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Home My WebLink AboutHAZARDOUS WASTENOTIFICATION OF "SILVER-ONLY" HAZARDOUS WASTE TREATMENT FORM Company Name Company Address(Mailing) ~ ~ City'~4~[~ , CA Zip Code 6~ 3 ]k9 / Unit Name _~.F//b~,4 g2~...~-Unit ID Number Is your company eligible for the exemptions noted on page 17 YES v/NO If no, then disregard this notice. If yes, then please check the applicable wastestream box: p~,r~/~,/C/~_.~Company EPA ID Number CA_0.~ -0~-- ---~ ~,~2. ~ S The recovery of silver from photofmishing/p'hotoimaging solutions and photoimaging solution wastewaters (provided that the solutions and wastewaters are "silver-only" hazardous wastes, and are not hazardous for any other reason or constituent). Wastestream # 2 under CESQT ~DTSC 1772B) -- if applicable. Wastestream # 7 under ~ (DTSC 1772B). Wastestream # 10 under CA (DTSC 1772B). -[] .... 4:- ~Wastestream-'#-2-under~BR-(l~TSC-1-772B)--ff-applicab!e~- Are you authorized for 'any other treatmem activity? YES NO){x'/ If yes, under 'which tier are you authorized? CESW~c CESQT CA.~ PBR STD. PERMIT FULL PERMIT Of your estinmted monthly total volume of wastes treated, what portion is "silver-only" hazardous photofinishing wastes treated to recover silver? (If this "silver-only" hazardous photofinishing portion is a significant portion of youx total wastes treated, you may be eligible for regulation under a lower permit tier. Please contact your local CUPA to determine or confirm your regulatory tie:: status.) I certify under penalty of law that this document was prepared under my direction or supervision and the information is, to the best of my knowledge and belief, true, accurate, and complete. Name (Print or Type) Date Please submit the completed notification form to your local CUPA and also send a copy to: Department of Toxic Substances Control Unified Program Section P.O. Box 806 Sacramento, CA 95812-0806 FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROG, RAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakerslield, CA 93301 INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # [] Routine ~ Combined [] Joint Agency [-i Multi-Agency [221 Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID#) Authorized for waste treatment and/or storage Reported release, fire. or explosion within 15 days of occurance Established or maintains a contingency plan and training Hazardous xvaste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed ~vhen not in use Weekly inspection of storage area 'V" Ignitable/reactive waste located at least 50 feet from property 1/ne Secondary containment provided Conducts dailv inspection of tanks Used oil not cofitaminated with other hazardous waste ! Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste ~vith completed manifest Sends manifest copies to DTSC Retains rnanifests fbr 3 years Retains hazardous xvaste analysis fi)r 3 years Retains copies of used oil receipts lbr 3 years 4 Determines if waste is restricted fi-om land disposal Inspector: - ~ _ ~ _.. Office of Environmental Services (805) 326-3979 Business Site Responsible Party \Vhite - Env. Svcs. Pink - Business Copy CITY OF BAKE]RSFIELD ]F]~]~E DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM ]INSPECTION CHECKLIST 1715 Chester Ave. 3rd Floor, ~akersfield, CA 93301 FACILITY NAME -4~'6--~t-C'57 ~ INSPECTION DATE Hazardous Waste Tier Permit Treatment Program ~,Combincd [~ Joint Agency ~3] Multi-Agency Complaint Section 5: ~ Routine Re-inspection Onsite Treatment Unit Tier: [~ PBR [~] CA ,~ CESW [~ CESQT Unit number & name: [~CEL [~ CECL OPERATION C V COMMENTS All hazardous wastes treated are generated onsite Onsite treatment notification ~brms available and complete Onsite treatment unit tier and/or count is correct on form Unit number is correct on notification form Number of tanks or containers is correct on form Treatment monthly volume is correct on form Waste identification & treatment is correct on form Complies with residual management requirements Properly closed a treatment unit Complies with tank and containment certification Developed and maintains a written inspection log Meets pretreatment standards for waste discharge Developed and maintains a Closure Plan on site [PBR] Developed and maintains a Waste Analysis Plan and Waste Analysis Records [PBRI Maintains Training Records on site [PBRI Obtained local permits for treatment operations IPBRI ~,, Identifies and labels Treatment Units [PBRI C=Compliance V=Violation Inspector: /./~t~' _q Office of Environmental Services (805) 326~3979 Business Site Responsible Party CA=Conditionally authorized CECL=Conditionally exempt commercial laundry CEL=Conditionally exempt limited White - Env. Svcs. CESW=Conditionally exempt specified wastestream CESQT=Conditionally exempt small quantity treatment PBR=Permit by rule Pink - Business Copy ~*"~%E OF (~ALIFORNIA-ENVIRONIv~NTAL PP, OTECTION AGENCY oF xoxi¢ SuBsX :ES comao[ RE~IOIq 1-101:51 Croydon Way, Suit~ 3 Sacnun~nto, CA 05827 PETE WILSON. Gov~rrmr CHECK!.I.~T AND INITIAL VERIFICATION INSPECTION REIq2)RT FOR Permit by Rule, conditionaUy Authorized, and ConditlonaUy Exempt Notifier~ FACILITY CONTACT-NAME: SIC CODE(S): g3Yq INSPEC'FION DATE: /'~c~ ?. ?& ! PBR CA _ CESW / CESQT TOTAL PBR ,, CA _ CESW / CESQT TOTAL NOTIFI~B UNIT COUNT: CORRECT UNIT COUNT: This daec. klist and imi~aion r~ort identify violations of state law regarding onsite treaters of hazar~ wa.