Santee City Council
December 10, 2025

Jan 2004 -06Q'O) (6a8efb86a 4ba425e9fbcohrl222) Fax 16193382377 Wal-Mart Stores Inc.

Fax Coversheet
Mon, 12 Jan 2004 13:54:39 -0600
Shannon Murray (Tax)
[email protected]
: Irene
16193382377
Change of Address-All Wal-Mart and Sam's Club in your county my files transmitted with it are CONFIDENTIAL and intended solely for the individual y to whom they are addressed. If you have received this in error please destroy it immediately.
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rt 12 2004 9 -0600) (6a8efb86754f4354ba425e9fbce Fax 16193382377 Page 2 of 4 Here are the list of stores in your county at your request, the permit numbers are included except for 3 locations that I was unable to get. I have put the facility address in the spreadsheet to so you can look those facilities up by that.

Thanks for all of your help.

Shannon Murray
FAX 479-273-4432
PHONE 479-204-2331
Email: [email protected]
Environmental Specialist Ill
t
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(Mon,; 12 2004 13 : q .. 00) (6a8efb86754f4354ba42Se9fbceb. ax 16193382377 Page 3 of 4 Store# Facility Address City
6235 6336 COLLEGE GROVE SAN DIEGO
6234 1900 UNIVERSITY VISTA
2291 75 N BRAODWAY :A;- · CHULA VISTA
. 2253 13487 CAMINO CANADA* 1'3SHO EL CAJON
5023 1200 HIGHLAND AVENUE NATIONAL CITY
2245 705 COLLEGE BLVD .i1= · OCEANSIDE
2494 2100 VISTA WAY oJF. OCEANSIDE
1700 13425 COMMUNITY POWAY
2150 710 DENNERY ROAD SAN DIEGO
2177 3382 MURPHY CANYON DIEGO
2479 3412 COLLEGE AVE. . -it- SAN DIEGO
1917 170 TOWN CENTER PARKWAYi\:1°3"').1'4-$ANTEE
2094 1800 UNIVERSITY DRIVE :t · VISTA
State
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
County

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO
I "
*Mart
Type Permit #

SAM'S CLUB

SAM'S CLUB
WAL-MART HK0?-132371 6HK26 ./'
WAL-MART HK0?-135110 6HK26 ·

WAL-MART
WAL-MART HK0?-134563 6HK26
WAL-MART HK0?-102815 6HK26
WAL-MART HK0?-132227 6HK26
WAL-MART HK07-134282 6HK70
WAL-MART HK07-135594 6HK70
WAL-MART HKlS-138580 6HK15
WAL-MART HK0?-132274 6HK26
WAL-MART HK0?-134236 6HK26
22) Fax 16193382 377 Page 4 of 4
O!nuntv nf "a:n
GARY W. ERBECK

DIRECTOR
August 20, 2003

DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619) 338-2222 FAX (619) 338-2088
1-800-253-9933
Bill Pacheco, Store Manager
Wal-Mart #1917
170 Town Center Parkway
Santee, CA 92071
Dear Mr. Pacheco:

RICHARD HAAS

ASSISTANT DIRECTOR
RE: Compliance Assessment of Wal-Mart's Response to the Compliance Inspection Report The Department of Environmental Health Hazardous Materials Division (HMD) is in receipt of Wal-Mart Store #1917 Response (the Response), dated July 25, 2003, to the Compliance Inspection Report of July 10, 2003. In accordance with Health and Safety Code section 25185 ( c )(3), the following assessment of that Response has been made to determine whether the corrective actions documented or proposed will achieve compliance.

The Response documents several items that have been brought into compliance; however, several other issues do not appear to have been resolved at this time. The items referred to below correspond to the numbered items in the Compliance Inspection Report issued to Wal-Mart Store #1917 on July 10, 2003.

Items Documented as Corrected
Item 2 - Receipts for 2003 battery disposal were received with the Response as requested.

Item 3 - According to the Response, the open, above ground storage tank for used oil will now be closed at all time unless adding or removing waste.

Item 4 - It appears, from waste receipts received with the Response, that Asbury hauled one 55- gallon drum of used antifreeze and three 55-gallon drums (which used to contain used antifreeze) on 7/15/03.

Item 5 - According to the Response, employees have now been instructed to clean up hazardous spills as they occur. It appears that the labeling issues specified in the report have been addressed.

Item 6 -The Response indicates there are photos of these re-labeled drums, and the Department is in receipt of these photos.
"Environmental and public health through leadership, partnership and science" Wal-Mart Store #1917 - 2 - August 20, 2003
Item 9 - A copy of a Hazardous Materials Business plan for Wal-Mart store #1917 was received by this Department and revised. A revised copy has been included in this mailing. Keep this document readily available in your files for use in training and use during the next inspection.

Items Needing Additional Corrective Action
Item 1 - Copies of receipts were not sent with the Response for the following waste streams:
- Used Oil
- Oil/water separation sludge (from the sump in the pit) - Photo processing waste
(The Department is in receipt of: drained used oil filter receipts, paint waste manifests, used antifreeze manifests and battery disposal records).

Item 7 & 8 - The Response did not adequately address training issues. Employee training regarding the four topics in the Hazardous Materials Business Plan (see Training Description Page ofHMBP) must be conducted within the first 6 months of hire and then annually.

Employee's job descriptions must be included with this training documentation. Employees who handle hazardous waste or hazardous materials in the course of their job, must have training that addresses safe handling, labeling and clean up among other topics. Please ensure Tire, Lube Express (TLE), photo processing and any other employees who need this training, receive specific training in these regards. All four topics in the HMBP must be covered annually. Within 15 days of receipt of this letter, conduct training on these topics and submit documentation that this training was conducted. Keep records of this training on site available to your inspector.

A corrective action form has been supplied so you can address these issues. Please complete, sign, date and return the form to my attention with in 15 days ofreceipt of this letter.

If you have questions relating to the complianc_e assessment above, please contact me, at (858) 495-5828. .

Sincerely, >?-------.

Manon Ehrhart, Environmental Health Specialist
Hazardous Materials Division
Attachment
cc: John Misleh, Supervising Environmental Health Specialist Wendy Morgan, Environmental Health Specialist
HMD File #132274
Certified Mail/RRR
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COUNTY OF SAN
-
DIEGO
·I COMPLIANCE INSPECTION REPORT
, an inspection of your business/facility was conducted in order to determine compliance with the California Health and ) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code owing remarks are intended to provide guidance to correct the violations noted on the attached violation report. 1ly oun l\Q_ ct-,' d /\ :
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in 0 k h )£l s . I 0 fV1. 1JJ ll rte. ... (OQ Tu-; ll _o./' no'f C ID\<Z. d. _,. Wdb '? do..y1 cl f>Jg_ ±1\ R.. lid cQ fh IS gnature of Business Representative Date Signed
nt of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 2/99) NCR
DISTRIBUTION: WHITE- RETURN TO HMD

YELLOW-BUSINESS RETAINS
County of San Diego
Department of Environmental Health
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EST. NUMBER It } 3d;) 7 'I
DATE 7 I I 0 I 03

P AGE OF '/ --'----

COUNTY OF SAN DIEGO

SUPPLEMENTAL INSPECTION REPORT
Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186-5261 (619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD
-.-, 1 . 1 •••rt.••,..'"''"',..' .. ,,...," VCI I /"\\Al DI ICIJ\ICCC OCTl\lf\IC EST. NUMBER _g._/_3 ........ ......

DATE ] I /0 I 0.:S
•·. t · Sp-PPLEMENTAL INSJ?ECTION REPORT
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partment of Environmental Health, Hazardous Materials Management Division, P.O. Box-85!&1, San Diego, CA, (619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD
- - · • •
06 • - • ,. .... •-•--• a.·-- VCI I /"\\Al DI OCT Alf\.lC fY ·OF SAN DIEGO
NCE INSPECTION REPORT -1
PERMIT# /
DATE J_1 f() tQJ_
PAGE _J_oFl •
pecific sectio111111111bcrs a/Titles 19 .! of the California Code of Regulations (CCR). Chapters 6.5. 6.95 of the Health (SDCCJ.
m 'or return to compliance to your Specialist. You may use the Corrective Action Form to document your se forms. Please call (619) 338-2222 or your Specialist Ir you have any questions.

EMENTS
mcc. 68.905
mber. 66262.12
DTSC. 66262.23
·ith DTSC. 66262.42
not on-site for 3
osal. 66262.81
1plcted. 66262.23
: on-site. 66262.40
DTSC. 66262.41
1vailablc. 66268.7
iuthorizat ion. 2520 I
'A of onsite treatment
I
lion has incomplete or
.01
>t available. 25244.19
:rials report not

3.10 :losed. 66265.173
mproperly labeled.
packaged. 66265.171
:rly managed. 66265.173
ondition. 66265.171
of property line.
erated lo minimize
Jn or release. 66265 .31
I weekly. 66265.174
r 270 days. 66262.34
Jff floor surface.
·container. 66265.177
separately. 66265 .177
ith waste. 66265.172
5250.7
; managed. 66266. I 30
1roperly labeled. 25124
>N
to: . 25189.5
f hazardous waste. 25163
ta manifest. 66262.20
nade. 66262. 11

TRAINING, CONTINGENCY PLAN & ER PROCEDURES
Viol VIOL VIOLATION DESCRIPTION
#
7 Training records unavailable. 66265.16
V0402 Training program not adequate. 66265.16
0 V0403 Facility not designed to minimize release. 66265.31 D V0404 Spill control equip not available. 66265.32
D V0405 Aisle space is obstructed. 66265.35
0 V0406 Contingency plan not prepared and/or on tile.
66265.51 , 66265.53

HAZARDOUS WASTE TANK SYSTEMS
D Vl601 Hazwaste tanks w/o
P.E. assessment. 66265 . 191 a,
66265.192a
D Vl602 P.E. Assessment report not complete. 66265.191 g, 66265.192k
0 Vl603 Hazwste tank system: no secondary containment.
66265 .193a
0 V1604 Secondary containment not kept empty.
66265. I 96(b)(c), 66265. I 94(c)
D Vl605 No daily tank inspection/inspect. log 66265.195 (b&c) 0 Vl606 Improper or absent spill/overfill protection.
66265. 194b
0 Vl607 Improper corrosion protection. 66265.191, 66265.192 D Vl608 Integrity assessment not done for tanks without secondary containment system. 66265.191
D V1609 Improper use of hazwaste tank system. 66265.196 0 V16IO No PE assessment report-repairs/changes. 66265. I 96g 0 V1611 Improper closure ofhaz waste tank unit. 67383.3, 66265.197

HAZARDOUS MATERIALS REQUIREMENTS

BUSINESS PLAN REQUIREMENTS
0 VIOOI
0 VI002
VI003
D V1004
0 VIOOS
0 VI006
D VI007
0 VIOOS
0 VI009
0 VIOIO
D VIOll
D VIOl2
D V2504
0 V2553
UPF perrnit not obtained for Haz. Materials. 68.905
Hazardous Materials Business Plan (HMBP) not
established/implemented. 25503.5
HMBP not amended to reflect changes25505
HMBP not submitted to HMO. 25505
Emergency Contacts not provided/current. 25509
Inventory is incomplete. 25504
Highly toxic gas (TLV:;:tO ppm) not disclosed in
chemical inventory. 68. 1 113
Annual carcinogen & reproductive toxin list not
submitted to HMO 68. I 113
Site map is not sufficient. 25509
Failure to report a release/threatened release. 25507
Personnel Training records not available. 19 CCR 2732
SPCC Plan required but not prepared. 25270.5 (c)
Owner or operator (0/0) Stationary Source (SS)
with > TPQ of a regulated substance (RS) did not
comply with Chapter 4.5 (CalARP process). 2745. t
010 of a new or modified SS with >TPQ of RS did
Not submit RMP. 2735.4, 25535 (d)
\TIVE DATE TITLE OF BUSINESS
nlSTRIRI ITION· WHITF-R F.TI JRN TO HM f): VF.I.I.OW -BlJSINESS RETAINS . ··.·
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JST. NO. H.__._...._.."'-""'-.:........&.--+-=-- 0 DATE -a TANK CAPACITY __ __ _
CONTENTS U 5 t () t L

SECONDARY CONTAINMENT
TYPE Srf t 1-

YEAR INSTALLED
U/L APPROVED (Y-/N-)--y-·---
TANK ID (if applicable) ____ _
SPECIALIST lff 6'JI) t..( 5 o .?
DA TE OF REQUEST '3 l >C\ I 0 2----
iuirements of the California Code of Regulation (CCR) for e 22 CCR section 66265.1920)). The Local Fire Marshal
__ __ Date t, I JY/o 1
in of the used oil/waste antifreeze above ground storage tank r waste antifreeze only (a non-RCRA waste) as defined in d design per municipal codes and the tank operator maintains nent.
ist, in addition to the requirement of item 3 above, be able to >blems. The HMO strongly advises that the tank system be and zoning requirements.
n logs onsite as required in 22 CCR sections 66265..194-195 :S are in-place at all times to prevent spills, leaks, or overflows <cept when there is a leak or spill, at which time the secondary fa or spill would need to be determined and corrective
oncrete (in good repair) or sealed asphalt (in good condition). 1 to an inspector during facility inspections.
>d for 3 years from the date of request for exemption above. ; a description of the proposed changes in writing to the HMO ons. Attached is a fact sheet developed by the HMO for your irements that may be enforced by other local, State, or Federal __ Date Signed 3 - / Cf -0 :).
n 129261, San Diego, CA 92112-9261; (619) 338-1122
County of San Diego
Department of Environmental Health
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CITY OF SANTEE
rfAYOR
Randy Yoepel
;1TY COUNCIL
Jim Barrell
Jack E. Dale
Lori Howard
Hal Ryan
;1TY MANAGER
Keith Till
June 25, 2001
County Of San Diego
Hazardous Waste Division
Subject: Aboveground Steel Storage Tanks, Wal-Mart, 170 Town Center Parkway, Santee As requested I am providing your office with the most current information on Wal-Marts aboveground oil storage tanks. Type of tanks that Wal-Mart has installed, is as follows.

Aboveground storage tanks forflammable and combustible liquids and was manufactured and tested by Hoover Containment, Inc. in accordance with the requirements of the Underwriter's Laboratories Standard UL 142.

Type of storage tank for Wal-Mart is a Luke Cube aboveground storage tank, for flammable and combustible liquid and designed UL 142. UL 142 is the standard for steel aboveground tanks for flammable and combustible liquids. The listing meets all requirements for atmospheric tanks of the National Fire Protection Association Section 30, 30A and the Uniform Fire Code Article 79.

Phil Davis, Dep ty Fire Chief
Fire and Life Safety Manager
10601 Magnolia Avenue • Santee, California 92071-1266 • (619) 258-4100 • www.ci.santee.ca.us Q Primed on recycled paper
ER Containment Inc.
6740 Bay Meadow Drive
Glen Burnie. MD 21060
-·

INSTALLATION
OF

ABOVEGROUND STEEL STORAGE TANKS
410-787-0010
FAX: 410-787-0011
1-800-777-2823
Aboveground Storage Tanks for Flammable and Combustible Liquids are manufactured and tested by Hoover Containment, Underwriter's Inc. in accordance with the requirements of the Laboratories Standard UL 142. · Proper installation is of utmost importance to ensure the expected service and life of the tank. The following installation· suggestions are furnished for your consideration.

1. Handle tank carefully. Use cables or chains of adequate length (not more than 90 degrees between the chains) attached to lift lugs provided. Oversize hooks will tear the lift lugs - use shackles, if necessary.

2. To insure compliance with applicable codes and regulations, tank and piping should be retested at jobsite before being enclosed, or placed in use, using 2 psi air pressure as soap solution is brushed over weld seams. Inspect tank contents before filling and replace tin caps with pipe plugs or · capped piping before test.

3. When testing a double wall tank the inner tank should be pressurized maximum to a of 2 psi then pressurize the outer tank by bringing the pressure up very slowly to 2 psi. Maximum capacity of the outer tank is very small in relation to the primary tank capacity. Compressors used for testing can over pressurize the outer tank space in seconds causing serious damage to the tank. ..

4. Install appropriate primary and emergency vent connections as indicated on tank and drawings.

5. Do not cut or weld on any tank that contains flammable or combustible liquids or vapors. Fire or explosion may result.

6. Contact your local Fire Marshall to assure compliance with local regulations and codes.

7. Be sure all drain plugs are secure by applying T efton tape or pipe dope around cast iron plug. 1/96
"Your Partner In Containment Solutions"
· e
1:. '\PONTAINMENT
.
·SOLUTIONS
A DENALI COMPANY 67 40 Baymcadow Drive Glen Burnie, MD 21060 --
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410-787-0010
Fax: :410-787-0011
LUBE CUBE, BENCH TOP, CATWALK, & UNDERCA 1W ALKS SPECMCATIONS .
. for

ALL AND/OR SECONDARY CONTAINMENT ABOVEGROUND TANKS FOR FLAMMABLE AND COMBUSTIBLE LIQUIDS NON FIRE RATED

1.0 GENERAL TANK DESCRIPTION:

1.1 Luke Cube Aboveground Storage Tanks, for Flammable and Combustible Liquids are designed, constructed, and listed in accordance with Underwriters Laboratories, Inc. Standard UL 142. UL 142 is the standard for St.eel Aboveground Tanks for Flanunable - and Combustible Liquids. The listing shall meet all requirements for atmospheric tanks of The National Fire Protection Association Sections 30, 30A, 31 and The Uniform Fire . Code Article 79 ..

1.2 Lube Cube tanks are designed and t.n.. listed as atmospheric tanks with a maximum · working pressure of l PSI. /·

1.3 The primary tank and the secondary contairunent tank shall have passed a proof of design hydrostatic pressure test of 15 PSI.

1.4 Each singlewall Lube ·cube tank shall be.equipped With six (6) NPT openings including one for an emergency vent. All secondary containment Lube Cubes shall incorporate the single wall openings plus an additional two (2) NPT openings, for monitoring the interstitial space and an emergency vent. The emergency vents shall be sized per NFPA & lfl... 142 requirements. l .S The tank shall be equipped with a minimum two (2) lifting lugs.

1.6 The tank Manufacturer shall provide proof (upon request) of a minimum S years of manufacturing l:JL 142 listed RECTANGULAR tanks.

1.7 · Luke Cube tanks include a 1 year warranty.

1.8 Threaded PVC plugs in fittings, not water tight.

2.0 PRIMARY STORAGE TANK (SINGLEWALL TANKS>
.

2.1 The primary storage tank shall be rectangular in design.

2.2 The welds shall be continuous.

The primary storage tank shall be constructed of ASTM A-569 or A-36 carbon steel, as required for compatibility of product being stored.

The primary tank shall be pressure tested in the factory to the UL 142 specifications. PHQ .

All foreign materials shall be removed from the surface of the tank.

The primary tank exterior shall be painted with l coat of shop primer.

The tank shall have a minimum of two (2) support feet.

SECONDARY CONTAINMENT TANK CDOUBLEWALL TANKS>
The secondary containment tank shall be rectangular in design.

The welds shall be continuous.

The secondary contairunent tank shall be listed by Underwriters Laboratories as secondary contairunent under standard UL 142.

The secondary containment tank shall provide a minimum of 110% secondary containment.

The secondary contairunent tank shall be equipped with a 2 inch monitoring port and a 4" to 6" or 8". vent port as required by Laboratories Inc.

The secondary contairunent tank exterior and that portion of the exposed primary tank shall be painted with 1 coat of shop primer . . The secondary contairunent tank shall be pressure tested in the factory to the UL 142 speci!ication. (3 MAY 1998
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WAL-MART #1917 RECEIVED
-------w01-.TJL- s- Arl 11q .. u--·
July 2, 2001
San Diego County Dept. of Environmental Health
Hazardous Materials Division
Attn: Mr. Catubay I Mr. Garchiturenas
P.O. Box 129261
San Diego, CA 92112-9261
Dear Sirs,
D. E. H.

MAJLROO i;
Per direction received from your visit on June 8, 2001, the following documents are enclosed for your perusal:
• Updated Business Plan
• Updated Site Plan
• AST Certification & Engineering Assessment for above ground waste oil tanks • Approval letter from Santee Deputy Fire Chief for above ground waste oil tanks If you have any further questions, please don't hesitate to contact me.

Sincerely,
Bill Pacheco
Store Manager
--

COUNTY OF SAN DIEGO

COMPLIANCE INSPECTION REPORT
fNESS NAME WAL- MAR.\ * lC\I 1
-RESS 170 \04)r..I C.1.>
'/ZIP --SA C. A q 7o1 (
e above date, an inspection of your business/facility was conducted in order to de ine compliance with the California Health and 1 Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code C). The following remarks are intended to provide guidance to correct the violations noted on the attached violation report.

Office Use Only
91J.N 1 4 2001
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Department of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 HM-924 (Rev. 2/99) NCR
DISTRIBUTION: WHITE- RETURN TO HMO
YELLOW-BUSfNESS RETAfNS
County of San Diego
Department of Environmental Health
EST. NUMBER H ;3 ::i._'"2,"7 4
DATE 0& I 0 I 0 (
PAGE OF 7
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f OF SAN DIEGO . NUMBER H 32274
;E INSP;ECTION DATE _o ...... c;---'-1 _0_,_g-'"-'-1-=o_,l.___ PAGE :3 OF 2>
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• specific section numbers of Titles 19/22/23 of the California Code of Regulations (CCR), Chapters r the San Diego County Code (SDCC).

II UNDERGROUND STORAGE TANK (UST) REQUIREMENTS:

V0108 W
vo1osw--
vo11s w
V0120W
vo11sw--
vo121 w--
vo122w--
V0123W--
V0116W--
V0124 W
V0221 W
> V0313W--
V0222 _W--
V0223W
vo202w--
vo2osw--
vo21ow--
vo226w--
V0207W--
V0224W--
V0213W--
V0214W--
vo21sw--
vo216W
V0313 W
V0319W--
V031SW--
V0316W--
V0317 W
ROCEDURES vo4os w
V0406W--
VOS01 w--
VOS08W--
VOS09W
V0609W __
V022SW
V0701 w--
V0702 W
V0125 W
vo12sw--
:QUIREMENTS:

V2001 W
v2002w--
v2001w-/
V2302 W
V2008W __

GENERAL UST REQUIREMENTS
[ ] Health Penrut not obtained 68.1005, 25284
[ ] Repair/modify/close permit not obtained 68.1005
[ ] UST Permit Application not submitted 25286(a)
[ ] Operating permit conditions violated 2712
[ ] Failed to notify HMMD of changes 25284
[ ] No owner/operator agreement 25284
[ ] No records of financial coverage 25292.2
[ ] No mainl/monil/calib records available 2712(b}, 2641(j) [ ] Monitoring F.quip. not tested annually 2630, 2641

MONITORING REQUIREMENTS (SINGLE WALL)
[ ] Leak Detection Method does not meet
performance standards 2643
] Integrity test not conducted 25292
] Copy of tank test not submitted to HMMD
within 30 days 2643
] Manual tank gauging (<2000 gal) 2645
not done properly
] Reconciliation not done properly 2646
] Reconciliation not approved for facility 2646
] Dispenser meter(s) not calib annually 2646
] Improper liquid measurements 2646
] Stick in poor condition 2646
] Improper monthly reconciliation 2646
] Failed to report excessive variation 2646
] Pressurized Product Piping Leak Device
not tested annually 25292
] No written monitoring procedure 2641
] No written emergency response plan 2641
] SIR reporting incorrectly done 2646.1

OUBLEWALL

RELEASE REPORTING
[ ] Failure to report an unauthorized release 25295
[ ] Release record log not available 2651 , 2650
[ ] No leak report/investigation/action 2652

CLOSURE
[ ] Temporary closure req. not completed 2671
[ ] Unused tank not properly closed 25298
[ ] Permanent closure req. not completed 2672
[ ] Failed to apply for temporary closure 25298

BUSINESS PLAN ELEMENTS
[ ] Emergency Response Pian inadequate 25504
[ ] Emergency Contacts not provided/current
25509
[ ] Pers el Training Program inadequate 25504
[ ] entory is incomplete 25504 J Site Map is not sufficient 25509 [ ] Acutely Haz. Mat. not registered 25533
V3002 T
V3007T--
V3010T--
V3011 T--
V3012T--
V300ST--
V3013T--
V3001 T--
V3003 T
V3014T __
V3015 T
V3016 T
V3017T __
V3018 T
V3019T--
V3020T--
V3021 T--
V3022T--
V3023T--
V3024 T
V3025 T
V3027T--
V3027T--
V3004 T
V3026 T
V3027T--
V3028T--
V3029 T
V3009 T
V3030T--
V3031 T
V3006 T
V3032T--
V3033T--
V3008 T
V2201 W
V2203 W
V2005 W -
Vl009W __
LEASE CALL (619) 338-2222 OR YOUR INSPECTOR IF YOU HA VE ANY QUESTIONS. c·
E DA TE SIGNED " TITLE
jous Materials Management Division, P. 0. Box 129261, San Diego, CA 92112-9261

WHITE-RETURN TO HMMD

OW-BUSINESS RETAINS
.· .....
. .
. ·-:, ·.- .· -:. ..· .. : .·.: . ·
.
..
!1{.ARDOUS MATERIALS & WASTE H# Date (
csocc6s.9o5and1f,a. W" Name (t.,: 03
(66265.53,25505) 7-}}tJ6 AddreSSL].O"fDV<lrJ C..ffiPf<l,dyStop 1--(u Coordinator verif1 66 5 . .52, 25509) tt:i-a1-J.

ZCOSFIR."f C-.-Y8'iTORY & WASTES ON HE 24 (25508(b)(vcrify), 25509(a)(maua{ inventory), 25509 . .3 (aamial w:me)) _JOB DESCRIPTION (66265.16) (66265.16, 25504(c), 2732)
ZliNIFOR.\.f HAZWASTE MANIFESTS, MII...KRUN MANIFESTS. EPA ID# (66262.40, 66263.42, 66262.12) _
WEEK.LY CONT AlNER INSPECTIONS (66265.174)
_
DAfLY·WASTE TANK INSPECTIONS Log (66265.195)
_••ABOVE GROUND HAZARDOUS WASTE. STORAGE TANKS (ASrs) PE CERT Plans A ImtaDadoa (6626'.191.ln) Wasce Containers: CLOSED, LABELED, GOOD CONDmON,AlSLE SPACE. CLEANUP &SAP'ETY£QUIP. ;coMPA TIBLE WASTE SEGRA TED, IGNITIBLE w ASTE GROUNDED & so FEET. IF REQUIRED SECONDAR.Y JNT CLEAN & ADEQUATE. APPROPfA TE SEct.JR.ITY. (22 CCR Chapter 12 & 15) ':-.'ore: Used oil and Antifreeze storage tanks may have the PE assessment conditionally waived it they comply with aill eoMiriom :ted in H.\lf.D form #927 l. · ::

ARGE QUANTITY HAZARDOUS WASTE GENERATORS
_ BIENNJAJ_ REPORT> I 000 Kg of RCRA Waste ANY ONE MONIH (66262.41) . . _ · SB 14 SOURCE REDUCTION PLAN-> 12,000 Kg/year, CERTIFICATION (PB. Rl!A, ID!mlal Ofticia1) (25244.19). :o;rc:ss every 4 Plan, Progress report & Summary progres! report due 911199. _
SPCC: Petroleum storage > 660 gals in one AST, or> 1320 gal above ground.. (PE review) (25270.S(c)) 'AZARDOUS WASTE RECYCLING
_Record of Who, for Wbar, Legitimate Market (25143.2(f)) _
CllPA on required form>lOOKg/mo (25143.IO(a))
1'AZARDOUS WASTE TREATMENT
_
UN1FIED PROGR.A.!\11 FOR.i.\ifS & AITACHE.MENTS (PBR (annual): 67450.2, CA: 25200.3(e), CE: 25201.S(d)) __
& CONTAINER SECONDARY CONTAINMENT PE CERTIFICATION (CA: 2S200.3(c)(4), PBR: 674S0.3(c)(9) _ANALYSIS INFLOW (CA: 25200.3(c)(6), CE: 25201.S(d)(3)) .
_QUANTITY TREATED (CA: 25200.3(c)(6), CE: 25201.S(d)(3)) _WASTE ANALYSIS PLAN (PBR: 67450.3(c)(8)A & 66265.13(b)) _ANALYSIS OUTFLOW (PBR: 67450.3(c)(IO), CA: 25200.3(c)(6)) _
WASTEWATER DISCHARGE PER.i.\i!IT CA:25200.3(c)(7), CE:2S201.S(d)(6)) _OPERATING PROCEDURES (CA: 25200.3(c)(6), CE: 25201.S(d)(3)) . _EMERGENCY PROCEDURES (66265.53) ·-·INSPECTION PROCEDURES & LOG (PBR; 67450.3(c)(8), CA: 2S200.3(c)(S), CE: 2S201.S(d)(3)) _
SECtJRJ."TY & SIGNS* (CA 66265.14 & 66265.17), FACILITY STANDARDS (PBR: Title 22, Chapter 15, Article 2) _
CLOSl.IR.E PLAN (PBR: 674S0.3(c)(ll))
_FINANCIAL ASSURANCE (FORM 1232), (CA & PBR: 67450.13)
_PHASE I ENVIRONMENTAL SITE ASSESSMENT (Form 1151), (CA & PBR: 25200.14) __ ANNUAL WASTE·MINIMIZA TION CERTIFICATION (PBR: 66262.45, CA: 25200.3(c)(2) & _ANNUAL REPORT upon request to DTSC (PBR 67450.3(c)(l0)) .. _
NOTIFlCA TION of NEW OWNER of TREATMENT. (CA & PBR 66265.12)

VTEDICAL WASTE GENERATORS
_
DEH permit obtained SDCC 68.1202 and 68.1203
_MEDICAL WASTE MANAGEMENT PLAN ... not required for KlO sites, EMERGENCY PROCEDURES (117935) _
BIOHAZARDOUS WASTE TRACK.ING DOCS (117943 & 945)
_ACCUMULATION AREA POSTED & SECURE ( 118310)
.
_CONTAINERS LABELED (BIO. CHEMO, PATH, Pharmaceuticals-INCINERATE ONLY) (118275) Name, (68.1201)
SOLID WASTE DU1vIPSTERS SECURE from UNAUTHORIZED ACCESS (68.1202) _LIMITED QUANTITY HAULER EXEMPTION (118030)
'vfEDICAL WASTE TREATMENT
_
PERMIT Reqd if >200 LBS/MO (HSC 118130)
r nr.· nATE. TIME, TEMP, MONTHLY SPORE TESTS (118215) - --- • _..,.""""It t C\ WW L 5 b
- ,,_!J,, rJ7 •"
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Hazardous Waste Tracking System - Reports e
California Home
Home
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EPA ID: CAC000778800 Name: lX WAL-MART STORES
INCORP.

Status: INACTIVE Inactive Date: 2000-10-25 Contact:

RON CLOER PROJECT MANAGER
County: SAN DIEGO SIC: Record Entered: 1992-10-
19 L d d ast UD 2000 10 25 1 ate : - -
I llName II Address llcity
lX WAL- 170 TOWN
Location MART STORES CENTER ISANTEE_CA INCORP. PARKWAY

llstatellz1p
IEJE
?OJ SOUTH Mailing WALTON BENDONVILLE AR 7271
BLVD
INCORP.

RON CLOER
DI-- IEJE Oper/Contact PROJECT MANAGER
B ase dONLY UDOn EPA ID CAC000778800 . .

Out-of- Toxic Calif. State Transporter Calsites Manifests? Manifests? Registration? Inventory Data? Data?

I NO II NO II NO II NO II NO I
End of Report
http://hwts.dtsc.ca.gov/ireports/facsrch03 .cfm ?epa _id=CAC000778800 12/8/2005 Hazardous Waste Tracking System - Reports Page 1 of3
Toxics Questions?
Public Notices
Calendar
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Site Cleanup
Managing Hazardous
Waste
Pollution Prevent!®
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''I
Depam;nt
-
-
Of Toxic
California Home
DTSC: HWTS Reports
HWTS EPA ID Profile
EPA ID: CAL000113791 Name: WAL-MART STORE
#1917
Status: ACTIVE Inactive Date: Contact: JAMIE

HUENS/ENVIRONMENT AL MGR
County: SAN DIEGO SIC: 45211 Record Entered:
1993 -08 -20 L d d ast uo ate : 2005 -09 -27
I llName Address
jw AL-MART STORE# 1917 170TOWN Location CENTER

PARKWAY
I
508SW
Mailing 8TH
STREET
81WAL-MART STORES, INC.
508SW
8TH
STREET
Oper/Contact l=E HUENS/ENVIRONMENT ALI 508 SW 8THST
EPA ID: CALOOOl 13791 Name: WAL-MART STORE
#1917
Status: ACTIVE Inactive Date: Contact: JAMIE

HUENS/ENVIRONMENTAL MGR
County: SAN DIEGO SIC: 45299 Record Entered:
1993-08-20 Last undated: 2005-09-27
II city
ISANTEl
IBentonv
IBentonv
IBentonv
I ll:::::N=am=e============llAddress llcity
!Location Jlw AL-MART STORE #1917 ISANTEJ
Mailing I I IBenronv
II
http://hwts.dtsc.ca.gov/ireports/facsrch03.cfm?epa id=CALOOOl 13791 Hazardous Waste Tracking System - Reports
e
c__J 11 WAL-MART 1508 SW STORES, INC.
0 IC t t
I
JAMIE HUENS/ENVIRONMENTALI 508 SW
per on ac .MGR -8TH ST
B ase dONLY upon EPA ID CAL000113791 . .

Out-of- Toxic Calif. State Transporter Release Calsites Manifests? Manifests? Registration? Inventory Data? Data?

I YES II NO II NO II NO II NO I
Calif. Manifest Counts and Total Tonnage
m = Manifest Count t=Total Tonnage
Ship Generator Trans. 1 Trans. 2 TSDF Alt. Year TSDF
Q (m) Q(m) Q(m) Q(m)
1994 0.00000 0.00000 0.00000 0.00000 0.17500 (t) (t) (t) (t) (t) l (m) Q(m) Q(m) Q(m) Q(m) 1995 0.00000 0.00000 0.00000 0.00000 0.10500 (t) (t) (t) (t) (t) l (m) Q(m) Q(m) Q(m) Q(m) 1996 0.00000 0.00000 0.00000 0.00000 0.05500 (t) (t) (t) (t) (t) 2(m) Q(m) Q(m) Q(m) Q(m) 1999 0.00000 0.00000 0.00000 0.00000 0.70850 (t) (t) (t) (t) (t) l (m) Q(m) Q(m) Q(m) Q(m) 2004 0.00000 0.00000 0.00000 0.00000 0.05600 (t) (t) (t) (t) (t) Waste Code By Year Matrix Report
Calif. Generator I Trans. 1 I Trans. 2 TSDF Alt. TSDF
RCRA Generator I Trans. 1 I Trans. 2 TSDF Alt. TSDF
End of Report
http://hwts.dtsc.ca.gov/ireports/facsrch03 .cfin?epa _ id=CALOOO 113 791

12/8/2005
·'
S1a11 of Calilor11i11-En1ir1111m1111af Proltelion Aooncy See Instructions on back of e 6. Otparlmtnl al fo.,c Sub111111c11 Conlrol Sacramonto, Calif0tnia
foim App•.,.ed OM& No. 2050-00l9 lf•pirai 9•J0·99} Plea11 p1;n1 or 'YP" · form d,.iaord lot u11 on olil• I I 2·pitc ::::1
c(
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UNIFORM HAZARDOUS Ma11il111 Docu.,enl No. l Pago I lnforrnaliOll i11 1he 1hoded cu1a1 WASTE MANIFEST 1 .7 9 . 2 0 ... 2 h not 1 equited liy hdoral fnw. ....... ol 1 ...... WAt=ro•MAR'I' and tAnlllno Addr•n

1.70 TOWN CENTER PARKWAY.SANTEE 92071
(818)449.8215 . A. Gontrolor'• Phone I ) ·

5. frn111porltr I Campany Noma
E
_c:;oloav Industries

1. frnn1porlor 2 Campany Noma
'ERIGKS\:)N1•1N&.• and Silo Addrau
·13739 SLOVER AVE;

6. US f PA ID Number
C .. AD98

8. US EPA ID Number
IO. US EPA ID Number
A. $1u1e· Manrl11l'Docum1n1
a. Slato GenerlllO•'t ID
C. State lran1pcrtor'1 ID 0 .. 1. 7 3
E. State Tran1poit1r'1 ID
f. lfDll1part1r'1 Phone
G •. Stoto f.ac.ilitr'a ID ,, . ., · , . ........ .,. . .. ,;, .. •: .,. oai: c!. A Oil) J :J U')l5
• · j:cSNTANA; cA"" 92337 ··: .. 9 3 3 , H. . . ... .Focili17'1Phollw . ... ...... . . · . (909)366 "6S01 -. . i .. . ... . .. . : ..... , ..• .. - ..... ......... .. . ...... r-z
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ADDRESS:SAME EMERGENCY.C()NTACT:(909)366-5601. JOBt1'7808 Tank(s)#7919 ...

Na. l 1 Ovanlil Wt/Vol I. Wn1te Number
Stol612 1' ••
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Stale
EPA/Olhor
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Ii. Hnndlino Cod11 for Wo1t11 Lllled Abo.t
a. q'j b.
c. d.

16. GENERAJOl'S CHflflCr\lfON: I heroby docla;e thot ti•• canlon" ol thi• can•ignn1•nl cue fully and accuratoll deicribod cibavo proper 1hipfino numo nnd are cla11ili1d, pacled, moiled, and lob1lod, and or• in all r .. pac11 in prupar condi1io11 for ltanaport by highwo11 acca1ding ta appticablt lutomationol and nnliclna oovornmtnl 11oulci1ian•.

II f um a laro• quantity o••truior, I "'till' 1ho1 I have a program In pluco lo reduce rho valumt and loaicity al waato g1noro11d to 1h1 deo••• 111 .. • dt111mlntd lo bo wcononrlcully ruacticabfo and tl1<ll I hava 11lectad lht praclicable m1tl1od of trootmanl, 1tarag1, or di1pa1al curranily awillabf1 lo ma which minlmi111 rho preHnt and lu1u10 d1t1ul ta human health and Iha onviranmenl; 01, ii f am a 1111011 quantity gnnaralot, I huvo modi u good faith effort la 111inin1iu my "'OllD oonorotion und •al1c1 Iha b111 wa110 managam•nl method rhat i1 owailahla to mD aud thatl con allord.

Doy Yoar
.. . .

PrintMl/Trped Nam• Signa!:;
1 /1 L. ,- A. t
,...
10--- tJ 1
DO NOT WRITE BELOW THIS LINE.
orsc 602lA IA/971
EPA 8700-22 ..... ...... ....... .. .. ...
-
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..
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.:• ... .. . •• ... :•
Whitu: tSOf SENDS TlllS COPY TO DlSC WITlllN :10 DAYS,
............... , .. . .. . .... ..... ..... . To: f'.0. Oo• 3000, S.mrnnonlo, CA YSUl2 . .. . . ' .. :· .. .. . ..

I
_
Slota of Califorftia-En•ironm11n1al Ptolec•ian Agal\cy for"' Appruvtcl 0M8 Na. 20.50•0039 (f•11im 9-30-991 Pl•••• prinl ., typo. fornulo1i11ned lor ul<I on al;lt /I :!·pitch} r,powri1ar. See Instructions on back of page 6. Dopo•lm•nl of fa•c Sub"""'"' Ccat.fornia 0 '" Ill " c'f "" a:I
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UNIFORM HAZARDOUS

WASTE MANIFEST
lron1pa1111 I Campuny N""''

1. c;..;,;;;,., US EPA ID Na
ASBURY ENVIRONMENTAL SERVICES Id
7'.'°fran•porlar 7 C°"'pany Noma

9. Do1ignatotl Focilil)r Noma and Silo Add1011

ADVANCED ENVIRONMENTAL
lm!l llllTml IWEllEtfDlrlltl,DI m
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8, US f PA ID Nurnbor

10. US f PA ID Nu .. bor
RQLENUIRONMENTALLV HAZARDOUS SUBSTANCESLLIDUID, Nos, (ETHYLENE GLYCOL & b.
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>: .:;i); .......... -_ :-.. -.. -. .....,,_ -(-. · .. ·-.. -.. --. -.-···-•·-'

15. Special Handlillo ln11ructiao1 ond Addi1iaoal folor"'a1ion

11.DVEB I m.ES
MEISI 171
000033
EMER&EN:Y aJa'llCT11E. lllRIU318l46HH9

16. GlllfRAJOJ'S CHllflC:ATION: I h111br deduro 1ha1 lhe conlonl• al lliiuonalo""""'I oro lullr anJ accura1alr.deacribad ""°'" br p•opor ,J,;ppi•o ""mo nnd nto 1 lauiliad, pacLoJ, ,...,Loci, and lnbtlad, anti aro In all r11ptc11 in proper caodilion lar knn•porl i>r hiol•wor accorcfinu ra applkaLla lnlornntianal or1d onrianal (JO•arnmant r1oulnlion" fl I am a laroe qunolily ll"•lralor, I c••"'r thal I hn.a n pr09forn la plrva ta taducu lho ••"'"'• ood tualciiy al wa1la o•naralad lo d1e d"ll"' I "°'" J11a1111inocl la ht ........... pr11Clicabla anJ lhol I have 1tloc11d 1ho li'octicablo ... Iliad nl lrea...,.r, •lotDG•• ar diaf>!!tol rurrontlr ovailolilo lo '"' ,.hfch rqinimi,., dit proaalll and lututo 1hraal la h-n hoallh and lhe anvfronrnonl; OR, I am a ''"°' quonlil)' gtneralar, I havo 11adt a ui>ad loi otl to mf n1ira my wa1la ganoratlon and 11loc1 lhcr hoal wnalo m""oO•monl mothod lhnt I• availoblo lo ••• and thnl I can allard .

19. DllCrepancy lnrli<alian Space
Monrh Dny Yoor
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MSC H072A ( 1/991
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Slole of California-Environmental Prolection Agency See Instructions on back of p 6. Departmenl of Toxic Sub•tonces Conlrol Socromento, Colilarnio
Farm Approved OMB No. 2050-0039 (Expires 9·3C-99}
Please print or type. Form desi9ned For u•• on elite /I 2·pilchJ .I•
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WASTE MANIFEST

3. Generolor'• Name and Mailing Address WALMART
170 TOWN CENTER PARKWAY
ATTN: BILL PACHECO
. s·ANTEE CA 9 2071
.d. Generator's Phone ( 6191 449-7900

5. Transporter I Company Nome
SAFETY-KLEEN SYSTEf1.S, INC

7. Transporter 2 Company Name
Shi iii 9¥9 IBHS 'I'

9. Designated Facility Name and Sile Address 000658
SAFETY-KLEEN SYSTEMS, INC. 3700 LAGRANGE .ROAD
SMITHFIELD KY 40068

6. US EPA ID Number
T

11. US DOT Descriplion (including Proper Shipping Name, Hazard Class, and ID Number) a. RB WASTE FLAMMABLE LIQUIDS, N.O.S. CTOL ENE Q ALIPHATIC HYDROCARBONS) UN1993 PG 1I FOOS ERG 128 b.
c.
d.

J. Additional Descriptions for Maf!•ials listed Above
IA) 0001
MonilHt Documenl No. 2. Page 1
of 1
Information in lhe shaded area•
is not required by Federal low.

A. Srate Manifest Document ·Number 23012666

8. Stote·Generalor's ID
C. Slate Tran•porter's ID [Re19rved.J
.o. Transporter's Phone

15. Special Handling Instruction• and Additional Information MFST R/T#l04470607 0001-8355-39 EMERGENCY RESP 800-468-1760(24 HR). S:A 1135804 C:A 1713187-2 SK CORf AUTHORIZED TO RETAIN LICENSED SUBSEQUENT CARRIERS AS NECESSARY. REP {(.,,.

