 respor~ible for gathering the reformation, the information is, to
the beat of my knowledge and belief, true, accurate, and complete.
I am awar~ that there are substaatial penalti~ for submitting false information, including the po.t~ibility of fines and imprisonment
for knowing violations.
Nm (Print or Type) Title
Signature (.L-.---'" Dat~ Signed
OPERATING REQUIREI~IEN'I'S:
Please note that generators treating h~ardous waste onsite are req'uired to comply with a. number of'operating requirtment~ ~'hich
differ depending on the tier[s) under which one operates. These operating requirements are set forth in the,.~tatutes and regulations,
some of which are referenced in the ~er.$peci. flc Factsheets.
SUBMISSION PROCEDURES:
You must .,~ornit two copies, of this completed notification by certified mail. return receipt reque.~ted, to:
Department of Taxic Substanc~ Control
Form 1772
.Onsite Hagardous Waste Treatment Unit
· 400 P Street, 4th Floor (walk in only)
'P.O. BoxeOd
'Sacramento. CA 95812-0806.
You must al~o ~bmit one c~,l~Y of the notification and attachments to the local regulatory agency in your jurisdiction as listtd in the
instruction materialx; You must al. to retain a cory ar part of your operating record.
All three forrn, r must have original signatures, not photocopi~.
' DTSC 1772 (1/93) ' Page 3
EXEMPT - SPEC]
WASTESTREAMS
UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Saf~ty Codo Section 2.5201.5(c))
NUb~£R OF TREATMENT DEVICES: ! , Tank(s) [ Container(s)
Each unit mast be clearly identified :md labeled on the plot plan attached to FOrm 1772. Assign your own unique number to e~
unit; The number can be sequential (l, 2, 3) or using any system you choose.
Enter the e~timated monthly total volume of ha:.ardou~ waste treated by this unit. This should be the maximum or high~t ama
treated in any month. Indicate in the narrative (Section Il) if your operations have seasonal variations.
l.. WASTESTREAMS AND TREAT~IENT PROCESSES:
Estimated Monthly Total Voluma Treated: pounds and/or t-t ~ galloon
The following are the eligible waste~treattt~ and treatment proc~ses. Please check all applicable .boxes:
~ 1. Treats r~sina mln~ in accor 'daaca with th~ manufacmrer'a instructions.
["'l 2. Treal comaincrs of 110 gallons or less capacity thai contained hazardous waslo by ri~slng or physical process,
such as crushing, shredding, grinding, or puncturing.
[~ 3. Doing special wastea, aa classified by tho department pursuant to tiilo 22, CCR, ~ction 66261.124, by
or by pa.~ivo or hot-aided ~vaporatioa to remow water.
[~ 4. Magnetic sepaxatioa or screening to r~move components from special wasto, as c[asaifiod by tho department put'au;
to titlo 22, CCR, aectiou 66261.124.
( [7"1 5~ Ncutraliz$ acidic or alkaline (ba.~) wa~t~, from thc r~gcncration of ion exchange .tm:din used to d~mincraliz~ wot,
~I~S WgatC callnot c..ontaia mo~c thwart_ 10 pcix:cnt acid or ba.~ by weight to b~ cligiblc for conditional exemptiot
['-] 6. Ncuwaliz$ acidic or alkalina (ba.~) waat~ f'tom the food proce.~iag indmtry.~ "
[~ 7. R~covery Of silver from photofinishing. The voluma limit for conditional exemption is 500 gallons per. senator
(at th~.aam~ location) ia any calendar month.
8. Gravity s~paration of the following, including thc u.~ of'floc~ulants and demulsificra if
[~! a. The $~ttling of solids from tho waste whe~ th~ rr~uitiag aqueouMLiquid sLream is not hazardons.
['-! b. The aepaxation of oil/water mixmr~ ;md aepaxation sludgea, if tho average oil r~:ovctnxl pct' month ia
than 25 ban-els (42 gallons per bah'el).
~ ., 9. Neutralizing acidic or alkalina (ba..~} matdfial by a state certified laboratory or a laboratory operated by
edueatioacd inatimtion. {To b¢ eligible for conditional exemption, this w~t¢ cannot contain more than 10
acid or ba.~ by weight.)