~e, oi~ating under an onsite i~ani .t~ tier. This inspec, lion verifies the information i~'ovided on form 1772. It also cover~' Ilen~'ator requir~nents, ~lthough a separate checklist may be u~l for those requirements. A thee. lanark indicates violation of the law, which are explained in mor~ ~ on the attached note sheets. The governing hws are lhe Health and Safely Code (i-ISC) and Title 22 of the California Code of Regulations {2J CCR), Generator Standards: Each inspection agency may are their own generator inspection cheddLrt or protocols, which are .mmmarized below. A full evaluation of each item or document is not conducted during the Vitrification Inspection, unless serious deficiencies are sarpeaed. '/ 1. Contingency plan has been prepared (ade~luately 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. 3x9 ~ Meet container management standards (storage time limits, closed, labelled, compatibility, inspected weekly, in good condition, with ignitables/reactives 50 feet from property line). 4A/~/ 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.c~, ..All wastes are properly identified. Treatment Items-Facility Wide: (Fad//ty mart xubmit a revixed Form 1 772 to correct error~ or omissions.) 6.t~/~ 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 ~te 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. The generator has complied with source reduction planning requirements (SB 14 and SB 1726). A checklist or plan is required ~fl_~ if annual hazardous waste volume is over 5,000 kilograms (approximately 11,000 pounds or 1,350 gallons). For CA or PBR notifiers: 11. Thc generator has an annual waste mlnixnization certification. (PBR submit with renewals.) Onsite Checklist (A) Page 1 of ~ February 10, 1994 t ~TAT~A-ENVIRONIJENTAL PROTE AGENCY DEPARTMENT OF TOXIC SUBSTANCES CONTROL REGION 1-10151 Cmydcm Way, S-;~ 3 Sacral, mm, CA 95827 P~TE WILSOH, Governor CHECKI.IgT AND INITIAL VERIFXCA'HON INSP~ON REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers UNIT SE[~F.T Complete one unit sheet for each unit either listed in the notification or identified during the inspection. Unit N,,mber: Notified Tier: Correct Tier: C k-'-~- ~ Notit'md Device Count: Correct Device Count: Tnnk~ / Containers Tank~ ~:~ Containers For aH Units: NO 12.0~-_ All hazardous wastes treated are generated onsRe. 13. ak Thc unit notification information is accura~ as to thc number of tank(s) or container(s). 14. t)K Thc estimated notification monthly treatment vol-me is appropriate for thc indicated tier. 15.0~, Thc waste identification/evaluation is appropriate for thc tier indicate~l. 16.~)k, Thc wastestream(s) given on thc notification form arc appropriate for thc tier. 17.0~ Thc treatment process(es) given on thc notification form arc appropriate for thc tier. 18. ~c~, Thc residuals management information on thc form is correct and documented for thc unit. 19.0k Thc indicated basis for not needing a federal permit on thc notification form is correct. 20.0t 21.~ 22 23j~,,~ There arc written operating instructions ;and a record of the dates, volumes, residual management, and types of wastes treated in the unit. There is a written inspection schedule (confixincrs-weekly and tanks-daily). There is a written inspection log of thc inspections conducted. 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.b/3rThc generator has secondary containment for treatment in containers. For each PBR unit: 25./~'fl There is a waste analysis plan and waste analysis records. 26. There is a closure plan for the unit. Unit Comments/Observations: (~f this is a unit that was not included on th~ notification form, tht violation is operating without a permit-H$C 25201(a).) Onsite Checklist (B) Page ~ of/-/ February 10, 1994 ~TATE OF ~AUFORNIA-ENVIRONM~t~'AL PROTECTION AGENCY DEPART~IEN~I' OF TOXIC SUBST ES CONTROl REGION 1-10151 Cwyckm Way, Suite 3 Sazmm=ato, CA 958:27 CHECKI.IRT AND INITIAL VERI~CAIlON INSPECTION REPORT FOR Permit hy Rule, Conditionally Authorized,. and Conditionally Exempt Notifiers SIGNATURE SHEET PETE WILSON, Goverrmr Onsite Recycling: only atuwer ~"dtis faciEcy recycles t~or¢ #Fro ~IO0 kilozram~/moruh o£ hazardous waste o=i~e. NO 27 £" ~The appropriate local agency has been notified. 28. All activities claimed under the onsite recycling exemption are appropriate. Releases: 29/~' fl Within the last three ycaYs, have there been any unauthorized or accidental releases to the environment of ha~mrdous waste or h~rdous waste constituents at thc facility? For purposes of a Tiered Permitting inspection, a release t~ the environment is unauthorized or accidental and does not include spills contained within containment systems. (if there has been a release, attach information on t. he status of the correaive action for the release(s).) This report may identify conditions observed thiis date that are alleged to be violations of one or more sections at the California Health and Safety Code fttSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of hnTardons waste. The violations may be described in more detail on the attached note sheets. If any violations are noted, the facility is required to submit a signed Certification of Return to Compliance within the stated time limits stated. (A model 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 and to the local enforcement agency. Inspector(s): Lead lns~c~ct0r: . n Other ]ns_tx:ctor: Signature: ,,/~,-~,~.~ ~_ .~5'/._.....-~ Signature: Print N~e: ~.,~.P ~ . -fYr~t~c, ~c' ~nt N~e: Tide: ~, ~., .~,/,~.~, ffct~fc5 h Tide: Ag~cy:~o./. o~ &x,~ ,~o~a/'~.c.c~ fa~6o[ Agency: Phone Num~r:(?c,~) ~ e 7 J?r'c Phone Numar: Facility Representative: Your signature ac,k~nowledges receipt of this report and does not imply agreement with the findings. Onsite Checklist (C) Page ..? of q February 10, 1994 STATE OF CALIFORNIA-ENVIRONMENTAL PitOI'I~CTION AGENCY DEPA{~I'I~ENT OF TOXIC SUB,,~ICE$ CONTROL S~r~.ato, CA 95827 PETI[ WIL$OH, Goverr~t CHECKLIST AND INITIAL VERIIFICATION INSPECTION REPORT FOR P~rmit by Rule, Coadifioaally Authorized, and Coaditioually NOTE SIIEET ~~'~i-~D) Page ~ of y___ Februa/-y 1-0]-1'~9-4--- TOM BURCH President 2000 H Street Bakersfield CA 93301 805/32~,-9~,8~ Fax:805/324~0471 STATE OF CALIFORNIA-ENVIRONMENTAL PROTECTI..J,~,~ AGENCY D~PARTMENT OF' TOXIC SUBST~~ ES CONTROL TI'F..RED PERMITTING CERTItlCATION OF RETURN TO COMPLIANCE PETE WILSON. Governor For Permit by Rule, Conditionally Autho,rized, and Conditionally Exempt Notifiers In the matter of the Violation cited on :..