16. GEN OR'S CERTIFICATION: I hereby declare lhal lhe canlenls ol lhis consignmenl are fully and accurately described above by proper shipping name and are clauilied, packed, and labeled, and are In all respects in proper condilion far transport by highway according lo opplicoble inlernationol and nolional governmenl rtgulalions. 111 om a large quantity generator, I certify thar I have a program in place to reduce the volume and toxicity of waste generated to the degree I have delermined lo be economically practicable and tho! I have selected lhe l'rocticoble melhod of treatment,. storage, or disposal . rrenrly available to me which minimizes the presenl and f..ture 1hreat to human health and lhe environmonl; OR, ii I am o small quanlily gentrator, I hove made a gOod lailh elf la minimize my wasle generation and selecl the best wasle manogemenl melhod tho! is available to me and lhal I can aflard.

Prinled/T
PRQLI A)0001713187
Wh ite: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS.

EPA To: P 0 . Box 3000, Sacramento, CA 95812 8700-22
Hazardous Waste Tracking System - Reports Page 1 of2
Toxics Questions?
Public Notices
Calendar
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Policies
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Managing Hazardous
Pollution Prevention
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California Home
DTSC: HWTS Reports
HWTS EPA ID Profile
EPA ID: CALOOOl 11207 Name: WAL-MART STORES
#1917
Status: INACTIVE Inactive Date: 2000-06-30 Contact:

JAMIE HUENS/ENVIRONMENTAL MGR
County: SAN DIEGO SIC: 45211 Record Entered:
1993-04-22 Last updated: 2005-03-02 I llName !!Address llcity Location IWAL-MARTSTORES#l917
!Mailing II IBENTO:
!owner llw ALMART STORES, INC. llDEPT 8013 llBENTO:

Oper/Contact =E HUENS/ENVIRONMENTAL 702SW 8TH E BENTO:

STREET
B ase dONLY upon EPA ID CALOOOll 1207 . .

Out-of- Toxic Calif. State Transporter Release Calsites Manifests? Manifests? Registration? Inventory Data? Data?

I YES II YES II NO II NO II NO I
Calif. Manifest Counts and Total Tonnage
m = Manifest Count !=Total Tonnage
Ship Generator Trans. 1 Trans. 2 TSDF Alt. Year TSDF
I I
http://hwts.dtsc.ca.gov/ireports/facsrch03.cfm?epa_id=CAL000111207 12/8/2005 Hazardous Waste Tracking System - Reports Page 2 of2
1995
1996
1997
1998
1999
2000
2003
Ship
Year
1996
Calif.

RCRA
l (m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 0.14590 (t) (t) (t) (t) (t) Q(m) Q(m) Q(m) Q(m)

0.00000 0.00000 0.00000 0.00000 1.18390 (t) (t) (t) (t) (t)

3. (m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 0.60450 (t) (t) (t) (t) (t) .8. (m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 1.66770 (t) (t) (t) (t) (t) 2(m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 1.75130 (t) (t) (t) (t) (t) l(m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 0.16680 (t) (t) (t) (t) (t) l (m) Q(m) Q(m) Q(m) Q(m) 0.00000 0.00000 0.00000 0.00000 1.25100 (t) (t) (t) (t) (t) Out-of-State Manifest Total Tonnage
Generator Trans. 1 Trans. 2 TSDF

0.2293 0.0000 0.0000 0.0000
Waste Code By Year Matrix Report
Generator Trans. 1 Trans.2 TSDF Alt. TSDF
Generator Trans. 1 Trans.2 TSDF Alt. TSDF
End of Report
·-
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...

Cal/EPA I Air Resources Board I California Integrated Waste Management Board Office of Environmental Health Hazard Assessment I State Water R• Conditions of Use I Privacy Policy I E-mail Webmasl•
The content found herein may not necessarily represent the views and opinions 01 © 2003 State of California.
http://hwts.dtsc.ca.gov/ireports/facsrch03.cfin?epa_id=CAL000111207 12/8/2005 •
See ln1tructlon1 on back of page 6.

Stott of C:•lfomlo-f,,.._ol Ptotoellon Ag1ncy form Approwtd OMI No, 2050-0039 !E1pl1n 9.:10.96) Pl- ptfnl at type. '°"" tl•lltlrwd lot ult Oii tfifw (I 2-pilfAJ lyplwrilflt.

UNIFORM HAZARDOUS

WASTE MANIFEST

1. 0.Mrotar's US EPA ID No.

O.partment al Ta1lc Sub11G11Cn Canttol *''"""''"· Calil11111o lnfotmotlon In llio 11Kid1d 0t001
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7, Tron1pert11 2 Company Name
9, Dtllgnotod foclllly Namo and 5119 Add11u
DoMemio/Kmloon
2000 N Almneda St
Compton, Ca
90222

6. US EPA ID Numbor
CADOZBZ77036
8, US EPA ID Numb11
10, US EPA ID Numbor
CAT080013l52

11. US DOT 0-riptlon Clncludlno Prop1t Shipping Name, Ha101d Cla11, and ID NumlMr) a,
II not 1oqulr1d by federal low.

Ethylene Glycol Noa-RCRA HazardoU1·Wute 0
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24 HolD'Emerpncy_ResponsoNumber l'.'310·886·3400 Gloves & <Joglos Attcotion: Mel HRrnM'

16. OENEIATOR'S CERTIFlc:ATIONt I hereby dedoro lhat the cant1nt1 al thh con1l11nment aro full)' and accurately detcrlbod abow by propor shipping nomo and are cla111flod, packed, 111a1hd, and labeled, and are In all 1ospoct1 In prop1t condlllOll fo1 ltanspoll by highway according to appllcobl1 llllomadonal and notional govomtllltll r1gvlollon1. oconomkally
If I om a large quantity 111n11ator, I certify that I have a program In ploco to re du co tho volurne and ta1ldty of -•to gonoraled ta tho degreo I have d1111mln1d to bo ptoctlcabl• and that I haw soltclod lhe practlcabl1 rnolhod of treotmonl, llatago, or dhpatol cu11111lly a.alloble ta me which mlnlmbos the pcttenl and futuro wa111
threat
mano
lo human hoalth and the 1nvlronrn1nt1 OR, II I am a small quanllty genorator, I hovt mode a goad faith tffOll to rnlnlmlr• my wo1t1 gonerotlan and select tho boll emont method !hat 11 a.allable to mo and lhQI I can afford.

19. Dl1er1pancy llldkatlon Spoce
I 20. Fad& Ownet or rotor Certlllcadon of rec1I t a ha1anlou mol11lal1 co .. 11d b P1llltedfTy1Md Nam• SlgllCllUfO Month Day Year
oy td
DO NOT WRITE BELOW THIS LINE.

DJSC 1022A Whihn TSOF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. ll /95) EPA 870<>-22 Too r.o. Bnx 3000, Soctamanlo, CA 95Dt2
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UNIFORM HAZARDOUS

WASTE MANIFEST
I • .:itnorotor'a US EPA ID Na. Manlloll Document Na. lnlormoliOfl In tho tlladod ar""a h not 11qulltd by federal law.
• 5. I Company Name Asbury Enviromnentut Servicoe

7. Tron1portor 2 Company Name
9, DollQnoted Focllily Na1111 ond Slht Addra11
DoMenno/Kerdoon
2000 N Alruncda St
Compton, Ca
90222

6. US EPA ID Numbor
CAD028277036
a. us EPA ID Nvmbtr

10. US EPA ID Numbtr
CAT080013352

11. US DOT Dotcrlptlan Proper Shipping Mamo, Haaard Clan, ond ID Numb11) a,
Ethylene Glycol Non-RCRA Hazardous Waste
Li uid No Placard Ro irod
b.
c,
d.

15. Special
24 Hour Emergency Response Number 1-310-886-3400
Gloves & Attention: Mel H811>er
,' t1
··.:.:': .. :; ·:;-

16.'oENERA TOR'S CERTIFICATION1 I hereby declare that the contenll of thla conllgnrnont are fully and accurately doacrlbad above by proper shipping norne and a1e c1o11lli1d, packed, maiked, and labalod, and are In all 111pte11 la proper condition far transport by highway accardino to applicable lnlernatlanal and nati-1 government reaulatloni.

If I am a large quontlly generator, I certify rhat I hawe a program In place ta reduce the volume and to1lclty al wall• generated t .. the degrff I ha,. dattrmlned to ba ocanomlcally prGctlcable ond tliat I h...., aelected tho procticabla mtlhocl ol 11eatmtnt, atarago, or dbpaiol curra111ly ovallablt to mo which ndnlrn1111 tflt proMAI ond IUlllra wost•
threat to human htahh and tho 11Wiranmonl1 OR, II I am a wall quantity g1neralor, I ha,. made a goad faith effort to mlnlml1e my wollo generation and 11lect the boll l'IDno ement m1thod that 11 available lo 1111 and that I con all01d.

DTSC 8022A (1/9'1
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Slate of Col4fom•o·-fnwiroMMn1al Proloclio" Agency
for"' Aprr.,.od OMB No 2050·0039 lhp1111 9·30·991 Pleo" prinl ot typo. lo1m d•sip•orl 1.,, vs• on vlif"d (11·,,.tchl typoW1t111. Seo lnslructions on back of pogu 6. o.....,1mon1 ol To.ic S.b11anc11 Control Sacromontc>. Cnlifornin 0 .,.,
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3. Gonurnlor'• Na1n• cuuJ Moilinu A1l1l1an
I. Ganara1or'1 US HA ID No
WAL.MART 11191 i 1i0 TOl'iNE CEf\'TER PARl\'WA 'i
ol Ganarulur"1 Pho110 SA'ITEE, CA 920j 1
5 frunspollur I Con1pC1ny Nama
ASBURY ENVIRONMENT Al. SERVICES
7 f rt1ntfH)flur 7 Compnny Nnmu.
9 Da1i911a1ad fncoliry Numo ond Silo AdJron
DEMENNO/l\ER001'1
:!000 N ALAMEDA ST .

Cll\tPTON. CA
I
o. US EPA ID Numbar

10. US EM ID Numbut
11 US DOI Oumi111ron lincludino Propar Shippino Nanro, Ho101d Clo11, and ID Numhorl u
ETH'll..ENE GL \'COL Nll>l-RCRA flAZARDOllS WASTE
Moftolall Documanl No. lnlormohon in 1ho 1hadod nr•n1
I01tz19 o· h nol 11quirad by fod..rnl In ...

A. Slalt Mani1111 Docvm1nt Nu11bar
B. Stal• Generot•u' 1 ID
C. Stat• Traruportor'1 ID

0. Tran1pa111r'1 Phone
E. Stoll Trontport1r'1 ID
f. Tranipot11r'1 Phon1
G. Slol1 foci "'I''• ID
H. Focilit(1 Phone
Con1uin1t••
Tr a

13. To1ol
Ounntil
310-537-7100

14. Unit
Wr/Val I. Wa1ln Numb1r
Slatt
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l,JQLllD NO PL:\rARD UEQ .... 1.._........_ ________ _ EPA/Olhet . S1at1 b
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J. Addlllanal Deocriptlano for Malerlal1 U11ed Abav1
A., ETHYLENE G. YCOL
WATER

MOJ'OR OIL
79%-65%
01%-0590
a.

ERG#127 c.

I .S Spocinl Hnndlino ond AJ1li1ionol lnlormo1ion
GLOVES CiCU\LES HOl.IH EMERGENCY RESPONSE NUMBER 1-310- JS i - 3-i(t8 ATTENTION: MEL HARPER
EPA/Othet
Slolo
EPA/Othor
Stoll
EPA/Olh1<
d.
16 GENERATOR'S CIRTIFICATION1 1 lruraby doclura lhnllha canllnll al 1hi• con1iinn11nl ore lully anrl accurnrelf; dotcribod ohavo br 111arar 1hi:;fing nomoonJ ora danilioJ, puc•od, \5 1n11tLecl, nnd lnbahrcl, and aro in ull rt1111oc" in p101un conclilion far l111ntport y highwuy according to upp icabla inlurnalionnl nnJ nat1011 gavarnll'lunt 100\llution•. ::i
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Slate ol Calilotnio-EnvlrOflmtntol Aglftcy form Apprond OM& No. 2050-00J9 (E1pi111 9·30•99) Plt0'9 print or type. Fo110 J.1i9n,.Har Ult on elilt I 12·piltb/ r,pewrir.r. Seo Instructions on back of page 6. D1po1lment ol Toaic Sul111onc11 Con11ol Sacromtnlo, California

UNIFORM HAZARDOUS

WASTE MANIFEST
I. Oonerlllar'• US EPA ID No. lnfarmalion in 1he 1hod1d arta1 i1 llOI roq .. lrod br ftderal law,

3. Clen1101or'• Na1H and Mailing AddrtH -f')R.../ /' / /'I/ 7- A. Sla1• Manll11t Oacumonl Humber #o 715wAJ 1"l"l(,P"'JY .• --10 -----·9;;;;...;::;. 6-=8-=2...;:;. 9.....: 4...;:;. 3-=9'--1: A. Oan1101or'1 Phont I

9. D"lgnotad f11cility Namo and Sito Add1111 I 0. US EPA ID Nu1nbtr

DEMENNO KERDDDN
• 11111t AJIO\ snm, IDPIOt, m 91222

11. US 001 DeicriptiOfl (including Prapnr Shipping Haza1d Clat1, and ID Nu11berl a . • NDN·RCRA HAZARDOUS WASTE, LIQUID <ETHYLENE GLYCOL> ND PLACARD REQUIRED b.
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d.

J, Addlllonol O.icrlpllon1 lor Malerla 1 Ualtd Abavti· -, - 1maarr.m1111 81.yCXll, 2o•-•o•
.... .., ••• 15,
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IS. !ipaclol Handling lnalruclion1 and Additio•al lnlurmalion ... :.

C. Slalt Tran1portor'1 ID
D. Tranaporltr'1 Phono .

E. S(Ght Tranapor11r'1 ID
C3ll>U7·7lll

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14. GlNllAlOl'S
marled, and
ClRllflCATION: I l1111br d1da11 tha1 tho conltnl• al rhia con1ion111nl a11 lull1 anrl accurotoly doicribad obo.o by proper 1hlpping name unil aro clauiliod, pacled, labolod, and are in nll ro1pocll in ptap11 condition far 11an1po1I br highway according lo applicable lntornollonol and notional o••urnn1t111 reaulatian1. praclicoblo
II I am a la1u•
and quanllly ooneralor, I co11il1 lhal I havo a p1ag1am In placo 11 11ducn tho •alumo and 1a1lcil)' al wa110 o•norolod lo rho dogroo I ha•o dotermin•d lo be ecanamically C1111l lh11t1.!tonmont;
thal I
OA,
ha•• 11loclocl tho f1taclicablo mothad al ltoalmont, 1lorogo, or cliapo1al cunonllr a•ailablo lo mt Which mlnlml1oa lh0 P"'""' and lut"'• thrtal lo human haahh availoblo lo mo and that I can
If I om
afford.
a •mall quantity gonorotor, I ha•a made o uood lailh ollorl la mlniml10 r wa110 gonoralian and 1olect boil wono managomonl mothod lhal II DISC B022A 1<1/971
EPA 0700-22
Month
DO NOT WRITE BELOW THIS LINE. '
Wliitn· JSOf SEMDS IHIS COPY 10 DISC WllHIN JO DAYS.

Jo P.O. Ho• JOOO. S11cra1na11lo, CA 95812
···.

Slat• of Col1fot11i-£n•llOlllllOfltal Prot.c1i011 Ag..,cy Seo Instructions on back o e 6. Deport"*'' al TOJ1te S..b1111nc: .. Control Sacramento. ColJorn1a
farm Ap..-..1 OM& No 20SCH>0391Eapir•• 9·30·991 Ploa .. print or type Fo<m de11gn.O /or.,. on e/1to /I 2·p•IC 0 "" .,,
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WASTE MANIFEST
"lan1le1I Docu""'"' No
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" nor required b,. federol 1-
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7 Tran1porlolt 2 Compony Nam•
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IS Speo.ool Hondlong l111trucllon• ond Add111anol lnlomoroon Slole
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16 GtNtltA10R'S
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CER1lflCA110N: I hereby doclor• diot the conltlll• al rh" con11anmen1 ore fully ond accura1olf. doac11bed abo .. by proper 1lupp1ng name and are clou1f1od, pocr..d, ond labeled, ond are •• all •••peel• 1n ptapor cond111an lor lran•port by h•ghway accardong lo app ocable 111ternallanal and nat1onol D""trnmenl tegula1oon1 111 om a latge quon111y gone•alot, I cet11fy 1h11 I ho .. a program 1n pion lo reduce the ,,.,fume and loa1c11)' al wo••• generaled to the dogr" I hove determined la be oconom1cally proctocablo and thot I ha .... locted Iha pract .. abla mothcid al lreolmonl, ••orage, or d1lpo1al currently a•a1lablo ta mo which m1n1m110• rho prettnl and future rhreot 1o humo• healrh and ........ .,anmotlt, OR. ,, , am 0 •mall quonhl)' o•ne•alot, I ha .. made a gOod la11h ellart ID m1n1m1ze my wa••• a-raloon and teloct tho bett watl• munageme111 molhod thor .. a•a1loble ro 1110 and thol 1 co11 ollard.

Day Year

19. D1acraponcy lndicatoan Space
rotor Cerllf1cat1on of rece1 t 01 nolod 1n llam 19
DO NOT WRITE BELOW THIS LINE.

DTSC 8022A I '/971
EPA 0700-22
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la
TSDF SENDS THIS COPY TO OtSC WITrtlN 30 DAYS
P 0 boa 3000, Socrull\anro, CA 958 I 2
Stoto of CnMor•ua-E"'"'on'"•"tal f'rot.ct.on Ao•nC'y b k f Form Approvud 0Mb No 2050-00JV IEapor .. ? JO O?) See Instructions on ac 0 page 6. O.parlnu•n• t>l loao< Co1111ol Plou\.O pont 01 typc F01m ""''D""d lor "' .. "" "'''° I p1rcli] 'ri'fl"'''"'' Sac rol'flo'ltO CoJ,forn•CJ 0 11'1
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DllrUllB IBWQf. 2ot-•ot
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1 Specrol Handlono ln111u<l•O•• ond Add•llOC>al lnformolro• 14 Unu
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DIZPGncr c:onAC'l': JCBr. HMl'U. c:i1ona1-3aoa
16 GENERATOR'S CERTIFICATION: I horeby doclaro 1ha11ho conlllnts ol rhu con11on-n1 010 fully and oc<u1a111lr. dalCro'-1 abo•o br prope1 \h1pp1no ""m• 010 clouolovd po<lod moiled. and lobetlod. ond oro 1n all ro,pec:•• '" prOpur condition lor trun•potl by highway accotd1n9 to opp 1cqbln 1ntnrnollonol and notional QO'ltttnm .. nt 11•gv(Qf1on• II t am a Iorgo quaftl•f'y QlllMrtOIOt. I corr.fr d1e1t I have a pro0rom '" place 10 reduce th. "olurM and toa1c.1y of .-n•le n•n••ot.d IO lhn daur•• I hawe cl.torna1nod to be prachcabl. and thus I l.ov11 Mlected the procr1coble method ol trealrNnt. 1I010U•· or dnpowl cvua11tl,, rawa1labl. to '"• which m1n.m11a' Iha J11•U1nl c.ind futu1n thrM'I to hUfllan heahh and rl10 onvuonmetll, OR, ti I om o 1mall qunrtl•ty gonaro101 I how noade a IJOOd lo.th eHOll to """'""'" my waste IJ"•••Ohon Md \Oloct tho bo11 -"• "'°""11'"'"'' ....lhoJ that " awa1lable to me and that I en• all0td 19 lnd1cat1on Space
T
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Pn•lod/Ty,...d Name Moolh Dar Yt'Ot
DO NOT WRll'E BELOW THIS LINE.

Dl$C IM971
EPA
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To
TSDF SENDS THIS COP'I' TO DTSC WITHIN 30 DAYS
P.0 8o• 3000, SocroMenla, CA 95812
Slolll of Calilornia-EnwirOM1onlal PrOlecl.on !.pency fo11n Approwad OMB No 2050-0039 (E•pira• 9·30·991 , O..par11n.., of Tu•i< Cnn1rol Ploo•e See Instructions on bock of page 6, P''"' or type Fotm d.1iotted for u1• on e/11e (I : ·pdchJ f1tuwrd0f Socromo"1u. (qliforn10 0 "" "" ..... N
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11 o Tovvl'"I (l t)\t r r1 \.ce C 'i1 c 71 A. Genora>Ot'• Phono f ..,\CI LI\.' C _ ?- ? Io.") o VS EPA ID N"""'°'
ASBURY ENUIRON11ENTAL SERUICES
9 De"Oftaled Fae.lily - a•d S11e Addlou 10. US EPA ID N.,.,ber D91ENNO KERDOON 2111 llRTll ll.Jlml STET, IDPTOli DI 91222
a.NON-RCRA HAZARDOUS WASTE, LIQUID <ETHYLENE GLYCOL>
b
( .
d .

J. Addld-1 O..criptla111 ror Ma1etlal1 ua1..i Abawe
n111U1111 er.-rcar. zoa-•o•
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Jmal cm. OU-051
No Placard
98163456
a. S1a1e Geneto1or'1 ID
/U 0. T1an1pofllt'1 Phone C3HU886-34el
E. $1a19 TNlnlf'Olllt"• 11>
F. Tnrnlf*llr'I PIMIN
G. SIDl9 focilil)l'1 ID
C318>S37·7110
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13. To1al
Ouanlity
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EPA/Othtt
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IS. Spociol Handling ln•lruclion1 ond Addirianal lnformalion 081133
EICIRGBHCr COllTAC!: llEr. HARHA. (310)38'1-3C08

16. GENERATOR'S
marhd, and lobofod.

C!ITIFICATION:
ond 010 in all
I hereby
ro•pocl•
doclano
in proper
1ha1 th.canlenl•
canditiDn
al thia comignm ... 1 are fully and occuratoly cloKribtd abawo by propar sl•ipping name and are cloniliod, packed, lor transpart by highway accatding lo applicable inlornolianol and nalional QOWlfnmenl rogulaliao•. 111
pra<1icable
am a largo
ond qvanlily 1ha1 I hawe gOftoralor, 1ole<tad I !Ire certify practicable thar I ha•• melhad a praorom in place la roduca lho •olume and ID•icil)' of watt• genontlod IO 1ho dagr .. I howo dolorminod to bo oconomicolly and 1ho onwiranmenl; OR. ii I "'" a 1maD quanlily o•••rotor. al rreatmonl, 110tOg•, or disposal curronlly a•ailoble IO mo which minimiz01 lhe ptetonl and luluro lhreal ta human hoal1h I """• made a gOod loi1h ellorl ta minimiH my .... ,. Q•llOtalion and '"'"'' •he bosl wo"• monaoemonl -hod •hut ;, aYGiloblv 10 ,,.. and thal I con allord. of Malarial•
Manlh
D0 Doy 0 "' Year c-1 s
Manlh Day Year

19. Di>eropancy lndicalion Spaco
00 NOT WRITE BELOW THIS LINE.
,,. ... , ·::=:t ·:!';, :Ci• 1{.Ji •l. 11..•f:'!l
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7. Tra••pa- 2 C-pany Noma

9. Dft;gno'1rll facilol)I Na,., ond Site Addreu 10. US EPA ID N•mber

11. US DOI DeKrip1ion li11cludill(J Proper Shipping Na'""• Hozord Clau, Giid IO N•111berl a .
d.

NON·RCRA HAZARDOUS WASTE, LIQUID <ETHYLENE GLYCOL>
nmrsmm awar. 2oa-•o•
-- 19'•55'

0.1t-05S

15. Special Handling l"'truction1 and Additional lnlor111111ion 2 Poga I lolarma•io• in 1ho ,h..,dod oraa'
;, not roquirecl b1 f.doral low.
98163552
ti. Factii,..,._ (311)537•7181
No. Type

13. Taral
Ouontitp
IA. Unit
W1/Vol I. WU. Numw
EPA/Other
IC. Hondliftl w- Li1tacl Mo..
0 c. d.
eeeeJ3
BllBRHMCY CQllU.C1': Dr. IWWD (310)38'1-:a•oa

16. GENEIATOl'S aRTIFICATION: I hereby declare thal the contenb of this con1i9nrn101 are fully and acc11tC11el)' d"cribed cibo.e by profl"' shipping name and a1a clauiliacl, packed, cind lo!Milod, and are in all respect\ in proper condilion for transport by highway occorcli"!J to applicable in11rnatia11GI and notional gO¥ernmenl raoulotions.

19. Oiscrepoocy lndicotion Spaco

20. Fotilit Ow .. r 0t orar Certifkotion of r«oi I of ha1orda.s ""'larial• c-rad Sig•alllre
0 DO NOT WRITE. BELOW THIS LINE.

OTSC 8022A l•/971
EPA 870C>-22
·
..
-
Wlti11:

To:

TSDf SENDS THIS COrt TO OTSC WITHIN 30 DAYS.

P.O. loll 3000, Socta-to. CA 9$112
511111 ol Colol0tnio-fr •• ironmen1ol Prc1t(liofl A91ncr form Aprr.,.1d OMI No. 2050•0039 lf•piro• 9·30·Y91 Pl1<11a print or l7po. form J.1ign1d for"" on 1li1t 11 Z·pit<hl '1/H•rillt. Seo Instructions on back of page 6, O.portm1nl ol Toaic s.b1l4•CO• Control Sotto.,1n'D, CololGlnio 0 ""' ""' ..... N
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ASBURY ENUIRONHENTAL SERVICES

7. Tron1po11tr 2 Cotnpon7 Nomi
f. TrQ111potlef1Phone : ... :>.'. · ... ,. : , .. : ,. ,·:.- :,.: .. ·

9. D11i9no11d Nomi 11nd Silo Addr111

DEHENNO KERDDON
2111 m 11.J1E1 mm, IDl'Jlll, m m2

11. US DOI Demiplion lincl•di1111 Propor Shipping Nome, Ha1ord Clan, 1111d ID Numbtrl 0 · NON·RCRA HAZARDOUS WASTE, LIOU ID <ETHYLENE GLYCOL> Na Placard b.
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IS. Spociol Handlinp ln•truction• ond Additional lnlormolion 010033 CDll'l'AO'f: Mu. IWUBR ..(310)28'1 9t09{.»

16. GINlRATOA'S
marked,
ClA11flCA110N: I ht11by d1tlore lliat "11 can11nh ol 1hiuon•ignm1n1011 fullt ond occ•ro11ly cl1m1bed obo.1 by proper •hipring na111 ond ot1 clo11ilied, pochd, and lnb1led, ond aro In oll re1pect• in propor condilion lor l1on1porl by highway occording ID opplicabl1 inltrnolianol ond noliono QDY1rn1111nl rta•lnlion•. 111 011 o Iorgo Qlnetalor, I e1r1ily lhol I ho•• o program in ploc• ID 1educe the •alume ond loaicitr ol wa111 a•ntrared to Iha clegte• I hoYI delttmined lo bl econorolcolly ptacricoble ond 1ho1 I hDYe "locred the proclicabl1 ratthocl ol t1ea11111nt, 11oro91, or di•pa1ol <•rteally DYailobl1 to m1 which minlmi11• 1h1 .P"""' and future 1h11D1 10 h-n h1olrh ond 1h1 1nvi1a11111nl, OR, ii I om a •n111ll q•on1i1y gon1tal111, I have made o good foirh ollart ID mlnlmiH mr wo11t gen11a1ian and 11lec111'9 L11t W11•t• mon..-1nt .... rhod rhar II owailable 10 me ond thot 1 can afford.

19. Dim•poncr lndicolion Space
l'rintecl/T111od Name Slqnatvtl Mail th Doy ""'' II z :i

DO NOT WR
DISC 8022A 14/971
EPA 8700-22
w1,;10: ISOF SfNO!' IHIS COl'Y TO DISC WlllllN Jil DAYS lo· P.O. 8o• 3000, Sncoamonra, CA 95812
\
I
SIOlo of Califo,..io-E..;ronftlOlllDf ProNCtian Af-7 Form ,\pprov.d 0M8 No. 2050-0039 IE•pi<H 9·30.991 PloaM or "'119· Form deti;lled /., uM on .lite (12·piich) 0 .,,
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CD

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WASTE MANlfESl

3. Genot010r'1 No.,. and MailitlQ Addre11
$. Tto••portwr I Compony Na...
·ASBURY ENUIRONIENTAL SERVICES

7. Tt0n1portwr :! C-pany Name

9. Doaignated Facility Nome and Sito AddrMI
DEIEftl MERDOON
• m llJIEll STEr, 1DF1D1i Ol E
a. NON•RCRA HAZARDOUS WASTE, UQUID
G <ETHYLENE GL VCOL>
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See Instructions on bock of page 6. °"""""•' ol to.ic S..b-.. Catl"9 Soc:,_10, Colii0tnio
...
.• :·"' ....
lnlDnllGlian in rM 1hodod orao1
;, nor ,..,,""9cf ltt fedc...r C..W.

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S1nto ol Californ10-Eiwironnwntal P1utec1ioft Ag.nty • r.,.., -'pp•a••d OM& No IE.,.••• Pl.usn print or .,,,.. Fotm de1i91tDd fat u .. CM"'''' tftw-rikr 0 11'1
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WASTE MANIFEST
J. G•..,.,.f, - aod Addrou
ltAl.JfART 11917
1'1111111D111 PaDA!, Sll1EF., Cl 92171
.i. e.-·· Pho•• I
l""'•P"llfl I Compan1 No ...

See lnstructians on back of page 6. DopatlWlont ol Toooc Svbr.IQnc•• CorutOI Sar:"'""',.'°· Coliforn10 1nloo-11on ,., lh<i •hodad oroo•
it llOI r-cioir•d by F-d.101 law.
98 513453
Sl9-44CJ·8215

6. US Er• ID Number
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Ouonlil\'
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133
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1 a GENEIATOl'S CEl1111CATION: lhorobr rlod01• thol '"'"""'""'' ol 1h» 'on.;o•-•are luU, and aocu•a•al, de,ct;bod abo..bJ pr•pe• .i,;pri•o - ond ore cla1.,f...I, and labeled. and aro in oll r••pK'' i1' prvptr condilllOl"l lar rran'flO" by highwor occ.ording lo opplii::able inlMnotionol ond 11gtiona QOW9""'*" r.gulot0..1. >
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Slole of Prolocllon Agoncy e Form Approvad OMB No. 2050-0039 (E.icpim 9·30·991 Pleoso prinl or r,pe. Form rlo1igned lor u10 on elh• I I 2•pitchl '1JIDwriler. See Instructions on back of page 6. Ooporlrntnl of To•ic Sub1lanct1 Canlrol Sacramento, Colilotnlo 0 Ill
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WASTE MANIFEST

1. G1n1rolor'1 US EPA ID No. Moniloll Oocumonl No. 2. Pogo I lnlormol ion in tho •horled oroo1

3. Clonorotor'> Noma and Malling Addreu
WALftART #1917
178 TtHf CEllTER PAm<WIY, SIWTEE, D\ 92071
A. Gona1alar'1 Phono I I 619-449-8215

5. Transporter I Campony Noma 6. US EPA ID Number

ASBURY ENVIRONMENTAL SERVICES

7. Tronsportor 2 Compony Namo

9. Ooiignolod facilily Na1na and Silo Addron

DEMENNO KERDOON
2888 NDRlH IU'fElA STREET I COM>TtW, 1'.11 98222
0 • RQ, ENU I RONMENTALL Y HflZARDOUS SUBSTANCES,LIQUID,NOS, <ETHYLENE GLYCOL & WATER>,9,UN3082,PGIII b.
c.
d • .

15. Spoclol Hondllng ln1lruclions and Addlllanal lnlarmalion "'t. SlJiO GLOVES & 60GGLES MRGENCV CONTACT: MEL HARPER 1310> 6e 5!t88 b not toquirod by Fodera! low.
of 1
.. :.: ·
005130
ALTERNATE TSDF: ADVANCED ENVIRONMENTAL SERVICES, 13579 llHITTRAM AUE. FONTANA; CA 92335 19091356-9025 CAT080025711

16. GENERATOR'S CERTIFICATION: I horoby do<laro 1ho11ho conlonl1ol1hl1 conslgnmonl aro fully and occurololy doacribod abo¥t by propot 1hlprlng nomo and aro clauillod, JIGClod, mnr•od, ond labalod, ond aro In all •••pacts In proper candilian for lran1port by highway according to appllcoblo lnlarnallonol and nallono govornmanl rogulalian1.

If I om o largo quontily gonorolor, I certify lhal I have o program In place lo roduco tho valumo and toxicity of wosla gon.,altd lo tho "dogroo I howi dolarmlnod bo and ihot I hovo saloctad tho procllcabla mothOcl ol traalmont, 1lorogo, or disposal e11rrlftlly ta mo which 11inimi111 1h1 pro1onl and lulura 1hroal 10 human hoobh and lho onvironmonl; OR, ii I om o small quonlity gonarolor, I havo moda o goad la ollorl lo mini 1 u m 1la gonorolion and 1olotl lho bo11 wo1le manogoment melhod lhol 11 avallobla lo ma ond lhal I can olfard.

Year

19. Diicroponcy lndicolion Space
t' ( (1 _
DTSC 8022A
EPA 8700-22
Whi10: ISllf !>ENDS THIS COl'Y TO OTSC WllHIN JO 01\YS. fo: P.O. Do• 3000. Sacrunmnlu, CA 95817
........ ......
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WASTE MANIFEST

3. Getlorotor'• Nnmo and Moiling AJd1111
WALtfART 11917
171 TOD CEITEI PWVAY, smEE, CA 92871
.C. Gonoralor'o PhOM I 61 Y•449•821S

5. Trantporlor I Company Namo 6. US EPA ID Numbor
Manile11 Documonl No. 2. Pao• I lnlormali an In lht 1hod1d 01oa1 It nnl rt"virod br fodo1al low.
i709296 al
9 8 5 0:929-S ·· . . : .. : . .· .. . ' - ,.• . . .

8. &tale <Hfl••alo1'1 ID , ..
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ASl:IURV ENU L HUNMENTRL SERU ICES

7. Tro11F0tlor 2Ca"'flanyNamo 8. USEPAIONYmbor E.
f, T11111tpGr1tt'a.Phon1 ·•. ---------------f
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.. . .• It. Handllna Cacloa for Wa"ll U111J Alia ... · EnM.9E llYlll. 281·481 •· · , : i>. .. . YITER . 791·551 HOTOR OIL 811-151 c. d.
. 1171

15. Spoclol Handli119 ln1lrue1io"' Dlld Additional lnfarmolio• 005130 110V£5 ' 6066l£S El£1!6e£Y COOltf 1 tE1. HIRPER (3191 563·3219 ll.TE191TE TSDF: ADVAtaD ENVIRINIENTll SERVICES. 13579 llUTTRAtf AVE. fOOmR, CA 92335 (989)356-9025 CATllsee111

16. G£NllAl01'5
marhd,
CERTIFICATION: I heroby dodare lhal th• coni.nh ol thii con1lan1n1nr art fully and accuraloly domib.d abo,. by p1opor 1hippino name ond ore clauiliod, and labeled, und 011 In all to1poc11 In propor candi1ia11 far 11an1po11 by hiphway according lo applicablt in11rna1ional anrl nolional oove1nm1nl roqulaliona. 111
prncricoblo
am a Iorgo 'l'!anlil)I oanoralor, I cenify lhol I hawo o program in placo I• rodvca lht valumo o d lo1ici1y al 111 oen11alod lo 1hu dog111 I ho•• de111min1d lo b1 oconamicolly and
and lhal I ha .. 1al1c1ad 1ho rraclicablo m11hod al l110lm1nl, 1101ag1, at di\pc>tal c• nllt owailobl• tllf which minimizo1 1h1 pra11nl and luh111 1h11ol la humon htuhh O•ailoble
tho 1nvi1anM1n1; OA, 111 om a 1maU quantily IJlnulalor, I ho .. lftOClo a gOod loi1h ollOI' inlnimi11 my 110 and Hlocl IM bell wooto IOO•ogtfllonl 1Mlhocl 1hot h la me and 1hat I can all0<d.

SignalU11

19. Oi mopancy lndicolion Spoct
DO NOT WRITE BELOW THIS LINE.

OTSC 8012A 14/971
EPA 8700-22
Wl1il• :.l:Mll:i 1111!1 Cul0Y i() W1llill'I ;111 1 w::, fo I' Cl. u, •• loCiu. :jn.:umu1111 . .,, (A ·1!1U'' ... ... , •l'"I• •• , ..... II tl "" 'h ... .,,, 1f""" 11 ..... ... ... .... :: •• !• ... :: ... ::.. •• '.:. •• .. ::"' I .

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WASTE MANIFEST
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3. Gon11ator'1 Nomo aod MaiRnv AddreH
WALJIART 11917
178 1IJlf IElfTER PARKWAY, SIWIEE, CA 92971
A. Gonornlor' 1 PhoH I 619-449-8215
.5. T ran1parlo1 I Company Nnmo 6. US EPA ID Numbor

ASBURY ENVIRONMENTAL SERVICES

7. Tran1porl<lr 2 Company Na,..

9. Do1lonotod facl5ty Nomo and Slit Addreu DEMENNO KERDOON cetil YIRTH rt.a STREET, an>Tllli CA 911222
Manlloll Docuroont No. 2. Pogo I lnlormDlian 111lht1hodacl 01101 ia llOI r•1111 ired b7 Federal law. 0 9 5 :3 al 1
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15. Special Handling ln111uction1 and Addi1ional lnlarmalian

61.DVES & 60GlilES EIERSENCY totrrACT: MEL HARPER (31G> 72e.5200 ALTERNATE TSDF: ADVANC£D EHYJROliMENTAL SERVICES, 13579 UHITTRAH AVE. FONTANA, CA 92335 (909)356-9025 CAT0800257l1

16. GENERATOR'S
roor\od, and
CEITlflCATION1 I hereby doclaro 1ho1 lb rantenu ol lhla con1Jgnmon1 are fully and accuraloly doicribod abo•• by prapor 1l1lpflng name aMI ar• dm1lllod, pac\od, lalitltd, and aro In all r11poc11 In propor condilian far lran1porl by hlgh-r according lo applicnblo inlornallonal and naliona ga..,.nmont 11gvlallan1,

19. Dimopanry Indication Space
·.· ·
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DISC 8022A (A/971
8700-a2 1r•11 11 .. ,r II 11 I! Ii 11:::7 ·".I
; ; .... ,.: · · ··"' 0 1 .. :.:.I R ............ . .. j .. -··' Wloilu: TSDF SENDS nus COl'Y to OTSt WllHIN 30 PAYS.

IC1: P.O. Ua• :IOOO, S11cr11n1•111a, CA 95612
..

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UNIFORM HAZARDOUS

WASTE MANIFEST

5. Tron1porlor I Cornpqny Noma

ASBURV ENVIRONMENTAL SERVICES

7. T ran1po11or 2 Cacnpany Noma

9. Oo1igna1od faclli1y Name and Silo Addron

DEMENNO KERDDON
2illlll ttJRlll llllEDA snm, CllPTllf1 Cll.IFDRHIA E

6. US EPA ID Numb.Ir
0 "NON-RCRR HAZARDOUS WASTE, LIQUID <ETHYLENE GLYCOL>
No Placard
b.
d.

J, Addillonal 01tcrlpllotl1 fiw Malerlal1 U11od Abavo
ElHYWE GLYCOi. 29M8• WATER .
. MOTOR OIL 81i·05•

2. Poe• I lnformalion in 1ho 1ho.r.d areas
;. nal rtqulr9d by federal law.
of 1
A. S1a1e/ilanlfall Dacumanl Numbor · ·• .· .. · · · : . .... ,,,. .. ... · :·::·: .. . "98845.685
a. Slolo Gonoralor'& ID
D. Tron&porler's "'°"•. . ( 310)
E. Slalo Tron1pallor'1 ID
F. Tran•potlor'& Pha.
c.

13. Tolal 14. Unil
WI/Val
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d.

EPA/Olher ·
EPA/Olhor

16. GENIRATOR'S
mo1L1J,
CERTlflCATION1 I ho1oby cl1cloro 1ha1 lho cooolonll of ••h cenllonmont aro l.U, and accurotaly domibod abov1 by propar d1ipplng name and aro cla"lfiad, pachd, nnd laloalad, oad aro In all r11pocll In prapar condilion 1111 br highway nrcording lo applicQbla lnlornalional and nolionaf oa•nmmonl 1ogula1lon1.

II I oon a lnrll" quanlily """°rulor, I cartifr lhal I havo a program in ploco IO rtduco rho volume lllld la.Jelly of wallo o•nooarod lo Iha cfeoraa I bava clalorftllnod to be oc-1ca11r, praclicablo und 1ha1 I hava 11lac1od Iha l'raclicoblo molhaCI ol h1almtnl, &lologu, or dl1po1al curranlly ...,.llQbfa lo 110 which mlni111lu11ha pra1onl and fuluro llwaal la human hoal11 and Iha a11vironman1; OR, If I 001 a 1niall quanlily gonoralor, I ha•• mado a good lairh affOJI lo mlnlmiza my wOlla oanotolion and 1alac1 Iha boil wa110 manaoama111 molhad 1ha1 11 n•ailoblo la mo and dial I can afford.

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Stall of r101t<1ion Aqoncy · b k f fotm Appro .. d OMI No. 2050-0039 IE.pir11 9·JO·HJ Saa Instructions on ac o pa go 6. O.po11m1ot of To1ic Sulutanm c..,1rol Soc•--. California lnlarmorian in 11111hoclocl "'"''
Pl1a11 prior., r,pe. fotm d11ion1J for 111• a11 eli1• /l1•pilchJ r,pew1i1tr.

UNIFORM HAZARDOUS .I. Geoora101'1 US EPA ID Na.·

WASTE MANIFEST
J. 0.ftlfal•"• Nam• and Moilina Addr111
WALnART 11917
178 Tllll COO'ER PARl!liRY, CA 92871
Gtftoratar'a Phooo I I 619-449•8215
S. Tronaporler I Campcnr Nome 6. US EPA ID Number
ASBUHY E::NUIHUNMENTAL SERUICES

1. Tra•nP'l•ltr 2c ... ,,...,Nume
. 9. D01i9nal1d facilily No.,. and Sil• AdJre11 I 0. US EPA ID NuOlbor

DEMENNO KERDOON
2«18 IClllTlt llMJ)'I STJm, tlJllTIJI, DI 90222
d.
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005130 6LOU£S & 606GLES · 91ERGaCY Cl»lTl1CT: MS. HARPER 13Ull 466-5010 rLTERNATE TSDF: ADVANCED £NVIRONl'IEHTAL f:ERV1C£S1 13579 llHITT!1A14 AUE. CA 92335 19691356-9925 CATe8ee257U

16. OINllAtOl'S
morled,
CUTiflCATION: I h111bydeclat1 lhallho ...,11nhol dolt c•n•lgllm1nl aro luUr and accuraf•lr. domibed abot0by propu 1hippingname ond 1111clu11llied,poclod, and labelod, and or• in oil r11pecl1 lo proper cond11lan f., lrnntj>Otl by hiohwor accord"'1J Iv applllobla lol4tnolionol and nGlional go..,nmenl roguloliona.

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procli<ablt
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Iha! I h .. , atloc1td •ho proclicnblo m11had al koorm.nl, 1larog1, ar dilpoaol cirrrenllr 01ailobl1 lo mt wlrlch minlml1aa 1ho P'"''"' and lurure llorool la hnon haahh nwoilobl1
'"° onulranmonl; 01, 111 om o trnaR quanlil)' gon1101ar, I haw• mode a gOocl lai1h ollorl 10 mlnlml11 mr wa111 g1111rarian nnd aoltcl Ille b"' waa11 manag-nl llllhod 111111 la lo ""' and Ila.JI I can afford. · · orsc eo22A 11 /9'1
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To· P.O. Bo• 3000, Sucranrenlo, CA 95812
Stote of Cal1fo1ft1a-f".,1ronmental Protechon AgenC'/ foom Aop10.1J 0M8 No IE•p;re19·J0·991 Pleat• p11nt or trp• '"'"' d•••s"rd tor "'Pon ,J,10 fl 2·pirchJ l)pew11'tr See ln5truction1 on back of page 6. Depo,,.1en1 ol To11c S.l111onc•• Con1tol Sacra"'antn. Cahlornio

UNIFORM HAZARDOUS

WASTE MANIFEST
l . Cien•ratar·, Naffte nnd Ma1llno Addr1H
WALnART A. SIG1t Maftl!e,1 '*-nt .......... r 11917
171 mtt CENTER PMGIHY, !irflTEE, !'.A 92171
.t. Gtnerarar·a Pho"• I
S. Tron1po11or I Campan1 Namo

ENVIRONMENTAL

7. Trnn•potter 2 Companr Nome

9. Dlligoalld Name ond $111 Addten DEHENNO l<ERDOCN
2N1 Nllllll IUEA STREET, CIK>TOI, CA 9lm
I. Stot• GtMralol'1 ID
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8 US EPA ID N•mbor I. Stole Traft1pa'19r'' ID l!sumll.J .

I I I I I I I I I I I I f, Tt'llftlpatlff'I Pit10. US EPA ID N•mb11r G. 511111 foclllr,,'1 IO . · · · l"'!.A.1T- - -011::3-- -
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15 Spn<inl ttaodf1n9 tn11roc1ion1 and Additional fnlotmarion ''"""'a .)VJ ILDUES & GOGGLES EMERGENCY CUNTACT: MEL HARPER <3101 466-5918 ll.TERHATE TSDFt ADUAl(ED ENVIRONMENTAL S£RUJCES1 13579 "'llTTiAM AVE. FONTANA, CA 92335 19091356-9925 CAT0800Z5711 16 GENHATOl'S
...arhJ, and lnboloil,
CHtfflCAtrON:
nncl nrct in aU
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daclare that rho contenh ol tlu• coo1iijo.,.nl nro fvll1 ond ncc .. alo!y Jemibo1l 1d1Cht by P"''"' •hiPJiing tM1mtc1Ml tMo clauiliarl, pucLod, in proper conditoon 101 lrnn1porl h1 hrghwny nccording lo applicnblo inlertHJlionnf n11tl n111ionol go.ernm1n1 ro0ulnrian1 prncl
II I am
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quonl1l1
that I ho•• gonorulor, 11locled I co1til1 rhar I ha•• a program in plate lo cluco tho wolume anol toaicit1 ol wa1tn u•n•mtod lo tl10 degree I hawo clater.,incHf to 111 econonucnllr, on1l 1hu 1nYatonmenl; OR. ti I o• n 1mall
lht 11•acticable malhod ol lroalmonl, Uar D'· , di•paml 1 n1111l1y::ilahl1 lo .... which min1mct .. rho r•••ont and Mull threnl la hvman hoaft I O uW1ifabfo lo mo and lhal I can allood. tjUOflhly o•nttolar, I l1ove mad• _
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UNIFORM HAZARDOUS

WASTE MANIFEST
I. Cl1n11a1or's US EPA 10 No •

3. Clonora10r'1 Name and Mailing Addrau
WALHART 11917
·111 TOO mm PARIVAI, SARTEE, CA 92971

4. Cloneralor'1 Phan• I 619•449-8215

5. Tronsporlor I C.....pany Name 6. US EPA ID Numbor
ASBURY ENU LRIJNMENTAL Sl:HV I CfiS C..:: A D 0 r
7, Transpart•r 1 Company Nam•

9. 0.1loncr1orl faclllry Name and Siio Add1011 10. US EPA ID Numb11

DEMENNO KERDOON
29" IORTB Al.A!EDA STREET, COKPTill, CA 9B222
CA'r
I I. US DOT Domiplion (Including Proper Shipping Namo, Ha1a1d Clo11, and ID Numbor) 0 'RD,ENVIRONMENTALLY HAZARDOUS SUBSTRNCES,LIDUID,NOS, <ETHYL£NE GLYCOL & WATER>,9 UN3082,PGIII b.
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3 2 2 :3 6 ol

15. Spoclccl ln11tucrion• nnrl Adclilional Information 00:i 1 J0 GLOVES & GOGGLES EMERGENCY CONTACT: HEL HARPER 1311!11 46&·5910 ALTERNATE TSDF: ADUANCED ENVJRONllENTAI. SERVICES, 13579 llHITTRAM AUE, FOl.rANA, CA 92335 191!191356-9025 CAT081!1025711

16. GENHAJOl'S CHTifl(AT10N1 I harobydodnra tharlho conronll ol 1hi1 con1igom1n1 aro lullyand accu101aly domibod aba•• by prapor 1hlprino namo nnd aru clu11ili•cl, pc1CLod, nnd labalod, and uro In all raipo<ll in prapor condirion lor lrnn1porl by highway n<cording lo npplicablo inlornutional nnd naliana govarnmanl rngulaliant. • 111 nn1 n lu.uo IJUunlity gomnnlor, I cnrlify thar 1 lin .. a pr"U'n• in pint• lo raduca tho YOlumo and IO•icity ol watlo gonnrakHI ro tho dog100 I hnvu rlotorminod ro Lo aconornlcnllr, pcnctlcubln nnd thur I hawa 1uloctud Iha ptaclicnblo mothricl ol lroalmonl, Uocogo, ar rli1pa1al currantly owailohln lo mo which n1inhni1u1 tho p111anl ancl lururo throal 10 hu11nn honll 1 and rho ••twironmonl; OR, ii I am a •mall quanlily gonornlor, I howo n1odo a good luith ulfarr lo minirni10 my wnilo oanoration and \Olacr 1ha basl wn1lo managornonl morhncl that I• availahle la mo and that I can crllorcl.

19. Oimo11nncylnclicalio11 Spnca
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lo: P.O. ho• 3000, S11rra11111n1a, CA 95612
.
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State of California-Environmental Protection Agency Form Approved OMB No. 2050-0039 (Expires 9·30-991 Please print or type. Form designed for use on elire (12·pilc •

UNIFORM HAZARDOUS

WASTE MANIFEST
See Instructions on back ofe e 6.

Manifest Document No.
6 7 7 9 8

2. Page 1
al
Deprtmenl of Toxic Substances Control
Sacramento, California
tnlor motion in the shaded areas
is not required by Federal low.

A. Stale Monilesl Document Number 2,2767798 3. Generator's Name and Mailing Addreu WAL-MART #06-1917 SANTEE" 170 TOWN CENTER PARKWAY 0 ...,
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SANTEE, CA 92071 4. Generator's Phone ( 6191 449-8215

5. Transporter I Company Nome

ISLAND ENVIRONMENTAL SERVICES

7. Transporter 2 Company Name
2000 N. ALAMEDA ST.

COMPTON, CA 90222
B. Stole Generator's ID

6. US EPA ID Number . i.:. State Transporter's 10 [Reserved.) C A R 0 0 0 0 5 3 4 0 5 D. Transporter's Phone (909) 598-4449

8. US EPA ID Number E. Stole Transporter's
F. Transporter's Phone
I 0. US EPA ID Number G. State .focilily's ID
C A T 0 8 0 0 1 3 3 5 2
IA. Unit
Wt/Vol I. Waste Number
11 . US DOT De1cription (including Shipping Nome, Hazard Class, and ID Number! a.
b.
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CLIENT:WAL MART
BILL TO :ISLAND ENVIRONMENTAL
W0#36504
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EPA/Otlier
State
EPA/Other
Stole
EPA/Other
K. Handling Codes far Wastes Lisied Above
a , b.
c . d.

16. GENHATOR'S
marked,
aRTiflCATION: I hereby declare lhot the contents of this.consignment ore fully and accurately de•cribed above by proper shipring name and ore clo11ilied, pocked, and labeled, and or• in all respocls in proper condition for transport by highway according lo applicable international and noliona government regulations. practicable
If I am a large quantity generator, I certify that I have a :P.'l'i!ram in place lo reduce the volumo and toxicity al waste generated to the degree I hove determined to be economically and
and that I have selected the procticobl1 methcid..Of treatment, storage, or disposal currently ovaifoble to me which minimizes lho present and future threat lo human health ava
the environment; OR, ii I om a small quantity made a gOod faith ellor1 to minimize my waste generation and select the best waste management method that is ilable to me and that I con afford. · ·
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DTSC 8022A (1 /99)
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White :

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TSOF SENDS THIS COPY TO DTSC WITHIN 30 DAYS.

P.O. Box 3000, Socromenlo, CA 95812

ENFORCEMENT
CASE

COMPLIANCE
SEE FILE #134563

FOR ALL RELATED

ENFORCEMENT

CORRESPONDENCE

AND FINAL ORDER
SAN DIEGO REGIONAL l C) I - t 1)

HAZARDOUS MATERIALS QUESTIONNAIRE
Business Name Business Contact Telephone#
Walmart Store #1917 Santee, CA Jennifer Twist ( 479 )
Project Address City State Zip Code
170 Town Center Parkway Santee CA 92071
Mailing Address City State Zip Code
2 001 SE lOth Street Benton" llle AR 72716
Project Contact Telephone#
OFFICE USE ONLY . - . I
UPFP# I 2 :. 2. Z- 7 <-(-· If
Hv# ' -nl 2£1
1 L,- 11
BP DATE <''S I '2{ I 'S"
204-2702
APN#
3810403700
Plan File#
Teresa Jones ( 913 ) 262-9095
The following questions represent the facility's activities, NOT the specific project description.

PART I; FIRE DEPARTMENT- HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: Indicate by circling the item, whether your business will use, process, or store any of the following hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal. Facility's Square Footage (including proposed project): 1 2 7 , 154 Occupancy Rating: Mercantile

1. Explosive or Blasting Agents N I A 5. Organic Peroxides N I A 9. Water Reactives N I A 13. Corrosives N I A

2. Compressed Gases NIA 6. Oxidizers NIA 10. Cryogenics NIA 14. Other Health Hazards NIA

3. Flammable/Combustible Liquids NIA 7. Pyrophorics N/A 11. Highly Toxic or Toxic Materials N/A 15. None ofThese.

4. Flammable Solids N/A 8. Unstable Reactives N/A 12. Radioactives N/A PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH- HAZARDOUS MATERIALS DIVISIONS HMO : If the answer to any of the questions Is yes, applicant must contact the ounty o San Diego azar ous Materials Division,, 5500 Overlan Ave., Sl.llte 110, S!'!n Diego, CA 92123. Call (858) 505-6700 prior to the issuance of a building permit. Stm;e rema in occupied dun.ng FEES ARE REQUIRED. Project Completion Date: __ / __ /___ of Occupancy: / __ /__ 0 CaiARP 1 Exempt
YES NO (for new construction or remodeling projects) ..

1. rn D Is your business listed on the reverse side of this form? (check all that apply). Date Initials

2. ua D Will your business dispose of Hazardous Substances or Medical Waste in any amount? D CaiARP Required

3. ua D Will your business store or handle Hazardous Substances in quantities equal to or greater than 55 gallons, 500 pounds -::---2'---- 200 cubic feet, or carcinogens/reproductive toxins in any quantity? Date Initials

4. D!l Will your business use an existing or install an underground storage tank? '5.

6. D
D
IX]
IZ] Will your business store or handle Regulated Substances (CaiARP)? D Will your business use or install a Hazardous Waste Tank System (Title 22, Article 10)? D CaiARP Complete
Date Initials
I
\

7. D Will your business store petroleum in tanks or containers at your facility with a total storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).

PART Ill: SAN DIEGO COU TY AIR POLLUTION CONTROL DISTRICT: If lhe answer to any of the questions below Is yes, applicant must contact the Air Pollution Contra District (APCD , 10124 Old Grove Road, San Diego, CA 92131-1649, telephone (858) 586-2600 prior to \he Issuance of a building or demolition I 'fi . oan.J:a.th P-CO k' . permit. Note: if the answer to quest ons 4 or 5 is yes, applicant must also submit an asbestos nob catioQ-I.c e A - .al-leasl 0-wor. H'I!J"EIS,'f. pnor to commencing demolition or renovation, except demolition or renovation of residential structures of four units o less. Contact the APCD for more lnforJ'flatlor .

YES NO
1' D ua Will the subject facility or construction activities include operations or equipment that emit c r are capable of emitting an air contaminant? (See the APCD factsheet at http://www.sdapcd,orq/info/facts/penmits.pdf, and the list of typical equ pment requirin a11 APCD permit on the rev rse side of this from. Contact APCD if you have any questions). J / Uib

2. D D (ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 eel of the outer boundary of a school (K thro gh 12)? (Search the California School Directory at http://www.cde,ca.gov/re/sdl for public and priva e schools or contact the appropriate school d strict).

3. lXI 0 Has a survey been performed to determine the presence of Asbestos Containing Materials

4. D lXI Will there be renovation that involves handling of any friable asbestos materials, or disturb!· tnbmaterlal that contains ab/et_sf_e

5. 0 ua Will there be demolition involving the removal of a load supp rting stry'qural member? A H - ' Briefly describe business activities: \ 3ri !Y !Proposed project:

Retail Store r..i checkouts/replace w/self-checkouts
'J Eo
I declare under penalty of perjury that to the best of my knowledge and '\') n d are true and correct.

Teresa Jones, BRR Architecture, Inc . 04 I 15 I 16
Name of Owner or Authorized Agent Signature If r or )l.(lrtrdflzed Agent Date FOR OFFICIAL US ONLY:

FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:

BY· ----------------------------- DATE. __ L.I ---'-1 __

EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY

APCO COUNTY-HMO APCO COUNTY-HMO APCO
'i:>.._,on Co11tf':.
liEWEO \ o....-
.._ g_ PN\lJOV < _T,
('"'I 8 -/ o'-_,OS 1€.9 'i(l;
'ty or sa<'
' 1-n. 1\
_,.
'A sta .,. only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permilling reqUirements may still apply.

HM-9171 (02111) County of San Diego - DEH- Hazardous Materials Division

SAN DIEGO REGIONAL

HAZARDOUS MATERIALS

QUESTIONNAIRE
Business Contact
Walmart Store #1917 Santee, CA
Telephone#
479 277-8476
Project Address State Zip Code APN#
170 Town Center Parkwa Santee CA 381-040-37-00
Mailing Address City State Zip Code Plan File#
170 Town Center Parkway Santee CA 92701
Project Contact Applicant E-mail Telephone#
Teresa Jones teresa.'[email protected] (913 262-9095
The following questions represent the faclllty's activities, NOT the specific project description.

Jl7
PART I: Fl E DEPARTMENT- HAZARDOUS MATERIALS DIVISION: OCCUPANCY CLASSIFICATION: ot r ulred for ro ects within the Cl of San Die o : Indicate by circling the item, whether your business will use, process, or store any o the !lowing hazardous materials. If any of the items are circled, applicant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.

Occupancy Rating: Facility's Square Footage (including proposed project):

1. Explosive or Blasting Agents NI A 5. Organic Peroxides NI A 9. Water Reactives NI A 13. Corrosives NI A

2. Compressed Gases N/A 6. Oxidizers N/A 10. Cryogenics N/A 14. Other Health Hazards N/A

3. Flammable/Combustible LiquidsN I JV. Pyrophorics N /A 11. Highly Toxic or Toxic Materials NI 16. None ofThese.

4. Flammable Solids N/A 8. Unstable Reactives N/A 12. RadioactivesN/A PAR I: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HE TH - HAZARDOUS MATERI DIVISION HMO : If the answer to any of the questions is yes, applicant must contact the unty of San Diego Hazardous Materials Division, 5500 vertand Avenue., uite 110, .an Diego, CA 92123.

Call (858) 505-6700 prior to the issuance of a building permit Store wip remain FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: D CalARP Exempt YES NO (for new construction or remodeling projects)

1. 511 D Is your business listed on the reverse side of this form? (check all that apply}. Date Initials

2. IID D Will your business dispose of Hazardous Substances or Medical Waste in any amount?

3. IID D Will your business store or handle Hazardous Substances in quantities greater than or equal to 55 gallons, 500 D CalARP Required pounds and/or 200 cubic feet?

4. D IX) Will your business store or handle carcinogens/reproductive toxins in any quantity? Date Initials

5. 0 00 Will your business use an existing or install an underground storage tank?

6. 0 IX) Will your business store or handle Regulated Substances (CalARP)? D CalARP Complete

7. IID D Will your business use or Install a Hazardous Waste Tank System (Title 22, Article 10)? Existing.

8. D IID Will your business store petroleum in tanks or containers at your facility with a total facility storage capacity equal to Date Initials or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).

PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT lAPCDl: The following questions are Intended to Identify the majority of air pollution issues at the planning stage. Your project may require additional measures not identified by these questions. Some residential projects may be exempt from APCD requirements. For more comprehensive requirements, please contact APCD at [email protected]: (858) 586-2650; or 10124 Old Grove Road, San Diego, CA 92131.

YES NO

1. IBI D Will the project disturb 160 square feet or more of existing building materials?

2. D !Kl Will any load supporting structural members be removed? If yes, contact APCD prior to Issuance of a building or demolition permit. A notification may be required at least 10 working days prior to commencing demolition.

3. KJ 0 (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed?

4. 0 Q!I (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, contact APCD prior to the issuance of a building or demolition permit. A notification may be required at least 10 working days prior to commencing asbestos removal.

5. D IX) Will the project or associated construction equipment emit air contaminants? See the reverse side of this fonn or the APCD factsheet (www.sdapcd.org/info/facts/oennits.pdO for typical equipment requiring an APCD permit. If yes, contact APCD prior to the issuance of a building pennit.

6. D D (ANSWER ONLY IF QUESTION 5 IS YES) Wiii the project ed construction equipment be located within 1,000 feet of a school bound ?
Briefly describe business activities: proposed project
Retail Store r Remodel I Exterior Paint I Signage Updates I declare under penalty of perjury that to the best of my knowledge an Teresa Jones
herein are true and correct.
12 t 01 t 17
Name of Owner or Authorized A ent Date
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________ __, ______________________ _ DATE: __ ........_ __ ......_ __

RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY

APCO COUNTY-HMO APCD COUNTY-HMO APCO
exempts businesses from completing or updating a Hazardous Materials Business Plan. Other pennitting requirements may still apply.

HM-9171 (08/15) County of San Diego - DEH - Hazardous Materials Division

LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO

DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISION Check all that apply:

AUTOMOTIVE
0 Battery Manufacturing/Recycling 0 Boat Yard
0 Car Wash
0 Dealership Maintenanr.e/Painting 0 Machine Shop
0 Painting
0 Radiator Shop
0 Rental Yard Equipment
0 Repair/Preventive Maintenance
0 Spray Booth
0 Transportation Services
0 Wrecking/Recycling

CHEMICAL HANDLING
0 Agricultural supplier/distributor D Chemical Manufacturer 0 Chemical Supplier/Distributor 0 Coatings/Adhesive
0 Compressed Gas Supplier/Distributor 0 Dry Cleaning
0 Fiberglass/Resin Application
0 Gas Station
0 Industrial Laundry
0 Laboratory
0 Laboratory Supplier/Distributor 0 Oil and Fuel Bulk Supply 0 Pesticide Operator/Distributor

CHEMICAL HANDLING
0 Photographic Processing
0 Pool Supplies/Maintenance
0 Printing/Blue Printing
0 Road Coatings
0 Swimming Pool
0 Toxic Gas Handler
0 Toxic Gas Manufacturer

METAL WORKING
0 Anodizing
0 Chemical Milling/Etching
0 Finish-Coating/Painting 0 Flame Spraying
0 Foundry
0 Machine Shop-Drilling/Lathes/Mills
0 Metal Plating
0 Metal Prepping/Chemical Coating 0 Precious Metal Recovery 0 Sand Blasting/Grinding 0 Steel Fabricator 0 Wrought Iron Manufacturing

AEROSPACE
0 Aerospace Industry
0 Aircraft Maintenance
0 Aircraft Manufacturing

OTHERS AND
0 Asphalt Plant
0 Biotechnology/Research
0 Chiropractic Office
0 Co-Generation Plant
0 Dental Clinic/Office
0 Dialysis Center
0 Emergency Generator
0 Frozen Food Processing Facility 0 Hazardous Waste Hauler 0 Hospital/Convalescent Home
0 Laboratory/Biological Lab
0 Medical Clinic/Office
0 Nitrous Oxide (NO,) Control System !XI Phannaceuticals 0 Public Utility
ral Refrigeration System
0 Rock Quarry
0 Ship Repair/Construction
0 Telecommunications Cell Site
0 Veterinary Clinic/Hospital 0 Wood/Furniture Manufacturing/Refinishing

ELECTRONICS
0 Electronic Assembly/Sub-Assembly 0 Electronic Components Manufacturing 0 Printed Circuit Board Manufacturing NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880.

LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District.

CHEMICAL
47 - Organic Gas Sterilizers
32 - Acid Chemical Milling
33 - Can & Coil Manufacturing
44 - Evaporators, Dryers & Stills Processing
Organic Materials
24 - Dry Chemical Mixing & Detergent Spray
Towers
35 - Bulk Ory Chemicals Storage
55 - Chrome Electroplating Tanks

COATINGS & ORGANIC SOLVENTS
27 - Coating & Painting
37 - Plasma Arc & Ceramic Deposition Spray
Booths
38 - Paint, Stain & Ink Mfg
27-Printing
27 - Polyester Resin/Fiberglass Operations
METALS
18 - Metal Melting Devices
19 - Oil Quenching & Salt Baths
32 - Hot Dip Galvanizing
39 - Precious Metals Refining

ORGANIC COMPOUND MARKETING
(GASOLINE. ETC)
25- Gasoline & Alcohol Bulk Plants & Terminals
25 - Intermediate Refuelers
26 - Gasoline & Alcohol Fuel Dispensing

COMBUSTION ROCK AND MINERAL
34 - Piston Internal - Combustion Engines 04 - Hot Asphalt Batch Plants 13 - Boilers & Heaters (1 million BTU/hr or larger) 05 - Rock Drills 14 - Incinerators & Crematories 06 - Screening Operations 15 - Bum Out Ovens 07 - Sand Rock & Aggregate Plants 16- Core Ovens 08- Concrete Batch, CTB, Concrete Mixers, Mixers 20 - Gas Turbines, and Turbine Test Cells & Stands & Silos 48 - Landfill and/or Digester Gas Flares 10 - Brick Manufacturing

ELECTRONICS
29 - Autorpated Soldering
42 - Electronic Component Mfg
FOOD
12 - Fish Canneries
12 - Smoke Houses
50 - Coffee Roasters
35 - Bulk Flour & Powered Sugar Storage

SOLVENT USE
28 - Vapor & Cold Degreasing
30 - Solvent & Extract Driers
31 - Dry Cleaning
OTHER
01 - Abrasive Blasting Equipment
03-Asphalt Roofing Kettles & Tankers
46 - Reverse Osmosis Membrane Mfg
51 - Aqueous Waste Neutralization
11 - Tire Buffers
17 - Brake Oebonders
23 - Bulk Grain & Dry Chemical Transfer & Storage
45 - Rubber Mixers
21 - Waste Disposal & Reclamation Units
36 - Grinding Booths & Rooms
40 - Asphalt Pavement Heaters
43 - Ceramic Slip Casting
41 - Perlite Processing
40 - Cooling Towers - Registration Only
91 - Fumigation Operations
56 - WWTP (1 million gal/day or larger) & Pump
Station
NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITIING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600.

Countv of San Dieao - DEH - Haz;irdnus M::ilF!ri::ds nivic:inn

SAN DIEGO REGIONAL

HAZARDOUS MATERIALS

QUESTIONNAIRE
Business Contact
Walmart Store #1917 Santee , CA
Project Address
Telephone #
479 277-8476
State Zip Code
170 Town Center Parkwa Santee CA 92701
Malling Address City State Zip Code
APN#
381-040-37-00
Plan File#
170 Town Center Parkway Santee CA 92701
Project Contact Applicant E-mail Telephone #
Teresa Jones teresa . ones@brrarch .com ( 913 ) 262- 909 5 The following questions represent the faclllty's activities, NOT the specific project description.

PART : IRE DE ARTMENT - HAZA DOUS MATERIALS VIS ON: OCCUPANC CLASSIFICATION: ot re ulred for ro ects within the Cl of San Ole o : Indicate by c1rchng the item, whether your uslness will use, process, or store any of the following hazardous materials. If any o the Items are circ e , app 1cant must contact the Fire Protection Agency with jurisdiction prior to plan submittal.

Occupancy Rating: Faclllty's Square Footage (including proposed project):

1. Explosive or Blasting Agents NI A 5. Organic Peroxides NI A 9. Water Reactives NI A 13. Corrosives NI A

2. Compressed Gases N/A 6. Oxidizers N/A 10. CryogenicsN/A 14. Other Health Hazards N/ A

3. Flammable/Combustible LiquidsN /JV. Pyrophorics N /A 11. Highly Toxic or Toxic Materials N /to. None ofThese.

4. Flammable Solids N/A 8. Unstable Reactives N/A 12. RadioactivesN/A PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DIVISION (HMO): If the answer to any of \he questions Is yes, applicant must contact the County of San Diego Hazardous Materials Division, 5500 Overland Avenue •. Suite 110, Diego, CA 92123.

Call (858) 505-6700 prior to the issuance of a building permit. Store wip remain FEES ARE REQUIRED Project Completion Date: Expected Date of Occupancy: D CalARP Exempt

1. 2.

3. 4.

5. 6.

7. 8.

YES NO (for new construction or remodeling projects)
IXI D Is your business listed on the reverse side of this form? (check all that apply).

IXI D Will your business dispose of Hazardous Substances or Medical Waste In any amount? IX! D Will your business store or handle Hazardous Substances In quantities greater than or equal to 55 gallons, 500 D
D
D
IX!
D
pounds and/or 200 cubic feet?
IX) Will your business store or handle carcinogens/reproductive toxins in any quantity? IXI Will your business use an existing or Install an underground storage tank? IX) Will your business store or handle Regulated Substances (CalARP)? D Will your business use or Install a Hazardous Waste Tank System (Title 22, Article 10)? Existing. !XI Will your business store petroleum In tanks or containers at your facility with a total facility storage capacity equal to or greater than 1,320 gallons? (California's Aboveground Petroleum Storage Act).

Date Initials
D CalARP Required
I
Date Initials
D CalARP Complete
Date Initials
PART Ill: SAN DIEGO COUNTY AIR POLLUTION CONTROL DISTRICT CAPCDI: The following questions are intended to identify the majority of air pollution Issues at the planning stage. Your project may require additional measures not Identified by these questions. Some residential projects may be exempt from APCD requirements. For more comprehensive requirements, please contact APCD at [email protected]: (858) 586-2650: or 10124 Old Grove Road, San Diego, CA92131.

YES NO

1. D

2. D 1X1

3. 4.

Kl
D
D
mi
Will the project disturb 160 square feet or more of existing building materials? Will any load supporting structural members be removed? If yes, contact APCD prior to issuance of a building or demolition permit. A notification may be required at least 10 working days prior to commencing demolition. (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Has an asbestos survey been performed? (ANSWER ONLY IF QUESTION 1 or 2 IS YES) Based on the survey results, will the project disturb any asbestos containing material? If yes, contact APCD prior to the Issuance of a building or demolition permit. A notification may be required at least 10 working days prior to commencing asbestos removal.

5. D IX! Will the project or associated construction equipment emit air contaminants? See the reverse side of this form or the APCD factsheet (www.sdapcd.org/info/facts/perrolts.pdf) for typical equipment requiring an APCD permit. If yes, contact APCD prior to the Issuance of a building permit.

6. D 0 (ANSWER ONLY IF QUESTION 5 IS YES) Will the project ed construction equipment be located within 1,000 feet of a school bounda ?
Briefly describe business activities:

Retail Store Paint I Signage Updates
12 / 01 / 17 I declare under penalty of perjury that to the best of my knowledge an Ter esa Jones \
Name of Owner or Authorized A ent \$1 Date
FOR
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION: ________ __,, _____________ _________ _

RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY

APCD COUNTY-HMO APCD COUNTY-HMO APCD
only exempts businesses from completing or updating a Hazardous Materials Business Plan. Other permitting requirements may still apply.

HM-9171 (08/15) County of San Diego - DEH - Hazardous Materials Division

LIST OF BUSINESSES WHICH REQUIRE REVIEW AND APPROVAL FROM THE COUNTY OF SAN DIEGO

DEPARTMENT OF ENVIRONMENTAL HEAL TH - HAZARDOUS MATERIALS DIVISION Check all that apply:

AUTOMOTIVE
D Battery Manufacturing/Recycling
D Boat Yard
D Car Wash
D Dealership Maintenance/Painting
D Machine Shop
D Painting
D Radiator Shop
D Rental Yard Equipment
D Repair/Preventive Maintenance
D Spray Booth
D Transportation Services
D Wrecking/Recycling

CHEMICAL HANDLING
D Agricultural supplier/distributor
D Chemical Manufacturer
D Chemical Supplier/Distributor
D Coatings/Adhesive
D Compressed Gas Supplier/Distributor
D Dry Cleaning
D Fiberglass/Resin Application
D Gas Station
D Industrial Laundry
D Laboratory
D Laboratory Supplier/Distributor
D Oil and Fuel Bulk Supply
D Pesticide Operator/Distributor

CHEMICAL HANDLING
D Photographic Processing
D Pool Supplies/Maintenance
D Printing/Blue Printing
D Road Coatings
D Swimming Pool
D Toxic Gas Handler
D Toxic Gas Manufacturer

METAL WORKING
D Anodizing
D Chemical Milling/Etching
D Finish-Coating/Painting
D Flame Spraying
D Foundry
D Machine Shop-Drilling/Lathes/Mills
D Metal Plating
D Metal Prepping/Chemical Coating
D Precious Metal Recovery
D Sand Blasting/Grinding
D Steel Fabricator
D Wrought Iron Manufacturing

AEROSPACE
D Aerospace Industry
D Aircraft Maintenance
D Aircraft Manufacturing

OTHERS AND
D Asphalt Plant
D Biotechnology/Research
D Chiropractic Office
D Co-Generation Plant
D Dental Clinic/Office
D Dialysis Center
D Emergency Generator
D Frozen Food Processing Facility
D Hazardous Waste Hauler
D Hospital/Convalescent Home
D Laboratory/Biological Lab
D Medical Clinic/Office
D Nitrous Oxide (NOx) Control System
!XI Pharmaceuticals
0 Public Utility
IZI Refrigeration System
D Rock Quarry
D Ship Repair/Construction
D Telecommunications Cell Site
D Veterinary Clinic/Hospital
D Wood/Furniture Manufacturing/Refinishing

ELECTRONICS
D Electronic Assembly/Sub-Assembly
D Electronic Components Manufacturing
D Printed Circuit Board Manufacturing
NOTE: THE ABOVE LIST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF HAZARDOUS SUBSTANCES. ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS SUBSTANCES MAY STILL REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS PLANS. FOR MORE INFORMATION CALL (858) 505-6880.

LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which include any of the following operations or equipment, will require clearance from the Air Pollution Control District.

CHEMICAL
47 - Organic Gas Sterilizers
32 - Acid Chemical Miiiing
33 - Can & Coil Manufacturing
44 - Evaporators, Dryers & Stills Processing
Organic Materials
24 - Dry Chemical Mixing & Detergent Spray
Towers
35 - Bulk Dry Chemicals Storage
55 - Chrome Electroplating Tanks

COATINGS & ORGANIC SOLVENTS
27 - Coating & Painting
37 - Plasma Arc & Ceramic Deposition Spray
Booths
38 - Paint, Stain & Ink Mfg
27 - Printing
27 - Polyester Resin/Fiberglass Operations
METALS
18 - Metal Melting Devices
19- Oil Quenching & Salt Baths
32 - Hot Dip Galvanizing
39 - Precious Metals Refining

ORGANIC COMPOUND MARKETING
(GASOLINE, ETC)
25 - Gasoline & Alcohol Bulk Plants & Terminals
25 - Intermediate Refuelers
26 - Gasoline & Alcohol Fuel Dispensing

COMBUSTION ROCK AND MINERAL
34 - Piston Internal - Combustion Engines 04 - Hot Asphalt Batch Plants 13- Boilers & Heaters (1 million BTU/hr or larger) 05- Rock Drills 14 - Incinerators & Crematories 06 - Screening Operations 15- Burn Out Ovens 07 - Sand Rock & Aggregate Plants
16 - Core Ovens 08 - Concrete Batch, CTB, Concrete Mixers, Mixers 20 - Gas Turbines, and Turbine Test Cells & Stands & Silos 48 - Landfill and/or Digester Gas Flares 10 - Brick Manufacturing

ELECTRONICS
29 - Automated Soldering
42 - Electronic Component Mfg
FOOD
12 - Fish Canneries
12 - Smoke Houses
50 - Coffee Roasters
35 - Bulk Flour & Powered Sugar Storage
SOL\/E!l!T USE
28 - Vapor & Cold Degreasing
30 - Solvent & Extract Driers
31 - Dry Cleaning
OTHER
01 - Abrasive Blasting Equipment
03 - Asphalt Roofing Kettles & Tankers
46 - Reverse Osmosis Membrane Mfg
51 -Aqueous Waste Neutralization
11 - Tire Buffers
17 - Brake Debonders
23 - Bulk Grain & Dry Chemical Transfer & Storage
45 - Rubber Mixers
21 - Waste Disposal & Reclamation Units
36 - Grinding Booths & Rooms
40 - Asphalt Pavement Heaters
43 - Ceramic Slip Casting
41 - Perlita Processing
40 - Cooling Towers - Registration Only
91 - Fumigation Operations
56 - WWTP (1 million gal/day or larger) & Pump
Station
NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITIING AIR CONTAMINANTS MAY REQUIRE AN AIR POLLUTION CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL DISTRICT AT (858) 586-2600.

HM-9171 {08/15) County of San Diego - DEH - Hazardous Materials Division 01'1' ICS: USE 014LYI HJpclete I!!J
IP!a;£
1 ONcrl
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A I. ESTABLISINI!Nr -E
P' lie Kay lilllbar l$2irJ'fl
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A9. DATI! YOU STARTED OR 1\SSLMED 8115 I NESS
140 DAY lR I I I I I I I I I I I I I I I I I I I I I I I I 97 1 6 117 122
AID. R&ASON FOR APPLICATION All •. TOTAL NIJ48ER OF EMPLOYEES m :::'-open I I 21'1 1o I
7 3 • atange of Ooltler 8 11
A 12. DO YOU HAVE PERMITS FOR ANY (IF THE FOLLOW INS I YES NO FOR OFFICE USE ONLY AIR POLLUTION CON1ROL DIS1111CT 0 121 116
0 I='
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SEllER DIS1111CT !FOR INDUSlliiiiL IIASTiSI 171 122

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HAZARDOUS WASTE FACILITY Cl 1=1 231 134
HAZARDOUS WASTE HAULER REGISTRATION Cl 0 ,,I l,a
0 n
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REGIONAL IIATER QUALITY CONTROL BOARD

OFPICE USE ONLY
SIC I SIC 2 CEIISUS 1RACT INC ElCPIRATION OAT!.
cooe CODE MINUIIL FEE MO DAY
I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 52 35 50 " 68 7• , 77 78 83 84 87 STATUS FIRE IIA TER c SEWER
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88 ai 9-,- • 93 95 County of San Diego (7/871 O.par1mant of Health Sarvloos PRINT WORLD SANTEE 10:16195626040 APR 02'93 10:59 No.003 P.03

1. e

SECTION A - HAZARDOUS WASTE GENERATION
If you know that your business generates, stores or handles hazardous wastes, please Section B of the questionnaire. All others must complete #1 through 16 that follows.

Does your business or store or handle any of the by-products or wastes listed 1n the bol\ below? YES &_r NO Circle the letters of the cate- gories found at your business. - - A, Solvents a, halOgenated - chloroform, methyl chloride b, oxygenated -ecotone, ethyl ocetate c, hydrocarbon• - bentene, stoddard d, unspecified solvent mixtures a. Sludget- alum, paint, degreoslng, caustic, paper, tetraethyl load, lime, tank botTom woste and matel sludge-----...
c. Wasta Oil/Mixed 011 motor fuel tank cleaning residue, oil separation waste, lube oil processing D, Pesticides and Pestle Ide Rinse Wator - Parathion, Malathion, Plazlnon, end oTher pesticides: pesticide residue from container rlnslnp E. PCB- mineral oil contemlnotad-electrleol capacitors, ballasts, and electrleal transformers F, Monomer/Polymeric Resin Waato - plastlo oootlng and lamlnoTing woate, resin coating, metal bind- Ing and coating resin rln&e waters G, Blclegleol Waste - Infectious hospital weate, laboratory and phormaoeutlcal research waste ex- ceeding 100 H, Orgonlc Liquid/Sol Ida- polymer extrualon waste, PVC residua, adhesive wasta, orgaqlo &tripper from aaml-conductor processing waste I , ConttiiD In a ted AQueous So 1 ut Ions : o, with reactive anions- azide, bromate, chlorate, cyanide, fluoride, hypoohlor• atq, nitrite, perchlorate, aulflde anlana, plating rlnso metal coat- Ings and metal parts cleaning solutions, b, with heavt metals- Including arsenic, barium, boryllllum, cadmium, chromium, cobalt, copper, lead, mereury, molybdenum, nickel, selenium, sliver, vanadium and zinc, o. with organic residues - Including degreaolng and motel cleaning solutions, e ulpment cleaning, dry cleaning, anticorrosion and coolont solution wastes, J, Acid SoluTions wastes battery eo plating waste, Printed circuit etching resldue,slllcon water roc onlng wastes, galvanizing waatea, other acidic solution WaStes with 2, K, Alkaline Solutions- waste& from metal plotlng, anodizing and etching, containing sodium or cal- cium hydroxide, and other solutions with pH.!. 12,, L, Asbestos - Insulation products, old pipe laglng
M, Motel Sludges and metal machining coolant sludges, metal pickling sludges, metal mechln• lng dusts 2, Do you dispose of any items in 11 by discharging them into the sewer system including floor drains, toilets, etc.? YES e!__l NO, 1=1 If yes, which categorypes) of by-products or wastes?----- /1,-......e.
3, Do you dispose of any ftems listed in 11 in a way other than disposal into the sewer system (for example, trash drain, on the ground, evarration ponds, land fills, etc)? YES r....:...__lr NO If yes, which· category(1es of by- products or wastes? ·.

DHS:HM-906 (B/87)
Coun.ty of' San 01 ego Department of Health Services
--- -· ····-··- •.. ····-. --- ..• PIIIJP. t
,_
PRINT WORLD SANTEE !0:16195626040 APR 02'93 10:59 No.003 P.04

4. 6.
e e
SECTION A • HAZARDOUS WASTE GENERATION (continued)
Do you any of the items listed in #1 another company/contractor or by yourself? NO c:J If yes, which category(fes) of b1-products or wastes? ?(It> d ::z-_ .;tr.c.- 6M-- ;;:...e • e :' ' Do you manifest (prepare the ortatfon document for hazardous wastes) any items 11sted in i#l? YES N If you answered "yes" to ..!!:!.X of the quest ons (1, 3, 4, or 5) your business or service does generate hazardous waste and a permit from the San Diego County Department of lh!lirth Services 1s required. Continue with Section 8 of the questionnaire.

PLEASE RETURN THIS SECTION DHS:HM-906 (8/87) Page 2
PRINT WORLD SANTEE !0:16195626040 APR 02'93 11:00 No.003 P.OS e

SECTION B - INVENTORY OF HAZARDOUS MATERIALS
A "hazardous substance" is a chemical, compound, or product for which a manufacturer or producer is required 1 aw to prepare a Materi a 1 Safety Data Sheet · (MSDS) for that substance. An R OS ls a document (usually 2 or 3 pages) which contains chemical composition information, fire and explosive data, health hazard data, reactivity data, spill or leak procedures, special protection Information and special precaution Information. An MSDS for a hazardous substance can be obtai ned from the supplier of that substance. Hazardous substances also include materials requiring placard warnings during transportation.

1. Does your establishment use or handle hazardous substances in quantities equal to or greater than 55 gallons, 500 pounds, or 200 cubic feet of gas_!t any one time?
Yes No L.l

2. the health hazards data or health and safety section of the Materi- al Safety Data Sheets (MSDS) to see if any chemicals or substances you use are designated as a substance (carcinogen) or substance which may cause birth defects, miscarriages, or damage to the human repro- ductive system (reproductive toxin). Does your use or handle carcinogens or reproductive toxins? Yes I I No

3. Does your establishment use or handle gases with Threshold Limit Values (TLV) or Average (TWA) of 10 parts per million or less? Yes 1=1 No 15[_1
If you have answered "Yes" tom of the above questions (1, 2, or 3). you do use or handle hazardous mater! al s that al'e subject to inventory requirements and a permit from the San Diego County Department of Health Services is required. Con- tinue with Section C of the questionnaire.

SECTION C - UNDERGROUND STORAGE TANKS
An •underground storage tank" is a tank. including piping. which holds hazardous wastes (as defined in Section A) or hazardous substances (as defined in Section B. regardless of volume) and has lOX or more of the total volume located below grade.

Does your business have underground storage tanks as defined above? No r-1 If you answered "yes" a permit from the San Diego County Department 0¥ Hea1t'li Services is required.

Underground storage tanks may not be installed. removed, destroyed, repaired or operated without permits from this Department,
Continue with the Hazardous Materials Summary on page 4.

DHS:HM-906 (8/87)
PLEASE RETURN THIS SECTION.

County of San Diego
Department of Health Services

,._..

PRlNT WORLD SANTEE ID:16195626040 APR 02'93 11:00 No.003 P.06 e

HAZARDOUS MATERIALS SUMMARY
Complete the following information regarding the handling at your business or service. Check ..!m! statement.
of hazardous materials
This business or service does generate hazardous waste, handles hazardous materials subject to the inventory requirements and/or has underground storage tanks that requires a permit from the San Diego County Department of Health Services.

I have determined that this business or service does not generate hazardous waste, handle hazardous materials subject to £lie inventory requirements or has underground storage tanks requiring permits from the San Diego County Department of Health Services.

I declare under penalty of perjury that to the best of my knowledge and belief the statements made herein are correct and true. I consent to all necessar¥ inspec- tions allowed by law and incidental to the issuance of required permit(sJ and the operation of this business.

Signature
MELVIN C. REDMAN
Title SENIOR VICE PRESIDENT
Date 4/2/93 Phone (SOl) 273-4094
Type of Busi ness:__ __ ..;.R:.:E:..:T.:..:A:..:I=L--------------------- Please complete the business information on the reverse of this page and return this questionnaire to the San Oiego County Department of Health Services in· the pre-addressed return envelope or mail using the following address.

SAN DIEGO COUNTY DEPARTMENT OF HEALTH SERVICES

ENVIRONMENTAL HEALTH SERVICES

HAZARDOUS MATERIALS MANAGEMENT DIVISION
P 0 BOX 85261
SAN DIEGO CA 92138-5261
If a San 01ego County Hazardous Materials Management Permit 1s required for your business or service a representative of th1s Department will complete an inspec· tion of your business. Permit fees will be determined from the inspection and a billing statement will be mailed.