DTSC 177~B (1!93) .. Page
CONDITION4LLY EXEMPT - SPECIFIED.W .AS~AMS
UNIT SPECIFIC NOTIFICATION
(pur~-m~nl Io ileahh a~d Sa/ely Cod~ Section 25201.5(c))
Il. NARRA, TIVE DE$CRIF~FIONS: Provide a brief description of the specific waste treated and the treatment procex$ us
2. TRE^TMENT PROCESS(ES) USED: ,,... .
RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all r~iduals from t_h~$ treatment un.
NO ' '
1. Do you discharg~ aoa-hazatdous aqueous waste to a publicly owned h'r, almeal wo[ka (POTW)Isewer?
~ ' 1~ 2. Do you dtschatg¢ non-hazardous aqueous wasl¢ uader aa NPDES pernul,
3~ Do you ha¥o your residual hazardom waste hauled off~ito blt a ~11islet~l barardou~ w~ hauler?
Il' you do. where i~ th~ wa~t~ .~mt? Check all that apply.
~ ~. Off, ire r~cTcling
[~ b. Thermal treatment
["] ¢. Disposal lo land
D d. Further Irealment
( ['-] [~ 4. Do you dispog of non-hazardous solid wasle reaidues at aa offsite Iocatioa?
El ~ 5. Other m~thod of disposal. Spocify:
IV. II&SIS FOR NOT NEEDING A FEDERAL PERMTr;
. · In order to demonstrate e.ligibili~.for one of the onMt~ treatment tiers, facilities are required to provide the basi~for d~lermining t.
a hazardo~ 'waste permit ~ not r~quired u~er th, red,rat R~ourct Collation a~ R~co~
r~gulatio~ ~opted u~er RC~ ~tl, ~. C~ of F~al Regulatio~
Choo*~ tht re~on~) t~t des~ib~ th~ oper~ion of yo~ o~it~ tremm,nt unit~:
' ~ 1. ~e h~rda~ w~te ~ing treat~ is not a ha~rdous w~te ~der f~eral law al~ough
w~tc ~dcr C~ifomia s~te law.
r'] 2. The waste is treated ia wastewater treatment units (tanks), ~ defined in 40 CFR Part 260.10, and diacharged
publicly owned treatment worka (POTW)/v.-weriag agency or under aa NPDES permit. 40 CFR 264.1(1t)(6)
40 CFR 270.2.
DTSC 1772B (!193) Palle ·
'
I CONDn'IONALL¥ EX:EMPT - SPEWED W~~A~
: UNIT SPECIFIC NOTtFICA~ON
(pu~ to-H~l~ ~d Safely C~e S~lioo ~201.5(c))
' IV. ~- BAS~ FQR NOT ~ED~G A ~DE~L PERM': (con~nu~)
~ 3. ~e w~te is tr~t~ ~ elemen~ neut~li~lion ~i~, ~ de~ in ~ CFR P~ 2~. !0, ~ ~g~ to a
PO~/~we~g ag~cy or ~der ~ NPDES ~t. 40 CFR 2~.1(g)(6) ~d ~ ~R 270.2.
~ 4. ~e w~te is t~ ~ a foully enclo~ tr~tment f~ility ~ de~ ~ ~ C~ P~ 2~. 10; ~ CFR 2~. l(g)(SL
[-=J 5.. The company generates no more than !00 kg (approximately 27 gallons) of b:~:,anJous waste in a'calendar month
and is eligible x~ a federal conditionally exempt small qu:mtity generator. 40 CFR 260. IO and 40 CFR '~61.5,
r'l 6. The waste is trealed in an accumulation tank or container within_ 90 days for over 1000 kg/month generators and
". laO or 270 days for generators of t~ to lOX) kg/monlh. 40 CFR 262.34.40 CFR 270. l(c)(2)(i), and the Preamble
" to the March 24, 1986 Federal Register.
[~] 7. .Recyclable materials are reclaim~ to recover economically significant amounts of silver or other precious metals.
40 CFR 261.6(a)(2)(iv). 40 CFR 264. l(g)(2), and 40 CFR 266.70.
r-i 8. Empty container rinsing and/or treatment. 40 CFR 261.7.
r'l 9. O~er. Speci6,:
V. TRANS~RTABLE TREATMENT UNIT: Check Ye~ or No. Please refer to the lnstruction~ for more Information.
~S NO
~ ~ ~ ~s ~t a T~mble Tr~tment U~t?
~ you ~ y~, you mint a~ complete ahd at~ Fo~ 1772E ~ ~ ~ ~
The Tier-Specific Factsheets contain a summary, bi' the operating requirements for this category.
P1eas~ review those requirements carefully before completing or submitting this notification package.