~. /~, /5' ? q As Identified in the Inspection Report dated Z~o. //~, /~ ? 2/ / ! Conducted by · ~,~ {--~.. ~ o,r Fo~,) .J~,l:r~ {--~ ~,r~-~ (~, -/to f _(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. 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. I am authorized to file this certification on behalf of the Respondent. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name (Print or Type) Signature Company Name Title EPA ID. Number DTSC-RETCOMP.CRT (8/94) St~t~ of. Caiiforn~ - CaKfornia Ea~'unmmtat ~ou ~ ~~ of T~ ~ C~ ONSITE W TE NOTI CATION FACIL~ SPECIFIC NO~FICA~ON For U~ by H~rdo~ W~t¢ Genemto~ Peffo~ng T~tment ~ Imti~ Under Conditio~ Exemption ~d Conditio~ Automation, ~ ~Revi~ ~d by Pe~tt By Rule F~dm~ t .... ~ N~ ]~ ' P~e r,fer m th~ ~tached l~tru~io~ before completing this fo~. ~ou m~ ~ti~ for more t~n o~ p~ining ti~ ~ ~ing th~ not~cation fo~, D~C J 772. You m~t ~tach a separate unit specific ~t~cation fo~ for each unit ~ th~ ~c~ion. ~ere are d~erent unit xpecific notification fo~ for ,ach o[ the four camgories a~ ~ ~itio~t ~tificmion fo~ for trampo~ tr,~me~ unitx ~'s). ~ou .only ~ve m submit fo~ for the tier(x~ th~ cover your unit(x). D~card or re~c~ t~ ot~ un~ fo~. N~ber each page of your complet~ ~tific~ion pac~ge a~ i~ic~e the mini n~ber of pag~ ~ t~ top of ,a~ page ~ the 'Page ~ of ~'. Put ~°ur EPA ~ Number on each page. Ple~e provide all of the info--ion requite; all fie~ m~t be completed ~cept those that stme '~ different' or '~ available'. Plebe ~pe the info~ation provid~ on th~ fo~ a~ a~ attac~ent~. The notification will not be considered complete without payment of the appropriate fee for each tier under which you are operating. (Please note that the fee:i, per TIER not per UNIT. For.example, if you operate 5 units but they are ail Conditionally Authorized, you only owe $1,140, NOT5 times $1,140. If you operate any Permit by Rule units and any units under Conditional Authorization you owe $2,280. ) Checks should be made payable to the Department of Toxic Substances control and be stapled to the top of this form. Please write your EPA ID Number on the check. Fill in the check number in the box above. I. NOTIFICATION CATEGORIES Indicate the number of units you operate in each tier. This will also be the number of unit specific notification forms you must attach. Conditionally ~t &hall Otantity Treatment operatior~ may not operate ani= ututer any oti~r tier. Number of units and attached unit specific notifications A. ~ Conditionally Exempt-Small Quaatity Treatment B. /. Conditionally Exempt-Specified Wast~tream (Form DTSC 1772A) (Form DTSC 1772B) Fee per Tier (r~t per uniO $ lO0 $ I00 Co Conditionally Authorized (Form DTSC 1772C) $1,140 D. Permit by Rule (Form DTSC 1772D) $1,140 ./ Total Number of Uni~ · Total Fe~ Attached II. GENERATOR IDENTIFICATION EPA ID NUMBER CA .'-- BOE NUMBER 0f availabla) H~HQ~ N~E (Comply or Facility) ~I[; ~ .fi..~ ~l~: / ~' //c/ ~ ~BA-~ing ~ai~ ~) CITY COUNTY CONTACT PERSON s · (Fire N~m~) (La~ N~m~) For DTSC ys~ O.ly I DTSC 1772 (1/93) Page I EPA ID NUMBER MAILING ADDRESS, IF DIFFERENT: COMPANY NAME (DBA) STREET Page 2 of~ CITY COUNTRY STATE ZIP (only conkolcU~ if no~ USA) CONTACT PERSON PHONE NUMBER(~)~ "' (Firs~ Name) (Las~ Name) III. TYPE OF COMPANY: STANDARD INDUSTR~£ CLASSIFICATION (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: 73~.. Photofinishing ~ 3672 Printed circuit board~ IV. PRIOR PERMIT STATUS: ChecIc yes or no to each question: NO Did you file a PBR Notice of Iaten~ to Operate' (DTSC Form 8462) ia 1992 for this location? Do you now have or have you ever held a state or federal hazardous waste facility full p~rmit or interim stems for any of these treatment units? Do you now have or have you ever held a state or federal full p~rmit or interim status for any other hazardous waste activities at this location? Have you ever held a varianc~ issued by the Department of Toxic Substances Control for the treatment you ax~ now notifying for at this location? Has this location ever b~a inspected by the state or any local agency as a ba:'ardous waste generator? Vo YES NO PRIOR ENFORCEMENT I'IISTORY: Not required from generators only notifying as conditionally Within the last three years, has this facility been the subject of any convictions, judgments, settlements, or final orders re, suiting from an action by any local, state, or federal environmental, hazardous waste, or public health enforcement agency? (For the purposes of this form, a notice of violation does not constitute an order and need not b~ reported unless it was not corrected and b~ame a final order.) If you 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 mon~ information) DT$C 1772 (I/93) -~ Page 2 · EPA ID NUMBER ATTACHMENTS: Page 3 A plot plan/map detailing the location(s) of the: covered mt(s) in relation to the facility boundaries. A unit specific notification form for each umt to be covered at this location. CERTIFICATIONS: This form must be signed by an authorized corporate officer or any other person in the company who has operational control and performs decixion-making.functionx that govern operation of the facility (per title 22, California Code of Regulation~ (CCR} section 66270.113. Ail thr~ copies mart have original sigrmmres. Waste 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 .'md future threat to human health and the environment. Tiered Permitting Certification I certify that the unit 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 