MOTE: If you do not use hazardous materials, generate hazardous waste, or have underground storage tanks xou are still regu1red to return this form, A representative of the San Diego County Department of Health Services may contact you to verify the information provided on th1s questionnaire.· DHS:HM-906 (8/87) Page 4
.-

HUGHES & LUCE, LLP
Attorneys and Counselors
Writer's D1rect Dial Number
214/939-5500
Ms. Joan K. Swanson, R.E.H.S.

Hazardous Materials Specialist
August 27, 1996
Department of Environmental Health
Hazardous Materials Management Division
1255 Imperial Avenue M5-D561
San Diego, CA 92186-5261
Re: Wal-Mart Stores, Inc.

I! \' --l
Underground Storage Tank Permit Application- Form A
Change of Information
Gentlemen:
17 I 7 Main Street
Suite 2800
Dallas, Texas 7520 I
214 I 939-5500
•· :·· 2t4/939-6!00(fax)
2 so FH 'SS
Other Offices
Austin
Houston
Fort Worth
Enclosed please find an Underground Storage Tank Permit Application - Form A, indicating a change of information for the Wal-Mart store located in Santee, California.

The real property has been transferred from Wal-Mart Stores, Inc. to Wares Delaware Corporation, exclusive of improvements. The tank owner will remain Wal-Mart Stores, Inc.

If you should have any questions or require additional information, please do not hesitate to call.

AH!mac
Enclosures
cc: Anthony G. Soards, Esq. (w/encl.)
A Registered Limited Liability Partnership lnclud1ng Profes<>10nal Very truly yours,
Ardie Hollowell
Paralegal
05249.0019:0191638.0 I

MARK ONLY

ONE ITEM
•• STATE OFCAUFOANIA

STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM A
D 1 NEW PERMIT
D 2 INTERIM PERMIT

COMPLETE THIS FORM FOR EACH FACILITY/SITE
D 3 RENEWAL PERMIT
D 4 AMENDED PERMIT
1Kf 5 CHANGE OF INFORMATION D 7 PERMANENTLY CLOSED SITE D 8 TEMPORARY SITE CLOSURE
0 INDIV[)UAL 0 PARTNERSHIP 0 LOCAL-AGENCY

DISTRICTS'
• H ONner of UST Ia a public agency, the foUowlng: name of Supervisor of division, section, or ofllce whk:h operatBBthe UST IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 322·9669 if questions arise.

TV (TK) HQ 1414-l-1 I I I I I I
V. PETROLEUM UST FINANCIAL RESPONSIBILITY· (MUST BE COMPLETED) -IDENTIFY THE METHOD(S) USED 1 SElF-INSURED
0 5 LEITER OF CREDIT
0 2 GUARANTEE
0 6 EXEMPTION
3 INSURANCE
0 99 OTHER
D 4 SURETY BOND
VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked.

1.o u.o

N OMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT COUNTY# JURISOICTION # FACILITY t1
0]
LOCATION CODE • OPTIONAL 'CENSUS TRACTI • OPTIONAL ISUPVISOR· DISTRICT CODE • OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPUCATION • FORM B, UNLESS THIS IS A CHANGE OF SITE IHFORIIATIOH OtU.

OWNER MUST FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM A (3193) ·--.- e
INSTRll-'IONS FOR COMPLETJ[NG lFtlM "A"
GENERAL li'\STRUCT!Oi'\S:

SECT!O!\ 2711 01 ·r;-ru: 23, C! L\l'; I h. C '. .: ru:{ ';!A CODE OF R E(;t;LATIO!\S A:\D SLCT!OI\S 25286, 25287, AND 25289 OF CHAPTER 6 7, D!VIS!O:> 2C, CALlFOR\IA !IF 1i :" \\. • '\' rY C• 1ll[ RCQL'iRE OW:"•iERS TO API'LY lOR AN' USTOPERA11NG PER.\fiT. ' L One FOJ{.\1 "A" shall be compl• ·· J r- , '<c\1' l'I'R \!IT many FAOUTY/Sri EJJ'FORMATION CHANGES,

2. SUBMIT OXE (l) 1:0R:\1 · \ r 1 .c1. !\ 'S·tt·, r ·g,.1rdl...::ss of the number of tal)ks lucated at the site.

3. Th s form shnu!d be completed,., , ·"''' "" 1·1-n11 I ·\PI'UCANT orthe LOCAL AGil."CY UI\DERGROUND TA!\K INSPECTOR.

4. Please l} pc or print dearly all h ..; , •• Wll• ,,n

5. Usc a hard point writing in,lnur<•_·nt ',,u ,1 t•uk l ... op1es.

6. Tank owner must submit a facll. y I' . 1 . • .•: tu J,,t·.tl agency B.S part of the apphcation sho...,.ing the location of the USTs with respect to butWings and ldndmMks ISccu.' 1 :-:-.: ··), ('( 'f( J.

7. Tmlk owner must suhmit docun· ,.. .. v.n ,. .liT wuh ''ate linnncial responsihtluy requirements to the local agency as part of the opplicatwn fur petroleum CST!> 1", . ' . l .. •·; l ). CCRf. 'lOP OF I·OR.\1: O'<L Y O:SI I ''
:\1ark :tn (X) m1hc box next to lh(' .: 1 • he. the reason tfl.e L·nn is completed. !. f AC!!JTY /SITE !1'1'0J.L\1 A TIO\ · · >! · ' ·,' ! \ ' HI-: C0.\1 PI.ETI: D) v l. Record namt· and (phy!> .. 1' ,,f un tank(!!).

NGTE: ST have a V.J.,, ,. ,•r. ;nclucl.ng cit). SLttc, and 7.tp code.

P.O. BOX l\ C:O.!BERS \k · '>: , .\l <I 'lU:.
ln...JuJc cro's str c l' ,1 1 • --· vt J

2. Phonenumbcrmusthaveannn· c ·l .t: lll,,'.:nl .. nbcri<.tht!Saml·,writc"SAVIE.,inpn)perlocation.

3. Ch"ck the appropriate box f,>r'l Yl·l · :; !.. 'I\ \S 0\\ :\l:RS!llP (c' CORPORATION, 1.'\DIYlDUAL, etc.).

4. CheckthcJ.pt)ropna!cboxfur·l"-1' (J: ]I'
S. If Facility/StU! is loc.-ttcd wnhin .n :- J•., r"\-,,,,,,.1 ··r other truo;t lands, du:ck the bu'- marked ''YES'',

6. Indicate the :SU.\1BER of TA:S"- '> ., '

7. theE P.J\.ID #or Y.ritc · 11 •:.: '1'-l\..C provHicd. !L PRO!'ERTY OW!\ER I:SFOR.\1,\'1 :o: .. \: : ll!lSi 1 \:CST BE CO:I-1l'LETEil) Complc1c nll items 111 this scclill ... , '·'' '.-. J l • ·.·r ire ::.amc uo;, t; If the same, v.rite AS SlTE" across this section. Be sure to check PROPERTYOW:\EK,H.i· t' .. o),,
U:. TA:O.X 0\V!\i R !.'<l-OR \!XriU\ .. \
Cmnplctc allncms tn th1s Sl'tll . · 1
tothcckTA:\KO\\:\[RSTYI·,; .. ,
, ,-: BL c< rr:J) ' . 1he s.tme i1S Sl:C I lOS' I, If the S:ltnc, \\rite "SA:.1E AS Sl I'E" across this section. Be sure •'
JV.l!OARD 01- E()CALIL \TIO:S ' .\< r :-.niH R !JE SLE ARTICLE 5, Cl!A!YrER 6.75, DIVlSJOI\ 20, C\UI-01(\J,\ liE,\ , .'L \\ , \l , , \ I ODE.) Enter :l.,.nd llf h.tliJhi.Jil·
Rc1;1<.trat Lt•n \I ith I he BOE \\ UJ •.
numbl!r of tJ,.J.lllm' pl.tccJ tn y<• .. ...,
h'IH un J<..: ... !•u:ll nun.bcr \\ith th ju
to B<)L .tt :11.._· f1.l: .• )v.lng
• c a.__l uunt 1\.Jmh:r v.htch rcquin:d h.:for..: yuur appHcatLon can he processed. 1 .. I r·· 'IVC a l.jLIJrtcr:y 'lllragc fcc n.:tun\ m n.por1tng the (J06 (0rnills) JX!I g.tllon fcc due on the · H ' .. \\ 11 I co(1l cx1·mpt from paymg tlw 'tor.Lgl: fee su rn" v. ill nol bt! ::.cnl. If you do not ·t I 1y 4ue,ti•l!\S rcp,<H•hng the Icc or tlJe BOE .at <JIU-322·9669 ur write , 'u.,IIun, Fud l P 0. l) X7•), r.m,..-nh), CA 9-1279·0UOJ. , V I'ErRl>LEl \11 FI:\•\'\CIAL
OFlTII E21,! liAI'lrR ih_l--\·
lJcntd'y lhl' 1,) ·
any f·eJv1.-t! ••r .JS \'
, I: l \ 'I HE. ll'i .-:TEll lOR l'E I R<>. LS'I' 0:\L Y, SE!o SEC!IO:"\S 2711 (•)(8) ,· • '' 11, :.t.: IJ.:J!O'\S
··,Jf. j.J.',Jf,llllh.:du'b-th. !elL:f.ll<i·JS!It:..:! fld..t r..::yum:mcnts.L:STsownL!dby :·1 n.' 'll's:irl!t:\en.pl ·
YL LEGAL:SOrii·!CAT!O'\ A:\D !lll II'\<; \Ill >IU SS
Check 0:\E !lOX f"r <he addrc-- tho: ", . r '"''' ''" 'lOTI I LECiAL A'\ D BILLI:\G :-lUll I ICAT!O:\S.

TA!\'K OW'\1-R OR \L'IIIOR - I·!' ,; I .-,, ,.,[-' I A: IV F. r 1),\TE TilE lllK\1 A'; 1:"\IJ!CA I ED. ISJ:E SECT!O.'\S 2711 (a)(l3) Oi- Ill LE 2J C!IAP 1'1:1' _., I-\, "R '\ lA l DllL 0!- RE< ,l'( \TIO:\S I []';STRl:ClO:\ !·Ol( TilE: OCALA< ':,.
1bc cotully n1 jun,d. tiun n .111
hy !Jil' }., .. ·,tl ..1!!,<''\.}, hv
\
' ', 11!1 be :au ,J h) co.!l1·1g the B{)MJ ,()JO) 227-4 "I he facLltty numher may he , · 1 n ..• t t..· ril.J.] 4.t<l C..-tl•not ar,) .1lrh 1lll·ucal churdt tl!rs. 1f Lhc local agency prefers '·

3.93 the State BoatJ to the foil- :t:> t • k ... ve It blank. / IT IS TilE RESl'O:"\SllliLIT1 111 , l:l- 'I IC,\,_ ,V;E\CY THAT 1:-.:SPECTS Tl!F. FAC!UI Y TO VERIFY THE ACCURACY OF HIE TillS AI' PUC XI lr l:o-. < .\,'\;\< l f BE PROCESSED II' TilE BOE ACCOl;I\T IS :'\OT FILLED L'l. THE LOCAL AGE:'\CY IS RI!Sl'D:'\SIIlLl: <ll\ II!!: cmiPLFriO;.; OF THE "LOCAL AGENCY USE O:SLY" III.'FORMATION BOX AND FOR FORWAI<DI'>:G 0\!; FOR.\!"·\ ·\';ll A\'iOCIATED FORM "B"(s) TO TilE FOLLOWL'\'G ADDRESS. TilE LOCAL AGENCY SHOULD RETAI:S Till: OR!Cii:\Al-'> A\.l I tiRWARD '!liE YELLOW COPIES TO THE FOhLOWlNG ADDRESS. THE COPY SHOULD BE RETAI:\ED BY 'Ill!: TASK 0\\?\Li{ -
STATE OFCALll-OK\lA
STATE WATER RESOL:RCLS CON'TROL BOARD
C/0 SW.E.E.P.S
DATA • n '\I ER
P.O. UOX 527
PARA:O!OUNT, CA 90723
FOR0120R1
I ··' I ' •
WESTERN PUMP1nc.
petroleum & lubrication equipment specialists
3235 "F" Street
Company Nfmlfl: WALMAHT
Dale: 4/18/96 Job Order #: 101 ::J'.· San DlegQ. California 92102 f619J 239-9988 • Fax (6191 239-9998
C!ty/G1/lJp:

Con!ad Nanie:
170 Town Center Pkwy
San lee, CA 92071
Stowl Retz.
619-440·8215
Stillle AJ; Above
HAY Z.B 12 13 PM '96
E N\{1, . .'1 i t-1 t·
Cuatomolllitdrhilitibofl VICES
MONITOB CERTIFICATION FOR POLLULERi CDlOlN
SGrvice P&rformed lll&t on $Gi)ttrate Ucket If
.. 117// .),7 /)" '> t1 I? r 7/..//_> / d,;2L __ -·------·-·-·-·-·---·------_______________ ·-·--· Ontt.>: !; ·_}.d
Part Number
----·---
• Descriptk>o
... ·
Uwt Gosi
L.ubor <!tal on B!l)iUate ticket II
Tech:

At-4-C/--
Anival: Depart: labor: Travel:

I/ 0 c) L.:.J2. ,,z. .. ,L __
,/ .. .. I
... ....... ____ _
'
Total:
e

COUNTY OF SAN DIEGO
BUSINESS NAME Mi... f'YI41i?:r # I q I L
ADDRESS I 'fo ""--nWNO {!;rlf?_. 'f>Kwy:' TITLE ___;:...,-;,...-___;,.--:--:---- CITY/ZIP & Cft;J.o:fl PHONE .

On the above date an of your business/facility was conducted in order to determine compliance with the ca'lftornia Health and Safety Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and thlJ'San Diego County Code (SDCC). The following remarks are intended to provide guidance to correct the violations 7oted 7 the attached violation report. P, 4 {Zk ,, @
.. 0-.-
,i
i ..... • ... · .. i . . )LA €Je(.,l Al G • v<> Lrt.FA."STE e rn-/le1Z rn' :s Si IJG \ .. ) U\-t3€LS ( wAf:Jr£· o/t.__, ) ore_ l:>tD !Jdr fM.Ve, .•.•.....•.•.•. , .•. >·-··········(····•··································· .et,"'-==s;.....:;..i.A@....;...:;_,€L::::..::;:...;i ····· .......... ... ( ..·.· ... ·.·· · ........ ·.. (
.. u /·.-·.• ••• • ••• -s)
A$ S-e:.Jo c...o"F't'es W1rnhtJ 3o DAYS
4) D L l=i : ARE AitJT CA..oSeD . Ttfe t> e.Un-r.S
wv=n..t: A!JD 9DL! I,.) 'F>L.A<!.-e EXveJ>r AoDI iJt, C12 12enul/1Ai"< ••••.·.·.····••·.·. > . ) FfZ-o-vv.._ T\tt . •
< < f .iu.J "'-1 ,J-eSS 'f=>t.A..,J: I iv1=:o-rz.mA::r1 f2 EGA-e.I::>i..JE> Cnrr&::c? _ i etr-erz:y_c;.

DR_ u.JtTI+<t-J .,3o l)A'-(S trF- A Set £€CfJTZnFic:?tr!-tn.J ··········· ..... ············<···· 'FDteM.. I
·. :=·.:::::,, :··
· ..· .··. < /JJif_er.Jrotl.Y : 5Tl)t261:> I :J
5!5 r:9trO otZ t;:;cro U3. hUJSr f3£
€D -;.6. 7i+o f<.-J Ol... R.eFeie,ee.Atvl L ":3
Atvo WAS++E7Z 56l.--VeNr wu.t.A3-e A:t>l>§>IO -n+E"
. ··•<i»wvic AS I Werii'DIG{,
. (619) 338·2222
County of San Die·
DEH:HM-924 (5/95) NCR
DISTRIBUTION: WHITE-RETURN TO HMMD
YELLOW-BUSINESS RETAINS Department of Environmental Heal'to., 0 F S A N D I
1 '· rt·····••·l
EST. NUMBER H <
DATE r I !.e

PAGE OF
BUSINESS NAME:
.{>.Nt-JI.-At_., j W/Ji.J -30 l>A:CS*.
-/.fffi AI30"/E Me- IWD mvsr
G-t etltUZ.a:..::re;D. $-rQtnVt;;.L,+
ONE; lr12_TUJo f5A'5t-t::r6 A-ND f'A:Si tn.

DHS:HM-9110 (8/90)
Hazardous Materials Management Division, PO Box 85261 San Diego CA, 92138-5261 (619) 338-2222
COU'Ity of San Diego
Department of Health Services
BUSINESS ADDRESS:

VIOLATION REPORT: The items checked below refer to specific section numbers of Titles 19/22/23 of the California Code of Regulations ICCR), Chapters 6.5, 6.7, 6.95 of the Health and Safety Code IHSC), and/or the San Diego County Code (SOCCI.

I HAZARDQ!.!S WAST!i BE!;l!,!IREM!iNTS: No's
·-:rwo ·
II !.!NP!iRGRO!,!ND STOBAG!i TANK f!.!SJI B!i!l!.!IBEM!iNU; RECORD KEEPING v UST REQUIBEMENTS
( I Health Perm1t not obtained SDCC 68.905 V0108 W I I Aeilth Perm1t not obtamad 68.1005,25284 I I No EPA Identification Number 66262.12 V01 05 w-- I J Repair/modify/close permit not obtained [ I Waste Manifests/Receipts not on-site for V0118 w-- 68.1005 - . I I UST Permit Application not submitted 25286(a) I I not properly completed 66262.23 V0120W I I Operating permit conditions violated 2712 Manifest copy not sent to CAL-EPA 66262.23 V0115w-- I I Failed to notify HMMD of 25284 TSDF signed-manifest not on-site 66262.40 V0121 w--: I I No owner/operator agreement 5293 I I Biennial report not sent to CAL-EPA 66262.41 V0122 w records of financial coverage 25292.2 [ I LOR Documentation not available 66268.7 V0123 )IY, No maint/monit/calib records available [ I Exceeion RJ:t. not filed with V011aw-- 2712(b), 2641 i CA -EPA 6262.42 tl/aJtC-rnJ '?OLLuLezr [ I Operating TSDF without authorization 25201 V0124W __

STORAGE AND HANDLING
MONITORING REQUIREMENTS (SINGLE WALL!
[ I Leak Detection Method does not meet · ,".'(&ste store11 longer t.nan 90 days 66262.34 V0221 W performance standards 2643 Waste container missing/improperly labeled V0222W I I Annual' lnterity test not conducted 26292 66262.34 [ I Copy of tan test not submitted to HMMD
Haz Materials not properly Ia el&d 25 2 V0223W within 30 days 2643 Waste container not kept closed 66265.173 V0202w-- I I Manual tank gauging (<2000 gal) 2645 [ Waste container in poor condition 66265.171 vo2osw-- not dona properly [ I Waste container(&) not properly managed V0210w-- I I Reconciliation not done pr':ferly 2646 66265.173 [ I Reconciliation not approve for facility 2646 [ I Dama11ed container not repackaged 66265.171 V0226W [ I Dispenser meter(s) not calib annually 2646 [ I Contaoner incompatible with waste 66265.172 V0207w-- [ I Improper liquid measurements 2646 [ I Incompatibles in the same container 66265.177 V0224w-- I I Stick m poor condition 2646 I I lncomr.atibles not stored separately 66265.177 V0213w-- I I lmJ?roper monthly reconciliation 2646 I llgnitib e Wastes loss than 50 feet 66265.176 V0214w-- I I Fa1led to report excessive variation 2646 [ I lgnitible Wastes not grounded 66265.31 V0215w-- I I Pressurized Product Leak Device [ I Storage area not inspected weekly 66265.174 V021&w-- not tested annually 252 2

DISPOSAL AND TRANSPORTATION
l I Onauth. dosposal of waste to 25189.5 V0313W
MONITORING REQUIREMENTS !DOUBLE WALL! [ I Waste determination not made 66262.11 V0319w-- [ I Unlawful transport of haz. waste 25163 V0315w--: !.'(!Omtorong system not Tunctoonal :J._tJ_:J_"J. [ I Waste transported without manifest 66262.20 V0316 w_ il"' No written monitoring procedure 2632 l I No Extremely Haz. Waste Permit 67430.1 V0317w. __ F"' Written rasflonse plan not available 2632 TRAINING, CONTINGENCY PLAN 8t EMERGENCY PROCEDURES Spiii/Ovarfi I allS'ip. not maintained or metalled 263 I I Tra1n1ng records unavailable 66265.16 V0406 W
I I Training not adequate 66265.16 V04oaw--
[ I not osigned to mmimiza release V0501 w-- RELEASE REPORTING 662 5.31 I I Fa1iure to report an unauthorized raleasa 25296 [ I Spill control equip not available 66265.32 V0608W I I Release record log not available 265 \ 2650 I I A1sla space is obstructed 66265.35 vososw-- I I No leak report/investigation/action 26 2 I I glen not and/or on file
6626 .51, 6265.5 V0609 W
Uo'Se {)t<ill MS - CLOSURE MISCELLANEOUS ( I Wasta ool contaminated 25250.7 '. V0225 W I I Temporary closure req. not completed 2671 Used oil filters improperly managed 6 266.130 V0701 w-- I I Abandoned tank not properly closed 25298 [ Damaged batteries improperly managed V0702 w-- I I Permanent closure roq. nc.t completed 2672 662 6.81 --
Ill HAZARDQ!.!S MATERIALS BUSINESS PLAN RE!;l!.!JREMENTS: BUSINESS PLAN ELEMENTS

RECORD KEEPING
[ I Health Permit not obtained SDCC 68.1105
[ I Business Plan not established/implemented
[ I Emergency Response Plan inadequate 25504
,·.i----\lf'll' ... Emergency Contacts not provided/current 25509 25503.5
[ I Business Plan not submitted to HMMD 25505
Plan not amended 25505
"'IT Personnel Training Records not available 2732

RELEASE REPORTING
I I Faolure to report a release/threatened release
25507
V2008W __
I Personnel Training Program inadequate 25504
Inventory is incomplete 25504
Site Map is not sufficient 25509
I Acutely Haz. Mat:·not registered 25633
V3002T
V3007,.---
V3010 T
V3011 ,.--- V3012,.---
V3005,.---
V3013,.---
V3001 ,.---
V3014T __
V3016 T
V3016,.---
V3017T __
V3018 T
V3019,.---
V3020,.---
V3021 ,.--- V3022 ,.--- V3023,.---
V3024T
V3025T __
V3026 T
V3027 ,.--- V3028,.---
V3029,.---
V3009 T
V3030,.---
V3031 T
V3006T
V3032 ,.--- V3033 T
V2201 W
V2203w--
V2301 W
V2006w--
V2202w--
v2oosw--
d. Please call (619) 338-2222 if you have any questions.

DEH:HM-923 (Rev. 1/95) NCR
DISTRIBUTION: WHITll-RETURN TO HMMD
YELLOW-BUSINESS lliiT AINS
f?A'\ • • f+ 3 J. ;J. ';f '(
S A N D I E G 0 Page \ of _i_
EST. NO. H 3rg_qt.c DATE 3{tt
TIME START lz 3 .5" END:Z,!J.-
'j- BUS. CODE /( 2.<.. I · ___ c_o_MP_L_IA_N_C_E_I_N_S_PE_C_T_I_O_N_RE_P_O_R_T_. __ _J BUSINESS NAME ;}"A 1..- /VI A;: 17 CONTACTno.i'. on
ADDRESS 17_ PwT TITLE
CITY/ZIP Sg!I\J.& CJZo11 PHONE '4'-l")t"\OO
On the above date an inspection of your business/facility was conducted in order to determine compliance with the California Health and Safety Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code (SDCC). The following remarks are intended to provide guidance to correct the violations noted on the attached violation report.

Office Use Only
.
.

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Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186·5261 DEH:HM-924 (Rev. 1/96) NCR
(619) 338·2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
County of San Diego
Department of Environmental Health
•

COUNTY OF 'AN DIEGO

SUPPLEMENTAL INSPECTION REPORT
e .ST. NUMBER H ?:/l271
DATE 3 I I :r I 't 7
PAGE k OF _'-f-l----
Office Use Only BusiNEss ADDREss: ziP coDE: q Zo7 I
uqdo.k&.
--_;;__ § Pho-k :
vr'S> I t1-.hoAJ
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f Business Representative
Department of Environmental Health, Hazardous Materials Management Division, P,O, Box 85261, San Diego, CA, 92186-5261 DEH:HM-9110 (3/96) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
•
COUNTY OF DIEGO .ST.
-
NUMBER H ?>2'2.. 7j
DATE 3 I /'t f/7
SUPPLEMENTAL INSPECTION REPORT PAGE OF '1
Office Only BUSINESS ADDRESS: n b Tbu.rn frnHv= Pwt ZIP CODE: CfZ07j "
---:--" __;_ __
... "
----·-'-- "" --
lVI/ !) 4t.<J
Title
Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186-5261 DEH:HM·911 0 (3196) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
\
-
OF SAN DIEGO .-
EST. NUMBER H 32-Z. 7"(
DATE __
BUSINESS ADDRESS: ....... · tr-l--O_F ___
VIOLATION REPORT: The items checked below refer to specific section numbers of Titles 19122123 of the California Code of Regulations (CCR), Chapters

6.5, 6.7, 6.95 of the Health and Safety Code (HSC), and/or the San Diego County Code (SDCC).

I HAZARDOUS WASTE REQUIREMENTS:

RECORD KEEPING
[ I Health Penrut not obtained SDCC 68.905 V0108 W
[ ) No EPA Identification Number 66262.12 votosw--
[ ) Waste Manifests/Receipts not on-site for V0118 W
3 years 66262.40
) Manifest not properly completed 66262.23 VOIZOW
) Manifest copy not sent to DTSC 66262.23 vousw--
) TSDF signed-manifest not on-site 66262.40 VOlll w--
) Biennial report not sent to DTSC 66262.41 votnw--
I LOR Documentation not available 66268.7 V0123W--
) Exception Rpt. not filed with DTSC 66262.42 V0116w--
) Operating TSDF without authorization 2520 I VOt24w--
STORAGE AND HANDLING [ I Waste stored longer t1Ul119o, 180, or 270 days 66262.34 V0221 W [ ) Failure to clean up hazwaste off of floor surface 66262.1 Ob V0313W-- [ ) Waste container missing/improperly labeled 66262.34 vomw-- [ ) Haz Materials not properly labeled 25124 voz:ow--
[ ) Waste container not kept closed 66265.173 vozozw--
[ ) Waste container in poor condition 66265.171 vozosw-- [ ) Waste container(s) not properly managed 66265.173 vouow-- [ ) Damaged container not repackaged 66265.171 V0226W-- [ ) Container incompatible with waste 66265.172 V0207W-- [ ) Incompatibles in the same container 66265.177 vo224w-- [ )Incompatibles not stored separately 66265.177 V02t3w-- [ ) Ignitible Waste less than 50 feet 66265.176 V0214W-- [ ) lgnitible Waste not grounded 66265.31 V0215W--
[ ) Storage area not inspected weekly 66265.174 V02t6w-- DISPOSAL AND TRANSPORTATION [ I Unauth. diSposai of waste to 25189.5 V0313 W [ ) Waste detennination not mnde 66262. I I V0319W--
[ ) Unlawful trnnsport of haz. waste 25163 V0315W--
[ ) Waste trnnsported without manifest 66262.20 V03t6v.r-- [ ) Extremely Haz Waste Pennit not obtained 25205.7 V03t7v.r-- rammg recor s unnvru e
) Training program not adequate 66265.16 V0406w--•
) Facility not designed to minimize release 66265.3 I VOSOl w-- ) Spill control equip not available 66265.32 vososw--
) Aisle space is obstructed 66265.35 V0509 W
) Contingency plan not prepared and/or on file
66265.51, 66265.53 V0609W __

MISCELLANEOUS
[ ] Waste od contatninated 25250.7 V0225 W
[ ) Used oil filters improperly managed 66266.130 V0701 w-- [ ) Damaged batteries improperly managed 66266.81 V0102w-- [ ) Facility has failed to notify local CUPA and DTSC of onsite treatment of hazardous waste (tiered pemitting) V0125W ) Onsite treatment of waste without authorization 2520 I V0125W-- 01 HAZARDOUS MATERIALS BUSINESS PLAN REQUIREMENTS:

RECORD KEEPING
[ I Health Penrut not obtained SDCC 68.1105
[ ) Business Plan not established/implemented 25503.5
[ ) Business Plan not submitted to HMMD 25505
D UNDERGROUND STORAGE TANK illSTl REQUIREMENTS:
25284
Repair/modify/close penni! not obtained 68.1005
) UST Penni! Application not submitted 25286(a)
) Operating penni! conditions violated 2712
) Failed to notify HMMD of changes 25284
) No owner/operator agreement 25284 f4 No records of financial coverage 25292.2 ) No maint/monit/calib records available 2712(b), 264Jij) MONITORING !SINGLE WALLl [ I t:e8k Detect10neth0d does not meet performance standards 2643
) Integrity test not conducted 25292
) Copy of tank test not submitted to HMMD
within 30 days 2643
[ ) Manual tank gauging ( <2000 gal) 2645
not done properly
) Reconciliation not done properly 2646
) Reconciliation not approved for facility 2646
) Dispenser meter(s) not calib annually 2646
) Improper liquid measurements 2646
) Stick in poor condition 2646
) Improper monthly reconciliation 2646
) Failed to report excessive variation 2646
) Pressurized Product Piping Leak Device
not tested annually 25292
) No written monitoring procedure 2641
) No written emergency response plan 2641
) SIR reporting incorrectly done 2646.1
RELEASE REPORTING [ I Frulure to report an unauthorized release 25295 [ ) Release record log not available 2651, 2650
[ ) No leak report/investigation/action 2652
CLOSURE [ I Temporary closure req. not completed 2671
[ ) Unused tank not properly closed 25298
[ ) Permanent closure req. not completed 2672
[ ) Failed to apply for temporary closure 25298

BUSINESS PLAN ELEMENTS
[ ) Emergency Response Plan madequate 25504
[ ) Emergency Contacts not provided/current
25509
V3002 T
V3007T--
V3010T--
V3011T--
V3005T--
V3003 T
V3014T __
V3015 T
V3016T
V3017T __
V3018 T
V3019T--
V3022T--
V3023T--
V3024 T
V3025 T
V3004 T
V3026 T
V3027T--
V3028T--
V3029 T '
V3009 T
V3030T--
V3006T
V3008 T
V2Z01 W
V2Z03v.r--
1 I Business Plan not runended 25505 tVfX Personnel Training Records not available 19 CCR 2732 V2001 W
V2002W--
V2007W--
V2003W--
V2302w--
) Personnel Training Program inadequate 25504
) Inventory is incomplete 25504
) Site Map is not sufficient 25509
V2301 W vzoosw--
vzzozw--
RELEASE REPORTING V2009W
[ I Frulure to report a release!
) Acutely Haz. Mat. not registered 25533
V2008W __
ST E CORRECTED. PLEASE CALL 61 ) 338-2222 OR YOUR INSPECTOR IF YOU HAVE ANY QUESTIONS. 'J.fl
TITLE
Department of Environmental Health, Hazardous Materials Management Division, P. 0. Box 85261, San Diego, CA 92186-5261 DISTRIBUTION: WHITE-RETURN TO HMMD
DEH:HM-923 (Rev. 10/96) NCR YELLOW-BUSINESS RETAINS
•
COUNTY OF SAN DIEGO . age ( ofll
DAT 5- =- 9:

COMPLIANCE INSPECTION REPORT 1 START /030 END -f=M_ . S. CODE SPECIALIST L.. ! t
BUSINESS NAME 11 CONTACf <Ji.. '1£ >) !t0oj , On the above date an inspection of your business/facility was conducted in order to determine compliance with the California Health and Safety Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code (SDCC). The following remarks are intended to provide guidance to correct the violations noted on the attached violation report.

Offloo u.""" -rt'6 pe0f= IW 1 4 1198 P' d zv{ H
11'
Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 129261, San Diego, CA, 92112-9261 DEH:HM-924 (Rev. 2/98) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
/ County of San Diego
Department of Environmental Health
..

EST. NUMBER H 3;J.;;l7f
DATE ·5 I J I Cf'B
PAGE r;)--. OF _-4...J· .____ __

COUNTY OF SAN DIEGO
I···· SUPPLEMENTAL INSP:Fj!CTION REPORT .

Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186-5261 DEH:HM-9110 (3196) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
COUNTY • OF SAN DIEGO • EST. NUMBER H 3¢-d] 4=
COMPLIANCE INSPECTION REPORT DATE 5[ I f I 98 · t _ PAGE 3 OF _l.f_.___ BUSINESS ADDRESS: __ ...... z.LJ.Jfl_.___,C"'-'e::...Jfll"-'-"-tt:'""'k'-/---------------- VIOLATION REPORT: The items checked below refer to specific section numbers of Titles 19/22123 of the California Code of Regulations (CCR), Chapters

6.5, 6.7, 6.95 of the Health and Safety Code (HSC), and/or the San Diego County Code (SDCC).

I HAZARDOUS WASTE REQUIREMENTS:

RECORD KEEPING
[ ) Health Pemut not obtained SDCC 68.905
[ ) No EPA Identification Number 66262.12
[ ) Waste Manifests/Receipts not on-site for
3 years 66262.40
Manifest not properly completed 66262.23
Manifest copy not sent to DTSC 66262.23
TSDF signed-manifest not on-site 66262.40
Biennial report not sent to DTSC 66262.41
[ ) LDR Documentation not available 66268.7
[ ) Exception Rpt. not filed with DTSC 66262.42
[ I Operating TSDF without authorization 25201

STORAGE AND HANDLING
[ 1 Waste stored longer than 90, 180, or 270 days 66262.34 [ 1 Failure to clean up hazwaste off of floor surface 66262.10b [ ) Waste container missing/improperly labeled 66262.34 [ I Haz Materials not properly labeled 25124
[ ) Waste container not kept closed 66265.173
[ ) Waste container in poor condition 66265.171
[ I Waste container(s) not properly managed 66265.173
[ I Damaged container not repackaged 66265.171
[ I Container incompatible with waste 66265.172
[ ]Incompatibles in the same container 66265.177
[ I Incompatibles not stored separately 66265.177
V0108 W
V0105W--
V0118 W
V0120W
vonsw--
vout w--.

V0122W __ .

V0123W--
V0116W--
V0124 W MONITORING RE UIREMENTS SINGLE WALL
Le DetectiOn e o oes not meet
performance standards 2643
) Integrity test not conducted 25292
) Copy of tank test not submitted to HMMD
within 30 days 2643
) Manual tank gauging (<.!000 gal) 2645
not done properly
I Reconciliation not done properly 2646
) Reconciliation not approved for facility 2646
I Dispenser meter(s) not calib annually 2646
) Improper liquid measurements 2646
) Stick in poor condition 2646
) Improper monthly reconciliation 2646
V3002 T
V3007T--
V3010T--
V3011 T--
V3012T--
V3005T--
V3013T--.

V3001 T--
V3003 T
V3014T __
V3015 T
V3016 T
lgnitible Waste less than 50 feet 66265.176
lgnitible Waste not grounded 66265.31
I Storage area not inspected weekly 66265.174
V0221 W
V0313W--
V0222W--
V0223W--
V0202W--
V0205W--
V0210W--
V0226W--
V0207W--
V0224W--
V0213W--
V0214W--
V0215W--
V0216 W
) Failed to report excessive variation 2646
) Pressurized Product Piping Leak Device
not tested annually 25292
V3017T __
V3018 T
V3019T--
V3020T--
V3021 T--
V3022T--
V3023T--
V3024 T
V3025 T
V3027T--
V3027T--
V3004 T
1 DISPOSAL AND TRANSPORTATION
[ ) Unauth. dtsposat of waste to 25189.5
[ ) Waste detemtination not made 66262.11
[ I Unlawful transport of haz. waste 25163
[ ) Waste transported without manifest 66262.20
[ I Extremely Haz Waste Permit not obtained 25205.7
Trrumng recor s unavail e 2 .I
I Training program not adequate 66265.16
I Facility not designed to minimize release 66265.31
I Spill control equip not available 66265.32
I Aisle space is obstructed 66265.35
I Contingency plan not prepared and/or on file
66265.51, 66265.53

MISCELLANEOUS
[ ) Waste od contaminated 25250.7
[ I Used oil filters improperly managed 66266.130
[ ) Damaged batteries improperly managed 66266.81
[ I Facility has failed to notify local CUPA and DTSC of onsite treatment of hazardous waste (tiered pentitting) [ I Onsite treatment of waste without authorization 25201 V0313 W
V0319W--
V0315W--
V0316W--
V0317 W
V0405 W
V0406W--
V0501 w--
voso8w--
V0509 W
V0609W __
V0225 W vo7ot w--
vo7o2 w
V0125 W
V0125W--
Ill HAZARDOUS MATERIALS BUSINESS PLAN REQUIREMENTS:

RECORD KEEPING
[ ) Health Permll not obtained SDCC 68.1105
[ I Business Plan not established/implemented 25503.5
[ ) Business Plan not submitted to HMMD 25505
) No written monitoring procedure 2641
) No written emergency response plan 2641
) SIR reporting incorrectly done 2646.1

RELEASE REPORTING
[ ] Frulure to report an unauthorized release 25295
[ ) Release record log not available 2651, 2650
[ ) No leak report/investigation/action 2652

CLOSURE
[ I Temporary closure req. not completed 2671
[ ) Unused tank not properly closed 25298
[ I Permanent closure req. not completed 2672
[ ) Failed to apply for temporary closure 25298

BUSINESS PLAN ELEMENTS
[ ) Emergency Response Plan madequate 25504
[ ) Emergency Contacts not provided/current
25509
/ [ I Business Plan not amended 25505 fXI Personnel Training Records not available 19 CCR 2732 V2001 W
V2002W--
V2007W--
V2003W--
V2302 W
) Personnel Training Program inadequate 25504
) Inventory is incomplete 25504
I Site Map is not sufficient 25509

RELEASE REPORTING
[ I Frulure to report a release/threatened release 25507 V2008 W ) Acutely Haz. Mat. not registered 25533
Department of Environmental Health, Hazardous Materials Management Division, P. 0. Box 129261, San Diego, CA 92112-9261 DISTRIBUTION: WHITE-RETURN TO HMMD
DEH:HM-923 (Rev. 1/98) NCR YELLOW-BUSINESS RETAINS
V3026 T
V3027T--
V3028T--
V3029 T
V3009 T
V3030T--
V3031 T
V3006 T
V3032T--
V3033T--
V3008 T
V2201 W
V2203 W
V2301 W
V200SW--
V2202W--
V2009 W
• •

COMPLIANCE INSPECTION REPORT
.
/ Signature of Bus1ness Representative Date Signed
Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 129261, San Diego, CA, 92112-9261 DEH:HM-924 (Rev. 2198) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
' County of San Diego
Department of Environmental Health

EMERGENCY RESPONSE PLAN

UNDERGROUND STORAGE TANK (USTJ MONITORING PROGRAM
This monitoring program must be kept at the UST location at all times. The information on this monitoring probtram is required by Sections 2632(d) and 2641(ii) CCR Title 23.

Facility Name: Wal *Mart Store Inc.

Facility Address: 170 Town Center Pkwy, Santee, CA 92071 Business Representative's Name: :::G.=ec::o:.=rc:g,_,e=--D=e.=Lc::u"'c'-'c'-'a'-'s"------------------------- Job Title: TLE Manager Phone: 619-449-8215
County Hazardous Materials Management Division Phone: _,6:.::1c:9:...-_4:...9::.5:::_-:::5:::8c:7:.=1:._ _______ -:-_______ _

1. If an unauthorized release Qeak or spill) occurs, how will the hazardous substance be cleaned up? Note: If a release hazardous substance reaches the environment; increases the fire or explosion hazard; is not cleaned up from the secondary containment within 8 hours; or deteriorates the secondary containment, then the county Hazardous ·Materials Management Division and the Fire Department must be notified immediately.

Notify management of the incident. Dry mop liquid if possible then place · liquid into proper container. In the case of oil the customer waste oil tank should be used, in all other cases the accumulation drum should be used. Mop up the area of the spill. Complete a hazardous waste label and apply the label to the drum. Place the drum into the hazardous waste storage area.

Notify "your hazardous waste handler of the drum and schedule the drum to be picked up within ninety (90) days of the incident. If the UST has leaked into the secondary containment a vacuum truck will be dispatched to remove all fluids from the main tank and secondary containment and the tank's integrity will be tested by a licensed tank tester.

2. Described the proposed methods and equipment to be used for removing and properly disposing of any hazardous substances.

As stated above the primary method for removing hazardous materials (waste motor oil) will be by using a dry mop and drum or using a vacuum truck. If the hazardous waste is in a drum it will be removed from the site by an authorized hazardous waste hauler. If a vacuum truck is used it will be the method of removal from the site.

3. Describe the location and availability of the required cleanup equipment in item #2 above.

The mop and accumulation drum are stored in the store service area and the vacuum trucks are dispatch from the hazardous waste haulers facility and are available 24 hours a day for 4 to 8 hour response.

4. Describe the maintenance schedule for the cleanup equipment.

The accumulation drums are picked up every 90 days.

5. List the name(s) and job title(s) of the person(s) responsible for authorizing any work necessary under the emergency response plan:

Name:George DeLuccas
Name: John Wise
Name: ______________________________________ __
Prepared By: Jay McNab /uLoDIItt..

Print Name
Title: TLE Manager
Title: TLE Service Manager
Title:----------------
This document was produced by Global EMS to help WAL •MART prepare their county Hazardous Materials Management Plans & Updates. If you have any questions please feel free to call our office.

GLOBAL EMS+ 444 North Ninth Ave.+ Upland, CA 91786 + (909) 920-0140

WRITTEN MONITORING PROCEDURES

UNDERGROUND STORAGE TANK (UST) MONITORING PROGRAM
This monitoring program must be kept at the UST location at all times. The information on this monitoring program is required by Sections 2632( d) and 2641 (ii) CCR Title 23.

Facility Name
Facility Address:

Wal*Mart Store Inc.
170 Town Center Pkwy
Santee, CA 92071
A. Describe the frequency of performing the monitoring:

Tank: Levels & product values are checked and logged daily.

The monitoring system is checked with tank levels
and certified annually.

Piping: Up stream fill line is gravity feed approximately 10 foot long its elevation is 2 foot below top of UST
sump, feed line flows at less Sgpm waste oil is
removed by vacuum from a elevated 4 inch pipe in UST
sump area, this piping is checked every month during
fluid removal.

B. What methods and equipment, identified by name and model, will be used for performing the monitoring:

Tank:Pollulert CD lOlN
Piping: Visual
C. Describe the locations where the monitoring will be performed:
(Facility plot plan should be attached)
Monitoring device is located on the wall behind the TLE cash register, the UST is located outside of service bay. (See site map for specific location)
This document was produced by Global EMS to help WAL *MART prepare their county Hazardous Materials Management Plans & Updates. If you have any questions please feel free to call our office.

GLOBAL EMS+ 444 North Ninth Ave.+ Upland, CA 91786 + (909) 920-0140 D. List the name(s) and title(s) of the people responsible for performing the monitoring and/ or maintaining the equipment:

Name Title
George DeLuccas Tire & Lube Express Manger
John Wise TLE Service Manager
E. Reporting schedule for certification of monitoring system:

Tank: Annually by Certified Tank Testing Vendor
Piping: Annually by Certified Tank Testing Vendor
F. Describe the preventive maintenance schedule for the monitoring equipment:
(Note: Maintenance must be in accordance with the manufacturers' maintenance schedule but not less than every 12 months.)
System is checked every day by pressing the test button on the front panel of the monitoring system control box.

G. Describe the training necessary for the operation of UST system, including piping, and the monitoring equipment:

Operators are trained on the daily procedure of monitor inspection and fluid level recording & in response to
monitor alarm or failure.