DTSC 1772B (1/93) P'~ge 11
· :. ,, SPECIFI YASTESTREA/ IS
~ UNIT SPECIFIC NOTIFICA~ON
(pun~; lo tl~lth ~d Safely C~e S~lion ~201~(c))
~IBER OF T~AT'~~ DE~CES: ] T~k(s) ,, .I Conuine~s) .
Each uni~ m~ be clearly idem~~ ~ ~bel~ on ~ht plot plan a,ach~ ~o Fo~ 1 ~. ~ign your own unique n~b~ ~o each
~ni~ ~e n~ber can be sequemial fl, 2, J) or ~ing any ~s~em you c~se.
Enter the ~imated momhly goml ~lmne of h~ardo~ w~e greated by ~hb unit. ~ s~uM be the ~bnum or high~ mnoum
~rea~ed in a~ momh. b~icm~ in the ~mi~ (Seoion !i) ~your opermio~ hm~ se~o~! mria~io~.
I. WASTE~REAMS ~'TREATME~ PROCESSES:
~timaied Montldy Tol~ Votume Tr~ted: ~unds ~d/or ~_~ gallons
~ ~efo)Jowing are ~h~ eligible wau~reanu ,u~ ~r~mm~m proc~ses. Plt~e ch~ck all applic~le bo~:.
~ I. Trois ~s ~x~ ~ accor~ce with the ~ufacmrer's instruction.
['1 2. Treat containers of I lO gallons or less capacity that contained .hn?a~dous waste by rinsing or physical proc~se.s,
such as crushing, shredding, grinding, or puncturing.
[~ 3. Drying special wastes,'as classified by the department pursuant Io litle 22, CCR, section 6626 I. 124, by pressing
or by passive or heat-~ided evaporation to remove water.
[~ 4. Magnetic separation or screening to rcmovc components from sPec'iai waste, as classified by thc department pursuant
to title 22, CCR, .~ction 6626 i. 124.
[] 5. Neutralim acidic or aikaline'(base) wastes from the r~generation of ion exchange media used to demineraliz~ water.
O-his wasle cannoI contain more thn~ 10 Imrcent acid or base by weight to I~ eligible for conditionnl exemplion.)
[~ 6. Ncutraliz~ acidic or alkaline (base) wastes from the food processing indnslry.
[~ 7. Recover,/of silver from photofinishing. The volume limit for conditional exemption is 500 gallons Per generator
(at tho same location) in any calendar month.
8. Gravity separation of the following, including the use of flocculanfs and demulsificrs if
[~ a. The settling of solids from Ihe wasle where Ihe resulting aqueonslliquidstrr, am is not Imzardons.
F-1 b. The separalion of oil/water mixnttes and separation sludges, if the average oil recovered per month is It. ss .
than 25 bm'r~ls (42 gallons per bar~i).
E] ' . 9, 'Neutralizing acidic or alkaline (base) matdrial by 'a state ceaified laboratory or a laboratory operated by aa
educational imtimtion. (To b~ ¢ligibl~ for conditional exemption, this waste cannot contain mote than 10 percent
acid or base by weight.)
DTSC 17'/'2B (1/93} -~ Page 9
' [ON4LL¥ EXEMPT - SPECIFIED WASTESTREAMS
UNIT SPECIFIC NOTIFICATION
t~ (punuanl Io lieahh and Safely Code Seclion 25201.$(c))
!!. : . NARRATIVE DESCRIPTIONS: Provide a brief de.~cription of the ~Pecific walte treated and the treatment proc~s
ii1. RESIDUAL I~I.~.NAGEMENT: Check Ye.~ or No to each question a$ it app!i~ to all r~idual~ fiom ~ treatment
YES NO
[~1.. El. I. Do you discharge non-haza~d0u$ aqueous waste to a publicly owned treatment works (POTW)ls~wer?
[-'] ' [~ - 2.' Do you dischargo non-hazardous aqueotu waste under an NPDES permit?
1~ E] 3. Do :you have your residual haza[dous w~te hauled of faire by a ~egistered haza~rdous waste hauler?
If you do, wher~ is tha waste sent? Check all that'apply.
['~ a. Offsil¢ recycling
1~ ' b. Thermal treatment
E] c. Disposal to land
E! d. Fmther tiealment
· * E! ~1 $. Other method of disposal. Specify:.