1, 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 comph,'te. I am aware that there are substantial penalties for submitting false information, including the possibility of fmcs and imprisonment for knowing violations. Name (Print 9r Type) OPE~T~G ~Q~~S: Title Date Signed Please note that generators treating hazardous waste 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 7~er-Specific Factsheets. SUBMISSION PROCEDURES: You must submit two copi~ of this completed notification by certified mail, return receipt requested, to: Department of Toxic Substances Control Form 1772 On. ire Hazardous Waste Treatment Unit 400 P Street, 4th Floor (walk £n only) P.O. Box 806 Sacramento. CA 95812-0806. You must also submit one copy o/the notification and attachments to the local regulatory agency in your jurisdiction as listed in the instruction materiai~. You must also retain a copy as part of your operating record. All three forms must have original signatures, not photocopies. DTSC 1772 (1/93) Page · .' ', .. _ .... u.. '" CONDITIONALLY EXEMPT ,. SPECIFIED wASTEsTP , ' I ''-, UN~ SPECIFIC NO~CA~ON (pu~t to H~ ~d Safety C~e S~tion ~201.5(c)) Each unit m~t be clear(v ident~ a~ ~bel~ on the plot plan ~tac~ to Fern 1772. ~sign ~que numb~ to each unit. ~e number can be sequential (1, 2, 3) or ~ing any ~stem you c~ose. Enter the estimated monthly total volume of h~ardo~ w~te tn~at~ by th~ unit. ~ shouM be t~ ~imum or higher ~ount treated in any month. I~icate in the na~ative (Se~ion II) ~your operatio~ ~ve se~o~l variation. I. WASTEST~A~ ~ T~AT~ PROCES~S: ~timat~ Mont~y To~ Vol~e Tr~t~: ~ ~d/or ~.~d~ gallons ~e following are the'eligible w~testre~ a~ tre~ment proc~s~. Ple~e check all applicab~ boxy: 1. Treats resins mixed in accordance with the manufacturer's instructions. Treat containers of 110 gallons or less capacity that contained hazardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or pun¢:turmg. Drying special wastes, as classified by the department pursuant to title 22, CCP,, section 6626 I. 124, by pressing or by passive or heat-aided evaporation to remove water. Magnetic separation or screening to remove components from special waste, as classified by the department pursuant to title 22, CCR, section 66261.124. 5. ["] 6. o Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demineralize water. (This waste cannot contain raore than 10 percent acid or base by weight to be eligible for conditional exemption.) Neutralize acidic or alkaline (base) wastes frora the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator (at the same location) in any calend,3~r month. Gravity separation of the following, including the use of flocculants and deraulsifiers if a. The settling of solids from the waste where the resulting aqueous/liquid stream is not ha?ardous. b. The separation of oil/water nfixtures ~nd separation sludges, if the average oil recovered per month is less than 25 barrels (42 gallons per barrel). · 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 I0 percent acid or base by weight.) DTSC 1772B (I/93) Page 9 II. · EPA ID NUMBER CONDITIONALLY EXEMPT., SPECIFIED WASTESTREAMS UNIT SPECIFIC: NOTIFICATION (pursuant to Health and Safety Code Section 2.5201.5(c)) Page 5___ of t7 NARRATIVE DESCRIPTIONS: Provide a brief desc,iption of the specific waste treated and the treatment process used. TREATMENT PROCESS(ES) USED: ,~"~- ('~,?T' ~r':[_. J~' T / C. RESIDUAL MANAGEhfENT: Check Yes or No to each question as it applies to all residuals from this treatment unit. 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 ba?nrdous waste hauler? If you do, where is the waste sent? Check all that apply. El a. Offsite recycling [-"[ b. Thermal treatment El c. Disposal to land d. Further treatment ['-] ~ 5. Other method of disposal. Specify: 4. Do you dispose of non-hazardous solid waste residues at an offsite location? 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 (Title 40, Code of Federal Regulations (CFR)). Choose the reason(s} that describe the operation of your onsite treatment units: The hazardous waste being treated is not a hazardous waste under federal law although it is regulated as a b,~ardous waste under California state law. ["'] 2. The wast~ is treated in wastewater treatment units (tanks), as defined in 40 CFR Part 260. I0, 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 (I/93) .- Page I0 IV. El El El · EPA ID NUMBER CONDITIONALLY EXEMPT ,. SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 2.5201.5(c)) BASIS FOR NOT NEEDING A FEDERAL PERME[': (continued) The waste is treated ~.n elementary neutralization unim, as defined in 40 CFR Part 260.10, and discharged to a POTW/sewermg agency or under aa NPDES permit. 40 CFR 264. l(g)(6) and 40 CFR 270.2. 4. The waste is treated ia a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264.1 (g)(5). The company generates no more than 100 kg (approximately 27 gallons) of hazardous waste ia a calendar month and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. The waste is treated in an accumulation tank or container within 90 days for over I000 kg/month generators and 180 or 270 days for generators of 100 to 1000 kg/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), and the Preamble to the March 24, 1986 Federal Register. Recyclabte materials are reclaimed 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. 8. Empty container rinsing and/or treatment. 40 CFR 261.7. 