HomeMy WebLinkAboutPIP 95-02; Dominie Press; Planned Industrial Permit (PIP) (11)s "
HAZARDOUS h4ATElRIALs
MANAGEMENT DMSTON
SAN DIEGO REGIONAL
HAZARDOUS MATERIALS QUESTIONNAIRE A1BrouBllolyEgyTLartrnrc:
COUHTY Of SAM DIE61
SAW€" A5 MOVE . "" p;RT I: FIRE DEPARTMENT - HAZARDOUS MATERIALS MAt:.~-G~~.:Ml DIVISION: OCCUPANCY CLASSIFICATION
Indicate by circling the item. whether your business will use. procoas, or store any of the following hazardous meterials. If any of the items ma ctrcled. applicant must contact the firs Protection Agency with jurisdiction prior to plan subminal.
1. Explosive or Blazing Agents 4. Flammable Solids '. 7. Pyrophorics 10. CryOgeNcs 13. Corrosives 2. Compressed Gases 3. Flammable or Combustible Liquids 6. Oxidizers .. 5. Organic Peroxides . 8. un~uble R~actives 11 Highly Toxic or Toxic Materials 14. Other Health Hazards 9. Water Reactives 12. Radioactives
PART I!: COUNTY OF SAN DIEGO HF 4LTH DEPARTMENT - HAZARDOUS MATERIALS MANAGEMENT DIVISION:
CONTIGGENCY PLAN REVIEW: OFFICE USE ONLY
If the answer to any of the questions is yes, applicant must contact the County of San Diego Hazardous Materials Management Division. 1255 Imperial Avenue. 3rd floor, San Diego. CA 9218G5261. Telephone (619) 338-2222 prior to the issuance Of 0 building permit.
FEES MAY BE REQUIRED *- Initials RMPP Required
Yes No
2.0 will your business dispose of Hazardous Subnancet or Medical Waste in any amount?
1.0 3 3.0 Will your business store or handle Hazardous Substances in quantities equal to or greater then 55 gellons. 500 pounds. 200 cubic feet or carcinogenslrsproductiw toxins in any quantity?.
4.0 WII your business use an cxistinc or install an underground storage rank? " ' 5. a WIII your business store or handle Acutsly Hazardous Materials? f Date lnlrials
PAKT 111: SAN DIEGO COUNM AIR POLLUTION CONTROL DISTRICT
TeleDhone (619) 694-3307 prior to the issuance of a building permit. If the answer to any of the questions is yes. applicant must contact the Air Pollution Control District. 9150 Chesapeake Drive. San Diego. CA 9212:
1. [l fi77WiS the intended occupant install or use any of the equipment listed on the Listing of Air Pollution Control District Permit CateGories. on :T.t
2. [l r] (ANSWER ONLY IF QUESTlON 1 IS YES.) Will the subject facility be located within 1.000 feet of the outer boundary of a school (K thru i Z
lo your business fisted on the reverse side of this form7 Dace Initials RMPP Completed
I
YES NO
reverse side of this form?
as listed in the current Directory of School and Community College Districts. published by the San Diego County Office of Education and :be current California Private School Directory, compiled in accordanca with provisions of Education Code Secdon 331 907
Briefly describe nature of the intended business acnw~
BOOK QaDGtSl-bl6, 6 brS'Te16uTlOd
Name of Owner or Authorized Agent:
(LfqM.OMJ )IuGfd ' 6- Cf%2lSTIrJ& 'JccN
Signature of Owner or Authorize are under penalty of perjury that to the best of my knowledge and belief the responses made hersin a:= x-:
and correct.
Do not write below this line Date:
- .. U
FIRE DEPARTMENT OCCUPANCY CLASSIFICATION:
BY: Date:
D(M~ ROM PERMIT nLaunmms "e, con OCCWAUCI UmOMo FOR BWG Pawn IUT NOT OCCUWCY COUNTY-HMMD APCD CDUNlY HMMD APCD COUNTY-HMMD APCD
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