.2
IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT:
in order to demon.~trate eligibili~, for one of the onlite treatment tiers, facilitie, are required to provide the bcuL~ for determining
a hazardou~ walt¢ ~oennit L~ not required utder the federal ReJourc¢ Comervation and RecareOt Act ~2~CRAJ and the federa~
regulation~ adopted under RCRA (Ihl¢ 40, Code of Federal Regulation~ (CFB)).
Choose the retfson($) that describe the operation of your ottfife treatment
D I. The hazardous waste being Ireated is not a hazardous waste under federal law although it is ~egulaled as a hazardous
waste under California state law.
E] ' 2. The waste is trealed in wastewater treatment units {tank~), a.s defined in 40 CFR Part 260. I0, and discharged to a
publicly owned Ireatment 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 !0
CONDH'IONRLLY EXEblPT - SPECWIED WASTF..TrREA~IS
UNIT SPECIFIC NOTIFICATION
(pursmmt to' kl~lth and Safety Code Section Z5201.5(c))
iV. ,s BASIS FOR NOT NEED~G X FEDERAL PER,'-,IIT: (continu~)
/"1 3. Tho w~ste is treated ia elemenary neutralization units, u defined ia 40 CFR Part 260. !0, and. disch~ged
POTWIseweria$ agency or under an NPDES permit. 40 CFR 264.1($)(6) ~ad 40 CFR 270.2.
f-'] 4. The waste is ttw. azed ia, totally enclosexl lreatment f~:ility as defined ia 40 CFR Part 260. i0; 40 CFR 264.
F'I 5.. The company generates no more than 100 kg (approxiraately 27 gallons) of lm,.,ml°us waste in a'c.~endar month
and is eligible as a federal conditionally exempt small qu~6t¥ generator. 40 CFR 260. IO and 40 CFR ~61.$.
ri 6. The waste is trealed ia an accumulation tank or container within 90 days for over 1000 kg/month generators and
"130 or 270 chys/'or generators of i~ to ICXXI kg/momh. 40 CFR 262.34, 40 CFR 2'/0. l(c)(2)(i), and the Pr~mble
· to the March 24, 1986 Federal Register.
[~ ?. Recyclable materials are reclaim~l to recover economically sigaific~at amounts of silver or other precious metals.
40 CFR 261.6(a)(2)(iv), 40 CFR 264.1(g)(2), and 40 CFR 266.70.
r-1 8. Empty container rinsing and/or tcea~menL 40 CFR 26 !.?.
[~i 9. C~en Specie:,
V. TRANSPORTABLE TREATMENT UNIT: Check Yes or No. Please refer to the bmr~csionx for more Informmio..
YES NO
F'I ~ Is this unit' a Transpombl~ Treatment Unit?
" If you nnS~ered yes, you must also complete ahd att~c_h Form 1772E to
The Tier-Specific Factsheets contain a summary bf the operating requirements for this categorT.
Ple. a.~ review those requirements carefullybefore completing or.submitting this notificatidn package.
DTSC 1772B (!/93) v .... ~s
=S'~ E ~F CALIPORNIA--CALIFORNIA ENVIRONMENOOTEcTIoN
AGENCY
PETE
WILSON,
Governor
DEPARTMENT OF TOXIC SUBSTANCES CONTROL ~
400 P STREET, 4TH FLOOR
P.O. BOX 806 .
SACRAMENTO, CA 95812-0806
(916) 323-5871
June 2, 1995
EPA ID: CAD983637513
PACIFIC ORTHOPAEDIC MEDICAL GROUP For facility located at:
ROBERT TAYLOR
2619 'F' ST 2619 'F' ST.
BAKERSFIELD, CA 93301 BAKERSFIELD, CA 93301
Authorization Date: 01/10/94
Dear Conditionally Authorized 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 17728 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 must'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: CAD983637513
If you have any questions r~garding 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.
Sin~y,
Michael S. Homer, Chief
Onsite Hazardous Waste Treatment Unit
Permit Streamlining Branch
Hazardous Waste Management Program
Enclosure
cc: ASTRID JOHNSON
DTSC REGION 1
STATE REGULATORY PROGRAM
1515 TOLLHOUSE
CLOVIS, CA 93611
STEVE MCCALLEY
KERN COUNTY
ENVIRON. HEALTH SERVICES DEPT
2700 M STREET, SUITE 300
BAKERSFIELD, CA 93301
Page 3 EPA ID: CAD983637513
ENCLOSURE 1
Units authorized to operate at this location:
UNDER CONDITIONAL AUTHORIZATION:
UNDER CONDITIONAL EXEMPTION:
A B