This document was produced by Global EMS to help WAL*MART prepare their county Hazardous Materials Management Plans & Updates. If you have any questions please feel free to call our office.

GLOBAL EMS+ 444 North Ninth Ave.+ Upland, CA 91786 + (909) 920-0140 v -· •
·.

WESTERN PUMP 1':{'
OoliTE
' .SEAVICE IIIM>ICl NUM8·f1
·-....._ ··+reum & equipment specialists· \S·..:f -·7; ' . -3 .:.1-y 7 s _j r---· 921 D:Z SERVICE INVOICE
(6191 23M9811 • faJI (6191 239-9925
I
I NAME 0
J NA'!"E WAL IVI/'?-'?.1 ' '.

N A0DAE88
a
olf I 76 v -r'JfAI/1/ e.,., e""'<
0 CITY STATE ZIP 0 CIT'! lfl/lt-1 STATE CA. ZIP
I 0
c TELEPHONE
A ONii T 4c,kf- E I
CUSTOMER OONTACI' 0 EA CONTACT
N
CUSTOMER ORDER NUMIEA I C.O.D. ICHAAOl I WI'RRANTY r· I CALL' NUiioliiER SEAVIC! REOVESTEO -A"' .-.tu A l- M6NI 'nJ R: CA
SERVICE f#O /(€72_ ?'fJ/If... I"
?"' If 11(/. 0 / { I ,A f" F'( VI tJ 1/ ,.,._,a 7 1 I
·' (L"U foA"' . .;tl ( l 1("-y /'I() 1Jii!. /·"'""/ ('.

I I
s 0\J.\NTITY ITEM NUMI!R DESCRIPriON I PRICE AMOUNT
' I . !
•. . .. I
'·
i
I
I
!
!
I
!
i
CAT& MECI<ANIC ARRIVE DEPART lABOR 'IOTAl ! '
.s-..r· (t:lJ /0: ..c;.{r, L......r /, e:.l ...... r PARTS I :

SAI.I!S TAX I
r !
! I
' 1
MAKE MODEL SIAIAL NO. MAK£ SERIAL NO.

MILES:

I:Jr.lllll! ID:II )Jif 11 tJ/9 # c rJ IDI
I ,fl IN ' /6/ N t9.:Z? ,r!)
I i <
I I I
i
LABOR
(\
}J /Jlir! {;; /996
TOTAL
(..tdv.: SALE
u· !G WP-11

CUSTOMER I
3li1G
• • . '
1 .EAK MONITOR INSPECTION REPORT
Site Name: L- 4R I
Site Address: .If I T-0 mw N C.e;AJ 'IJFJe
t.flA-1<1
Contact Name: 6
Phone Number: _ (''Sl..J::{"
JUS "P' StrHt
S..n Dl.gQ. Callh>rftla 92102
1619)696-5777
FAX 1619) 6Wr67S7
K<.dJM'
Equipment Manufacturer: /J u L(.,(.j L/£72. r M "N I "' Model Number. (!.. 0 1 o 1 N
Sensor fl. Type LoCIIfion
•• 1tL __ (f"@V0t<l.. _ ·(flu Nt/'
Operable
d.!<.
.. :lt.to?._ _;e1;..--- _ -.. . --·- - -- -- - . 6 .. .. ;::::_ :::::::== --·--·-·--.-----------·--------+------- ---- . -----4-------- ----·--- 1· . ··-··---·-·· --·-·-------t·--·----_______ .:. __ - --------· ------------·--····----............ _ .._________ _.... .... -........ _ ---·- ... _ ... _ . ----·- - .... - - ---. - Comments:
f
I rre:-s-17(£.Z) A·c f-•' (fltPI) 0' 6 ri. .

At-b p-t/ A.jC?f (')1\1 /v.. 4L1
!
Technician:

CJ Cre ' $.

Print Name . Rev (02194)
•
813 391;/d 3li;IQ
• .. • •
WAL*MART STORES INC.

RISK MANAGEMENT TEAM
702 S.W. 8th Street
Bentonville, AR 72716-9078
January 31,1998
I am the Chief Financial Officer of Wai*Mart Stores, Inc., et al. This lener is in support of the use of the fmancial test of self-insurance, to demonstrate fmancial responsibility for compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or non-sudden accidental releases in the amount of at least $2,000,000.00 per occurrence and $2.000.000.00 annual aggregate arising form operating an underground storage tank(s).

Underground storage tanks at the following facilities are assured by this financial test by this owner or operator, and/or guarantor: See anached.

A financial test and/or guarantee is also used by this owner or operator or guarantor to demonstrate evidence of fmancial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR Parts 271 and 145:

EPA Regulation for state of business operations (specify stale):

Closure (It 264.143 and 265.143)
Post-Closure Care <H 264.145 and 265.145)
Liability Coverage <H 264.147 and 265.147)
Corrective Action(§ 264.101 [b))
Plugging and Abandonment <I 144.63)
Other State Programs (specify state):

Closure
Post-Closure Care
Amount
N/A
N/A
N/A
N/A
N/A
...

N/A
N/A
*Note: Where this document is to be utilized by a petroleum storage tank vendor, then the words "petroleum storage tank vendor" shall be substituted for ·'owner or operator" where appropriate.

Liability Coverage
Corrective Action
Plugging and Abandonment
Hazardous Waste Management Regulations:

Closure(VR672-10-l H 10.7.Cand9.7.C)
Post-Closure Care (VR 672-10-1 H 10.7.E. and 9!.7.E.)
Liability Coverage (VR 672-10·1 It 10.7.0. and 9.7.G.)
Corrective Action (VR 672-10·1 H IO.S.L.2.)
Plugging And Abandonment (40 CFR § 144.63)
TOTAL $0.00
NIA
NiA
N/A
N/A
N/A
N/A
N/A
N/A
· ... ...
• •
This owner or operator or guarantor has not received an adverse opinion. a disclaimer of opinion. or a "going concern" qualification from an independent auditor on his fmancial statements for the latest completed fiscal year.

ALTERNATIVE I
I.

2. 3.

4. S.

6. 7.

I.

9. 10.

II.

12. Amount of annual UST aggregate
coverage being assured by a financial
test, and/or guarantee
Amount of corrective action, closure
and post-closure care costs, liability
coverage and plugging and abandonment
cost covered by a financial test, and/or guarantee
Sum of lines I and 2
Total tangible assets
Total liabilities (if any of the amount reported
on line 3 is included in total liabilities, you may
deduct !hat amount from this line or add that
IIIDOUllt to line 6)
T111gible net worth
(subtract line S from line 4)
Is line 6 at least equal to line I above?
u.s
X
Is line 6 at least equal to lhe sum of line
I plus 10 times line 2?
Have financial statements for the latest
fiscal year been filed with the Securities
and Exchange Commission?
Have financial statements for the latest
fiscal year been filed with the Energy
Information Administration?
Have financial statements for the latest
fiscal year been filed with the Rural
Electrification Administration?
Has financial information been
provided to Dun and Bradstreet and has Dun
and Bradstreet provided a financial
strength rating of at least BB
($200,000 to@ $299,999)7
X
X
X
$2,000,000.00
S2,000,000.00
$4,000,000.00
$44,291,000.000.00
S26,881,000,000.00
$17,410,000,000.00
..

X
X
•
•
l3 . If you did not answer "Yes" to one of lines 9 through 1-2, please anach a report from an independent certified public accountant certifying that there are no material differences between the data reported in lines 4 through 8 above and the fmancial statements for the latest fiscal year. c: finresp.doc
-.--::;.- ...... ;:
....
•

GLOBAL EMS I LE
Engineering & Mechanical Services
Letter of Response '- :r: = ::::0 r- rn ,.,
p. z .......,
July 20, 1998 r -.J -=..
--I .. .... ""' - .. CD :r1 if, - r· U1 - -- 0 ,..,..... Department of Environmental Health Hazardous Materials Division -· .. J:;:a.
a .. = fT1 :::>
.-- ' t.O 0 (j) CD
P.O. Box 85261
San Diego, CA 92186-5261
File#
Violation Location:

H32274
WalMart#1917
Inspection Date:
170 Town Center Parkway
Santee, CA 92071
5/1/1998
Inspector: L. Thompson
Violation
V3026- UST Monitor
audible alarm not
functioning.

V3013- Letter of
financial responsibility.

V3027- Written UST
monitoring procedures
V3028- Written UST
emergency response plan.

V0115- DTSC copy of
manifest onsite.

V0121- TSDF copy of
manifest not on site.

V0405- Training records
unavailable.

V0215- Ignitable waste
container not grounded.

V3003- UST monitor not
tested annually.

Sincerely,
1-rH..J.LJayMcNab
Corrective Action Taken
The UST monitor has a switch that disables the audible
alarm. The manager and his associates were trained on the proper use of the test function.

A copy of the letter of financial responsibility was included with the HMBP that is included with this letter.

A copy was submitted with the HMBP that is included
with this letter.

A copy was submitted with the HMBP that is included
with this letter.

Manifests were sent to DTSC as was requested by the
inspector.

Manifests were requested from vendor and will be kept on site for 3 years.

Associates have all been trained and all signed
documentation is now kept on site.

The ignitable waste container is now properly grounded as requested.

The monitor was tested by Western Pump and the
certificate is included with this letter
444 North Ninth Ave., Upland, CA 91786
Phone I Fax (909) 920- 0140
' '
GLOBAL
• • EMS
Engineering & Mechanical Services
July 20, 1998
Joan Swanson
Department of Environmental Health
Hazardous Materials Management Division
P.O. Box 129261
San Diego, CA 92112
Dear Joan,
,.., rQ· ..-' , •.• ,. 'L. ! •!""· D z,,: f." : ·.· ,. . . ·. ·: i' rr- . ! - ' •lo..;o,o JuL Zl B AN '98
E •"' . !o •.

HEAI-;H
Our firm represents WalMart Stores, Inc. in regards to environmental issues. We just completed the Business plan updates for each store along with inspecting each store in regards to compliance issues. Enclosed you will find the updated Hazardous Materials Business Plans for each of the stores in San Diego County excluding the store in Santee since their plan was updated and given to L. Thompson direcdy by the store.

During a review of the WalMart store files in San Diego County a notice of violation was found in each store's ftle. No documentation was filed stating any corrective actions that were taken, so I have also included a response letter detailing the corrective actions that were taken to correct each violation for each of the NOV's along with support documentation.

If their are any questions regarding this package please feel free to call me at my office.

Sincerely,
Jay McNab
444 North Ninth Ave., Upland, CA 91786
Phone I Fax (909) 920 - 0140
· ·. ·
wE!TERN J · · petroleum equipment specialists
M .A.•-; , r;-
1 jDQ I>'
""I
S.an C.allfornl.a 92102 '-J I f 6 (619J 696-5777
FAX (619J 696-5757
Site Name: fJJ/r L - 1--1 4 R I
Site Address: If J 1'-0 7rt1/AI (I !PV le'J\? IQ (I /.fi.J ' n ,; . \f'lr;<) ree.

Contact Name:

Phone Number:

Equipment Manufacturer: T /-1 CAJ I 7C
Model Number: C'-/J /CI /'I
Sensor # Type Location
fr/V IUrJ '- UIE V1
{./,...,.,
9 Y.C7/
Operable
cJ.K.

C;.f(.
-------------- -------------------- /) -------_----- d ----:::::::=== ----·----------·--------
----------------------- ---------
Comments:

I o 11-ee:>K. c::n f" rre- 1/ElJ A ( c 0 e.r..../ s--c /"?. ./1 ( (_... Ft; l\_)0_ !/1 ;y' )Y /") R /v1 A{ L
. -l Technician: · · - . . 0
{__ t:S · CA.-"""! Cr·£
Print Name (S' --.e.:_9 S3
Rev (02/94)
j>"fi ____ .)
'j I"UMI"
leum & lubrication equipment .lisU
' 32 5 "F" Street · ,, S Diego. California 921 02 •.
f619J239-9988 • Fax f619J239-9925 ,p.ft,
SEIIYit;t INVOICE NUMBER
l
-.3 ....,'1' 7 s-:

SERVICE INVOICE
I NAME J NAME tr/A L /' . ./!/-'_A) 0 '
N ADDRESS B ADDRESS ·' ,_ v -· '. ·: ,·· L __ , .,,.;,._;; 0 CITY STATE ZIP 0 CITY ; '1.4.A. I STATE /jjl. ZIP
I c '/ '
c TELEPHONE A TELEPHONE T .,_ ' / _ .. E I
CUSTOMER CONTACT 0 CUSTOMER CONTACT """'
N
CUSTOMER ORDER NUMBER jco.o. !CHARGE I WARRANTY !SALESMAN I CALL NUMBER SF.RVICEREOUESTED __ ..___ .. __
/
s QUANTITY ITEM NUMBER DESCRIPTION PRICE AMOUNT

DATE MECHANIC ARRIVE DEPART LABOR TRAVEL TOTAL
\ 11' 1'/''f:.;: 9: .(r 1o: ..:..\ r I ,_ I r- TOTAL PARTS <=; -·.t ,. :;7 ',.

I

SALES TAX
1-
MILES
MAKE MODEL SERIAL NO. MAKE I MODEL SERIAL NO
b: .Ill::· tll ;c-.::J. .I- _):? ,-,, . ('", _:-; _/,/ __ ,' I ,J'/.1'/ :,:-,":".:.!) /C I ,,.; 9.;:( .'?
LABOR
(\
RECEIVED BY /7/'J . L 'P ' U; DATE TOTAL . //k:. -r / /)/2 - v / lc::/y}'l_,_ '........,-t/7Yl_f /) ; 1.- I ; s /198 SALE r j/ •./ 0 WP-19

CUSTOMER
• WAL*lVIART INC.

RlSK 1\'IANAGEMENT TEAM
702 S.W. 8th Street
Bentonville, AR 72716-9078
January 3!,1998
lam the Chiei Financial Officer of Wai*Mart Stores, Inc., eta!. This letter is in support of the use of the tinanciJitest of self· insurance. to demonstrate financial responsibility for compensating third pJrties for bodily injury and properry damage cJused by sudden accidental releases and/or non-sudden accidentol releJ.Ses ln tile amount of at least S2.000,000.00 per occurrence and S2.000,000.00 annual aggregate 3Jising form an underground storage tank(s).

Underg:ound storage tanks at the following facilities are by this tinancial test by this owner or oper..tor. and/or guarantor: See attached.

A financial test ;:nd/or guarantee is also wed by this owner or operator or guarantor to demonstrate evidence of responsibility in the following amountS under other EPA regulations or state programs authorized by EPA under 40 CFR Pam 271 and 145:

EPA Regulation for each state of business operations (specify state):

Closure <H 2154.1 and 265.J4j)
Post-Closure C.ue 264.145 and 265.145)
Liability 264.147 and 265.147)
Corrective Action (q 264.101 [b])
Plugging and Abandonment (9 144.63)
State Prog..-ams (specify state):

Closure
Post·Ciosure Care
Amount
N!A
N/A
N/A
Nl,>.

N/A
N/A
NIA
..
':-lote: Where this document is to be utilized by a petroleum storage tank vendor, then the word' "petroleum $torage tank vencor" shall be substit\lted for "owner or operator" where Liability Coverage
Corrective Action
Plugging and Abandonment
Hazardous Wa.ste Management Regulations:

Closure (VR 672-10-1 10.7.C md 9.7.C)
Post·Closure Care (VR 672·10·1 §§ l0.7.E. and 91.7 E.)
Liability Coverage (VR 672-10-l §§ 10.7.G. and 9.7.G.)
Corrective Action (VR 672-10-1 §§ 10.5.L.2.)
Plugging And Abandonment (40 CFR 14.4.63)
TOTAL SO.OO
NIA
N/A
N/A
N/A
N/A
N/A
N/A
N/A
f't£"1
.. :·
··.··
' This owner or operator or guara-has not received an adverse opinion, a discla-of opinion. or a ··going concern" qualification from an independent auditor on hb tinancial statementS for the latest completed tiscal year.

ALTERNATIVE I
I.

2. 3.

4. s.

6. 7.

8. 9.

10. 11.

Amount of annual UST aggregate
coverage being assured by a financial
test. and/or guarantee
Amount of corrective action, closure
and post.closure care costs, liability
coverage and plugging and abandonment
cost covered by a tinanci:ll test, and/or guarantee
Sum of lines I and 2
Total tangible assets
Total liabilities (if any of the amount reported
on line 3 is included in total liabilities, you may
deduct that amount from this line or add that
amount to line 6)
Tangible net worth
(subtract line S from line 4)
Is line 6 at least equal to line l above'/
ru
X
Is line 6 at least equal to the sum of line
1 plus 10 times line 2'?
Have tinancial statements for the latest
tiscal year been tiled with the Securities
and Exchange Commission?
Have tinancial statementS for the latest
fiscal year been filed with the Energy
lnformiltion Administration?
Have financial statements for the latest
fiscal year been filed with the Rural
Electrification Adminismnion?
X
X

12. Has financial information been
. / .. ' ··: '. ·-..
provided to Oun and Bradstreet and has Dun
and Bradstreet provided a financial
strength rating of M least 8B
($200,000 to@ S299,999)? X
S2,000,000.00
$2.000,000.00
$4,000,000.00
,ooo.ooo oo
S26.881 ,000,000.00
$17,410,000,000.00
X
X
: .
c ..
..
o; •
; 13. If you did 1101 answeAs" to one of lines 9 through 12, please attachAPort from 31\ certified public accouZt certifying that there are no material differenWbetween the data reported in lines 4 through S above and the $Utements ior the latest tiscal year. c: fwesp.doc

SAN DIEGO
BUSINESS NAME VV ,t
ADDRESS I /D Pt,J;;j
CITY/ZIP q J.o] \
office Use 9nJy
.....__ '8
' ''
r
' '
·;
' !
II-Z3-11
Date Signed \Title
Department of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 DEH:HM-924 (Rev. 2/99) NCR
DISTRIBUTION: WIUTE- RETURN TO HMD

YELLOW-BUSINESS RETAINS
County of San Diego
Department of Environmental Health
co.ITY OF SAN DIEGO • EST. NUMBER H J )2 7
COMPLIANCE INSPECTION REPORT DATE __ t_/ __ _ 2
VIOLATION REPORT: The items checked below refer to specific section numbers of Titles 19/22123 of the California Code of Regulations (CCR), Chapters

6.5, 6.7, 6.95 of the Health and Safety Code (HSC), and/or the San Diego County Code (SDCC).

I HAZARDOUS WASTE REQUIREMENTS: II UNDERGROUND STORAGE TANK (UST) REQUIREMENTS:

SDCC 68.905
No EPA Identification Number 66262.12
Waste Manifests/Receipts not on-site for
3 years 66262.40
I Manifest not properly completed 66262.23
I Manifest copy not sent to DTSC 66262.23
I TSDF signed-manifest not on-site 66262.40
I Biennial report not sent to DTSC 66262.41
I LDR Documentation not available 66268.7
I Exception Rpt. not filed with DTSC 66262.42
I Operating TSDF without authorization 25201

STORAGE AND HANDLING
[ I Waste stored longer tJlaJl90, 180, or 270 days 66262.34 [ I Failure to clean up hazwaste off of floor surface 66262. lOb [ I Waste container missing/improperly labeled 66262.34 [ I Haz Materials not properly labeled 25124
[ I Waste container not kept closed 66265. I 73
[ I Waste container in poor condition 66265.171
[ I Waste container(s) not properly managed 66265. I 73 [ I Damaged container not repackaged 66265.171
[ I Container incompatible with waste 66265.172
[ I Incompatibles in the same container 66265.177
[ I Incompatibles not stored separately 66265. I 77
[ I Ignitible Waste less than 50 feet66265.176
[ I lgnitible Waste not grounded 66265.31
[ I Storage area not inspected weekly 66265.174

DISPOSAL AND TRANSPORTATION
[ I Unauth. dtsposaJ of waste to 25189.5
[ I Waste determination not made 66262.1 I
[ I Unlawful transport of haz. waste 25163
[ I Waste transported without manifest 66262.20
[ I Extremely Haz Waste Permit not obtained 25205.7
V0108 W

VOIOSW--
V0118W--
V0120 W vousw--
vout w--
vot22W--
V0123W--
V0116W--
V0124 W
V0221 W
V0313W--
V0222W--
V0223W--
V0202W--
V0205W--
V0210W--
V0226W--
V0207W--
V0224W--
V0213W--
V0214W--
V0215W--
V0216 W
V0313 W
V0319W--
V0315W--
V0316W--
V0317 W

TRAINING, CONTINGENCY PLAN & EMERGENCY PROCEDURES
[ ] Trammg records unavailable 66265. I 6 V0405 W
[ I Training program not adequate 66265.16 V0406 w-- [ I Facility not designed to minimize release 66265.31 VOSOI w-- [ I Spill control equip not available 66265.32 V0508 w-- [ I Aisle space is obstructed 66265.35 V0509 w--
[ I Contingency plan not prepared and/or on file --
66265.51, 66265.53 V0609 w __

MISCELLANEOUS
[ I Waste ot! contaminated 25250.7
[ I Used oil filters improperly managed 66266.130
[ I Damaged batteries improperly managed 66266.81
[ I Facility has failed to notify local CUPA and DTSC of onsite treatment of hazardous waste (tiered pemitting)
I Onsite treatment of waste without authorization 25201 V0225 W
vo7ot w--
V0702w--
V0125 W vousw--
III HAZARDOUS MATERIALS BUSINESS PLAN REQUIREMENTS:

RECORD KEEPING
[ I Health Permtt not obtained SDCC 68.1 105
[ I Business Plan not established/implemented 25503.5
[ I Business Plan not submitted to HMMD 25505
[ l)lusiness Plan not amended 25505
/ [ ·1 Personnel Training Records not available 19 CCR 2732

RELEASE REPORTING
[ I Frulure to report a release/threatened release 25507 V2001 W
V2002W--
V2007W--
V2003 W
V2302W __
V2008 W

GENERAL UST RE UIREMENTS
[ H t Penmt not obtrune 8.1005, 25284
[ I Repair/modify/close permit not obtained 68.1005
[ I UST Permit Application not submitted 25286(a)
[ I Operating permit conditions violated 2712
[ I Failed to notify HMMD of changes 25284
[ I No owner/operator agreement 25284
[ I No records of financial coverage 25292.2
[ I No mainUmoniUcalib records available 2712(b), 264l(j) [ I Monitoring Equip. not tested annually 2630, 2641

MONITORING REQUIREMENTS (SINGLE WALL)
[ I Le3k Detectton Method does not meet
performance standards 2643
I Integrity test not conducted 25292
I Copy of tank test not submitted to HMMD
within 30 days 2643
I Manual tank gauging (<2000 gal) 2645
not done properly
I Reconciliation not done properly 2646
I Reconciliation not approved for facility 2646
I Dispenser meter(s) not calib annually 2646
I Improper liquid measurements 2646
I Stick in poor condition 2646
I Improper monthly reconciliation 2646
I Failed to report excessive variation 2646
I Pressurized Product Piping Leak Device
not tested annually 25292
I No written monitoring procedure 2641
I No written emergency response plan 2641
I SIR reporting incorrectly done 2646.1
Momtonng system not unct10n
I No written monitoring procedure 2632
I Written emergency response plan not available 2632
1 SpilUOverfill equip. not maintained or installed 2635

RELEASE REPORTING
[ 1 Frulure to report an unauthorized release 25295
[ I Release record log not available 2651, 2650
[ I No leak report/investigation/action 2652

CLOSURE
[ I Temporary closure req. not completed 267 I
[ I Unused tank not properly closed 25298
[ I Permanent closure req. not completed 2672
[ I Failed to apply for temporary closure 25298

BUSINESS PLAN ELEMENTS
[ I Emergency Response Plan madequate 25504
[ ) Emergency Contacts not provided/current
25509
I Personnel Training Program inadequate 25504
I Inventory is incomplete 25504
] Site Map is not sufficient 25509
) Acutely Haz. Mat. not registered 25533
V3002 T
V3007T--
V3010T--
V3011 T--
V3012T--
V3005T--
V3013T--
V3001 T--
V3003 T
V3014T __
V3015 T
V3016 T
V3017T __
V3018 T
V3019T--
V3020T--
V3021 T--
V3022T--
V3023T--
V3024 T
V3025 T
V3027T--
V3027T--
V3004 T
V3026 T
V3027T--
V3028T--
V3029 T
V3009 T
V3030T--
V3031 T
V3006 T
V3032T--
V3033T--
V3008 T
V2201 W
V2203W __
V2301 W
Vl005W--
Vl202W--
V2009 W
PLEASE CALL (619) 338-2222 OR YOUR INSPECTOR IF YOU HAVE ANY QUESTIONS.

DISTRIBUTION: WHITE-RETURN TO HMMD
DEH:HM-923 (Rev. 1/98) NCR YELLOW-BUSINESS RETAINS
r •
To:

Phone#:

Fax#:

From:

Re:

Project#:

Via:

We transmit the following item(s):

Letter of Transmittal
Veronica Garmo
County of San Diego
12/4/03 - 11 :37 AM
Department of Environmental Health
Hazardous Materials Division
1255 Imperial Avenue, 3rd Floor
San Diego, CA 921 01
(619) 338-2232
Beth Mullaly
Expanded Food Remodel
Wai-Mart Store #1917
Santee, CA
96501804
Fedex - 2nd day
Please find enclosed the following, for the Expanded Food Remodel (Refrigeration Remodel) project for Wai-Mart Store #1917, located at 170 Town Center Parkway, Santee, CA:
1 - Hazardous Materials Questionnaire
1 - Fee for Clearance, in the amount of $75.00, Check No. 16720.

I am submitting the above documents in order to obtain a clearance, so that the clearance can be submitted along with the plans to the building department for plan review.

Please contact me with any comments or if you have any questions at my direct number (913) 236-3393.

I have also enclosed my business card. The clearance needs to be returned to my attention.

Sincerely,
Beth Mullaly
Permit Coordinator
Cc: File
Beth Mullaly
Harold J. Havens • Architect
6700 Antioch Plaza. Suite 300 • Merriam, Kansas 66204
TEL 913-262-9095 FAX 913-262-9044
EMAIL [email protected] WEB www.brrarch.com
Member of American Institute of Architects
. '
(p ( tj 2ft' </ I 00
Po--J w .... -{ CPI'?J ;2..fY- cf.;va
7: USE ONLY
.:.H;_) 3.:Z.;l.ff
SAN DIEGO REGIONAL ___ _. __

APCD -------------
PART 1: FIRE DEPARTMENT· HAZARDOus MATERIA MANAGEME DIVISION: OCCUPANCY ClASSIFICATION Indicate by circling the item, whether your business will uae, process, or store errv of the following hazardous material&. If any of the items are circled, applicant must contact the Fire Protection Agency wilh jurisdiction prior to plan aubminal.

1. Explosive or Blasting Agents 4. Flammable Solids 7. Pyrophorics 10. Cryogenics 13. Corrosives

2. Compressed Gasea 5. Organic Peroxides 8. Unstable Reactives 11. Highly Toxic or Toxic Materials 14. Other Health Hazards

3. Flammable ot Combustible Uguids 6. Oxidizers 9. Water Reactive• 12. Radioactivas PART II• SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAl HEALTH -HAZARDOUS MATERIALS MANAGEMENT DIVISION IHMMDI :

If the answM to any of the questions is yes, applicant muat contact the County of San Diogo Haz01doUfl Materials Management Division, 125Simperlal Avenue, 3nf Floo<, San Diego, CA 92101. Telephone (619) 338·2222 prior to the issuance of a building 0 CaiARP Ex...npt department permit. . I
Date Initials -- FEES MAY BE REQUIRED
. 0 CalARP Required
1 • [ your business listed on 1he reverse side of this form 1 · I

2. your business dispose of Haz8fdoua Sutmancea or Medical Waste in any omount1 Data

3. WiH your business atore or handle Hazardous Substances in quantities equal to or greater than 55 gallons, r .. pounds, 200 cubic feet or carcinogena/roproductive toxins In any quantity7 0 CaiARP Complete 4 ..... .!:::1.- your business use an existing or instaU an underground storage tank1 I

5. F- business store or handle Regulated Substances(CaiARPJ1 Date Initials

6. },« WiU yow business use or install a Hazardous Wuta Tank System (Title 22, Articls 1 01 PART Ill. SAN Q!E9Q COUNTY AIR PQllUT!ONS CONTROL DISTRICT II the &nswer to any of the questions Is yes, applicant must coiltact the Air Pollution Control District. 9150 Chesapeake Drive, San Diego, CA 92123.

Telephone (619) 694-3307 prior to the issuance ol a build"mg depanment permit. .

1. 0 Will the intended occupant instaH or use any of the equipment rooted on tho Usting of Ail Poliutlon Control District Permit Categories, on the reverse aide of this form 1

2. 0 0 (ANSWER ONLY IF QUESTION t IS YES.) Will the subject facUity be located within 1,000 fest of the outer boundary of a school (K through 121 u listad In the curront Directory at School and Community ::olleoa Districts, pub6shed by the San Diego County Office of Education and e current California Private School Directory, compiled in occordance with provisions of Education Code Section 331901

3. or structure for which this
Briefly buainess activity end proposed projecti
FOR OFFICIAl USE OHL Y:

Date
lE-3405
mo.oo.

FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:: ___ __;. __________ -;::-:---------------- BY:, _______________________________ Oata: ______________ _ EXEMPT OR 110 F\llllHUilltfOIIMATION AEOU!Ra>
COUNTY·HMMD APCD
OEH:HM-9171 (10f.l8)
.......

RE'l.£ASE0 FOR BUILDING PERMIT OUT NOT FOR OCCUPANCY
COUJ!J,Y·HMA\1?. APCD
AEL£ASEO 'ron
County of San Oiao;c
Department of Environmental Hea:lt.

COUNTY • OF SAN DIEGO
I COMPLIANCE INSPECTION REPORT I\
BUSINESS NAME WAL- MAR.\ * lctl1 -JADDRESS 170 lt>\..0.-l C..GI-'tt\'l..- CITY/ZIP \SA C.. A q 7 01 (
On the above date, an inspection of your business/facility was conducted in order to compliance with the Health and Safety Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code (SDCC). The following remarks are intended to provide guidance to correct the violations noted on the attached violation report.

Office Use Only
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Title
Department of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 DEH:HM-924 (Rev. 2/99) NCR
DISTRIBUTION: WHITE- RETURN TO HMD

YELLOW-BUSINESS RETAINS
County of San Diego
Dcpartmenl of Environmentalllealth
e
COUNTY OF SAN DIEGO EST. NUMBER H 2.:<?."14
DATE 0{;7 I 0 ¥ I 0 (
DEH:HM-911 0 (3196) NCR
SUPPLEMENTAL REPORT PAGE =<... OF ___::: 7 __ _
BUSINESS ADDRESS: V1 2' V'<J..J.t-t.Nf«-1 1 >A CiVD'( f ,....?\. 5 oe I+A"Z-An-PDJS
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DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
rJ Vt (I.() ;I
coiiTY OF SAN DIEGO • EST. NUMBER H 3'2. 2 '7 4
I. COMPLIANCEINSPECTION REPORT DATE oc; I og= I o f
PAGE OF -:2>
BUSINESS ADDRESS: .;_,.... ...... rz+-(-----
VIOLATION REPORT: The items checked below refer to specific section numbers of Titles 19/22123 of the California Code of Regulations (CCR), Chapters

6.5, 6.7, 6.95 of the Health and Safety Code (HSC), and/or the San Diego County Code (SDCC).

I HAZARDOUS WASTE REQUIREMENTS: II UNDERGROUND STORAGE TANK (UST) REQUIREMENTS:

RECORD KEEPING
[ ] Healih Penrut not obtained SDCC 68.905
[ 1 No EPA Identification Number 66262.12
[ 1 Waste Manifests/Receipts not on-site for
3 years 66262.40
1 Manifest not properly completed 66262.23
1 Manifest copy not sent to DTSC 66262.23
] TSDF signed-manifest not on-site 66262.40
1 Biennial report not sent to DTSC 66262.41
1 LOR Documentation not available 66268.7
] Exception Rpt. not filed with DTSC 66262.42
1 Operating TSDF without authorization 25201

STORAGE AND HANDLING
V0108 W
V0105W--
V0118 W
V0120 W
V0115W--
V0121 w--
VOI22W--
VOI23W--
V0116W--
VOI24 W
stored longer than 90, 180, or 270 days 66262.34 V0221 W [ ] · ure to clean up hazwaste off of floor surface 66262.10b V0313 I [ aste container missing/improperly labeled 66262.34 ':V:0222:w-:.:z- [ 1 Haz Materials not properly labeled 25124 V0223 W
[ 1 Waste container not kept closed 66265.173 V0202 w-- [ 1 Waste container in poor condition 66265.171 V0205 w-- [ ] Waste container(s) not properly managed 66265.173 V0210 w-- [ ] Damaged container not repackaged 66265.171 V0226 w-- [ 1 Container incompatible with waste 66265.172 V0207 W-- [ 1 Incompatibles in the same container 66265.177 V0224 w-- [ ] Incompatibles not stored separately 66265.177 V0213 w-- [ ] Ignitible Waste less than SO feet 66265.176 V0214 w-- [ ] Ignitible Waste not grounded 66265.31 V0215 w--
[ ] Storage area not inspected weekly 66265.174 V0216 W

DISPOSAL AND TRANSPORTATION
[ 1 Unauth. dtsposlll of waste to 25189.5
[ 1 Waste deterntination not made 66262.11
[ 1 Unlawful transport of haz. waste 25163
[ 1 Waste transported without manifest 66262.20
[ 1 Extremely Haz Waste Permit not obtained 25205.7
V0313 W
V0319W--
V0315W--
V0316W--
V0317 W

TRAINING, CONTINGENCY PLAN & EMERGENCY PROCEDURES
[ ] Training records unavatlable 6626S.I6 V0405 W
[ 1 Training program not adequate 66265.16 V0406 w--
[ 1 Facility not designed to minintize release 66265.31 VOSOI w-- [ 1 Spill control equip not available 66265.32 VOSOS W
[ 1 Aisle space is obstructed 66265.35 V0509 W
[ 1 Contingency plan not prepared and/or on file -- 66265.51,66265.53 vo609 w __

MISCELLANEOUS
[ 1 Waste oil contantinated 25250.7
[ 1 Used oil filters improperly managed 66266.130
[ 1 Damaged batteries improperly managed 66266.81
[ 1 Facility has failed to notify local CUPA and DTSC of onsite treatment of hazardous waste (tiered pemitting)
] Onsite treatment of waste without authorization 25201 V0225 W
V070I w--
vo702 w
VOI25 W
VOI25W--
III HAZARDOUS MATERIALS BUSINESS PLAN REQUIREMENTS:

RECORD KEEPING
[ 1 Health Penrut not obtained SDCC 68.1105
[ 1 Business Plan not established/implemented 25503.5
[ 1 Plan not submitted to HMMD 25505
[.,j"Business Plan not amended 25505
[ 1 Personnel Training Records not available 19 CCR 2732

RELEASE REPORTING
[ ] Failure to report a release/threatened release 25507 V2001 W
V2002W--
i
v
V2008W __

GENERAL UST REQUIREMENTS
[ 1 Heaiih Penrut not obtained 68.1005, 25284
[ 1 Repair/modify/close permit not obtained 68.1005
[ 1 UST Permit Application not submitted 25286(a)
[ 1 Operating permit conditions violated 2712
[ 1 Failed to notify HMMD of changes 25284
[ 1 No owner/operator agreement 25284
( ] No records of financial coverage 25292.2
[ ] No maint/monit/calib records available 2712(b), 2641(j) [ ] Monitoring Equip. not tested annually 2630, 2641

MONITORING REQUIREMENTS (SINGLE WALL)
[ 1 Leak Detectton MethOd does not meet
performance standards 2643
1 Integrity test not conducted 25292
] Copy of tank test not subntitted to HMMD
within 30 days 2643
1 Manual tank gauging (<2000 gal) 2645
not done properly
1 Reconciliation not done properly 2646
1 Reconciliation not approved for facility 2646
1 Dispenser meter(s) not calib annually 2646
1 Improper liquid measurements 2646
1 Stick in poor condition 2646
1 Improper monthly reconciliation 2646
1 Failed to report excessive variation 2646
1 Pressurized Product Piping Leak Device
not tested annually 25292
1 No written monitoring procedure 2641
] No written emergency response plan 2641
] SIR reporting incorrectly done 2646.1

MONITORING REQUIREMENTS WALL)
[ 1 Momtonng system not functional :r32
[ ] No written monitoring procedure 2632
[ ] Written emergency response plan not available 2632
[ 1 SpiiUOverfill equip. not maintained or installed 2635

RELEASE REPORTING
[ 1 Fmlure to report an unauthorized release 25295
[ 1 Release record log not available 2651, 2650
[ 1 No leak report/investigation/action 2652

CLOSURE
[ 1 Temporary closure req. not completed 2671
[ 1 Unused tank not properly closed 25298
[ 1 Permanent closure req. not completed 2672
[ 1 Failed to apply for temporary closure 25298

BUSINESS PLAN ELEMENTS
[ ] Emergency Response Plan madequate 25504
[ 1 Emergency Contacts not provided/current
25509
1 Pers el Training Program inadequate 25504
[ 1 entory is incomplete 25504
[ Site Map is not sufficient 25509
l J Acutely Haz. Mat. not registered 25533
V3002 T
V3007T--
V3010T--
V3011 T--
V3012T--
V300ST--
V3013T--
V3001 T--
V3003 T
V3014T __
V3015 T
V3016 T
V3017T __
V3018 T
V3019T--
V3020T--
V3021 T--
V3022T--
V3023T--
V3024 T
V3025 T
V3027T--
V3027T--
V3004 T
V3026 T
V3027T--
V3028T--
V3029 T
V3009 T
V3030T--
V3031 T
V3006 T
V3032T--
V3033T--
V3008 T
V2201 W
V2203 W
V2301Wd V2005W--
\ vi2o2"w-, - V2009W __
_A.I.I,., VIOL!\.2x-). CORRECTED. PLEASE CALL (619) 338-2222 OR YOUR INSPECTOR IF YOU HAVE ANY QUESTIONS. <"s n- c

ESTABLISHMENT REPRESENTATIVE DATE SIGNED TITLE
Department of Environmental Health, Hazardous Materials Management Division, P. 0. Box 129261, San Diego, CA 92112-9261 DISTRIBUTION: WHITE-RETURN TO HMMD
DEH: HM-923 (Rev. 1/98) NCR YELLOW-BUSINESS RETAINS
•
-!f.f.ARDOUS MATERIALS & WASTE H# Date {gfe ' . Name
(66265.53. 25505) 70 tJ 6 Address L].o 'fOtAlrJ C..ffi i?f<Uy Stop _ t lJ _L"_ft..'nergency Coordinator verift 66 5.52, 25509)
L co:-o"FIR.'wt l)<VE"TOR y & WASTES ON HE 24 (25508(b)(vcrify), 25509(a)(:IUU1ua( inventory), 25509.3 (umual w.urc)) _JOB DESCRl.PTION (66265.16) .
(66265.16, 25504(c), 2732)
Zui-iiFOR.'-1 HAZW A'STE MANIFESTS, MILKRUN MANIFESTS. EPA ID # (66262.40, 66263.42. 66262.12) _ WEEKLY COl'fl' AINER INSPECTIONS (66265.174)
_ DAILY'WASTE TA..'IK INSPECTIONS Leg (66265.195)
r- • • ABOVE GROUND HAZARDOUS WASTE STORAGE TANKS (ASTs) PE CERT Plms & IDsfallatioa (66261.191.192) _1../_ Waste Containers: CLOSED, LABELED, GOOD CONDmON, AISLE SPACE. C'LEAN UP & SAFEtY EQVIP. "?"COMPATIBLE WASTE SEGRA TED, IGNITIBLE WASTE GROUNDED&: 50 FEET, IF REQUIRED SECONDAJt.Y :ONT Al?-<"ME'<'T CLEM-I & ADEQUATE. APPRO PIA TE SECURITY. (22 CCR Chaprer '12 &: 15) '•:--<ote: Used oil and Antifreeze W<4.te storage ta.J:1b may have the PE assessment conditionally waived if they comply with :i!ll :.Sted in H.\!ID fonn #9271. r
!_ARGE QUANTITY HAZARDOUS WASTE GENERA TORS
_BIENNIAL REPORT> 1000 Kg of RCRA Waste ANY ONE MONIH (66262..41) . _- SB 14 SOURCE REDUCTION PLAN·>l'Z,OOO Kg/year. CERTIFICATION (n. REA.Intmlal OBicial) (25244.19). 'rogress every 4 Y=· Plan, Progress report & Summaryprog;teu report due 9/ll'J9. ·. · ··-SPCC: Petroleum storage> 660 gals in one AST, or >1320 gal above ground, (PE n:view) (25270.5(e)) '-fAZARDOUS WASTE RECYCLING ·--Record of Who, for What, Legitimate Market (25143.2(£)) _ ?S"otify ClTPA on required form >lOOKg/mo (25143.10(a)) /-t'AZARD0(/5 WASTE TREATMENT
_ "[]"N1FIED PROGRMJ FOR..\1S & AITACHEMENTS (PBR (a.cnua1): 67450.2, CA: 25200.3(e), CE: 25201.5(d)) __ TAl'JK & CONTAINER SECONDARY CONTAINMENT PE CERTIFICATION (CA: 25200.3(e)(4), PBR: 674S0.3(e)(9) _ANALYSIS INFLOW (CA: 25200.3(c)(6), CE: 25201.5(d)(3)) . _QUANTITY TREATED (CA: 25200.3(c)(6), CE: 25201.5(d)(3)) _WASTE ANALYSIS PLAN (PBR: 67450.3(c)(8)A & 66265.13(b)) _ANALYSIS OUTFLOW (PBR: 67450.3(c)(10), CA: 25200.3(c)(6)) _ NDUSTRA.IL WASTEWATER DISCHARGE PER..\1IT (PBR:67450.3(c)(5), CA:25200.3(c)(7), CE:25201.5(d)(6)) _OPERATING PROCEDURES (CA: 25200.3(c)(6), CE: 25201.5(d)(3)) .. _EMERGENCY PROCEDURES (66265.53)
·-INSPECTION PROCEDURES & LOG (PBR: 67450.3(c){8), CA: 25200.3(c)(5), CE: 2520l.S(d)(3)) -·-SECURJ."TY & SIGNS* (CA 66265.i4 & 66265.!7), FACILITY STANDARDS (PBR: Title 22, Chapter 15, Article 2) _CLOSURE PLAN (PBR: 67450.3(c)(11))
_FINANCIAL ASSURANCE (FORM 1232), (CA & PBR: 67450.13)
_PHASE I ENVIRONMENTAL SITE ASSESSMENT (Form 1151), (CA & PBR: 25200.14) __ ANNUAL WASTE MINIMIZATION CERTIFICATION (PBR: 66262.45, CA: 25200.3(c)(2) & 2$202.9) _ANNUAL REPORT upon request to DTSC (PBR 67450.3(c)(10)) .. _NOTIFICATION of NEW OWNER ofTREA ThfENT. (CA & PBR 66265.12)

MEDICAL WASTE GENERA TORS
DEH permit obtained SDCC 68.1202 and 68.1203
=MEDICAL WASTE MANAGEMENT PLAN ... not required for K10 sites, EMERGENCY PROCEDURES (117935) _ BIOHAZARDOUS WASTE TRACKING DOCS {117943 & 945)
_ACCUMULATION AREA POSTED & SECURE ( 118310) . .
_ CONTAINERS LABELED (BIO. CHEMO, PATH, Pharmaceuticals-INCINERATE ONLY) (118275) Name, Address, Telephone (68.1201)
_ SOLID WASTE DUMPSTERS SECURE from UNAUTHORIZED ACCESS (68.1202) _LIMITED QUANTITY HAULER EXEMPTION (118030)

MEDICAL WASTE TREATMENT
_ PERMIT Reqd if >200 LBSIMO (HSC 118130)
_LOG: DATE, TIME, TEMP, MONTHLY SPORE TESTS (118215)
__ OPERA T!NG PROCEDURES & ANNUAL CALIBRATION (118215)
.. -- .. · .. ·---- : , •• i - • -- ,.._ : ·.·- • • • • •• -. ::..----···i...=.l..'.::..... -·"-!.._ •! :..- . . • •. -:..-:., ·-· • • . ___ , -·
"'
L 5 b
.J
(
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•

CITY OF SANTEE
MAYOR
Randy Vocpel

CITY COUNCIL
Jim Bane\!
Jack E. Dale
Lori Howard
Hal Ryan

CITY MANAGER
Keith Till
June 25, 2001
County Of San Diego
Hazardous Waste Division
Subject: Aboveground Steel Storage Tanks, Wai-Mart, 170 Town Center Parkway, Santee As requested I am providing your office with the most current information on Wai-Marts aboveground oil storage tanks. Type of tanks that Wai-Mart has installed, is as follows.

