• DANGEROUS WASTE COMPLIANCE CHECKLIST/QUESTIONNAIRE, CHAPTER 173-303 WAC * * * -;"\ * * * -I,

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PART I: COVER INFORMATION

This part of the checklist/questionnaire is applicable to all persons who handle

dangerous waste. This cover information includes a review of the Notification Form and

confirmation of other general information necessary to maintain accurate files and

records.

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1. INSPECTOR INFORMATION

WDOE Inspector:

Inspector's Signature:

Office (circle 'one): NW

Date of THIS Inspection:

~. Date of LAST Inspection:

Other Inspectors Present:

SW C E IND

Phone #:

Name: ,Agency: ------------ Phone #:

",.

2. BUSINESS INFORMATION

Business Name

Address:

Zip Code:

_____________ EPA/State ID #:

County:

Business Location (If:

Other Than Address)

Contact Person: Phone It: --------------------
Business Representatives Present During Inspection: c

Name:

3. NOTIFICATION FORM REVIEW

Notification Form Filed: Yes

Notification Form Revisions: Yes

Title:

No

No

Date:

Date:

Date:

Date:

Phone II:'

Is the information provided in the

most recent Notification Form still

accurate? (If not, note any deficiencies in Comments, below.)

Comments:

4. ADDITIONAL INSPECTION INFORMATION

Time Inspector Entered Site:

Left Site:

Yes

No

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Were photographs taken during the inspection? Yes

No

If yes, how many?

(Note: A brief description of the pictures should be prepared and included

in the inspection report.)

Were any problems encountered regarding:

Permission to enter the site:

Permission to have access to any areas on the site:

Permission to have access to any records:

Other:

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Were samples taken during the inspection? Yes

No

If yes, where and of what were samples taken:

Were samples split with the owner/operator? Yes

No

Were chain of custody procedures follows? Yes

No

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'::H~ .' .:' .J- t
Y - Yes N Ne

'RA - Net Applicable

e - See e-nt

1. Does the generator accumulate waste on-site in containers prior

to transport?

If yes, BnSfIer quest:ions 2 t:hrougb 5 'below.

2. Is the waste transported off-site for treatment, storage or

disposal, moved to an on-site permitted storage area, recycled

on-site, or treated in containers or tanks (with regional

approval) within 90 days of generation?

If no, was a 30-day ext:ension grant:ed by Ecology?

PERSONNEL TRAINING [330]

c

3. Does the owner/operator maintain a written training plan at the

facility?

a) If yes, does t:he plan include:

1) Job title and written job description, employee name

for each dangerous waste management related position?

o

2) Description of type and amount of training for ,each

position? ...

3) Records documenting training completion?

b) Are training records for former employees kept for five

years from last date of employment?

c) Is the training program directed by a person knowledgeable

in dangerous waste handling practices?

d) Is the training relevant to the positions in which the

facility staff are employed?

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o
• e) Do facility personnel participate in an annual review of

the training provided in the program?

Y - Yes N - No

IIA - Not; Applicable

e - See eoa-nt;

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f) Is training given within 6 months of employment or within 6

months-of an employee being assigned to a new position?

g) Are new employees supervised until they complete the

training program?

h) Does the training program:

1) Teach personnel to perform their duties in a way that

ensures compliance with WAC l73-303?

2) Instruct personnel on contingency plan implementation?

3) Familiarize personnel with emergency equipment and

systems, and emergency procedures?

CONTINGENCY PLAN AND EMERGENCY PROCEDURES [350]

4. Is a contingency plan maintained at the facility?

If yes,

a) Is it a revised SPCC (or other emergency) plan?

b) Does the contingency plan include:

1) A description of actions facility personnel must take

to comply with sections 350 and 360?

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2) For off-site facilities, a description of actions to

be taken upon receipt of an unacceptable dangerous

waste shipment which presents a hazard to public

health and the environment?

3) Arrangements with local emergency response

organizations?

4) Emergency coordinators' names, phone numbers, and

-addresses?

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5) List of all emergency equipment at facility,

descriptions of equipment, and locations?

, _Y -.-'les N - No

.--'NA- Not Applicable-

- ---C --- See Coament

c

6) Evacuation plan for facility personnel?

c) Were copies of the contingency plan and revisions submitted

to local emergency organizations?

d) Is the plan current?

5. Is there an emergency coordinator on-site or on-call at all

times? [360]

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DANGEROUS WASTE INSPECTION CHECKLIST

-- Narrative Explanation Sheet --

FACILITY NAHE: _

INSPECTOR: INSPECTION DATE: _

Please indicate which Part, Section, and question number your comments

correspond to: