Business Name_ | _____ |
Location Address_ | _____ |
Mailing Address_ | _____ |
Business NAICS_ | _____ |
Nature of Business | |
EPA ID Number | |
(if available) | |
Environmental | |
Contact Name_ | _____ |
Title of Contact Person_ | _____ |
Mailing Address_ | _____ |
E-mail Address_ | _____ |
Phone Number | |
List of Perchlorate | |
Materials Handled:_ | _____ |
______ | |
______ | |
______ |
Has the business plan has been updated to include perchlorate-containing materials pursuant to Health and Safety Code section 25504.1? Yes or No
Check the appropriate boxes to identify if the quantity is: | |||
How much perchlorate materials... | None | Less than or equal to 500 pounds of solids or 55 gallons of liquids a year | Greater than or equal to 500 pounds of solids or 55 gallons of liquid a year |
does your business manufacture or process? | |||
does your business use to manufacture or produce a product? | |||
are used or combusted? | |||
are stored? | |||
are offered for sale or procurement? | |||
are generated as waste? | |||
are treated or recycled onsite? | |||
are treated or recycled offsite? | |||
are discharged under a permit or waiver issued by | |||
the SWRCB or a RWQCB? | |||
are sent for offsite disposal? |
Cal. Code Regs. Tit. 22, § 67384.7
Note: Authority cited: Sections 25210.6 and 58012, Health and Safety Code. Reference: Sections 25210.5, 25210.6 and 25504.1, Health and Safety Code; and Sections 14231- 14623, Food and Agricultural Code.