Aboveground storage tanks for flammable and combustible liquids and was manufactured and tested by Hoover Containment, Inc. in accordance with the requirements of the Underwriter's Laboratories Standard UL 142.

Type of storage tank for Wai-Mart is a Luke Cube aboveground storage tank, for flammable and combustible liquid and designed UL 142. UL 142 is the standard for steel aboveground tanks for flammable and combustible liquids. The listing meets all requirements for atmospheric tanks of the National Fire Protection Association Section 30, 30A and the Uniform Fire Code Article 79.

Phil Davis, Dep ty Fire Chief
Fire and Life Safety Manager
10601 Magnolia Avenue • Santee, California 92071-1266 • (619) 258-4100 • www.ci.santee.ca.us Q Printed on recycled paper
HOC!aVER·
Containment Inc. •
6740 Boy Meadow Drive
Glen Burnie. MD 21060

INSTALLATION
OF

ABOVEGROUNDSTEELSTORAGETANKN
41G-787-Q010
FAX: 410-787-QOll
1-800-777-2823
Aboveground Storage Tanks for Flammable and Combustible Liquids are manufactured and
Underwriter's
tested by Hoover Containment, Inc. in accordance with the requirements of the Laboratories Standard UL 142.

Proper installation is of utmost importance to ensure the expected service and life of the tank. The following installation suggestions are furnished for your consideration.

1. Handle tank carefully. Use cables or chains of adequate length (not more than 90 degrees between the chains) attached to lift lugs provided.

Oversize hooks will tear the lift lugs- use shackles, if necessary.

2. To insure compliance with applicable codes and regulations, tank and piping should be retested at jobsite before being enclosed, or placed in use, using 2 psi air pressure as soap solution is brushed over weld seams.

Inspect tank eontents before filling and replace tin caps with pipe plugs or capped piping before tesi.

3. When
maximum
testing a double wall tank the inner tank should be pressurized to a of 2 psi then pressurize the outer tank by bringing the pressure up very slowly to 2 psi. Maximum capacity of the outer tank is very small in relation to the primary tank capacity. Compressors used for testing can over pressurize the outer tank space in seconds causing serious damage to the tank.

4. Install appropriate primary and emergency vent connections as indicated on tank and drawings.

S. Do not cut or weld on any tank that contains flammable or combustible liquids or vapors. Fire or explosion may result.

6. Contact your local Fire Marshall to assure compliance with local regulations and codes.

7. Be sure all drain plugs are secure by applying Teflon tape or pipe dope around cast iron plug.
1/96
"Your Partner In Containment Solutions"
(
•
I
SOLUTIONS lo. IIENAIJ COMPANY
6740 Baymeadow
MD 21060
•
.;. :· . . . . , .. !
410-787-0010
Fax: 10-787..0011
LUBE CUBE, BENCH TOP, CA 1W ALK, & UNDERCA 1W ALKS
SPECIFICATIONS .
. for
'SINGLEWALL AND/OR SECONDARY CONTAINMENT

ABOVEGROUND TANKS FOR FLAMMABLE AND COMBUSTIBLE LIQUIDS

NON FIRE RATED

1.0 GENERAL TANK DESCRIPTION:

1.1 Luke Cube Aboveground Storage Tanks, for Flammable and Combustible Liquids are designed, constructed, and listed in accordance with Underwriters Laboratories, Inc.

Standard UL 142. UL 142 is the standard for Steel Aboveground Tanks for Flammable -
The
and Combustible
National
Liquids. The listing shall meet all requirements for atmospheric tanks of Fire Protection Association Sections 30, 30A, 31 and The Uniform Fire Code Article 79 ..

1.2 Lube Cube tanks are designed and UL listed as atmospheric tanks with a maximum

1.3 · workillg pressure of I PSI. -'
The primary tank and the secondary containment tank shall have passed a proof of design hydrostatic pressure test of IS PSI.

1.4 Each singlewall Lube ·cube tank shall be-equipped with six (6) NPT openings including one for an emergency vent. All secondary containment Lube Cubes shall incorporate the single wall openings plus an additional two (2) NPT openings, for monitoring the UL
interstitial space and an emergency vent. The emergency vents shall be sized per NFP A & 142 requirements. ·

1.5 The tank shall be equipped with a minimum two (2) lifting lugs.

1.6 The
manufacturing
tank Manufacturer shall provide proof (upon request) of a minimumS years of UL 142listed RECTANGULAR tanks.

1.7 · Luke Cube tanks include a I year \varranty.

1.8 Threaded PVC plugs in fittings, ":Ot water tight.

2.0 PRIMARY STORAGE TANK (SINGLEWALL TANKS) .. 2 .I The primary storage tank shall be rectangular in design.

2.2 The welds shall be continuous.
. . ,•

2.3 2.4 .

2.5 2.6
'\\\,

3.1 .

3.2 3.3

3.4 • •
The primary storage tank shall be constructed of ASTM A-569 or A-36 carbon steel, as required for compatibility of product being stored.

The primary tank shall be pressure tested in the factory to the UL 142 specifications. (3 PSI)
All foreign materials shall be removed from the surface of the tank.

The primary tank exterior shall be painted with 1 coat of shop primer.

The tank shall have a minimum of two (2) support feet.

SECONDARY CONTAINMENT TANK (DOUBLEWALL TANKS>
The secondary containment tank shall be rectangular in design.

The welds shall be continuous.

The secondary containment tank shall be listed by Underwriters Laboratories as secondary containment under standard UL 142.

The secondary containment tank shall provide a miniinwn of II 0% secondary containment.

3.5 ·The secondary containment tank shall be equipped with a 2 inch monitoring port and a 4" to 6" or 8" em.ergency vent port as required by Laboratories Inc.

3.5 The secondary containment tank exterior and that portion of the exposed primary tank shall be painted with 1 coat of shop primer.

3.6 The secondary containment tank shall be pressure tested in the factory to the UL 142 specification. (3 }II)
MAY 1998
(
l.
. .

Snntcc, C A 92071
(619H49-7900
July 2, 2001
•
San Diego County Dept. of Environmental Health
Hazardous Materials Division
Attn: Mr. Catubay I Mr. Garchiturenas
P.O. Box 129261
San Diego, CA 92112-9261
Dear Sirs,
•

RECEIVED
D. E. H.

MAILROOM
Per direction received from your visit on June 8, 2001, the following documents are enclosed for your perusal:
• Updated Business Plan
• Updated Site Plan
• AST Certification & Engineering Assessment for above ground waste oil tanks • Approval letter from Santee Deputy Fire Chieffor above ground waste oil tanks If you have any further questions, please don't hesitate to contact me.

Sincerely,
Bill Pacheco
Store Manager
COUNTY • OF SAN DIEGO
ausiNEss NAME LJal- (1\(IJ" '}-
ADDREss l1 0 \ o w 1\ Ct "'ier
crrYtZIP 5 r CA '1)-o I
,, \
'· .
. NO. H 3 ;),;;?.. 7
T ANK CAP ACITY __ l(LJtJ"'-"-0"-------
CONTENTS U 5 t cl) t L

SECONDARY CONTAINMENT
TYPE Sri: 1: IYEAR INSTALLED __ ___,,._ __
UIL APPROVED (YIN) _ _,Y __ _ TANK ID (if applicable) _______ _ SPECIALIST lff"-'9 t_.( o v-'

DATE OF REQUEST
l;l' I certify that the above ground used oil/waste antifreeze tank meets the requirements of the California Code of Regulation (CCR) for .· exemption from the Professional Engineering Assessment [reference Title 22 CCR section 66265.1920)]. The Local Fire Marshal installation, usage, and desigrJ approval is attached.

Owner/OperatorSignature &.Jt PrintName .[)au Cc.f-f I Date t.,/:>Y/D I The Hazardous Materials Div1s1on (HMO) conditionally approves the installation of the used oil/waste antifreeze above ground storage tank as long as you comply with the following terms and conditions:

TERMS AND CONDITIONS
I. The aboveground tank, installed after July I, 1991, must contain used oil or waste antifreeze only (a non-RCRA waste) as defined in · HSC section 25250.1 and has no connected piping.

2. The local Fire Marshall approved and/or permitted the installation, usage, and design per municipal codes and the tank operator maintains documentation supporting this requirement.

3. The primary tank is surrounded with greater than 100% secondary containment.

4. If the tank system is exposed to precipitation, the secondary containment must, in addition to the requirement of item 3 above, be able to handle a 25 year, 24 hour rainfall event, with no intrusion or flooding problems. The HMO strongly advises that the tank system be completely covered to prevent such problems, following all local building and zoning requirements.

5. The facility must have a written leak detection program and daily inspection logs onsite as required in 22 CCR sections 66265.194-195 for review by HMO inspectors. Ensure that appropriate controls and practices are in-place at all times to prevent spills, leaks, or overflows from occurring. The secondary containment should be kept ·empty and dry, except when tbere is a leak or spill, at which time the secondary containment must be thoroughly cleaned out within 24 hours. The cause of a leak or spill would need to be determined and corrective actions taken (refer. 22 CCR section 66265.196).

6. The tank must be installed and maintained on a non-permeable surface, i.e. concrete (in good repair) or sealed asphalt (in good condition).

7. The operator needs to revise their Business Plan site map, if applicable.

8. The facility should maintain a photocopy of this notification onsite to show to an inspector during facility inspections.

Provided you do not change the configuration of the tank, this exemption is good for 3 years from the date of request for exemption above.

In the future, if you make any changes or modifications to the tank system, submit a description of the proposed changes in writing to the HMO 30 days before making the changes to ensure compliance with applicable regulations. Attached is a fact sheet developed by the HMO for your information regarding the regulation of hazardous waste tank systems.

This approval does not exempt your facility from compliance with additional requirements that may be enforced by other local, State, or Federal agencies with regards to storage of hazardous materials in tank system.

Dep11rtment ofEnvironm ntal Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 DISTRIBUTION: Original to Business Owner/ Copy to HMD
DEH:HM-927l(a) (Rev. 6/00)
County of San Diego
Department of Environmental Health
GARY W. ERBECK

DIRECTOR
. August 20, 2003
•
C!Inuntu of

DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619) 338-2222 FAX (619) 338-2088
1-800-253-9933
Bill Pacheco, Store Manager
Wal-Mart #1917
170 Town Center Parkway
Santee, CA 92071
Dear Mr. Pacheco:

RICHARD HAAS

ASSISTANT DIRECTOR
RE: Compliance Assessment ofWai-Mart's Response to the Compliance Inspection Report The Department of Environmental Health Hazardous Materials Division (HMD) is in receipt of Wal-Mart Store #1917 Response (the Response), dated July 25, 2003, to the Compliance fuspection Report of July 10, 2003. ill accordance with Health and Safety Code section 25185 (c)(3), the following assessment of that Response has been made to determine whether the corrective actions documented or proposed will achieve compliance.

The Response documents several items that have been brought into compliance; however, several other issues do not appear to have been resolved at this time. The items referred to below correspond to the numbered items in the Compliance fuspection Report issued to Wal-Mart Store #1917 on July 10, 2003.

Items Documented as Corrected
Item 2- Receipts for 2003 battery disposal were received with the Response as requested.

Item 3 - According to the Response, the open, above ground storage tank for used oil will now be closed at all time unless adding or removing waste.

Item 4 -It appears, from waste receipts received with the Response, that Asbury hauled one 55- gallon drum of used antifreeze and three 55-gallon drums (which used to contain used antifreeze) on 7/15/03.

Item 5 - According to the Response, employees have now been instructed to clean up hazardous spills as they occur. It appears that the labeling issues specified in the report have been addressed.

Item 6- The Response indicates there are photos of these re-labeled drums, and the Department is in receipt of these photos.
"Environmental and public health through leadership, partnership and science" • Wal-Mart Store #1917 - 2 - August 20, 2003
Item 9- A copy of a Hazardous Materials Business plan for Wal-Mart store #1917 was received by this Department and revised. A revised copy has been included in this mailing. Keep this document readily available in your files for use in training and use during the next inspection.

Items Needing Additional Corrective Action
Item 1 -Copies of receipts were not sent with the Response for the following waste streams:
-Used Oil
-Oil/water separation sludge (from the sump in the pit) - Photo processing waste
(The Department is in receipt of: drained used oil filter receipts, paint waste manifests, used antifreeze manifests and battery disposal records).

Item 7 & 8 - The Response did not adequately address training issues. Employee training regarding the four topics in the Hazardous Materials Business Plan (see Training Description Page ofHMBP) must be conducted within the first 6 months of hire and then annually.

Employee's job descriptions must be included with this training documentation. Employees who handle hazardous waste or hazardous materials in the course of their job, must have training that addresses safe handling, labeling and clean up among other topics. Please ensure Tire, Lube Express (TLE), photo processing and any other employees who need this training, receive specific training in these regards. All four topics in the HMBP must be covered annually. Within 15 days of receipt of this letter, conduct training on these topics and submit documentation that this training was conducted. Keep records of this training on site available to your inspector.

A corrective action form has been supplied so you can address these issues. Please complete, sign, date and return the form to my attention with in 15 days of receipt ofthis letter.

If you have questions relating to the compliance assessment above, please contact me, at (858) 495-5828.

Attachment
cc: John Misleh, Supervising Environmental Health Specialist Wendy Morgan, Environmental Health Specialist
HMD File #132274
Certified Mail!RRR
. . . OFFICE USE ONLY
REGIONAL .

HAZ DOUS MATERIALS QUESTIONNAfRE' '-----------J
Business Contact Telephone#
Plan File#
Telephone#

1. 0 Explosive or Blasting Agents 5. 0 Organic Peroxides 9. 0 Water Reactives

2. 0 Compressed Gases 6. 0 Oxidizers 10. 0 Cryogenics

3. 0 Flammable/Combustible Liquids 7. 0 Pyrophorfcs 11. 0 Highly Toxic or Toxic Malerials

4. 0 Flammable Solids 8. 0 Unstable Reactives 12. 0 Radioactives

13. 0 Corrosives

14. D, Other Health Hazards

15. Q None of These
PART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH HAZARDOUS MATERIALS DIVISIONS !HMDl: If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Division, 1255 Imperial Avenue, 3" ftoor, San Diego, CA 92101.

Call (619) 338-2222 prior to the issuance of a building permit FEES ARE REQUIRED. Expected date of Occupancy

1. Is your business listed on the reverse side of this form?

2. Will your business dispose of Hazardous Substances or Medical Waste In any amount?

3. Will your business store or handle Hazardous Substances in quantities equal to or greater than

4. 5.
. 6.
0 0
0 55 gallons, 500 pounds, 200 cubic or carcinogens/reproductive toxins in any quantity? Will your business use an existing or install an underground storage tank? Will your business store or handle Regulated Substances (CaiARP)? Will your business use or Install a Hazardous Waste Tank System (Title 22, Article 10)? 12·-G9-U3 EDNA :lu0'573
0 CaiARP Exen:\pf,, ;JO
I
Date Initials
0 CaiARP Required
I
· Date Initials
0 CaiARP Complete
I
Date Initials
PART Ill: San Diego County Air Pollution Control District: If the answer is yes to any of the following questions, applicant must contact the Air Pollution Control 9150 Chesapeake Drive, San.Diego, CA, 92123. Call (858) 650-4550 prior to the Issuance of a building permil YES Nj)

1. 0 Will the subject facility install or use any of the equipment listed on. the Listing oi Air Pollution Control District Permit Categories, on the reverse side of this form? · · ·

2. · 0 0 (ANSWER ONLY IF QUESTION 1 IS YES) Will the subject facility be located within 1,000 feet of the outer boundary of a school (K through 12) as listed in the current Directory of School and Community College Districts; published by the San Diego County of Education and the current California Private School Directory, complied in accordance with the provisions of Education Code Section 33190? · Does the building or structure for which this permit is requested contain any friable asbestos? Is there demolition involvin the removal of a load su ortin structural member?

EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY RELEASED FOR OCCUPANCY MD COUNTY -HMMO APCO COUNTY -HMMO APCO ·•:·:,:.l APCO
DEH:HM-9171 (08/02) County of San Diego- DEH- Hazardous Materials Division COUNTYtitF SAN DIEGO

CORRECTIVE ACTION FORM TO
DOCUMENT RETURN TO COMPLIANCE ,JD ,o3 -----
BUSmESSNAME __
ADDRESS ----''----'-"""----'-'-'-'""'-'-.l---lo....,.__u......::'------'--"'.....u.=+---- CITY s o..12f .e e.._ (tJ.I o /y11

VIOL DATE
# CORRECTED
INDICATE HOW VIOLATIONS WERE CORRECTED r·
(ATTACH ANY SUPPORTING DOCUMENTATION TO THIS FORM)
/'f.:r wt7H RssoC!!3T.£.S t9NO 7>/SC!U.S.ScD oF
coNTA-1-NEI< BJ£1N() C!t.o.S:D Rr TIHE.S.

HI'9ZRI2D OF
70 Foa.ow uP.

O<SIAIESS '2..-9A/ ENC!C..OsED
I certify under penalty of law that this business/site has corrected all violations marked on the Compliance Inspection Report/Notice of Violation.

I have personally examined and am familiar with the information submitted and believe the information is true, accurate and complete. I am ' authorized to f!_le this certification for the business/site, and that there are significant penalties for false information.

Party (Print Name): \....\... \ Job Title Wnc-<: (1c\o., ,......- • >if Signature of Responsible Pa- . Date: "tl. 1 -zs I ca.3 f(\.x :# g S 8 ).£ 1Y-3 7rD
<( Mail completed form and supporting documentation to the address listed below Department of Environmental Health, Hazardous Materials Division, P.O Box 129261, San Diego, CA 92112-9261; (619) 338-2222; 1-800-253-9933 . .....__________ -
DEH:HM-926 (Revised 05102) NCR DISTRIBUTION: WHITE-RETURN TO HMO; YELLOW-BUSINESS RETAINS •• •
Environmental Action Plan
Wai*Mart 1917
170 Town Center Parkway
Santee, CA 92071
Wal*mart now has in place, a Computer Based Learning program that requires each associate that has a job code in specified areas to complete this training module. The topics in this module cover many areas regarding the importance of protecting our storm drains from run off, and the proper procedures in handling hazardous materials.

In addition to this training, there will be a bi-annual review for both management and the associates in these areas. At this time, signatures will be collected, as to document whom has attended these meetings. The CBL module will also be reassigned at that time.

This is my current plan of action. If there are any questions, please feel free to contact me at 619-449-8215.

Kevin Graber
Tire & Lube Express Manager
Wai*Mart 1917
Santee, CA 92071
•
Oinuntu of jian
GARY W. ERBECK

DIRECTOR
August 20, 2003

DEPARTMENT OF ENVIRONMENTAL HEALTH
P.O. BOX 129261. SAN DIEGO. CA 92112-9261
(619) 338-2222 FAX (619) 338-2088
1-800-253-9933
Bill Pacheco, Store Manager
Wal-Mart #1917
170 Town Center Parkway
Santee, CA 92071
Dear Mr. Pacheco:

RE: "' Compliance Assessment ofWal-Mart's Response to the Compliance Inspection Report The Department of Environmental Health Hazardous Materials Division (HMD) is in receipt of Wal-Mart Store #1917 Response (the Response), dated July 25, 2003, to the Compliance Inspection Report of July 10, 2003. In accordance with Health and Safety Code section 25185 (c)(3), the following assessment of that Response has been made to determine whether the corrective actions documented or proposed will achieve compliance.

The Response documents several items that have been brought into compliance; however, several other issues do not appear to have been resolved at this time. The items referred to below correspond to the numbered items in the Compliance Inspection Report issued to Wal-Mart Store #1917 on July 10, 2003.

Items Documented as Corrected
Item 2- Receipts for 2003 battery disposal were received with the Response as requested.

Item 3 - According to the Response, the open, above ground storage tank for used oil will now be closed at all time unless adding or removing waste.

Item 4- It appears, from waste receipts received with the Response, that Asbury hauled one 55- gallon drum of used antifreeze and three drums (which used to contain used antifreeze) on 7115/03.

Item 5 - According to the Response, employees have now been instructed to clean up hazardous spills as they occur. It appears that the labeling issues specified in the report have been addressed.

Item 6- The Response indicates there are photos of these re-labeled drums, and the Department is in receipt of these photos.
"Environmental and public health through leadership, partnership and science" Wal-Mart Store #1917 • August 20, 2003 - 2 -
Item 9- A copy of a Hazardous Materials Business plan for Wal-Mart store #1917 was received by this Department and revised. A revised copy has been included in this mailing. Keep this document readily available in your files for use in training and use during the next inspection.

Items Needing Additional Corrective Action
Item 1 - Copies of receipts were not sent with the Response for the following waste streams:
-Used Oil
- OiVwater separation sludge (from the sump in the pit) - Photo processing waste
(The Department is in receipt of: drained used oil filter receipts, paint waste manifests, used antifreeze manifests and battery disposal records).

Item 7 & 8 - The Response did not adequately address training issues. Employee training regarding the four topics in the Hazardous Materials Business Plan (see Training Description Page ofHMBP) must be conducted within the first 6 months of hire and then annually.

Employee's job descriptions must be included with this training documentation. Employees who handle hazardous waste or hazardous materials in the course of their job, must have training that addresses safe handling, labeling and clean up among other topics. Please ensure Tire, Lube Express (TLE), photo processing and any other employees who need this training, receive specific training in these regards. All four topics in the HMBP must be covered annually. Within 15 days of receipt of this letter, conduct training on these topics and submit documentation that this training was conducted. Keep records of this training on site available to your inspector.

A corrective action form has been supplied so you can address these issues. Please complete, sign, date and return the form to my attention with in 15 days of receipt of this letter.

If you have questions relating to the compliance assessment above, please contact me, at (858) 495-5828.
p;;:n?tPr---
/Manon Ehrhart, Environmental Health Specialist
Hazardous Materials Division
Attachment
c:c: John Misleh, Supervising Environmental Health Specialist Wendy Morgan, Environmental Health Specialist
HMD File #132274
Certified Mail!RRR
COUNTY
-

OF SAN DIEGO

COMPLIANCE INSPECTION REPORT
__
ADDRESS __
CITY /ZIP __ ______________ _
•
On the above date, an inspection of your business/facility was conducted in order to determine compliance with the California Health and Safety Code (H&S) Chapters 6.5, 6.7, 6.95; Titles 19,22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code (SDCC). The following remarks are intended to provide guidance to correct the violations noted on the attached violation report. omceuseOnly f<.oun IlL Tnsfll c"h' dfl : ·
-f cu " bv .:tvai/a.b/Q..
:in ll k r. !!\ 1 I .. :f±; o fV1. 1JJ t1 r±e.. Coo 7A i" fi.Q/ {loT kerf= ciO\e_d • .._. Wjfb,o :.1_ do...y, ±A,R. /,d cO ±h;s
7-;6-C:J Ass!
Signature of Business Representative Date Signed
Department of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 DEH:HM-924 (Rev. 2/99) NCR
DISTRIBUTION: WHITE- RETURN TO HMO

YELLOW-BUSINESS RETAINS
County of San Diego
Department of Environmental Health

COUNTY OF SAN DIEGO

SUPPLEMENTAL INSPECTION REPORT
c
Office Use Only
tit
EST. NUMBER • I 7 y
DATE 7 I I 0 I 03
PAGE ;;), OF _ _,_'/ __
Title
Department of Environmental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186-5261 DEH:HM-911 0 (3196} NCR
(619} 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
COUNTY OF SAN DIEGO ' EST. NUMBER 1 3;;a 7 Y
DATE 7 I LO I 0.:S
SUPPLEMENTAL INSPECTION REPORT PAGE .$ OF '-/
Office Use Only ?JtJ]} I
partment of Environmental Health, Hazardous Materials Management Division, P.O. San Diego, CA, DEH:HM-9110 (3/96) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
'/;)61
COUNTY • OF SAN DIEGO

COMPLIANCE INSPECTION REPORT
• PERMIT # /3 d-0> 7 'f
DATE :l_t /() tQJ_
PAGE _j_ OF _j_
VIOLA TIOX REPORT: l11e itL·ms checked below refer to specific section numbers of Titles /9 ami Safety Code (liS(). wu/lvr the Sa11 Diego Coullfy Codl! (SIJCC). .] of the California Code ofR egulations (CCR). Chapters 6.5, 6.95 of the f/ealth All \'iolations rnu!lt be corrected. Submit documentation of return to compliance to your Specialist. You may use the Correcth;e Action Form to document your return to compliance. Your can prO\·· ide the!lc forms. Please call (619) JJK-2222 or your Specialist if you have any questions.

HAZARDOUS WASTE REQUIREMENTS

RECORDKEEPING
D vol31
D vo132
D vom
D vo134
rgl' \'0!36
D vot37
D vo13s
D vo139
D vo14o
D VOI41
D vo142

VIOLATION DESCRIPTION
UPF Pcm1it not obtained SDCC. 68.905
No EPA Identification Number. <ih262. 12
Manifest copy not sent to DTSC. 66262.23
Exception Rpl. not filed with DTSC. 66262.42
Waste Manifests/Receipts not on-site for 3
years. 66262.40
No records of battery disposal. 66262.8 I
Manifest not properly completed. 66262.23
TSDF signed-manifest not on-site. 66262.40
Biennial report not sent to DTSC. 66262.41
LOR Documentation not available. 66268.7
Opcratmg TSDF without authorization. 25201
Failed to notify local CUPA ofonsite treatment
of hazardous waste. 2520 I
D \'0143 Tiered Pcm1itting notification has incomplete or incorrect information. 25201
D \'0144 SBI4 compltance doc. not available. 25244.19
D \'0145 Excluded recyclable materials report not
submitted to HMO. 25143. I 0

AGE AND IIANDLING
\'0201 Waste container not kept closed. 66265.173
\'0202 Waste container missing/improperly labeled.
66262.34,25143.9
\'0203
\'0204
V0205
\'0206
\'0207
Damaged container not repackaged. 66265.171
Waste container not properly managed. 66265.173
Waste container in poor condition. 66265.171
Ignitable Waste< 50 feet ofpropcny line.
66265.176
Facility no maintained/operated to mmimize
possibility of tire, explosion or release. 66265.31
Storage area not inspected weekly. 66265. 174
Waste stored> 90, 180, or 270 days. 66262.34
Hazwaste not cleaned up ofT floor surface.
66262.10b
\'0211 lncompattbles in the same container. 66265. 177
\'0212 Incompatibles not stored separately. 66265.177
Container incompatible with waste. 66265.172
Waste oil contammated. 25250.7
Used oil filters improperly managed. 66266.130
\'0216 Hazardous materials not properly labeled 25124

DISPOSAL AND TRANSPORTATION
0 0
0 \'0301
V0302

TRAINING, CONTINGENCY PLAN & ER PROCEDURES
VIOL
Q' V0402
0 V0403
0 V0404
0 V0405
0 \'0406

VIOLATION DESCRIPTION
Training records unavailable. 66265.16
Training program not adequate. 66265.16
Facility not designed to minimize release. 66265.31
Spill control equip not available. 66265.32
Aisle space is obstructed. 66265.35
Contingency plan not prepared and/or on file.
66265.51,66265.53

IIAZARDOUS WASTE TANK SYSTEMS
0 Vl601 Hazwaste tanks w/o P.E. assessment. 66265.191a, 66265. 192a
0 \'1602 P.E. Assessment report not complete. 66265.191 g, 66265. 192k
0 \'1603 Hazwste tank system: no secondary containment. 66265. 19Ja
0 Vl604 Secondary containment not kept empty.
66265.196(b)(c), 66265. 194(c)
0 \'1605 No daily tank inspection/inspect. log 66265.195 (b&c) 0 \'1606 Improper or absent sptll/overfill protection.
66265. 194b
0 Vl607 Improper corrosion protection. 66265.191, 66265.192 0 Vl608 lntegnty assessment not done for tanks without
secondary containment system. 66265.191
0 Vl609 Improper usc of hazwaste tank system. 66265.196 0 \'1610 NoPE assessment report-repairs/changes. 66265 196g 0 Vl611 Improper closure ofhaz waste tank unit. 67383.3, 66265.197

HAZARDOUS MATERIALS REQUIREMENTS

BUSINESS PLAN REQUIREMENTS
0 \'1001
0 V1002
\'1003
0 \'1004
0 VI005
0 VI006
0 \'1007
0 \'1008
0 \'1009
0 VIOIO
0 VIOII
0 \'1012
0 \'2504
0 V2553
DATE SIGNifB/
UPF permit not obtained for Haz. Materials. 68.905
Hazardous Materials Business Plan (HMBP) not
established/implemented. 25503.5
HMBP not amended to reflect changes25505
HMBP not submitted to HMO. 25505
Emergency Contacts not provided/current. 25 509
Inventory is incomplete. 25504
Highly loxic gas (TLV::;IO ppm) not disclosed in
chemical inventory 68. 1113
Annual carcinogen & reproductive toxin list not
submitted to HMO 68.1113
Site map is not sufficient. 25509
Failure to report a release/threatened release. 25507
Personnel Training records not available. 19 CCR 2732
SPCC Plan required but not prepared. 25270.5 (c)
Owner or operator (0/0) Stationary Source (SS)
with >TPQ of a regulated substance (RS) did not
comply with Chapter 4.5 (CaiARP process). 2745. I
010 of a new or modified SS with >TPQ of RS did
Not submit RMP. 2735.4, 25535 (d)
TITLE OF BUSINESS R£!"RESENTATIVE
DISTRIBUTION: WHITE-RETURN TO HMO; YELLOW-BUSINESS RETAINS ..

COUNTY • OF SAN DIEGO

COMPLIANCE INSPECTION REPORT
susiNEss NAME # r=;
ADDRESS __

CITY /ZIP

ION CONTACT/TITLE
ltrtA . /11 p
44:'1-3196
() JUL 1 2llJ4
-
' "0-t'o-\u {b o c.t.M · "'ls' Ccu t-< •
0 This is an annual certification that the Hazardous Materials Business Plan (in,·entory, emergency contacts, emergency response plan, and employee training plan) is current and includes all the information required in the H&SC and is maintained at the site where hazardous materials are stored. Initials of Business Representative al Health, Hazardous Materials Division. P.O. Box 129261. San Dieeo, CA 92112-9261: (619) 338-2222: sdcdeh.ore HM-924 (09/03) NCR DISTRIBUTION: WHITE- RETURN TO HMD YELLOW-BUSINESS RETAINS • • EST. NUMBER H {) 2..21--<f.--
DATE ] I l- I 0 't
PAGE 2 OF ..5

COUNTY OF SAN DIEGO
,. SUPPLEMENTAL INSPECTION REPORT
Office Use f'hly ZIP CODE: ---
11/@?plf
- .,.-'-'---- -. d=,
DEH:HM-911 0 (3196) NCR
(619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
COUNTY OF • SAN DIEGO • EST. NUMBER H { S ZZ rtfDATE f I 1- IUD 1=- DEH:HM-911 0 (3196) NCR
SUPPLEMENTAL INSPECTION REPORT PAGE· 3 OF S
BUSINESS ADDRESS: ::;;:_;_· ---ZIP CODE: __
ss Representative
ental Health, Hazardous Materials Management Division, P.O. Box 85261, San Diego, CA, 92186-5261 (619) 338-2222
DISTRIBUTION: WHITE-RETURN TO HMMD

YELLOW-BUSINESS RETAINS
COUNTY OF • SAN DIEGO
' .. ·
EST. NUMBER • H __ ,_{ __
DATE: 1 -1- -k D4-
PAGE: __ 4-_.___ OF '£
BUSINESS ADDRESS: \ - • ZIP CODE:----
DEH:HM-9110 (Rev. 2199) NCR
alth, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222 DISTRIBUTION: WHITE-RETURN TO HMO

YELLOW-BUSINESS RETAINS

COMPLIANCE
•

INSPECTION REPORT
DATE 1-- t___2t 0 4-
PAGE OF :f"'
VIOLATION REPORT: 111e items checked below refer to ,\pecific .\ection numbers of Titles /9 & 22oft he Cal{fornia Code qfR egulations (CCR). Chapters 6.5, 6.95 oft he Health and Safety Code (HSC). and/or the San Diego Coon()• Code (SDCC).

All \'iolations must be corrected. Submit documentation of return to compliance to your Specialist. You may use the Correcti\'c Action Form to document your return to compliance. Your Specialist can pr0\1idc these forms. Please call (619) 338-2222 or your Specialist if)'OU have any questions.

HAZARDOUS WASTE REQUIREMENTS

RECORD KEEPING

VIOL VIOLATION I)ESCRIPTION
D V0131 UPF Permit not obtained SDCC. 68.905
VOI32 No EPA Identification Number. 66262.12
VOI33 Manifest copy not sent to DT.SC. 66262.23
VOI34 Exception Rpt. not filed with DTSC. 66262.42
D V0135 Waste Manifests/Receipts not on-site for 3
years. 66262.40
D VOI36 No records ofbattel)' disposal. 66262.81
VOI37 Manifest not properly completed. 66262.23
V0138 TSDF signed-manifest not on-site. 66262.40
D VOI39 Biennial report not sent to DTSC. 66262.41
D VOI40 LDR Documentation not available. 66268.7
D VOI41 Operating TSDF without authorization. 25201
D VOI42 Failed to notif)' local CUPA ofonsite treatment of hazardous waste. 2520 I
D VOI43 Tiered Pennitting notification has incomplete or incorrect information. 2520 I
D VOI44 SB 14 compliance doc. not available. 25244.19
D VOI45 Excluded recyclable materials report not
submitted to HMD. 25143.10

STORAGE AND HANDLING
D V0201 Waste container not kept closed. 66265.173
D V0202 Waste container missing/improperly labeled.
66262.34, 25143.9
D V0203 Damaged container not repackaged. 66265.171
D V02114 Waste container not properly managed. 66265.173 D Vll205 Waste container in poor condition. 66265.171
D V0206 Ignitable Waste< 50 feet of property line.
66265.176
D Vll207 Facility not maintained/operated to minimize
possibility of fire, explosion or release. 66265.31
D V0208 Storage area not inspected weekly. 66265.174
D V02119 Waste stored> 90, 180, or 270 days. 66262.34
D V0210 Hazwaste not cleaned up off floor surface.
66262.10b
D V0211 Incompatibles in the same container. 66265.177
D V0212 Incompatibles not stored separately. 66265.177
D V0213 Container incompatible with waste. 66265.172
D V11214 Waste oil contaminated. 25250.7
D V0215 Used oil filters improperly managed. 66266.130
D V0216 Hazardous materials not properly labeled. 25124

DISPOSAL AND TRANSPORTATION
V0301 Unauth. disposal of waste to: . 25189.5
V0302 Unlawful transportation of hazardous waste. 25163 V0303 Waste transported without a manifest. 66262.20
V0304 Waste determination not made. 66262.11

TRAINING, CONTINGENCY PLAN & ER PROCEDURES

VIOL VIOLATION I)ESCRIPTION
D V0401 Training records unavailable. 66265.16
D V0402 Training program not adequate. 66265.16
D V04113 Facility not designed to minimize release. 66265.31 D V0404 Spill control equip not available. 66265.32
D V0405 Aisle space is obstructed. 66265.35
D V0406 Contingency plan not prepared and/or on file.
66265.51' 66265.53

HAZARDOUS WASTE TANK SYSTEMS
D Vl601 Hazwaste tanks w/o P.E. assessment. 66265.191a, 66265.192a
D Vl602 P.E. Assessment report not complete. 66265.191 g, 66265.192k
D Vl603 Hazwste tank system: no secondary containment.
66265.193a
D Vl604 Secondary containment not kept empty.
66265.196(b)(c), 66265.194(c)
D Vl605 No daily tank inspection/inspect. log 66265.195 (b&c) D Vt606 Improper or absent spill/overfill protection.
66265.194b
D Vl607 Improper corrosion protection. 66265.191, 66265.1 n D Vl6118 Integrity assessment not done for tanks without secondary containment system. 66265.191
D Vl609 Improper use of hazwaste tank system. 66265.196 D Vl610 No I'E assessment report-repairs/changes. 66265.196g D Vl611 Improper closure ofhaz waste tank unit. 67383.3, 66265.197

HAZARDOUS MATERIALS REQUIREMENTS

BUSINESS PLAN REQUIREMENTS
VIOOI
VI002
VI003
VIOII4
VJOOS
V1006
VI007
V10118
Vlllll9
VIOIO
VIOl I
Vllll2
V2504
V2553
UPF pennit not obtained for Haz. Materials. 68.905
Ha?.ardous Materials Business Plan (HMBP) not
established/implemented. 25503.5
HMBP not amended to reflect changes25505
HMBP not submitted to HMD. 25505
Emergency contacts not provided/current. 25509
Inventory is incomplete. 25504
Highly toxic gas (TL 0 ppm) not disclosed in
chemical inventory. 68.1113
Annual carcinogen & reproductive toxin list not
· submitted to HMD 68.1113
Site map is not suflicient. 25509
Failure to report a release/threatened release. 25507
Personnel training records not available. 19 CCR 2732
SPCC plan required but not prepared. 25270.5 (c)
Owner or operator (0/0) Stationary Source (SS)
with >TPQ of a regulated substance (RS) did not
comply with Chapter 4.5 (CaiARP process). 2745.1
010 of a new or modified SS with >TPQ ofRS did
Not submit RMP. 2735.4, 25535 (d)
DISTRIBUTION: WHITE-RETURN TO HMO; YELLOW-BUSINESS RETAINS 0 )i
e.- "flJ

COUNT-OF SAN DIEGO

CORRECTIVE ACTION FORM TO

DOCUMENT RETURN TO COMPLIANCE
SPECIALIST ..... (_L-__
INSPECTION DATE:

BUSINESS NAME !jf,l '
ADDREss r1-o _ Pr

CONTACT
CITY j&,./e_-c_ ZIP 'j (}07-1

VIOL DATE INDICATE HOW VIOLATIONS WERE CORRECTED
# CORRECTED (ATTACH ANY SUPPORTING DOCUMENTATION TO THIS FORM) j lot33 7/r/OLI mar. i p.g,.s, + (!J) fJ '1 s tnt 7tJ 01 G (!., in -b lt..£L. e.vtlk..l t7p-<- . -p? 2 'Titz I bf !'M"· if.t.>+ }-now OVI -Fi(.e.. ( ut.) ltWf 3 7{q lolt 6i+e - ·
V!t?u1 1. or- 3. of U • iA ,j.J '" r,.,,, I
4 ...
5 6 .· ........ -:-:.-:»
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7 c....
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:I r-·
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8 .__. I 'I
)urn 0
,.,., -:- =:o _,..
-
9 C.J· IT! ·-,. I.:J (0
10 I certify under penalty of law thatthts busmesslstte has corrected all vwlatwns marked on the Compltance lnspectwn Report /Nottce of Vtolatton.

I have personally examined and am familiar with the information submitted and believe the information is true, accurate and complete. I am am aware that there are significant penalties for submitting false information.

Responsible Party (Print Name):

Signature of Responsible Party: ______________ Date: __ _;/ ___ . ___ _

4. Mail completed form and supporting documentation to the address listed below Department of Environmental Health, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222; 1-800-253-9933 DEH:HM-926 (Revised 05/02) NCR DISTRIBUTION: WHITE-RETURN TO HMO; YELLOW-BUSINESS RETAINS Cl!nuntu nf Jian
GARY W. ERBECK
·DIRECTOR
July 28, 2004
Mr. Richard Pastor

DEPARTMENT OF ENVIRONMENTAL HEALTH

HAZARDOUS MATERIALS DIVISION
P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619) 338-2222 FAX (619) 338-2377
1-800-253-9933

OFFICIAL NOTICE
Director of Environmental Management
Wal-Mart Stores, Inc.
702 Southwest 81
h Street
Bentonville, Arkansas 72716-0505
Dear Mr. Pastor:

RICHARD HAAS
This Jetter is a follow-up to the Hazardous Materials Divisions (HMD) recent inspections of your Wal-Mart stores listed below:

Store# Address HMD Permit# Inspection Date
2094 1800 University Drive, Vista, CA 92083 134236 06/23/2004 1700 13425 Community.Road, Poway, CA 92064 132227 07/06/2004 2253 13487 Camino Canada, El Cajon, CA 92021 135110 07/07/2004 2291 75 North Broadway, Chula Vista, CA 91910 132371 07/12/2004 5338 4840 Shawline Street, San Diego, CA 92111 202079 07/08/2004 1917 170 Town Center Parkway, Santee, CA 92071 132274 07/07/2004 -·--- . inspections,-it was observed that unusable hazardous wastes including: household chemicals, pool chemicals, garden chemicals, paint, and related hazardous spill waste were not being · properly managed. It appears that procedures in place at the store level do not distinguish between a hazardous material and a hazardous waste as both are treated and shipped to a central location as a hazardous material for further disposition. The written procedure used at each store is titled "Shipping Procedures for Hazardous Materials CG703" and it describes in detail, the shipping procedures for Hazardous Materials, and how to distinguish between "Consumer Commodity ORMD" and hazardous materials for Department of Transportation (DOT) purposes. Your procedures also require store personnel to use a hand held terminal that reads the Universal Product Code (UPC) to determine how a material should be shipped back to a regional location for proper classification and appropriate disposition.

The HMD has determined that this method ofmanaging hazardous waste is in violation of California Health and Safety Code (HSC) Section 25163 (transporting hazardous waste without a valid registration), Title 22 California Code ofRegulations (CCR), Section 66262.11 (waste determination "Environmental and public health through leadership, partnership and science" • •
Mr. Richard Pastor -2- July 28, 2004
not made at generating facility prior to shipment), HSC 25160 and Title 22 CCR Section 66262.20 (hazardous waste transported without a manifest) and Title 22 CCR Section 66262.34( d)(2) (failure to ensure that employees are thoroughly familiar with proper waste handling).

As part of your return to compliance, the HMD is requiring you to develop written procedures at the corporate level for your stores in San Diego County that incorporates methods for complying with the above deficiencies. These procedures would also be applicable to your other California stores.

To avoid future enforcement action, a copy of these procedures shall be submitted within 30 days of receipt of this official notice to:

Mary Avastu, EHS ill
Hazardous Materials Division
Department of Environmental Health
P.O. Box 129261
San Diego, California 92112-9261
In addition, we are requesting to meet with to review these violations and your written procedures. We believe this meeting will help prevent future violations and potential enforcement actions. Please contact Mary Avastu, EHS ill, Enforcement Coordinator, at (619) 338-2090 or me at (619) 338-2395 to set up this meeting. Thank you for your cooperation.

Attachment
_ _,.. 1JC .• ::.. .
cc: Jamie Huens, Wal-Mart Solid Waste Manager
Ed Slater, Supervising EHS, HMD
Mary Avastu, EHS ill, HMD
File 134236
File 1"32227
File 135110
File 132371
File 202079
File 1"32274
. ;. . .. ·
. . .. UPFP# . (3':l.:J... ilJ
BP DATE ·'8 131 I

HAZARDOUS MATERIALS QUESTIONNAIRE
Business Name
!)J a.l Metv-·t S bu e. .±ll q 1/
Business Contact
DoV'I If\ CA-. lN\ l "l.:e .. \ l e..

Telephone#
419 -Wf-02:>2..5 · Project Address Zip Code APN#
\lO TOWI/\ Cci/\kr Pk-w qz.o'll
Mailing Address State Zip Code . Plan FRe#
2QOt SE iO{VJ
City
tll c:..- AR 12-IJCo I !Cf-ot+
Telephone# q 13 - 23Co -5 4-S q
The following questions represent the facility's activities, NOT the specific project description.

PART 1: FIRE DEPARTMENT- HAZARDOUS MATERIALS DMSION: OCCUPANCY CLASSIFICATION: Indicate by checking the item, whether your )usiness will use, process, or store any of lhe following hazardous materials. If any of the items are checked, applicant must contact lhe Fire Protection /V;Jency IIIith jurisdiction prior to llfan submittal. · ·
I. 0 Explosive or Blasting Agents 5. 0 Organic PeroXides 9. 0 Water Reactives 13. 0 Corrosives 0 Compressed Gases 6. 0 OXidizers 10.0 Cryogenics 14. 0 Olher Health Hazards . .

J. 0 FJamrnableiCor'nbustible Uqulds 7. 0 Pyrophorics 11.0 HlghlyToxfcorToXicMaterials k 0 Flammable Solids 8. 0 Unstable Reactives 12. 0 Radloactives · 15. jl'None of These
,ART II: SAN DIEGO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH - HAZARDOUS MATERIALS DMSIONS !HMDI: If the answer to any of the 1uestions is yes, applicant must oontaet the County of San Diego Hazardous Materials Divislon, 12551mperial Avenue, 3id floor, San Diego, CA 92101. ::all (619) 338-2222 prior to the Issuance of a building permit . · 'EES ARE REQUIRED. Expected date of Occupancy · 0 CsiARP Exempt YES NO
I. 3 0 Is your business listed on lhe reverse side of this loon? Date Initials ' 0 WiD your business dispose_ of Hazardous Substances or Medical Waste In any amount? I. IZ!l· U WiD your business store or handle Hazardous Substances In quantities equal to cir greater than 55 gallons, 500 pounds, 200 cublc feet, or carcinogens/reproductive toxins In any quantity? · k 0 Wdl your business use an eXisting or Install an underground storage tank? '· 0 1!9 WiD your business store· or handle Regulated Substances (caiARP)? i. 0 lkl' WiD your business use or ins!all a Hazardous Waste Tank System (TIUe 22, Article 10)? Date Initials
0 CaiARP Required
0 caiARP Complete . I
. . · . Date '---:1-.-niti::-a-:-ls--
. · . · · . IIFZ:F04 1!1:41 ,m.m··· • ART Ill: San Diego County Ai.r Pollution Control District: If lhe answer Is )'es to any of the following questions, mu!lredlftact tne'IVr Pollution >istrict, 9150 Chesapeake Drive, San.Diego, CA, 92123. cau (858) 650-4550 prior to the Issuance of a building permit · . $80,00 ·vEs NO
0 Will lhe subject facility lnstaa or use any of lhe equipment listed on. the Usting Oi Ai.r Pollution Control District Permit categories, on the reverse side of this form? - · ·
0 0 (ANSWER ONLY IF QUESTI9N 1 IS YES) \Vfllthe silbject fadlity be located within 1,000 feet of the outer boundary of a school (K through 12) as. listed the current Directory of School and Community College Dlsbicts; pubtished by lhe San. Diego County of Education and lhe current california Private School Directory, complied in accordance with the provisionS of Education Code Section 33190? · 0 6!!l Does the building or structure for Which this permit Is requested oonlaln any friable asbestos? 0 liiiiJ Is there demolition involvi the removal of a load su n structural member? ·oR OFFICAL USE ONLY· · "IREDEPARTMENTOCCUPANCYCLASSIFICATION:. ______________ -..,.-:-------::------------ DATE:
:Y: ______________________ _

EXEMPT OR NO FURTHER INFORMATION REQUIRED RELEASED FOR BUILDING PERMIT BUT NOT FOR OCCUPANCY

COUNTY-HMMD APCO
RELEAsED FOR-OGCUPANCY
COUNTY -HMMD § APCD ·
:t
·J>o
r- rr· :xJ ...

O:I:

O·
:X:
,EH:HM-9171 (08/02) County of San Diego- DEH- Hazardous Materials Division ... ,LIST OF BUSINESSES ww REQUIRE REVIEW.AND APPROVAL F8M COUNTY OF SAN DIEGO

DEPARTMENT OF HEALTH- HAZARDOU-ATERIALS DIVISION

AUTOMOTIVE
Battery Manufacturing/Recycling
Boat Yard
Car Wash
Dealership Maintenance and Paint
. Machine Shop
Painting
Radiator Shop
· Rental Yard Equipment
Repair, Major Overhaul
Spray Booths
Transportation Services
Wrecking and Recycling

METAL WORKING
Anodizing
· Chemical Mining/Etching
Finish Coating, Painting
Flame Spraying
Machine Shop-OriUing, Lathes, Mills
Metal Plating
Metal Preppinglaiemlcal Coating
PreCiOUS Metal Recovery
Sand Blasting, Grinding .

Steel Fabricator
Wrought Iron Manufacturing

CHEMICAL HANDLING
. Agricullu'lll Suppliers/Distributors
Chemical Suppliers/Distributors
Chemical Manufacturers
Coatings/Adhesives
Compressed Gases Suppliers/Distributors
Dry Cleaning
Fiberglass/Resin Applications
Gas Stations
Industrial Laundry
Laboratories ··n.

Laboratory Suppliers/Distributors
Oil and Fuel Bulk Supply
Pesticide Operators/Distributors
Photographic Processing
Pool Supplies/Maintenance
Printing/Blue Printing
Road Coatings
Swimming Pool (Gas Chlorination Systems
Only)
Toxic Gas Handler
Toxic Gas Mfg

ELECTRONICS
Electronics Components Mig
Electronics Assembly and Sub Assembly
Printed Circuit Board Mfg

OTHERS AND MISCELLANEOUS
Refrigeration Systems
No. Control Systems
Asphalt Plant
Chiropractic Offices
Co-Generation Plant
Dental Clinic/Office
Frozen Food Processing FaCilities
Government Agencies
Hazardous Waste Hauler
Hospitals/Convalescent Homes
Laboratories, Biological Latioratories
Medical Clinics/Hospitals/Offices
Pharmaceuticals
. Bloledl Laboratories
Public Utilities
RockQuany
Veterinary Clinic/Hospitals
Wood/Furniture Manufacturer/Refinishing
. Ship Repair/Construction
Telecommunications CeU Sites
Dialysis Centers

AEROSPACE
Aerospace Industry
Aircraft ManufaCturing
Aircraft Maintenance
NOTE: THE ABOVE UST INCLUDES BUSINESSES, WHICH TYPICALLY USE, STORE, HANDLE, AND DISPOSE OF

ANY BUSINESS NOT INCLUDED ON THIS LIST, WHICH HANDLES, USES OR DISPOSES OF HAZARDOUS . REQUIRE HAZARDOUS MATERIALS DIVISION (HMO) REVIEW OF BUSINESS FOR MORE INFORMATION CALL (619) 3J8.·2222.

LIST OF AIR POLLUTION CONTROL DISTRICT PERMIT CATEGORIES Businesses, which indude any of the following operations or equipment, will require dearance from the I>Jr Pollution Control District.

CHEMICAL
47 "?' .. -, 32'- Acid ... ' • \ _.·
33,:-.,. Can & Coil Manufacturing
44 ·-Evaporators, Dryers & SHils Processing
Organic Materials
. 24 - Dry Chemical Mixing & Detergent Spray
Towers ·
35 - Bulk Dry Chemicals Storage
55 - Chrome Electroplating Tanks

COATINGS & ORGANIC SOLVENTS
27 -Coating & Painting
37- PlaSma Arc & Ceramic Deposltion·Spray
Booths
38- Stain & Ink Mfg
27- Printing
27 - Polyester Resin/Fiberglass Operations
METALS
18 - Metal Melting Devices
19 - Oil Quenching & Salt Baths
· 32 - Hot Dip Galvanizing
39 - Precious Metals Refining

ORGANIC COMPOUND MARKETING
!GASOLINE. ETC!
25 - Gasoline & Alcohol Bulk Plants & Terminals
25 - Intermediate Refuelers
26 - Gasoline & Alcohol Fuel Dispensing

COMBUSTION ROCK AND MINERAL
34 - Piston Internal - Combustion Engines 04 - Hot Asphalt Batch Plants 13 - BaUers & Heaters (1 minion BTU/hr or larger) 05- Rock DriRs 14 -Incinerators & Crematories 06- Saeenlng Operatiais
15 - Bum Out Ovens 07 - Sand Rock & Aggregate Plants
16 -Core Ovens 08- Concrete Batch, CTB, Concrete Mixers, Mixers 20- Gas Turbines, and Turbine Test Celts & Stands & Silos 48- Landfill and/or Digester Gas Flares . 10- Brick Manufacturing

ELECTRONICS
29- Automated Soldering
42- Electronic Coinponent Mfg
FOOD
12 - Fish Canneries
12 - Smoke Houses
50 - Coffee Roasters
35- Bulk Flour & Powered Sugar Storage

SOLVENT USE
28 -Vapor & Cold Degreaslng
30- Solvent & Extract Driers
31 - Dry Cleaning
Qil::ISB
01 -Abrasive Blasting Equipment
03 -Asphalt Roofing Ketlles & Tankers
46- Reverse Osmosis Membrane Mfg
51 -Aqueous Waste
11 - nre Buffers
17 ,.. Bralre DeboOders
23- Bulk Grain & Dry Chemical Transfer & Storage
45 - Rubber Mixers
21 -Waste Disposal & Redamalion Units
36- Grinding Booths & Rooms .
40 - Asphalt Pavement Heaters
43 - Ceramic Slip Casting
41 - Perlite Processing
40 - Cooling T ewers - Registration .Only
91 .:. Fumigation operations
56- WWTP (1 million gaVday or larger) & Pump
Station .. .,_ ·, • :• < " , ..
>'' .:.·. ,; ': ·:·-'--:.:..;.
,; ---.. ;:;;, --- ,.

NOTE: OTHER EQUIPMENT NOT LISTED HERE THAT IS CAPABLE OF EMITIING AIR MAY REQUIRE AN AIR CONTROL DISTRICT PERMIT. IF THERE ARE ANY QUESTIONS, CONTACT THE AIR POLLUTION CONTROL 45?<J. '.fl _. '',
w .• :·· .
' .

DEH:HM-9171 (08/02) County of San Diego- DEf:I- Hazardous 1l *Mart (Fri.,. 9 Jan 2004 14:. -0600) (a026b9dbc7c54692baeef0767faa461d) Fax 16193382377 Page 2 of 2 •
WAL-MART .. t . _ Bentonville. AR 72716-0555
January 9, 04
County of San Diego
Department of Environmental Health
PO Box 129261
San Diego, CA 92112-9261
Attn: Irene
As requested, please change your contact person for sending renewals from Twyla Garvey to Matthew Bryan at the phone number of479-204-0140. Also, please note a mailing address of702 S.\V. 8th Street, Bentonville, AR 72716-0555 for all future renewal applications, compliance issues, and licenses to be sent. If you are required to mail the license direct to the licensed premises, please mail a copy to the above-referenced address for our records, or fax to 479-273-4432. If you are required to have a contact person, it would be Matthew Bryan at 479-204-0140.

If there are any questions, please contact me at ( 479)204-2331 Sincerely,
Shannon M. Murray
Phone: (479)204-2331
Fax: (479) 273-4432
Email: [email protected]
Environmental Specialist III
1l *Mar1: (Fri., 9 Jan 2004 14:--0600) (a026b9dbc7c54692baeef0767f.) Fax. 16193382377 Wal-Mart Stores Inc.

Fax Coversheet
Date: Fri, 9 Jan 2004 14:28:16 -0600
From: Shannon Murray (Tax)
Email: [email protected]
To: Irene
Fax: 16193382377
Subject: Renewal's Letter
This fax and any files tr::Jnsmitted with it are CONFIDENTIAL and intended solely for the individual or entity to whom they are addressed. Iryou have received this in error please destroy it immediately.

al *Mart (Mon. 12 Jan 2004 13411ij9 -0600) (6a8efb86754f4354ba425e9fb4111t22) Fax 16193382377 Page 1 of 4 Wal-Mart Stores Inc.

Fax Coversheet
Date: Mon, 12 Jan 2004 13:54:39 -0600
From: Shannon Murray (Tax)
Email: [email protected]
To: Irene
·Fax: 16193382377
Subject: Change of Address-All Wal-Mart and Sam's Club in your county This fax and any files transmitted with it are CONFIDENTIAL and intended solely for the individual or entity to whom they addressed. If you have received this in error please destroy it immediately.
al*Mart 12 Jan 2004 13-9 -0600) Fax 16193382377 Page 2 of 4 Here are the list of stores in your county at your request, the permit numbers are included except for 3 locations that I was unable to get. I have put the facility address in the spreadsheet to so you can look those facilities up by that.

Thanks for all of your help.

Shannon Murray
FAX 479-273-4432
PHONE 479-204-2331
Email: [email protected]
Environmental Specialist Ill
al*Mart
I'·
(Mog, 12 Jan 2004 13.9 -0600) (6a8efb86754f4354ba425e9fb-22) Fax 16193382377 Page 3 of 4 Store # Facility Address City
6235 6336 COLLEGE GROVE SAN DIEGO
6234 1900 UNIVERSITY VISTA
2291 75 N BRAODWAY :#:" · CHULA VISTA
2253 13487 CAMINO 1'35110 EL CAJON
5023 1200 HIGHLAND AVENUE NATIONAL CITY
2245 705 COLLEGE BLVD :1\: · OCEANSIDE
2494 2100 VISTA WAY 1F- csL OCEANSIDE
1700 13425 COMMUNITY POWAY
2150 710 DENNERY ROAD · SAN DIEGO
2177 3382 MURPHY CANYON ROAD1Fio5"5""'ltsAN DIEGO
2479 3412 COLLEGE AVE.. 4\:. SAN DIEGO
1917 170 TOWN CENTER PARKWAYifl'3:l.')lfSANTEE
2094 1800 UNIVERSITY DRIVE 'II> · VISTA
State
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
CA
County

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO

SAN DIEGO
a l *Mar;t , (Mog, 12 Jan 2004 13-9 -0600) (6a8efb86754f4354ba425e9fb-22) Fax 16193382377 Page 4 of 4 Type Permit#

SAM'S CLUB

SAM'S CLUB
WAL-MART HK07-132371 6HK26 ./'
WAL-MART HK07-135110 6HK26

WAL-MART
WAL-MART HK07-134563 6HK26
WAL-MART HK07-102815 6HK26
WAL-MART HK07-132227 6HK26
WAL-MART HK07-134282 6HK70
WAL-MART HK07-135594 6HK70
WAL-MART HK15-138580 6HK15
WAL-MART HK07-132274 6HK26
WAL-MART HK07-134236 6HK26
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I 20J4 9:53/ST. 9:52/NO. 6323692£22 P 2
McKittrick Waste Treatment Site
Approval Ill umber
Recertification Generator Waste Profile 13
"
71 ,,
Phone: (559) 386-6145 Fax: (5591 386-6109 ""o< I
Current Number 06129/0lt · h ( -f!..J
llllportant: The generator or author!i:ed representauve of the generator must complete this profile tn full. Pleaee attach any addiUonal tnfonnatlon requested. MWTS accepts waste shipments only after waste prollling and approvaL 1 -Generator Information A
Generator Name J N c_.. Company Representative V&;."\0 ILFactlltyName __ .$1012-E::;,,;IJc.._ ntte 6NV•r'L..

Industry· R..E"""e!\ Bft(.F}.'> Emergency Contact "'Ti vY\ f3o'i p,y Fa.cillty Address lfA&wv S S EPA ro No. _
Clty _ VAv'Z...cov S L.oc..o,.'"t'.O N Factltty Phone VA-tY.o..J County · 3tate _ llp _ After hours number e QQ '=\-0'0 ?, '{ J Emergency number 5?3 00 L{oo t.( '?>'f J
Estimated waste volume: 30'C:)1 Q9-!= D Tons D Cubtc Yardsj(aallons 0 Drums a Other------ Frequency: C Stngle Event 0 Day D Week 0 Month 0 Year ______ _ Transported by: D Ron ofT box D Dump truck t;f(vacuum truck 0 Drum (type/stze) _Other:. ____ _ Section 3- Waste Properties (at room temperature, check all that apJl 0 Solid 0 SemJ solld 0 51ullgt 0 FUter cake
0 Powder . 0 Soil
0 Concrete 0 Woo<l 0 PPE 0 ___ _ Fla!!h point ·F ___ ..:..::....:._. _____ _ Phases: fi( Single 0 Bl·layer D MuiU·layered Odot 0 None O(.Mtld D Strong Descrtt>e ·Q! "- pH range ....6._ to _6_ Asbestos > 1% 0 Yes ):.No
Section 4- Transportation (complete all items. If Item iS not applicable, ut;e · 15 this waste a DOT Hazar!lou& Material 0 Tl':l11ep<>rter Proper US OOT Shipping NllJtl<! tJ/ft: Techr: on l
us oor HEIZaJ'd Class JJ}ft
section 5- Analysis (analysis must be performed by a California State Certified Laboratory) Wa.ste Analysts Attached Iebeck alllhat apply! 6( CA Title 22 Metal$ {)( VolaUie Organla D TPH Gali/Dlcl>d 0 BT.K o I'CB's o Semi·volatuc o Hctblddes/Pe&Ueldea AQu41,'"\t_ JOx I Suction 6- Generator Knowledge, and Certlflcatlo
t. Is Ull!l w:JSte a haxardow aa Wlll!tc defined by
RCM. 40. CF'R Part 261 or 22 CCR Artlde ll7
Z. Is the wal!t.e from a non source listed In 40
CFR Pm 261.3! [F CO<ks)?

3. Is lhe waBte stream from a spedllc SOW'cc Usted
1n 40 ern Part 261.321 (K Codes)?

4. IB the wM<e from a d1scanled chanlall pt'Oduct. off
spedllcaUon &pectes. oontalna rt:sldue and/or
residue llBted In 40 CPR Part 21!1.3311'
Codes and U Codes)'?
S. thr. WA&te have any hazardous cha.racterutlc 0 Yes
UBted 1n 40 CFR Part 261 Subpart C (0 c<XIes)?
W<l$to detennlnatlon based on (check all that apply)
Generator Certlllcatton 0 Other (explain)
(THU:• APR 1 9: 53/ST. U2/'JO. 6323SS2422 P
McKittrick Waste Treatment Site
Generator Waste Profile

FAX (559) 386·6109 17

6. 1.9 the waate spcdllcally excluded Crom
hazardOu$ wnste reguln.Uon 1n 40 CFR Part
261.4? If so. plea$«: au.act\ an explanaoon
Including the spectllc exclusion 1n 40 CFR
Part 261.4.
7, Is the waste miXed With a ha2ardous waste?
B. Is the waste being trrnlroiOr a &Jn&te
hazardous chaJ'actei1st1c? If oo auactt an
(l(!)lanatlon.

9. lillll Ute watite been 'handled" o!'dl5!)0$cl'
of 811 a llamnlous Wll&te, ma.ter1al, Ql' via a
Unlform Hnzan:IOU!> Wute Manifest? U so.
please attach nn expiiUlation.

I 0. Is this wa.9te from a mte currenuy being y"' Ni
remedlated under rule& of ·
Independent Analysis o MSDS *owled;.e or Process/
l huebst ctrttfll that I am an oatllorl.ud "'JI1"'1:8mlative qJ1 tlur Gmerator tdcnUJicd herein 1D provide the Information submttted on this ronn and any attached documeota and enter ln1D this on the generator's l>eha.lf: that I have lllllde t1 eomplete and lhorougl\lnveetlgat1on of all matlers relevant to tJ1c completion of thllllorm, that. r.o U1e IM!at of my kJ•gwledge, alllnwnoat1on suppUed b truly repTestntaUve of the above mentioned Wli.Btc and that aU known or suepccll:ll hazardous coost1tuenlls. or aafety hazards W1U1 have bet:O dl&ctosed herein. I agree to notJlY MW1'S lfl.lte"' Is any change In the stream Information •ubalttted fur acceptance.

I alllo cert:IIY that all I:SIWlples were collected acoordlng to EPA Method Em 846. that samplc.e were analy.!ed by a Ca.Urol'llla. State Certtllerl 1-m) and that chain of custody Wll.11lttaclled. I further certi1Y that the wastes submltte<l for diRpMill are non·ba&ardou&tn aocordance wtth California Health and Safety Code, and the Code of Federal ReguiAt;i(lllll and any appUcable local Laws or n:gulaUon&. 0 Blllf CettU'fcatfon · I have based this waste detennlllatlon o( the knowledge of the wal)(e generating prooc1111 and I certify that the waste mntalnB no const1tuenta tOOl would necessitate analytlcal testing tD det.:nnttte that w-.wlc:: II$ nonhazan:low M per ntlc:
22 CCR 66261, JO (aJ(21(BJ.

Anlucal This 18 an annual n:ctttlflcatlon oC an cxi&Uilg proll!e, 1 cat1fy that either; tbe waste genernttog proeesiJ has not .-.hanged and 1 have the waste. Or' I have reanalyzed the waste and have attached aJpks to this form. . c &t:sro/L Company W.A.L . I rN c
fCK" McKittrick Waet& Use Only
Waste 0 Approved 0 Rejected by
I
Date ___ ________ _
- .. U9 dOOk,
PONo. ---------------------------------- Job No/Name ______________________ _ WM Sale9mari --------------------
WM Price Quote --------------------
Comments: _______________
/
\
,
.-·-·
WM
McKittrick Waste Treatment Site
Acceptance NQtice
jl I
Date: 4/7/2004
To: Peggy Stepe
Fax: 909-869-1006
• I
I
I

APPROVAL'PENDJNG
Company: Island Environmental SIGNATURE.

PLEASE SIGN & RETURN
ASJnll From: Esther Salazar
Subject: Wal-Mart
Waste: Clarifier, Waste Water
I
' i . We at McKittrick Waste Treatment Site (MWTS) would like to take this time to thank you for your interest in those services provided by MWTS. After reviewing the information provided during profiling, wt h.a've determined the waste submitted meets the acceptance outlined in our facility permits. Plehe · · enter on each non-hazardous manifest the following profile number: 404-150-IV. · ·! :

This Profile is good for one year. If further shipments are required the profile must be recertified anrlually.

No notice will be sent to you. Please submit your profl.le for recertilication 30 days in advance to any delays. · '
The price for of this waste Is·
If the load, as requires solidification, the dispos,a' rate will be charged at $60.00/foni . I
If there is a discrepancy with this price please call immedia'tely.

All drivers are required to wear the following ppe: Hard-hat, safety glasses, gloves, steel toe bdots' & reflective vest.

Special Conditions:
2005 Recertification requirements:

To schedule a load please notify Connie Williams with our Department 24 hours J advance@ (661) 762-7366. All loads must be scheduled "No Exceptions". . :

Unscheduled loads will be charged a $300.00/Fee. ·
All discrepancies should be addressed to Mike Rivera @ (661) 762-7366 I All billing questions should be addressed to Connie Williams@ (661) 762-7366 . i If you have any questions or need further assistance, please feel free to contact me@ (559) 386-6145. 1 . I .

To Acknowledge Please Sign & Return (Fax #(559) 386-6109) --·· -· Printed Name, Title Date i
I
I
•
DeMenno I Kerdoon 13dd-7<f,
DEMENNO I KERDOON'S LABORATORY IS CERTIFIED BY THE CALIFORNIA DEPARTMENT OF HEALTH .:C.:(.eJ SERVICES ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM ( ELAP) CERT. II 2037 l J

GENERATOR'S WASTE PROFILE WORKSHEET

GENERATOR'S INFORMATION
A. GENERATOR'S NAME I 00'- U_W<..-7: .N':.-B.

C. GENERATOR'S ADDRESS V o '0 $. D.

EPA ID# ---'-IJ"---H-_·
PHONE(
E. CITY, STATE,
F. GENERATOR CONTACT ·--,--;·l'v'. s:-•t-----:
' ,-
H.
j_
L.

A.

B.

C.

G.

CUSTOMER NAME I S'r-J•J·JL, L
/' TRANSPORTER NAME y:_..,.,__,-J) '2N.·J •.IL ·:y"""'£..j} ·,0::=,:::, K.

TRANSPORTEREPA ID# ________ ___ M.

E. DOES THIS WASTE CONTAIN PCB'S?

CHAIN OF CUSTODY RECORD
TITLE l2cp •
PHONE fioi ( ll - L<t <-\. C'.(,
PHONE ficl St '1 '+'-\ l
CONTACT \\1M 6..:-u I
.. . V6'> . . ')(... . nC' ·
PROFILE# 262.548

CUSTOMER
SAMPLE# __
GENERATOR'S NAME: ---')..>-'--J./__-L __ '::...} _______ _ PHONE: ____ 07"_" ____ __
ADDRESS: ')J-'-'/1._!.. o-J ..::::..

SAMPLE DATE I TIME: 81, 2..'-{ I / p,.__, PHYSICAL STATE ( D NO. OF CONTAINERS: SAMPLED BY: 1 oJo.-\
SAMPLE TYPE: GRAB :;if COMPOSITE 0 OTHER --------------- ANALYSIS REQUEST: OTHER-------------------
PRECAUTION: 0 REACTIVE 0 CORROSIVE 0 OTHER
(1) RELINQUISHED BY: J I
SIGNATURE: ;::i:...----/' "' )./, DATE I TIME: B(J.>' ;L_f vV\ PRINTED NAME 1 1 I 1 .::: '.J ?/' COMPANY NAME: I t>C-1..''-'D f2'N\/ 5-$2-VC.C::

SIGNATURE: ! DATE I TIME: g 1_ )"" c,.-( b f 0 (2) RECEIVED q .· - ( I PRINTED NAME \Z ffi,.;cl !b COMPANY NAME: _ _,})-'-+/4 1(,__ _____ _ (3) RELINQUISHED BY:

SIGNATURE:------------

PRINTED NAME------------
(4) RECEIVED BY:

SIGNATURE:-----------

PRINTED NAME ------------
FORM1001 REV.!-2-01 SPECIAL INSTRUCTIONS:

DATE I TIME:--------------
COMPANY NAME: __________ _
DATE I TIME:--------------
COMPANY NAME: __________ ___
\
Dlf De Menno I Kerdoon 13Zl.7:f
DE MENNO I KERDOON'S LABORATORY IS CERTIFIED BY THE CALIFORNIA DEPARTMENT OF HEALTH :;::::;' t?: SERVICES ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM ( ELAP) CERT. # 2037 [ 1 1::/

GENERATOR'S WASTE PROFILE WORKSHEET

GENERATOR'S INFORMATION
A. GENERATOR'S NAME ' !0-C:--- t l . .uu:- .N:_s.

J_
EPA ____ _
C. GENERATOR'S ADDRESS V c '0 $. D. PHONE(
E. CITY, STATE, ZIP--------=--------------------
F. GENERATOR CONTACT _·_...,.-: __ ___;' •1=----<-==--- H.

J.

G.
---r ' ,-. CUSTOMER NAME f ./-6.-t-....:I\ ";;'N•J·.f>- I. /" TRANSPORTER NAME •. 5 ''_..,. , ... ;J_) f'?N.'hiL \ "::x:.'"S K.

TITLE /2.e=.-p •
PHONE (/ll1 Ill - 2..'1'-1.

PHONE eel '-( 4-'4l
L. TRANSPORTER EPA ID# ---------- M. CONTACT \1:\Jv\ ·&.:.,_(=--'<....

A.

B.

C.

D.

E. DOES THIS WASTE CONTAIN PCB'S?
F. DOES THIS WASTE CONTAIN DIOXIN? (F020-F028)
G. DOES THIS WASTE CONTAIN SULFIDES OR CYANIDES?
H. DOES THIS WASTE CONTAIN PESTICIDES OR HERBICIDES?
(IF YES, IDENTIFY IN ITEMS A OR D ABOVE.)
I. DOES THIS WASTE CONTAIN SOLVENTS?
(IF YES, IDENTIFY IN ITEMS A OR D ABOVE.)
J. DOES THIS WASTE CONTAIN PLATING WASTE?
K. HAS THIS WASTE BEEN MIXED WITH RCRA LISTED WASTE?
yes K.
yes
yes ¥
yes
yes ;<_
yes 0.
no
no
no
no
no
no
(F, K, U OR P EPA WASTE CODES) yes "f- no
L. IF YOU HAVE MSDS FOR COMPONENTS IN THIS WASTE,
PLEASE ATTACH ....................................................................................... MSDS ATTACHED 0 M. IF YOU HAVE CURRENT ANALYSIS OF THIS
WASTE, PLEASE ATTACH ................................................................. CHEMICAL ANALYSIS ATTACHED 0

GENERATOR'S CERTIFICATION
I HEREBY CERTIFY THAT THE INFORMATION PROVIDED ON THIS DOCUMENT. IS TRUE AND ACCURATE. AND NO INTENTIONAL MIS· REPRESENTATION HAS BEEN CQMMITTED BY ANYONE. I FURTHER CERTIFY THAT ANY SAMPLE(S) PROVIDED WITH THIS WASTE PROFILE WERE TAKEN AND IN ACCORDANCE WITH 40 CFR 261, APPENDIX 1 AND ARE ACCURATE AND REPRESEN· TATIVE OF MY ACTUAL WASTE STREAM. I HEREBY AGREE TO NOTIFY DEMENNO I KEROOON SHOULD THIS WASTE STREAM CHANGE IN ANY WAY. J 0
---.. . AUTHORIZED SIGNATURE 'ti --../"- ·\).._..} Y>. DATE .....8_ I 2.:-,. I a::; PRINT NAME AND TITLE --r ....... ·. G "JI...J t:"'11- f...c::""/Jf',_f::-'56''-'J N 7 ',./ C , 1 FORI.! NO 1001 REV 1·2·01
08-30-05 01:14pm From-0/K SERVICE +3105378386 ·T-076 P.02/0Z F-404 ueMenno 1 Keraoon 13;;o74 GENERATOR'S WASTE PROFILE WORKSHEET OEM fl·{-e., EN NO I KEAOOON'S LABORATORY

OF HEALTH

IS CERTIFIED BY THE CALIFORNIA DEPARTMENT
(ELAP) CEAT.

SERVICES
# 2037
ENVIRONMENTAL LABORATORY ACCREDITATION PROGRAM PROFII.E # 262548 . 0 TRUCK IN PLANT
;;i ADVANCE SAMPLE PROFILING

CUSTOMER
SAMPLE It-----

GENERATOR'S NAME
TAANSPORTEANAME ____

PHYSICAL CHARACTERISTICS
COLOR i3A9<1.J#!j/f ODOR SEDIMENf ----:;,.,..c..-
pH 7•tJ GRAVITY BS & W
WATER SOLUBLE __ yes__.!( no REACTIVIIY
PHYSICAL CHARACTERISTICS ACCEPTABLE- REFER TO LAB FOR COMPLETE PROFILING _g./ PHYSICAL CHARACTERISTICS UNACCEPTABLE - REJECT 0
TESTED BY DATE ___ c!jA=-_'z.>...c..:j74_'tJ.F" _____ _

CHEMICAL COMPOSITION OF WASTE

HALIDES INORGANIC
TOTAL HALiDES .<_ ;ou PPM ELEMENT
INORGANIC HALIDES PPM < z. <.>

CADMIUM PPM
ORGANIC HALIDES PPM CHROMIUM < z.. _,
PPM
.. LEAD .z.. PPM
pcsfs PPM
L b,, o PPM
PPM ,.,..._
PPM

ADDITIONAL ANALYSIS PEA REQUEST

COMMENTS
FORM NO. 1001 REV. 1·:2.01
STATE 10 01045 "
J/. .. ! t' . •,: .. ,
) . :- ' .
' . : '·" (
CA827 .,
DOT C8b 72 .• ,
ISlAND ENviRONMENTAL SERVICES, INC. , ,:· Waste Management & Transportation

TRANSPORTATION RECEIPT
WORK ORDER i 31-.2. 7L-f
041203 fil-e..

Established 1982
33S9 BLVD •• POMONA, CALIFORNIA 91768 • (800) 400-4347 • (909) 598-4449 • FAX (909) 598-0041 ""' '
Col)tact. KEVIN GRABER ·· '
Job .,. SM-ITEE · ···'
Address. ·170 TOWN CEl'<'TER PARKWAY
.· · SANTEE CA 92071.

Phone
Hours (619)449-8215.
.# CALOOO!l 1207
Salesma'b7
BiiiTo WAL-M.4.RT#06-l917
ON FILE ;
Job Description
·SIX MONTH SERVICE
- SAJ\'TEE
. ·.-.......
'·· ••• - ••• "t-".

Bins Delivered: tt._ __ _,Jjc._ _______ Liner Y N
. Bins Picked Up: "----.....tt:'--------------
Equipmen! Needed

1. 2.

3. 4 ..

5. 6.

7. 8 ..

9. 10. : .. '
O.rder.Date ..•..•. _
..•.. , .. ,
Appointment Date
•.:.'
3118/2004 .. ... ,,_, 15 . .. .. ..... p .. J. ,_ .. ,._Unit# 7 c::>":.V. 3/19/200-1
nme
Facility MCKIITRJCK '\\'ASTE DISPOSAL ·
· . . .... I f .1 If
Appt. T1me: To Scheduled w1th. _____ _
Supplies
'•'··· ·,:· - -·
., .. ·
· .. ,
·,_,' -·. . ..:-...
,, ·.
.... Date

ACCOUNTINC
·s. Transporter 1 Company Name
.'ISLAND ENVIRONMENTAL SERV

7. Transporter 2 Company Nome

9. Designated Facility Nome end Site Address

MCKITTRICK WASTE DISPOSAL
56533 HIGHWAY 58 WEST
MCKITTRICK CA 93251

11. Waste Shipping Nome and Description

1. Generator's US EPA ID No.
c; 1\ 0, 0. 0, 1, 1, 1. 2. 0,
s
C F. ['. 9. 8. 0. 6. 3. 6. 8. 3.
a. NON HAZARDOUS CLARIFIER WASTE, LIQUID
A. Transporter's Phone
{661)762-7366
D. Additional Descriptions for Materials Listed Above
lla) #303-106-IV
E. Handling Codes for listed Above

15. Special Handling Instructions and Additional Information WEAR APPROPRIATE PROTECTIVE GEAR.

BILL: ISLAND CLIENT: WAL MART
JOB SITE: SANTEE, CA
W/0 041203 .

19. Discrepancy Space
24 HOUR PHONE 909) 598-4449
1917
or Operator: Certification of receipt of waste materials covered by TRANSPORTER# 1
!
'
EPA# · _ -.'STATE ID 11045 ·if . ,._CA827 .: ". ·
DOT <l85272 .
-. •,1 } · L. '" . .. j
ISLAND E,NYIRONMENTAL SERVICES, INC; . · ) i

TRANSPORTATION RECEIPT
W9RK ORDER /,3 2J_ 7c{
\ . _. \ .. Waste ManagementJf:.Transportation
:·,· \ , .. t:.:::.::.. <
044037 file .

Established 1982
·. ,, ' .
3359 W. POMONA BLVD. • POMONA, CAUFORNIA 91768 • (800) 400-4347 • (909) 598-4449 • FAX (909) 598-0041 .. Customer#
Order DatW 19.17 • I . . .,
D;iver 9!21i:io64 AtT . Unit# 17
Phone. • :-· .•• : .. .. __ . • ·:·
Appointment Date . ···-" ...

Facility.

REMEDY ENVIRONMENTAL
32bb E. FRONTERA ST.
nme
!;lours •. :.

EPA I C)_# • . • .. , .•... ,
PO# :.<;f\L(}()()lll29,7. Appt. (?j.: 92806 Scheduled with '----- Salesman .. · ,, .
_Bill To. 0!,,. ··"· ......... · .... . . WAL-MART#06-1917 - · :Jq2
Job Des<AATS;(C?!':IVILLE, ,AR
,· .. ,·. "• .... ' .
. , S)';R;.YiCE
.; r '-'·•;
SANTEE
72716
·,!) •.

Bins Delivered: ,tt_ __ _.,'---------Liner Y N .

Bins Picked Up: tt_ __ _.tt _______ _:_ ____ _
Equipment .Needed
J.

2. 3.
<1:.;
5 ..
6 ..

7. 8 ..

9. 1Q.
.. ' _. " ···-·· . ·. ·; ...

EPAID # .. , .

Phone CAL000200500
Manifest# .· (714)630-2307
Disposal ncket # 44037 . \
Directions ., . _/
·'

1. 2.

3. 4.

5. 6 ..

7. 8.

9. 10.
· .. '
. :' ;.· ·'
·- ........ ·•.
"-) . . :·· •. :..,
'··· .. ' ....
ustomer Signature
,t[J \ II-./. ol(,/-
'""'Prirlt Name Date Driver Signature (Off-Lo
NOTE: THIS IS A MODIFIED MANIFEST FOR THE DISPOSAL OF YOUR WASTE US EPA 10 Number A. Transporter'$ Phone
B.. Transporter's Phone
Designated Facility Name and Site Address US EPA 10 Number C. Facility's Phone (714) 630-2307
o. NON-HAZARr,OUS W\.STE LIQUID (CLAF.IFIER)
D. Additi.onol Descriptions for Materials Listed Above
lla)CLARIFIER

15. Special Handling Instructions and
WEAR APPROPRIATE PROTECTIVE GEAR.

BILL: ISLAND .CLIENT: WALMART
JOB SITE: 170 TOWN CENTER .PKWY.

19. Discrepancy Indication Space
\Yu. /.
2 4 HOUP. PHONE
1917
SENTEE,CA.

E. Handling Codes for Wastes listed Above
(909) 598-4449
W0#44037

20. Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19. #!

CERTIFICATE OF RECYCLING

REMEDY ENVIRONMENTAL SERVICES
This certificate is presented, as proof that the shipment listed has been Recycled/ reclaimed by re-melt or processing to recover intrinsic value. Remedy Environmental Services, Adams International and Adams affiliate companies certify that all state, local and federal laws were complied within the recycling process.

Material Description:

Wal-Mart #06-1917- Santee
170 Town Center Parkway
Santee, Ca 92071
Generator Certified Non Haz
Water used for steel processing
9786
Receiving Facility: Remedy Environmental Services
3200 E. Frontera Street
Anaheim, Ca 92806
Date Received: 11/03/04
Amount Received:

Manifest Number: 44037
Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Controlled substances receipt in Pharmacy. Controlled substances are sent to Fort Worth Texas twice a year.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Close up of controlled substances receipt in Pharmacy.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Close up of pharmaceutical returns receipt in Pharmacy. Regular expired medications are sent to Bentonville, Arkansas monthly.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 20-gallon drum labeled toluene and aliphatic hydrocarbons. This is in the outdoor "Bale Storage" area between the propane storage cages.

Wai-Mart #1917 170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Close-up of label on the 20-gallon drum labeled toluene and aliphatic hydrocarbons in the outdoor "Bale Storage" area.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Propane storage in the outdoor "Bale Storage" area.
---- -------- -
Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 More propane storage in the outdoor "Bale Storage" area. The 20-gallon drum of waste is inside this blue half-drum.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 More propane storage in the outdoor "Bale Storage" area. These cylinders are rusty and are not used for the floor cleaner or forklifts.

WaHUiart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 This is inside an "ORM-D" box as it is being prepared to ship to Las Vegas Return Center. ORM-D boxes get shipped on a pallet with all ofthe other Returns Center returns (except the "Vendor Claims Destroy" items).

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Overview ofthe Claims Department's tote area.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Overview of the Claims Department's tote area.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit.# 132274- Manon Maschue photographer 10/28/05 Fluorescent light tubes for Return's Center.

Wai-Mart #1917 170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 One of the damaged containers in the special box that will be sent to Return Center separately from ORMD. This box is "Vendor Claims Destroy".

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Close-up of the previous damaged container in the special box that will be sent to Return Center separately from ORMD. This box is "Vendor Claims Destroy".

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Close-up ofthe contents of a "Vendor Claims Destroy" special box that will be sent to Return Center separately from ORM-D.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Tote for spray cans that get returned to Returns Center.

L
Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Contents of tote containing spray cans that get returned to Returns Center. According to the claims staff, the nozzles have been broken off by customers during use and are getting sent to Returns Center to see if they count for credit.

Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 Super Clean Degreaser, when damaged on shelves or returned partially used by customer's is sent to Return Center as "Vendor Claims Destroy". The store collects these until they gather enough to send in a box. ----------------------------------------------------------- Wai-Mart #1917170 Town Center Parkway, Santee, CA 92071 CUPA Permit# 132274- Manon Maschue photographer 10/28/05 These are the Drained Used Oil Filter containers missing accumulation start dates.

L
---
COUNTYtiF SAN DIEGO
\ CORRECTIVE ACTION FORM TO

DOCUMENT RETURN TO COMPLIANCE
BUSINESS NAME tJd.
•

ADDRESS

SPECIALIST
INSPECTION DATE: / 0 ;f? ;a5 -------
CONTACT /kJ j /)a/r,n.,

VIOL DATE INDICATE HOW VIOLATIONS WERE CORRECTED
# CORRECTED
·=_:, =--'
v .. CJ
8 c:> : ') ::_<;
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v -.J CJ
9 r-. I <l
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I certify under penalty of law that this business/site has corrected all violations marked on the Compliance Inspection Report /Notice of Violation.

I have personally examined and am familiar with the information submitted and believe the information is true, accurate and complete.

Signature of Responsible Party:

Send complete
Job Title /7&-# &;J
Date:.!J' 1.tl/ I o..s-- 1 /
Date: /R_ I j? It)
)J All violations noted on date listed above were corrected.

HM-926 (09/03) NCR DISTRIBUTION: WHITE-RETURN TO HMD: YELLOW-BUSINESS RETAINS ·. $·,.
'/
.COUNTY4tF SAN
I< ··. · · L . ' : I
BUSINESS NAME Wal-Mart #1917
ADDRESS 170 Town Center Parkway \ o
E.NiER£.0 CITY/ZIP Santee, CA 92071 ·, ·· ..

An inspection of your business was conducted, under the authority of Section 25185 of the Health and Safety Code. This inspection was conducted with purpose of detennining compliance with Chapters 6.5, 6. 7, 6.95 in Division 20, of the California Health and Safety Code (H&S); Titles 19, 22 and 23 of the California Code of Regulations (CCR); and the San Diego County Code (SDCC). Thefo/Wwing statements describe conditions which are violations of the law or that require further investigation. These observations require afonnal response and/or immediate corrective action be taken. Failure to correct these violations or to provide infonnation requested in a timely manner may be a factor in detennining the course of further legal action.

NOTE: Reinsoection fees will be charged if additional inspections are reguired to determine compliance.

Y N/A Y N/A
X 0 Unified Program Facility Permit current and available Permit Expires on: 31/0CT/06 X 0 Hazardous Materials Business Plan Available 0 0 Employee Training is adequate X 0 Waste disposal records available for review X 0 Waste containers kept closed 0 0 Emergency contacts current X Updated today 0 0 Waste containers kept labeled X 0 Chemical inventory current 0 Updated today X 0 Waste containers in good condition 0 All violations noted on this compliance inspection report were corrected during this inspectt& Routine Hazardous Materials/Wastes Inspection conducted this date with permission from Debi Dalton, Storc.@ii. Ass/ Manager. Walkthrough, with Ms. Dalton, included Claims Department (employees, Casandra (Casie) Kindrix and Invoice Clerk (who has claims experience), Joyce Weems), Pharmacy with Fay Lui, Pharmacist, "TLE" with Josie Lopez-Cox, TLE Manager, Aaron Stevens, Automotive Support Manager (inside), & Katrina Miller, Automotive Department Manager (inside) and Photo Department Manager, Roz Van Dyne. Visits were also made to the Customer Service Area (returns), the propane storage cages ("Bales Storage"), the Hardware (paints) Department, and the garden area. 20 photos . were taken of claims, TLE, propane and pharmacy area and returns and will be provided if requested.

ObservationsNiolations/Notice to Comply RECEIVED NOV 0 2 2005 I) Training Program not adequate. The 6 year employee in the TLE said he cleans up spill of battery acid or spilled good oil with "spill magic" and then leaves it in the trash for the maintenance crew to pick up. This is disposal of a hazardous waste to an unauthorized location and represents a poor training program. This is a REPEAT VIOLATION from July, I 0, 2003.

VIOLATION 0402 - Personnel training is not adequate to ensure compliance with California hazardous waste/materials regulations. CCR 66265.16
CORRECTIVE ACTION- -Make sure that training with regard to hazardous waste disposal is carried ·oui: Keep records for proper disposal of absorbents _for 3 years. 2) As above, absorbents used t?. up hazardous materials such as lead acid battery liquid and. oils _(even jf they are not used 01ls) must not be d1sposed to trash unless they are detenruned jo be f1 tso fatnrf<lt-1-,,/ICI' IS. 9ald -fl, lu p lett_ I "(J ur;Jf!J "7tlll ft, .. ·• • .. , . . ·t
ual cerf ation thaUhe'Hazardous Materials Business Plan (inventory, emergency·- · .. ncy respon e plan, and employee training plan) is current and des all the . . · ··-· . ··. · d in the &SC and is maintained at the site where hazardous materials. are stored.· IDitials of
ealth, Hazardous Materials Division, P.O. Box 129261, San Diego, CA 92112-926i; (6i9) 338-2222; sdcdeh.org COUNTY4JF SAN DIEGO
BUSINESS ADDRESS: 170 Town Center Parkway
Con't
• PERMIT
DATE
PAGE
# 132274
10/28/05
2 of4
ZIP CODE: 92071
VIOLATION 03;e1 - · osal or causing the disposal of hazardous waste to an unauthorized point (ground, storm drain, sewer syst ash, r air). HSC 25189.5
CORRECTIVE A - -Immediately STOP disposing of absorbed hazardous materials to trash. Manage as hazardous waste or do a complete waste determination to decide how to manage. 3) The two used oil filter containers do not have an accumulation start date. This is a REPEAT VIOLATION from July 10,2003.

VIOLATION 0215- Used oil filters improperly managed. 66266.130 CORRECTIVE ACTION- -Used oil filters must be recycled following specific guidelines, or be managed as a hazardous waste. Used oil filter storage containers must be labeled as "drained used oil filters", and show initial date of accumulation. Used oil filters must be drained of free flowing oil. 4) OBSERVATION- Owner or operator has not determined that the tank system is fit for usc. Double wall used oil I anti-freeze tank system does not have an engineering certification.

VIOLATION 1601 -The owner or operator has not obtained a written assessment reviewed by an independent registered professional engineer, registered in California, in accordance with section 66270.11(d) that attests to the tank systems integrity. CCR 66265.191 (a)
CORRECTIVE ACTION- -Within 60 days of the inspection date, provide one of the followingI) A written assessment reviewed by an independent registered professional engineer, registered in California, in accordance with section 66270.11(d), that attests to the tank systems integrity. request (DEH- HM-9271). This request must meet all the terms and conditions listed on the ...-----torm and require an inspection by ):OUT local fire marsP.ftl. SDFD at 619 533 4477, er Santee FD at it 619-258-4100(ext204)M1ek atlaltif"tl3) Replace the tank system. Note- New tanks also require certification. Used oil tanks are required to meet applicable rw. .. standards for hazardou;; waste tanks. handout jllld implement daily inspection program log for waste oil tank. -21 1/) S/q;t.ltl
5) There is a 20-gallon container (in secondary containment) out in the Bale Sorrage area (between the two propane cages) that has a Safety Kleen hazardous waste label that reads" Use by 2/2005" and appears to contain "Waste Flammable Liquids DOO l ". This drum has been on site longer than the 90 days permitted by the large quantity hazardous waste generator status of this facility.

VIOLATION 0209 - Hazardous waste is stored in excess of allowable time-period without a State permit or written variance. CCR 66262.34
CORRECTivE ACTION- -DISPOSE OF THE ABOVE STATED WASTE WITHIN 30 DAYS AND SUBMIT PHOTOCOPIES OF THE DISPOSAL RECEIPTS/ MANIFESTS TO MY ATTENTION. 6) Storing hazardous waste onsite longer than permissible time lines is considered Operating a Hazardous Waste Storage Facility and requires extensive permitting by the California DTSC.

VIOLATION 0141 - Operating a Storage Facility without receiving written authorization from DTSC. HSC 2520 I Department of Environmental Health, Haza !JUS Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222; sdcdeh.org COUNTY"F SAN DIEGO
I
BUSINESS ADDRESS: 170 Town Center Parkway
Con't
• PERMIT
DATE
PAGE
# 132274
10/28/05
3 of4
ZIP CODE: 92071
CORRECTIVE ACTION-- Storage of hazardous (RCRA) waste for periods longer than those allowable by State law requires a permit from the DTSC. Do not accumulate and store hazardous waste for greater than allowable accumulation time limits pursuant to CCR Title 22 Section 66262.34 without a State DTSC permit to do so.

REMARKS:

A. Pharmacy returns controlled substances twice a year to Carolina Logistics in Texas, through "USF". All other expired medicine goes to Wal-Mart Return Center in Bentonville, AK. Pharmacy does a monthly inventory check for expiring meds.

B. Hazardous wastes generated on site must be managed according to California Hazardous Waste Management Laws.

C. Starting February, 2006, it is ILLEGAL to dispose of fluorescent light tubes to the trash. Maintain records of Universal Waste Disposal.

D. There are some older looking latex paint containers in the "Bale Storage" area. Be advised that if these materials become no longer usable, you will need to recycle the latex paint (you cannot simply dry it out for the purpose of disposal). As for the older looking glue containers, be sure to manage appropriately and maintain proper proof of management on site.

E. There are 4 ways damaged goods are managed in the Claims Department. Regular non-hazardous returns for credit.

ORM-D (hazardous damaged goods), universal waste returns & "Vendor Claim Destroy" returns.

HANDOUTS:

AST Certification Exemption Form
Corrective Action form
Within the time frames stated in this report, correct the violations. Within 5 more days, provide a written to the address listed on this report, providing corrective actions taken to resolve the items noted above. You may use the corrective action form to document return to compliance and attach any supporting documentation. You may send a letter with documentation if you prefer.

Be advised, if a re-inspection is needed to determine return to compliance, a re-inspection fee may be issued.

Deparbnent of Environmental Health, azardous Materials Division, P.O. Box 129261, San Diego, CA 92112-9261; (619) 338-2222; sdcdeb.org

OF SAN DIEGO

COMPLIANCE INSPECTION REPORT DATE
PAGE
BUSINESSADDRESS: __ V/OI.A.TION REPORT: 71te item.f c·hec·ked be/em' refer tt> specifil· senitm numbers tJj'Title..- /9 & 22oft I Ca/{/(mtia CtJde t?{ R l'Kiilaricms (CCR). Chapters 6.5. 6. 95 clthe 1/ea/th and Safety Code (lfSC). and/or the San Diexo Cowr(v Code (SIJCC). · · All violations must be corrected. Submit documentation of return to compliance to your Specialist. You may use the Correcth·e Action Form to document your return to compliance. Your can provide these fonn'i. Please call (619) 338·2222 or your Specialist if vou have any questions.

HAZARDOUS WASTE REQUIREMENTS

RECORDKEEPING

VIOL VIOLATION DESCRIPTION
D VOI31 UPF Permit not obtained SIX:C. 68.905
D VOI32 No EPA ldentilication Numllcr. 66262.12
D VOI33 Manifest copy not sent to DTSC. 66262.23
D V0134 Exception Rpt. not filed with DTSC. 66262.42
D VOI35 Waste Manifests/Receipts not on-site for 3
years. 66262.40
D VOI36 No records of disposal. 66262.81
D VOI37 Manifest not operly completed. 66262.23
D VOI38 TSDF sign -manifest not on-site. 66262.40
D VOI39 eport not sent to DTSC. 66262.41
____ -P,. VOI40 LD ocumentation not available. 66268.7
\._ • ·· .• -" voi!f perating TSDF without authorization. 25201 o--VOI<12-Failed to notify local CUPA of onsite treatment of hazardous waste. 2520 I
D VOI43 Tiered Permitting notilication has incomplete or incorrect information. 25201
D VOI44 SB 14 compliance doc. not available. 25244.19
0 VOI45 Excluded recyclable materials report not
submitted to HMO. 25143.10

STORAGE AND HANDLING
0 V0201 Waste container not kept closed. 66265.173
0 V0202 Waste container missing/improperly lallcled.
66262.34, 25143.9
0 V0203 Damaged container not repackaged. 66265.171
0 V0204 Waste container not properly managed. 66265.173 0 V0205 Wa,te container in poor condition. 66265.171
0 V0206 Ignitable Waste< 50 feet of property line.
66265.176
0 V0207 E.a "lily not maintained/operated to minimize
p ssibility of fire, explosion or release. 66265.31
0 V0208 torage area not inspected weekly. 66265.174
\ _ ,· li!-vo209-1 Waste stored> 90, 180. or 270 days. 66262.34 ' ---o-vo210 ·' Hazwaste not cleaned up off noor surface. 66262.10b
0 V0211 Incompatibles in the same container. 66265.177
0 V0212 Incompatibles not stored separately. 66265.177
0 incompatible with waste. 66265. 172
__ -0-- Waste oil contaminated. 25250.7
_. : J!• . vo21' Used oillilters improperly managed. 66266.130 0 V0216 Hazardous materials not properly labeled. 25124

TRAINING, CONTINGENCY PLAN & ER PROCEDURES

TION DESCRIPTION
aining records unavailable. 66265.16
Training program not adequate. 66265.16
Facility not designed to minimize relea,c. 66265.31
Spill control equip not available. 66265.32
• Hazwaste tanks w/o P.E. assessment. 66265.191 a. ., _____ . 66265.192a Vl603
Vl604
VI 60S
Vl606
Vl607
Vl608
Vl609
Vl610
Vl611
P.E. Assessment report not complete. 66265.191 g.
66265.192k
Hazwste tank system: no secondary containment.
66265.193a
Secondary containment not kept empty.
66265.196(b)(c). 66265.194(c)
No daily tank inspection/inspect. log 66265.195 (b&c)
Improper or absent spill/overlill protection.
66265.194b
Improper corrosion protection. 66265.191. 66265.192
Integrity assessment not done for tanks without
secondary containment system. 66265.191
Improper use of hazwasle tank system. 66265.196
NoPE assessment report-repairs/changes. 66265.l96g
Improper closure of haz waste tank unit. 67383.3,
66265.197

HAZARDOUS MATERIALS REQUIREMENTS

BUSINESS PLAN REQUIREMENTS
0 VIOOI UPF permit not obtained for Haz. Materials. 68.905 0 Vl002 Hazardous Materials Business Plan (HMBP) not
established/implemented. 25503.5
0 VI003 HMBP not amended to renect changes. 25505
0 VI004 HMBP not submitted to HMD. 25505
0 VI005 Emergency contacts not provided/current. 25509
0 VI006 Inventory is incomplete. 25504
0 VI007 Highly toxic gas ppm) not disclosed in
chemical inventory. 68.1 I 13
0 VI008 Annual carcinogen & reproductive toxin list not submitted to HMD. 68.1113
0 VI009 Site map is not suflicient. 25509
0 VIOIO Failure to report a release/threatened release. 25507 0 VIOl I Personnel training records not available. 19 CCR 2732 0 VIOI2 SPCC plan required hut not prepared. 25270.5 (c) 0 V2504 Owner or operator (0/0) Stationary Source (SS)
with> TPQ of a regulated substance (RS) did not
comply with Chapter 4.5 (CaiARP process). 2745.1
0 V2553 0/0 of a new or modi lied SS with> TPQ of RS did Not submit RMP. 273 .4. 25535 (d)
SIGN
25189.5
nsportation of hazardous waste. 25163
sp ed without a manilest. 66262.20
66262.11
DISTRIBUTION: WHITE-RETURN TO HMO: YELLOW-BUSINESS RETAINS •· ·. .RUN ON 05/02/2005
Ship ff·onl:! Stor·e *: 1917
Adcl-: 170 TOO CENTER PfRKI>i!Y

SANTEE , CA
Shipping Contents:

Ship PI( (1 P1·op g;· 31 i ·i T!J Name
92071.
• 1 BOX C!rrosiw Liquid N.O.S <Socliun Scdiun s·i I inte) •
HazanJ Pad:-inQ Class ID Nb·. C-.·a:.p" UPC
LI'U 760 000007919100'/23
'
REPORT
IX!T
E;::enptiono
This
t!_! the
is to certifY. that the above naued a··e clas:;·ii']ed, dew··ihed, packaged• marked ard 'labeled, and in the p··opet" cordition f!Y trans( ot lf9CFR 176.27(C). regulations of the liS l\q;.,1;·--tmerrt of ln;·usiH:rhl:ion. It is decl.;.n!d of' the contB·iner has been ca'l"ied out in accordance w \ Pn:pwed By: Receivt'd By: _ Rt>ceived Date:
\\--\ \ V\---\\ Manageen
• Shipped. Oi a:

Cunments i! ------ ................ --................ _ ... _. --....................... -................. _ ....... . ···------------------.... _ .. _____ .. _______________ .. ____ _ -------------------------------··--·-----------
------------------·--••''' -------
;';w chemic<l em':·,.:J,;ncy: Spil, Leak, Fi1··e, Exposre, 1W Accident --- Call lAl•:mtJ·ec day or nigrl: ..................... . -·M-OM-- ww -•- .. -·-- oo •• o o , o" .,_- "'"' ••--·-·----·-----------·-· ---·--••OOM-0 ------·-·----·-···--••-- -• • • ••• "' --· -··--------- •o •••-- --· -·---· --·----· -·--···-••-•M• *>!**l!->! WAL-MiRT STORf:S, INC. CONFIDENTIAL
CA 92071.
---.---·----............................... ..
p.2
STmr:;, :fr!C. STORE f-K). 01917
Hllt.:l,lrlT BILL OF LAiiiNG
t·KlT
Cla-im 06191 7?.0502000't
!hi' Too C)tSj
Bdtf-: __ ..1,.6.L .. ,.----N-oJ.-.----· .. -3-+-D..J __ REPORT NO. S3PIIJ\ZBOL
H ra anl P ac l:'i ng DG< T
Class II) NI:J•. Cntp UPC b:enpt ion> LBS - . ----····-·-···-·---·----- ··-·---·· -·------·-----·--·---·-----·-·----·---· .. ··---------------·-··· ·-------·-----------------·--·--------·-------------------·---·----- !.1'11.760 0000079H10il'l23 ---.. -·--.......................... _____ .................... - ........ ------- . -----.. ---------------·-------· .. -----.. ... . .......................... ____ ..... . ---------·--------------.. --·---·-- --------------- l-'•11- d;;;mical ,,m::··;•-;,lcy: Spil, Le<lk• Fin• Exposre• Iii" Accident--- Call Q;>:·nt.:r·ec day Ol" nig1l.: 80Q--It2lt-9300 ---------------·-------·----·-------·------------------- RUN ON 0510517.005 13:1+8:27
Ship From: Store t: 1917
Adcr: 170 TQ>IN CENTER PIRKI!JIY
SANTEE , CA 92071
Shipping Contents:

Ship R<& Proper !hi RJi rg Name
• 1 OOX Petrol eun ga.ses• 1 iqu<'!fi ed or 1 iquefi €1.1 petrol gas •
By:

Managee1··:

Shipped · Ui a: ---'.t-----
WAL-MIRT SHRES, lHC. STORE 1'0. 01917
HA7.MAT BILL OF LADING
I'«>T NEOOTIABLE
011917105050113
Ship To:

Add-:
.J 6..,4:., fi'91<)
b!1lf1PbJFfiJd'7s='foJo
Hazard Packing Class ID Hl:r. UPC

2.1 IM10"15 000007001t219205

REPORT N(
OOT
Exenptions
Received Date:
• Conments: --------------· ----------------------
-------·------·--·----···-----------Fot· chemical Spih leak, Fire, Exposre, or Accident --.Call lhentrec clay or roig"lt 80D-It21t-9300 ------- STORES, INC. OONFIDENTIAL *lliHHC<f
92071
-?· 2-tJf z.

WAL-MfRT ST<RES• lNC. STORE !'{). 01917 HAZMAT BILL OF LADING I'«>T NEOOTIABLE
m1917W5ffi0ll3
Ship To:

Add-:

J 6.-,4., /$ 9
g:9'oJI>
Hazard P ac king Class ID Ntr. UPC
REroRT NO. !ilPIIi\ZOOL
DOT
F.xenpt ions
------------------------------------------------------------------------------------------------------------- lta!i!jlt LBS or liquefied petroleum gas 2.1 I.N107fi 000007001!219205 -----------------·------------------------------------------------------------------------------------------ •
naned matetials <re pt-r.pN-11' classified, described, package:!. m ed ard labeled, md are i proper cordition f!J" transp!J"tation acciJ'·dillg "l:he US l!€>parbnent of Transp<rtation •. It is declared that c of "l:he container bee c<rried out in acconlance wii:h "lhe provisions Received Date:
---------------------------------------------------------------------------------------------------------- -----·- Fo;· chemical en-et·gency: Spih Leak, F.xposre. or Accident --.Call lheml:r'ec day or roi!jlt SOD-1+211-9300 ------·-·--------------------------- ll!flHIIHf STORES, INC. OONFIDINTIAL lHI!HHI*
m
.\'.
·. ,.TRANSPORTATION RECEIPT . . ·-· .. ' ...
.. WORK ORDER
. DOT. 485272 c. . .. . · ·'" , . . , ,. ISLANlJ ENVIRONMENTAtSER¥IGES,t:INC .. _· ... 1 . -· · · • . · - Wqste Manpgetjzent & TratiSportation 054403
/322-74 t;' !: .. .... " . ' .... : ... · :· . '.--'·. Established 1982 : /f_ 3359 W. POMONA BLVD. o POMONA, CAIJFORNIA 91768 o {800) 400-4347 o (909) 598-4449 • FAX (909) 598:0041 . .:_1,:;;
"""I"SS ... .-.. :·., ,; •... 170 JQWN CENTJ:R PAR.IliiiiAY •• ';,;;. ·''\"·:·;;\. ,.\;;,;. .. ·.: ... ..,.,_.._.,.1 ... •. .. ...
...
...
.. .. ,_.,. __ ., •-···. ,_ . ..>...,..:- .. .".w·:. .,, ,;., "1 ,I;I"6JQ .. #. ... ,.,,, ___ : ....... , ,,,,, .. ;, . . ...... ,,. c .• c .o ... '.,,,,,., • '" . e.Q.Jt ... :·. ,, ; '.:. . '" _._,_ .::; .. ·.c..... -:· .... .•:.: ::
.,, .
.!3.iii.TQ i:L.-.;,.,.;;;.,,.702.S.W.,STH.STREET '· .. ,;; _,,.,.: .... ,-,_,,, BENTONviLLE,.AR. 72716 _.,.• ·t-C;-b·.: .. ··"· ,.t;.: :. &:·. :·,, ·.; ......
,Job Qescription SIX MO .. SERVICE (OlL Y WATER) .
-.Bins .. D.ellvered:: # '· .,; · ·# ·' ·. · . Liner ,,,y N .; .Biris flcked Up: n >: .• ·.:::; •:# ....... ·, ... -·.·:.· . .... ,' .EQI.!lJlme!l! •.. -:: >;,Ji•:, .. ic.kc·,•.c·: .;. · ,; .u;.,".''. 1 .:i"f··:.c ... :• .
e ...,; .•. ,:.
... ;,;. .... ....• •. ,_,,,,,,
NOTE: THIS IS A MODIFIED MANIFEST FOR THE DISPOSAL OF YOUR WASTE :."f .. , ... _ ,_. · :-B ... Y. " 7"t¢+.;.LVDi!#...;:v • 010412005 07:00:00 . .:'"-"""'·;,; · ..'IX. '"''0;:,;,, Facility PROCESSING COMPANY , : ·--!:-1
• "·"·'' ''""'""-12345-l!AKELANO RD:·"-' __ .. ,.,_,; ,,,,.. .,,,._,.;;, '""''·"''';'""''"·:,_,... .. ,_.,,, .. ' ,-.c"';':: . .-i.,;,:,SANTA FE SPINGS .-... -.. :CA .: .. -:: ...... ":·:90670 .,,,;,. .:, . Appt. Time: To Scheduled with ______ _ _ . '1:·. • •• : ... ,t&j .,· L ,·
)944-611-1 .. .. .. ·,. .. -:...; _l
.. #J .. .. /·.c · .. ,..: ..... --.Y ..... ,r .. ·,
_# .... _ .._,.,,,,., ,, . .... _.. .. '.
.Directions_ : .. .. >. ' ... "· L> .... • ,J .... '
.•.. ,,..,. .• ·:: .•. _
d:..: ._., .f.,,d ..... • :;...t•J:.;; ."-'J.J.'.t".;."i!I_..;JJ...'l. •. -:, .. ;,:· .. .. ... . ,;;_ ... ..
• .• -.!!:;·;:--=-. \f,l;· • .:•.t;- O .:· ':t.:..:..::,i:-J.::..\ ; J. : .... .. _.,. .. ;r •. , . .L .. -;_:. ... ..:..: ..;. __ M, .. < .. ... ..: • ... . . ::.: . ..:- ::/_.t J: .. r· .. "'-:' :\
·J .-..

1.1.9: . . ...
. ·.· :t<·
ACCOUNTING .

US EPA ID Number
WA!l'I'E LIQUID : (OII.Y WATER) :

19. Indication sp·ace
bSIO} Y . C),o?
C. Facility's Phone

12. No.

E.
· .....

F_acility Owner or Operator: Certificatiori of of waste materials by this manifest except as noted in Item 19. \ \
;.--:-
12345 Lakeland Road, Santa Fe Springs, CA 90670
Phone: (562) 944-6111 Fax: (562) 944--8522
.... ..

CERTIFICATE OF RECEIPT & MANAGEMENT
OF

NON-HAZARDOUS WASTE
Generator: Wal Mart Tire & Lube Centers
Confirmation #'s: C-203
Date(s) of Receipt: I 0/05/05
\Vaste Profile #: 05-1028
Effective Date: 10/05/05
This certificate will verify that the Non-Hazardous Waste that was transported to Lakeland Processing Company in Santa Fe Springs, California on the date(s) noted above was received and properly managed in accordance with the permit conditions as specified in the City of Santa Fe Springs, Conditional Use Permit #620 and the Sanitation Districts of Los Angeles County Permit# 016674.

Lakeland Processing Company
Authoriz
flPlirl? .

Job _[!ascription
·- .: ·, .. '
';.,,_-
' .. ' ,, ''
.. :W:...?, .• -_ ... _ \ ...... ... ::._.-.._,;_ .... •• "..,"". _,, ..... _:;,- · · .. ;;.c#. ,: ••• , -, · .• :.;:.: ,.; _,. __ ,Liner Y-'· N , ,.,,,. __ ,,., .. ,.:·.' . __ ....... ,.: ... ,·. :-·--··'· ., _,, ,.,:r-:; ..... ;, . .,.... ,:;..: .. : . __ ... :-.... -. -. . , _, .. :, .·.o_o .... .:-. .. ...... .. ... -- ;: .. . ;.;. .:;i ·-
.... .• .
i; .. : ... , ;. .. •'v• ,· ' . .0•••.+ ..... , ... ,...:;, ;,,..:-:£ .... '•' .. .. .. .. .. ;:S. ;, _;·. _·.,.··:· J..
...

8. 4.:· • .i; r .. 1\L. .:f ... .• ..
·TRANSPORTATION RECEIPT

WORK ORDER
051545
/321-IH.
__ Established 1982 {j(f:_
• ..;,,,_,_, .
:9.r:derJl:a1!L0.:.04/1112005 -.; "'':: .. , __ .,;:::::::,_,.-;. _Appqintm.eot [!ate_ .04/11!.2005 12:00:00 . , .Time .. ·· ....... ; ... i .•.

Facility __ _ REMEDY ENVIRONMENTAL . . . " ' . -·' ..... -· .,_, " ' . . .... ,_
Disposal Jicket #
_Directions .... .,:.,. .... . .': .......... .. .. , ' =..,.,, ·: :.- ;;., ... ... ,..t-".2 ' ... :
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Driver Signature (Job Site)
:17)-\J"G'";z..,a.,._ QLJ1-,R...)(
o/rint Name r Date '(Off·Load) "'*""3
NOTE: THIS IS A MODIFIED MANIFEST FOR THE DISPOSAL OF YOUR WASTE . . flO« /,M .eJOft't.
;; .. .. .
..
.A.L.o.o.o.z.o.o.s.o.o
AAZARDOUS·-wASTE" .. LIQUID, (CLARIFIER WASTE)
'··
D. Additional Descriptions for'Materials listed Above E. Handling Codes for Wastes Listed Above lla) CLARIFIER WASTE GEAR. 24 HOUR PHONE (909) 598-4449
JOB SITE: 170 TOWN CENTER

19. D:isCreponcy Indication Space

CERTIFICATE OF RECYCLING

REMEDY ENVIRONMENTAL SERVICES
This certificate is presented, as proof that the shipmt:nt listed has been Recycled/ reclaimed by re-melt or processing to intrinsic value. Remedy Environmental Services, Adams International and Adams affiliate companies certify that all state, and federal laws were complied within the recycling process.

WAL-MART #1917- SANTEE
170 TOWN CENTER PARKWAY
SANTEE, CA 92071
Receiving Facility: Remedy Environmental Services
3200 E. Frontera St.
terial Description: Generator Certified Non-Hazardous
Water used for Steel Processing
11703
Anaheim, CA 92806
Date Received: 04/28/05
Amount Received:

Manifest Number:
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TRANSPORTATION RECEIPT

WORK ORDER
ISLANI) INC.
·' ' -
Phone
Hours
EPA ID #
f'O #.

Salesman
Biii.To .-
Scope of Work
SANTEE, CA 92071. .... · . .,_ . . . .. . . . ' .. . .... :, ... ..;/ . .. (619)449-8215
702 S.W. BTI1 .. STREET
. BENTONVILLE. AR 72716
e SERVICE fka
Bins Delivered: a# ___ _.,_ ________ ___.,Li.une..,r_-'-y__,_N.._ Bins Picked Up:"-----""--'-------------
Equipment Needed
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Appointment Date I I :. !I.M
Facility TEf(VT.JRi<S
891Q ROCHESTER AVE ..

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PANCH·:> CA
Appt. Time: -:c-,-:-c=-To Scheduled with, _____ _
EPA ID # 0 I 0 I 08
Phone (909)476-2308 . ..

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Disposal Ticket #
Directions
Personnel
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Date Driver Signature· (Off·Load) ·Date Print Name I
/,M tjM(It ACCOUNTING
Generator's US EPA ID No.

9. Designated Facility Name and Site Address

K-PURE WATERWORKS
8910 ROCHESTER AVE., RANCHO CUCAMONGA, CA

11. Waste Shipping Nam8 and Description
a.NON-HAZARDOU3 WASTE LIQUID (CLARIFIER)
d.

D. Additional Descriptions for Materials Listed Above
Handling Instructions and Additional Information
D .7
US EPA ID Number
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US EPA ID Number
US EPA ID Number
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APPROPRIATE PROTECTIVE GEAR. 24 HOUR PHONE (909) 598-4449 WALMART 1917

ENVIRONMENTAL SERVICES

19. Discrepancy Indication Space
A. Transporter's Phone •
C. Facility's Phone
(909) 476-2306

12. No.

E. Handling Codes for Wastes Listed Above

20. Facility Owner or Operator: Certification of receipt of waste materials covered by this manifest except as noted in Item 19.

ORIGINAL ·RETURN TO GENERA TOR
. ct?C7(? .
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Net Ton1: --'-"-,--
x240 ·--· gallon•
KPUR·I02 (Rev. 9/05) .· , ..
61489
61449
61448
61447
61450
61446
DRIVER

ESTIMATE
1000
200
200
200
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. 13.2.:2.. tt_f
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uiuoad Time Out: '. : ..:.:,, :-. ,":, ·---.. ,·, ... ' .. _ -. '•·. in: V • 2i) " .. . , . '
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T r:ansac ti on · 1 vkiSht. 72120 lb
·' ..

Date .. ··· .. ·.
·Inbound Tilite-Oii34 ·pw · ·
··outbound Time;03:57 P!1
Truck-If 13-2.500·' · · ·
·Transaction . · 1
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STATE
EPAt CARQ00053405
STATE ID t 1045 '
. \! ' .. ;-_.
am¥ 1 DOT 465272 · . · · .

ISLAND ENVIRONMENTAL SERVICES, INC. . • Waste Man(:igement & _Transportation ••\ 2490 W. JI9MONA BLVD. o POMONA, CALIFORNIA 91768 o (800) 400-4347 o (909) 598-4449 o FAX (909) 598-0041 / "' .... ''·
.JC?t?:$jte ,,;,,,, WAL-MART #1917 • SANTEE
Acldre_ss · •--"-1 70 TOWN CENTER PKWY.
' ·' . _._. ·.. · 'SANTEE ' Stale ; . CA 92071-
Phone. 6194498215
!:lours ....
_EP.A,IQ.# CAL000111207
P.Q # ... -: ....

Sal!jsrnan ·· TIM BOYER
BIU To .. , .• . _.
·--·· ·•- > :.,.. Terms: .-.. Net 30
. ..j!":!fl
Job Qescription SIX GOING TO IMp
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Equipl);l_ent Needed .
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!_:;ustorn_er _IL. ,._,W1917 /
Order,Date_, .· .• >1210112006 .
.Driver .• fft!o'!r:: Sh.v;,S
_Appointment Date 12/05/2006
Facility WATERWORKS
8910 ROCHESTER AVE .. RANCHO CUCAMONGA
<i;'i ,. ;
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_Time
CA 91730-
Appl. Time: To ____ Scheduled with _____ _
EPA ID # · 010108
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ACCOUNTING

1. Generator's US EPA 10 No. Manifest
C A L 0 0 0 1 1 1 2 0 l&<o&•t!l 1'-14·
449-8215
S. Transporter 1 Company Name

ISLAND ENVIRONMENTAL SERVICES

7. Transporter 2 Company Name

9. Designated Facility Name and Site Address

K-PURE WATERWORKS
8910 ROCHESTER AVE.,
RANCHO CUCAMONGA, CA 91730

11. Waste Shipping Nome and Description
US EPA ID Number
US EPA ID Number
A R 0 0 0 1 6 3 0 9 7
0 Non
d.

D. Additional Descriptions for Materials Listed Above

15. Special Handling Instructions and Additional information ·.;;,.) APP# 51909
WEAR APPROPRIATE GEAR. W0#66043

19. Discrepancy Indication Space
A. Transporter's Phone
qnq-.o;qR-444Q
B. Transporter's Phone
C. Facility's Phone
909-476-2308
E. Handling Codes for Wastes listed Above

20. Facility Owner or Operator: Certification of receipt of waste· materials cover8d by this manifest exc;ept as noted in 19.

ORIGINAL· RETURN TO GENERATOR
66043
66036
66037
66039
66031
66032
66040

SAN DIEGO COUNTY

DEPARTMENT OF ENVIRONMENTAL HEALTH-CUPA

HAZARDOUS MA TERJALS DIVISION
PERMIT#: 3d..J.,_7
09 P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619)338-2222 FAX (619)338-2377
l-800-253-9933

HAZARDOUS MATERIALS BUSINESS PLAN

CERTIFICATION STATEMENT
The Califomia Health & Safety Code (H&SC), Division 20. Chapter 6.95. Section 25505 provides for the following The San Diego County, Department ofEnvironmental Health, Hazardous Materials Division (HMD), as the administering agency, requires a business that handles hazardous materials to submit the hazardous materials inventory, a list of emergency contacts, and a site plan, in lieu of a complete Hazardous Materials Business Plan (HMBP), only after the initial submillal of a complete HMBP. The business must certity that a complete HMBP has been prepared and is maintained at the site where the hazardous materials are stored.

A complete HMBP includes the items to be submitted to the HMD and an Emergency Response Plan and Employee Training Plan, as established in H&SC Section 25504. The business must also annually certify that the HMBP is current and maintained on site. See Back for instructions and further clarification.
3 CA
one ofthe
•
0 INITIAL CERTIFICATION: This is to certify (H&SC Section 25505(e)(l)) that a complete HMBP, which includes the hazardous materials inventory, a list of emergency contacts, a site plan, emergency response plan, and employee training plan, has been prepared and is maintained at the site where the hazardous materials are stored.

ANNUAL CERTIFICATION: This is an annual certification (H&SC Section 25505(d)&(e)(2)) tbattbe HMBP, wbirh includes the hazardous inventory, a list of emergency contatts, a site plan, emergency response plan, and employee training plan, is cui 1 ent and includes all the information required in H&SC Section 25504, and and is maintained at the site whert the hazardous msterials are stored Attached are changes to the hazardous materials inventory and/or list of emergency contacts. For site map revisions, submit only the pages that have a change or revision and attach to this certification .. 0 CERTIFICATION OF CHANGES/REVISIONS: This is to certiJY that tbe HMBP bas beea reviewed (H&SC Section 25505(<) & 25510) and aU necessary changes/revisions bave been made. Tbe HMBP is current and is maintained at tbe site where tbe banrdous materials are stored .. Attached are changes to the hazardous materials inventory udlor Jist of emergency contacts. For site map revisions, submit only the p.agcs tbat have a change or revision and attarh to this certification.

AS AN AUTHORIZED REPRESENTATIVE. I CERTIFY UNDER THE PENALTY OF LAW, THAT I HAVE

PERSONALLY EXAMINED AND AM FAMIUAR WITH THE INFORMATION AND BELIEVE

IDRTSITE
FIRE DIST .. __
IS ACCURATE, AND COMPLETE.

HMBP ACCEI'I ED :. _ ___,/ _ ___,/ __
BY:. _____________________________ ___
Emergency Response Plan
[] Employee Training
Site Map
104/02) NrR ni'{trihntinn· Whit!';- HMr)o Vt'JIOW - RmtiM Revised: 12/6/2006 lof9
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SAN DIEGO COUNTY

DEPARTMENT OF ENVIRONMENTAL HEALTH- CUPA

HAZARDOUS MATERIALS DIVISION
P.O. BOX 129261, SAN DIEGO, CA 92112-9261
(619) 338-2222 FAX (619) 338-2377
1-800-253-9933

BUSINESS OWNER/OPERA TOR IDENTIFICATION

BEGINNING DATE
702 Southwest 8th Street

ENDING DATE
2of9
·I
manatt
manatt 1 phelps 1 phillips
May 15,2007

VIA FEDERAL EXPRESS AND EMAIL
Mr. John Misleh
Hazardous Materials Division
Department of Environmental Health
County of San Diego
520 I Ruffin Road, Suite C
San Diego, CA 92123
Craig A. Moyer
Manatt, Phelps & Phillips, LLP
Direct Dial: (310) 312-4353
E-mail: [email protected]
Client-Mancr: 24583-046
m1 MAY 1 7 2007 I!J
ENVIRONMENTAL HE'.AL TH
. Re: Used OiJ/Petroleum Storage Tanks at Wal-Mart Tire and Lube Facilities
Dear Mr. Misleh:

Manatt, Phelps & Phillips, LLP represents Wal-Mart Stores, Inc. ("Wal-Mart") in connection with the County of San Diego Department of Environmental Health Hazardous Material Division's (the "County'') March 20, 2007 inspection of the belowgrade vaulted tanks located at three Wai-Mart stores in the County of San Diego. This letter responds to your letter of March 27, 2007 which addressed a number of issues relative to the status of the new and used oil tanks and whether the sump waste produced at Wai-Mart's tire and lube ("TLE") facilities is properly classified as non-hazardous waste (the "March 27th Letter''). This letter responds to each of those issues in turn.

I. Classification of Bel.ow;-Grade Vaulted Tanks as Exempt USTs As you know, Wai-Mart submitted a letter to the County dated October 6, 2006 indicating that the below-grade vaulted tanks located at the eight San Diego Wal-Mart stores were eligible for an exemption to the underground storage tank ("UST") requirements under California Health & Safety Code Section 25283.5. Wal-Mart later supplemented this letter with photographs and diagrams depicting the tanks. The County informed Wal-Mart that the tanks would need to be inspected before any exemptions could be issued. On March 20, 2007, the County inspected the tanks at three of the eight TLE facilities.
11355 West Olympic Boulevard, Los Angeles, California 90064-1614 Telephone: 310.312.4000 Fax: 310.312.4224 Albany I Los Angeles I New York I Orange County I Palo Alto I Sacramento I Washington, D.C. manatt
manattl phelps I phillips
Mr. John Misleh
May 15,2007
Page2
The March 27th letter indicated that a number of the below-grade vaulted t,anks needed to be re-positioned in order to qualify for the exemption. The letter further suggested that Wal-Mart submit a voluntary plan to the County before the tanks are physically moved in order to ensure that new tank positions satisfy the County'.s interpretation of the exemption criteria.

Wal-Mart is currently preparing architectural drawings that depict the new locations of the tanks at all eight TLE locations. The tanks will be re-positioned according to the instructions you provided Tim Buckley (Wal-Mart's District Manager) during the March 2007 inspection. As we discussed, however, the 800-gallon used oil tank at the Murphy Canyon Road location (store #2177) cannot be moved more than six inches from the wall. You indicated during a conversation on April 10, 2007 that, given the physical challenges involved, positioning this tank six inches from the wall would be sufficient to qualify for the exemption. As you instructed, we will make sure that the store cleans the area behind the tank to enhance visibility during the inspection. As soon as the architectural drawings are completed, Wal-Mart will submit the plans along with the County's consultation forms for your review. We understand that after approving the architectural drawings, the County will conduct a final inspection of each store before issuing the exemptions.

II. Classification of Floor Sump Waste as Hazardous or Non-Hazardous In your letter, you express concern that the waste that is collected in the floor sumps might be hazardous. As you requested, we have enclosed records regarding waste classification information for these wastes. These records were provided to us by Island Environmental, the contractor that hauls the waste from the eight TLE locations approximately every six months. These records include non-hazardous waste manifests, profiles, and analytical results from periodic testing over a multi-year period.

Our review of the enclosed records indicates that the floor sump waste should not be classified as a hazardous waste under the Department of Toxic Substances Control regulations codified at Title 22 of the California Code of Regulations ("Title 22 regulations"). Chapter 11 of the Title 22 regulations defmes what is a hazardous waste.

Under Section 66261.3, a hazardous waste can include (1) wastes exhibiting certain hazardous characteristics identified in article 3 of chapter 11; (2) wastes listed in Article 4 and Article 4.1 of chapter 11 that have not been excluded by the U.S. EPA Administrator; (3) wastes that are listed in, or contain a constituent in Appendix X of Chapter 11 (except c._ _______ ···--- ....
:
,I . !
manatt
manattl phelps 1 phillips
Mr. John Misleh
May 15,2007
Page3
for when these wastes are known to not have hazardous characteristics under Article 3, or have been tested and do not show such characteristics); or (4) certain mixtures of wastes that are not relevant here. 22 Cal. Code Regs. § 66261.3(a).

The floor sump waste does not exhibit any of the characteristics defmed in Article 3 of Chapter 11 and is not listed under Articles 4 or 4.1. Thus, the floor sump waste should not be considered to be a hazardous waste. As the enclosed records indicate, the floor sump waste has been evaluated by at least two laboratories certified by the California Department of Health Services. The analyses performed by Enviro-Chem in March 2004 and September 2005 are the most detailed. Both tests show that the floor sump waste is less than one tenth of one percent Total Recovered Petroleum Hydrocarbons (EPA Method 418.1) or "oiVgrease" (EPA Method 413.1). In addition, the testing conftnns that the floor sump waste fails to meet any of the hazardous waste criteria, in that it is not ignitable (22 Cal. Code Regs. §66261.21), corrosive (22 Cal.

Code Regs. §66261.22), reactive (22 Cal. Code Regs. §66261.23), or toxic (22 Cal. Code Regs. §66261.24). In the last category of toxicity, which is the primary concern when considering oil and water mixtures (see, for example, Appendix X of Chapter 11), the testing shows that the floor sump waste did not exceed any Total Threshold Limit Concentration or regulatory level of any contaminant for which it was tested, and the waste also easily passed the fish bioassay test.

The fact that this waste has been accepted at non-hazardous recycling facilities (as documented in the enclosed records) is further strong evidence that the floor sump waste is not hazardous. The recycling facilities to which Island Environmental brings the waste routinely sample the waste to conftrm that the waste they accept is not hazardous. In 12 years of business, Island Environmental has never had a load of this type of waste rejected for being hazardous.

III. Classification of Floor Sumps as USTs
You also express concern that the floor sumps in the TLE bays may themselves constitute USTs. Regarding the floor sumps at the Poway and Murphy Canyon Road locations, you state that "[i]fthese floor sumps ever contained a hazardous substance then they may meet the definition of a UST and require registration and an operating permit from HMD to operate these underground sumps." In support of this statement, you cite the definition of "hazardous waste" and the UST permitting requirement at Cal. Health and Safety Code Sections 2528l(h) and 25284.
• !
!
manatt
manatt 1 phelps 1 phillips
Mr. John Misleh
May 15,2007
Page4
However, Wal-Mart believes that the definition of "underground storage tank" in Cal. Health and Safety Code Section 25281(y)(1) specifically exempts these sumps from treatment as USTs. Section 25281 (y)(1) states in relevant part:
(y) (1) "Underground storage tank" means any one or combination of tanks, including pipes connected thereto, that is used for the storage of hazardous substances and that is substantially or totally beneath the surface of the ground. "Underground storage tank" does not include any of the following:
***
(C) Structures, such as sumps, separators, storm drains, catch basins, oil field gathering lines, refinery pipelines, lagoons, evaporation ponds, well cellars, separation sumps, lined and unlined pits, sumps and lagoons. A sump that is a part of a monitoring system required under Section 25290.1, 25290.2, 25291, or 25292 and sumps or other structures defined as underground storage tanks under the federal act [Solid Waste Disposal Act] are not exempted by this subparagraph.
(emphasis added). Wal-Mart believes these floor sumps constitute "sumps" within this statutory exemption. The sumps collect wastewater from the trench drains prior to pumping this wastewater to the clarifier as part of the wastewater treatment system discharging to the sanitary sewer. The sumps are thus a component of the facility's wastewater treatment system. In addition, none of the conditions in subparagraph (C) that otherwise might preclude the exemption apply. The sumps at issue here are not part of a monitoring system that would be required under Health and Safety Code Sections 25290.1, 25290.2, 25291, or 25292. Moreover, the sumps are not defined as underground storage tanks under the federal Solid Waste Disposal Act because they do not collect "regulated substances" and they fall within an exemption in the statutory definition (in subparagraph (I)) which excludes tanks in underground areas that are situated upon or above the surface of the floor. 42 U.S.C. § 6991 (1 0). 1 1 The federal Solid Waste Disposal Act defmes "underground storage tank'' as:
...
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./
manatt
manatt I phelps 1 phillips
Mr. John Misleh
May 15,2007