9. Other:. Specify: Vo TRANSPORTABLE TREATMENT UNIT: Check Yes or No. NO Please refer to the Ir~tructions 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 l-i eA. boo ~ L~-e, 0 F-F 'Dco£ Name 1st Notice _._.._ 2fid Notice 047 494 588 FILE INt~JT CITY ADDRESS , , , ~. O~ ~ .b~g&t~- STATE EPA ID FILE TYPE OTHER REMARKS STATE OF CALIFORNIA--ENVIRONMENTAL PROTECTI iENCY PETE WILSON, Governor DEPARTMENT OF TOXIC SUBSTANCES CONTROL 400 P Street, 4th Floor P.O. Box 806 Sacramento, CA 95812-0806 (916) 323-5871 08/16/93 EPA ID: CAL000082255 HENLEYS PHOTO, INC. THOMAS BURCH 2000 H ST. BAKERSFIELD, CA 93301 For facility located at: 2000 H ST. BAKERSFIELD, CA 93301 Authorization Date: 08/16193 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 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 aeeura.cy of information submitted by you in the notification:s 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: CAL000082255 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 offie~ at the letterhead address or phone number. Sincerely, Michael $. Homer, Chief Onsite Hazardous Waste Treatment Unit Permit Streamlining Branch Hazardous Waste Management Program Enclosure 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 ENCLOSURE 1 llnitr authorized to operate at this location: UNDER CONDITIONAL AUTHORIZATION: EPA ID: CAL000082255 UNDER CONDITIONAL EXEMPTION: #1 L HAZARDOUS WASTE TREATMENT NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION For Use by Hazardous Waste Generators Performing Treatment ~ Initial Under Conditional Exemption and Conditional Authorization, [] Revised and by Permit By Rule Facilities ONSITE Please refer to the attached Instructions before completing this form. You may notify for more than one permitting tier by using this notification form, DTSC 1772..You must attach a separate unit specific notification form for each unit at this location. There are different unit specific notification forms for each of the four categories and an additional notification form for transportable treatment units (TTU's). 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 notification package and indicate the total number of pages at the top of each page at the 'Page __ of__'. Put your EPA lD Number on each page. Please provide all of the information requested; all fields must be completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any attachments. · The notification will not be considered complete without payment' of the appropriate fee for each tier under which you are operating. (Please note that the fee is per TIER not per UNIT. For example, if you operate 5 units but they are all Conditionally Authorized, you only owe $1,140, NOT5 time~ $1,140. If you operate any ,Permit by Rule units and any units under Conditional Authorization you owe $2,280.) Checks shouM be made payable to the Department of Toxic Substances Control and be stapled to the top of this form. Please write your EPA ID Number on the check. Fill in the check number in the box above. I. NOTIFICATION CATEGORIES Indicate the number of units you operate in each tier. This will also be the number of unit specific notification forms you must attach. Conditionally ~t Small Quantity Treatment operation~ may not operate ~ under any other tier. Number of units and attached unit specific notifications A. ~ Conditionally Exempt-Small Quantity Treatment (Form DTSC 1772A) B. ~ Conditionally Exempt-S~%~ (Form DTSC 1772B) C. Conditionally Authori/_~l_'" / _ '~ X~'~ (Form DTSC 1772C) D. Permit by Rule' [~/~;~ '~'/ (Form DTSC 1772D) EPA ID NUMBER CA NAME (Company or Facility) (DBA-Doing Businesa Aa) PHYSICAL LOCATION Fee per Tier (not per uniO $ 100 $ 100 $1,140 $1,140 Total Fe~ Attached $ /~, BOE NUMBER (if available) H~HQ~_ CITY COUNTY CONTACT PERSON IFo r DTSC Use Only ZIP q~',~/- Region / DTSC 1772 (1/93) Page I EPA ID NUMBER MAILING ADDRESS, IF DIFFERENT: COMPANY NAME (DBA) STREET CITY COUNTRY CONTACT PERSON STATE (only complete if not USA) (First Name) (L~st Name) ZIP - PHONE NUMBER(~).__- IH. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: Use either one or two SIC codes (a foUr disit number) that best describe your company's products, services, or industrial activity. Example: 7384 Photopni~hing .l~_ ~ 3672 Printed circuit boards YES NO YES NO PRIOR PERMIT STATUS: Check yes or no to each question: Did you file a PBR Notice of Intent to Operate' (DTSC Form 8462) in 1992 for this location? Do you now have or have you ever held a state or federal hazardous waste facility full permit or interim status for any of these treatment units? 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? 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? Has this location ever been inspected by the state or any local agency as a ba?~rdous waste generator? PRIOR ENFORCEMENT HISTORY: Not required.from generators ~only notifying as conditionally Within the last three years, has this facility been the subject of any convictions, judgments, settlements, or final orders resulting from an action by any local, state, or federal environmental, hazardous waste, or public health enforcement agency? (For the puq~oses of this form, a notice of violation does not constitute an order and need not be reported unless it was not corrected and became a final order.) If you answered Yes, check this box and attach a listing of convictions, judgments, settlements, or orders aad a copy of the cover sheet from each document. (See thc Instructions for more information) DTSC 1772 (1/93) Page 2 · VI. ATTACHMENTS: Page 3 A plot plan/map detailing the location(s) of th.~ covered unit(s) in relation to the facility boundaries. A unit specific notification form for each umt to'be covered at this location. ore CERTIFICATIONS: This form must be signed by an authorized corporate o. fficer or any other person in the company who has operational control and performs decision-making fitnctions that govern operation of the facility (per title 22, California Code of Regulations (CCR) section 66270.11). All tirade copies must have original signatures. Waste 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 Permittine Certification I certify that the umt 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 1, 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 direcltly 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 fines and imprisonment for knowing violations. Name (Print 9r Typ~) Signature Title Date Signed OPERATING REQUIREMENTS: Please note that generators treating hazardous waste 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 Tier-Specific Factsheets. SUBMISSION PROCEDURES: You mast submit two copies of this completed notification by certified mail, return receipt requested, to: Department of Toxic Substances Control Form 1772 Onsite Hazardous Waste Treatment Unit 400 P Street, 4th Floor (walk £n only) P. O. Box 806 Sacramento, CA 95812-0806. You must also submit one cop~ of the notification and attachments to the local regulatory agency in your jurisdiction as listed in the instruction materials. You must also retain a copy as part of yo,,lr operating record. All three forms must have original signatures, not photocopies. DTSC 1772 (I/93) Page 3 EPA ID NUMBER UNIT NAME NUMBER OF TREATMENT DEVICES: CONDITIONALLY EXEMPT- SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) /" Tank(s) Container(s) Each unit must be clearly identified and labeled on the plot plan at~ached to Form 17'22. Assign your own unique number to each unit. The number can be sequential (1, 2, 3) or using 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 (Section II) if your operations have seasonal variations. WASTESTREAMS AND TREATMENT PROCESS]CS: Estimated Monthly Total Volume Treated: _pounds and/or /3t~ gallons The following are the eligible wastestreams and treatment processes. Please check all applicable boxes: I'-! 1. Treats resins mixed in accordance with the manufacturer's instructions. .["1 2. 3. I-'! 4. ['-I 5. C] ["] 9. Treat containers of 110 gallons or less capacity that contained hazardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. 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. Magnetic separation or screening ~ remove c0mpone'~ts from special waste, as classified'by the department pursuant to title 22, CCR, section 66261.124. 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.) Neutralize acidic or alkaline (base) wastes frora the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator (at the same location) in any calendar month. Gravity separation of the following, including the use of flocculants and demulsifiers if a. The settling of solids from the waste where the resulting aqueous/liquid stream is not hazardous. 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). 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 EPA ID NUMBER CONDITIONALLY EXEMlrr - SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page NARRATIVE DESCRIPTIONS: Provide a brief description of the specific waste treated and the treatment process used. 1. SPECIFIC WASTE TYPES TREATED: p~ 7'-g) /::ig/l~ !/l/~ 5 ]li/~lr~ /2 d.:V,'~-~/A/~ 2. TREATMENT PROCESS(ES) USED: III. RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all residual~ from this. treatment unit. .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 was~te hauled offsite by a registered hazardous waste hauler? If you do, where is the waste sent? Check all that apply. I'-i a. Offsite recycling 1-'] b. Thermal treatment [] c. Disposal to land d. Further treatment 4. Do you dispose of non-hazardous solid waste residues at an offsite location? ["] ~ 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 (~tle 40, Code of Federal Regulations (CFR)). Choose the reason(s) that describe the operation of your onsite treatment units: ' The hazardous waste being treated is not a hazardous waste under federal law although it is regulated as a hazardous waste under Califorma state law. [--] 2. The waste is treated in wastewater treatment units (tanks), as defined 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. DT$C 1772B (1/93) Page 10 ; .~,~ _~-~, EPA ID NUMBER El CONDITIONALLY EXEMPT -~SPECIFIED WASTESTREAMS UNIT SPECIFIC. NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) BASIS FOR NOT NEEDING A FEDERAL PERMrr: (continued) 3. Page ff_~of ~ The waste is treated in elementary neutralizatiion units, as defined in 40 CFR Part 260.10, and discharged to a POTW/sewering agency or under an NPDES permit. 40 CFR 264. l(g)(6) and 40 CFR 270.2. ["-! 4. The waste is treated in a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264. l(g)(5). I-'l 5. The company generates no more than 100 kg (approximately 27 gallons) of hazardous waste in a calendar month and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. The waste is treated in an accumulation tank or container within 90 days for over 1000 kg/month generators and 180 or 270 days for generators of 1130 to 1000 kg/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), and the Preamble to the March 24, 1986 Federal Register. Recyclable materials are reclaimed to recover economically significant amounts of silver or other precious metals. 40 CFR 261.6(a)(2)(iv), 40 CFR 264. l(g)(2), ~md 40 CFR 266.70. ['"] 8. Empty container rinsing and/or treatment. 40 CFR 261.7. l-'l 9., Other. Specify:~ Vo El TRANSPORTABLE TREATMENT UNIT: Check Yex or No. Please refer to the Instructions for more information. Is this unit a Transportable Treatment Unit? If you answered yes, you must also complete and attach Form 1772E to this page. The Tier-Specific Factsheets contain a summary of the operating requirements for this category. Please review those requirements carefully before completing or submitting this notification package. DT$C 1772B (1/93) Page 11 STATE OF CALIFORNIA--CALIFORNIA ENVIRONMENTAL PROTECTION AGENCY =.~____u_~ ~C DEPARTMENT OF TOXIC ES CONTROL 400 P STREET, 4TH FLOOR P.O. BOX 806 SACRAMENTO, CA 95812-0806 (916) 323-5871 PETE WILSON, Governor 10/24/94 EPA ID: CAL0(K~82255 HENLEYS pHOTO INC THOMAS BURCH 2000 H ST BAKERSFIELD, CA 93301 For facility located at: 2000 H ST BAKERSFIELD, CA 93301 Authorization Date: 08/16/93 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/o:r 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, pursmmt 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 caleulat{d 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 notification.,; mentioned above, and your compliance with all applicable requirements in the Health and Safety Code. Any misrepre.~mtation 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. Printed on Recycled Paper Page 2 EPA ID: CAL000082255 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 offic~ at the letterhead address or phone number. Michael S. Homer, Chief Onsite Hazardous Waste Treatment Unit Permit Streamlining Branch Hazardous Waste Management Program Enclosure CC: TIM NAPRAWA 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 ENCLOSURE 1 Un/ts authorized to operate at th/s/oau/o~.- UNDER CONDITIONAL AUTHORIZATION: EPA ID: CAL000082255 UNDER CONDITIONAL EXEMPTION: gl 1 c NSITE W TE T] ATME NOTI CATION ~ ~ -- ; . ~ 'FACIL~ SPECIFIC NO~FICA~ON 0 L no~caaon[o~, D~C 1772. Yo~ ~ ~aeh ~ separate ~ni~ =pee~c ~a~eation [o~ ~or e~eh ~ ~ ~h~ ~e~ion. ~ere are d~erem ~na =pec~c no~catW~ ~o~ [or each o~ ~he [o~r cmegori~ ~m~= ~'s). Yo~ only ~e to =~bma ~o~ ~or the ~ier(=) ~ co,er your ~na(=). D~e~rd or re~e~ ~ o~ ~n~ ~o~. N~ber each page o~yo~r co~p~ ~c~ion pac~ge ~ i~ic~e rhe wml n~ber o~pa~ ~ ~ wp o~ eaeh p~ge ~ ~he 'Pa~e ~ o~ ~ '. Pat your EPA ~ N~mber on each page. Plebe provide M~ o~ ~he info--ion require; ~ ~e~ ~ be completed ~cep~ ~hose ~ha~ =r~e '~ d~erem' The notification will not be considered complete without paymem of the appropriate fee for each tier under which you are operating. (Please note that the fee is per TIER not per UNIT. For eccample, if you operate 5 units but they are all Conditionally Authorized, you only owe $1,240, PLOT5 times $1,I40. If you operate any Permit by Rule units and any units under Conditional Authoriz. ation you owe $2,280.) Checks should be made payable to the Department of Toxic Substances control and be stapled to the top of this form. Please write your EPA ID Number on the checlc Fill it~ the check number in the box above. I. NOTIlelCATION CATEGORIES Indicate the number of units you operate in each tier. This will also be the number of unit specific notification forms you must attach. Cotutitionalty ~t Small Quantity Treatment operations may not otaerate anit~ under any other tier. Number of units and attached unit specific notifications ~--~. ~s Con A. ~ Conditionally Exempt-Small Ql~t~q}~[-~t~_!~orm DTSC 1772A) . .:,.,,". ~ ~ -,:,,% .: %: \ 13. / Conditionally Exempt-$peci.fled?Tastestream ';~or~ DT$C 177213) I Conditionally Authoriz~l T $ '1994 (Fo DTSC 1772C) D. .... Permit by Rule \ k (Fo~ DTS¢ 1772D) / Total Number of Umts Fee per Tier (not per unit) $ 100 $ I00 $1.140 $1,140 Fee $ II. GE,¥ERATOR IDENTIFICATION · EPA ID NUMBER CA . BOE NUMBER (if available) bI~HQ~ NAME (Company or Facility) ;-~.~fl..l L-d~ ~ .~.~ ~/~: "7'--C' JIb/ ~ ~BA-~ing ~si~ ~) crrV COUNTY CONTACT PERSON ca zn, (Firat Naw~) (L~ Name) For DTSC Us~ Only Region / DTSC 1772 (1/93) Page 1 EPA ID NUMBER MAILING ADDRESS, IF DWFERENT:~ COMPANY NAME (DBA) STI~ET Page 2 of~ CITY COUNTRY CONTACT PERSON STATE (only cortkoletc if not USA) (F~. Name) (Last Name) ZIP PHONE NUMBER( ).__ III. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: Use either one or two. SIC codes (a/our digit number) that be-~:t describe your company% products, services, or industrial activiU. Example: 7384 Photofinishing ~ 3672 Printed circuit boards '7 3V4 S, ond: __ YES NO PRIOR PERM1T STATUS: Check yes or no to each question: Did you file a PBR Notice of Intent to Operate' (DTSC Form 8462) in 1992 for this location? Do you now have or have you ever held a state or federal hazardous waste facility full permit or interim status for any of these treatment tinilY? Do you now have or have you ever held a state or federal full permit or interim status for any other ba:'nrdous waste activities at this location? Have you ever held a variance issued by the Department of Toxic Substances Control for the treatment you are now notifying for at this location2 Has this location ever been iaspectect by thc state or any local agency ~ a hazardoua waste generator? Vo YES NO PRIOR ENFORCEMENT HISTORY: Not requirtd from generators only notifying aa conditionally extvnpt. Within the last three years, has this facility l:een the subject of any convictions, judgments, settlements, or final orders resulting from an adtion by any local, state, or federal environmental, hazardous waste, or public health enforcement agency? (For the purl~ses of this form, a notice of violation does not constitute an order and need not b~ reported unless it was not corrected and became a final order.) If you 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) Page 2 EPA' ID NUMlaER Page 3 VI. ATTACHMENTS: A plot plan/map detailing the location(s) of the covered umt(s) in relation to the facility boundaries. A'unit specific notification form for each umt' to be covered at this location. CERTIJ:ICATIONS: 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 fimctions that govern operation of the facility (per title 22, California Code of Regulations (CCR) section 66270.113. All thn~e copies must have original sigrumtr~. Waste 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 Certification 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 1, 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 evaluat~ 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, inc[~ading the pos~ibilityof f'mes and imprisonment for knowing violations. ~ ~ ~ -~f] O ["7 [cfi q Name (Print .or Type) ~1] ,, ~tl~; Title · ' Date Signed Please note that generators treating hazardous waste 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 77er-Specific Factsheets. SUBMISSION PROCEDURES: You must xubmit two copie~ of this completed notification by certified mail, return receipt reqUeXted, to: Department of Toxic Substances Control Form 1772 Onsite Hazardous Waste Treatment Unit 400 P Street, 4th Floor (walk tn only) P. O. Box 806 Sacramento, CA 95812-0806. You must also ~ one aop~ of the notification and attachmems to the local regulatory agency, in your jurisdiction as listed in the instruction materials. You must also retain a copy as part of your operating record. All three forms must have original signatures, not photocopies. DTSC I772 (I/93) Page 3 ¢OND T O ALL-¥ XEM T ' WAST STREA S' -- UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) NUI~ER OF TREATMENT DEVICES: ,. Tank(s) i -- --/-- Container(s) ' Each unit mu~t be clearly identified and labeled on the plot plan cmached to Form 17?2. Assign your own unique number to each unit. The number can be sequential (I, 2, 3) or using any system you choose. Enter the estimated monthly total volume of hazardous waste treated by this unit. This should be tl~ maximum or highest amount treated in any month. Indicate in the narrative (Section II) if your operations have seasonal variations. I. WASTESTREAMS AND TREATMENT PROCESKES: Estimated Monthly Total Volume Treated: ._pouadsand/or /3d? gallons The following are the eligible wastestreams and treatm,~.nt processes. Please check all applicable boxes: ["] 1. Treats resins mixed in accordance with the manufacturer's instructions. Treat containers of 110 gallons or less capacity that contained hazardous waste by rinsing or physical processes, such as crushing, shredding, grinding, or puncturing. 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. Magnetic separation or screening to remove components from special waste, as classified by the department pursuant to title 22, CCR, section 66261.124. ['-! 6. 7. Neutralize acidic or alkaline (base) wastes from the regeneration of ion exchange media used to demmeralize water. (This waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.) Neutralize acidic or alkaline (base) wastes from the food processing industry. Recovery of silver from photofinishing. The volume limit for conditional exemption is 500 gallons per generator (at the same location) in any calendar month. Gravity separation of the following, including I:he use of flocculants and demulsifiers if a. The settling of solids from the waste where the resulting aqueous/liquid stream is not hazardous. 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)., · 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.) DTSC 1772B (1/93) Page 9 EPA' I'D NUM~iER CONplTIONALLY EXEN[Fr. SPECIFIED WAST~AMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201,5(c)) N,&RRATFVE DESCRIPTIONS: Provide a brief description of the specific waste treated and the treatment proce, xs used. 1. SPECIFIC WASTE TYPES",,TREATED: /'~/~i~,;/,~{ ! A-'E.~ ~ L.//'.=; ~ /~ ~L..~t~,;A/~ 2. TREATMENT PROCESS(ES) USED: ~"2.~-(':,TF~.f':/_.Y'T/C. ~ / L ~ ' ~ /~ ~ ~' ~ l' ~ 1TI. RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all resMuals 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? Do you have your residual hazardous waste hauled offsite by a registered hazardous waste hauler? If you do, where is the waste sent? Check all that apply. [--i a. Offsite recycling ['"] b. Thermal treatment ~l c. Disposal to land ~ d. Further treatment 4. Do you dispose of non-hazardous solid waste residues at an offsite location? ~,~ 5. Other method of disposal. Specify: IV. BASIS FOR NOT NEEDING A FEDERAL PERM3~: In order to demonstrate eligibili~, 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 (RCRZ) and the federal regulations adopted under RCRA (']Ttle 40, Code of Federal Regulations (CFR)). Choose the reason(s) that d~scribe the operation of your onsite treatment units: The hazardous waste being treated is not a hazardous waste under federal law although it is regulated as a bn?-rdous waste under California state law. The waste is treated in wastewater treatment ,mits (tanks), as ~Jefmed 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. 'DTSC 1772B (I/93) Page 10 IV. [21 EPA ID NUMBER CONDITION~ALLY EXElVIPT- SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(c)) Page ~of5 BASIS FOR NOT NEEDLING A FEDERAL PERMIT:: (continued) The waste is treated iu elementary neutralization units, as defined in 40 CFR Part 260.10, and discharged to a POTW/sewering agency or under an NPDES tx:mt. 40 CFR 264. I(g)(6) and 40 CFR 270.2. 4. The waste is treated in a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR 264.1 (g)(5). The company generates no more than 1043 kg (-'~pproximately 27 gallons) of hazardous waste in a calendar month and is eligible as a federal conditionally exemp~t small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. The waste is treated in an accumulation taak or container within 90 days for over 1000 kg/month generators and 180 or 270 days for generators of 100 to 1000 k.g/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), and the Preamble to the March 24, 1986 Federal Register. Recyclable materials are reclaimed 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. 8. Empty container rinsing and/or treatment. 40 CFR 261.7. 9. Other:. Specify: Vo TRANSPORTABLE TREATMENT UNIT: Check Yes or No. Is this unit a Transportable Treatment Unit? If you answered yes, you must also complel~e and attach Form 1772E to this page. Please refer to the Instructions for more information. 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 ' ~ooP~ LIe_. Wv ' ..1... puss,~ -0oo~-- 0 PF