# r`r'1A~ GENE AL INfOF~MAT{0...Please pent or type in the unshaded areas onl y (fill to areas are...
Transcript of # r`r'1A~ GENE AL INfOF~MAT{0...Please pent or type in the unshaded areas onl y (fill to areas are...
![Page 1: # r`r'1A~ GENE AL INfOF~MAT{0...Please pent or type in the unshaded areas onl y (fill to areas are sp.'ed for elite type. I e • 12characrers;inch). S ,NVIROfVM6N A4. ; PR9TECTION](https://reader033.fdocuments.in/reader033/viewer/2022050121/5f51751ac5edc332725fa313/html5/thumbnails/1.jpg)
Please pent or type in the unshaded areas only
(fill to areas are sp .'ed for elite type. I e • 12characrers ;inch) .
S ,NVIROfVM6N A4 . ; PR9TECTION AGENC Y
4 I # r`r'1A~ GENE AL INfOF~MAT{0mv
si t yf - - .tl .
ts t Is a acility which currently resu is m ac argei
;to'wstsrs ;of .the U.S. other than those described inA or B above? (FORM 2C) " '•
Form Approved OMB No . 158- RU 175 N 'i
C.'CNCRAL IN5TRUC710NS t.CS'4a~
If ap reprinted babel has bean ~ roylded, fix
It in the` ifesignated̀'space . :f7eviavr'' tha Infiorm;
.adore carefully, J.f any of It Js Jslcotread cisn 0,through ' t nd4^ rr~the Lorrectr' to n
6ebae, a
el n^'itaf{ 4 Isb , ar3w ffiitsvfde 'alt 'tn ` the `''~ha'i'?~oc~yd''S~P~tI,'~p►eafe`'l~r'p , .
Proper . fill-inprea(s~ 1dW . It the label ,ls, fplete ~F
comp1 etee red co,,rrect, off(: iyeledj~ nott 'com
p)t8~la_'be rep •' ed i 1esi/ sV `` mp~ to offmust comP/efed`'}~e
items 1f'ho Iabef `hps~been ;jroyfded.'Fefer tothe , ructions Jor eds. " ,$d escrip-ttions lltl,'for the ¢9II uthorT ores under;"ithich1is data Is cd actey
f PQ1.LUTANVT~CHARACYSrRISTICS answer. • ,ou need to wbrnh"~ny~ler ntt appicaflonarlns~
rthePA. if yQu s ytts" to any
rnp ete A'tlip ► ~`oleermine whe ttrt
ain
1h.e i ~. .
AU io { y"o uO . ustform
this formIf yo
u djhe a sweremo' o arm.(, ion ou Hasa mot wpm any of M tormi 1(qu and answer' no if youur'actw y
` pplemenai omi'I attached 1f nswer no '. .o each Qua y ,-, x1' yn A J, 1 d
slxe uded from ermtt raqusrI ements ; see Section C of the f n fruction%See also, Section 1) of the Instructions for definitions of held-laced teens
Poww(isv '- I
U- S 4-1-O-.1 .. a w: . '~;_ `?"*$pECiPIC QUESTIONS
, 'fry ,,.. ras
Ppw w~^ SP~CIII~ QUEIONS
is No ATTAc cO
ATTACH E
1 , either axjstinp or prgvoied)B Does or Will f}ITs faciljfY (.t t i this suit ty' publicly owned treatment works h 'include p I~rsceMlatsd anllrlal faadirtg operation or
aquatic animal production faeUity which results-Which results to a discharge to watm of the'U .S. ?
pRM 2A) discharge towaten9f the U.S.? (FOAM 2B) :o at-- -'
E Does or will this facility Treat store, or dispose ofhizardouswastes ? (FORM 3 )
Do you or will you Inject at t Is facility any proauceawater or other fluids which are brought to the su rfac e
ri connection with conventional oil or natural gas pro-S_ on,'fnjecL~~ ~Id ` . 1Bnhanced (eCOyery ofl~( natufefgas,1?r 1eo lu Us for .ofege of ;tiqui d
h4'drocarbot '? ( FORM 43 ` '? • t• ~i.
rmrti PrograLlortoltdated(Read the "'GeneraI lnstruchon
e ' before startin g
STREET OR P.O . 13O X
663 CAPJi)GA i/VEI ( 1 \ 16 )
.: -- . . . :S . CITY OR TOW N
~~'I
I_)i1r1\ I AR F
. :;.1'f4,x,1 ;1 " '-, A'STR C BT .IROUTE_N9.CIR.OT,H6R,SPEC!FjC 4
TOP i~ ;J001_SEY CANYON ROAD _TI
CD A C ..~... 9 ctn 1 IC
Is t u a propo ct Ity (other than those aescrr
In A or a above.' whIch '*111 result In H dhcharge to
'waters of the U.S.7 WORM 0 1F. 'Do you 'Or jvill jioi lriject att this "facility Industrial or
municipal effluent below the lowermost stratum con.
' afning,'within, one quarter 'mile `of he well bore .
findergrouri I sources o f d r j hking water ? (FORM 4 )
H. Do you or will you inject at this facility fluids for spe-cial processes such as reining of sulfur by the Frasc h
e ~ 'r Tot Ion min fig o~, j 1ne' Jo situ embusTon 7f fosil peg thermal 1
t-11 ", _VP
" .STATE K . ZIP CODE . .A OIt IU k n o
Ywn
C.'OO E
C.STATEI D . ZIP COD E
930615
r'nMTiNtiF IN REVERS E
HDMSe00034279
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IA . NAMt
RCCKWELL INTERNATIONAL CORP OR ATIO N
T~.TUS or OPERATOR (Enter the-appropriate letterinto the answer box ; if "Other'
(specify )1r L Bt /othCr than federal or state1 P
a ri (tin ~ D -OTHR (sPec~lYl. }ty
:sRRIVATE u4 tt_ s.
-'~ ' ot:,STRET OR P,O . 6OX. •'~r .'
P I AL I I H I v
.: :r . C ITY on TOWN
EL SEGUND O
X.`EXISTINq,ENVIRONMENTAL PERMITS
(spec 'r
specify . )
G . STAT E H . ZIP COD E
CA 11 9024 5
PSO (Air Emissions from Proposed Sources)
E . OTHER (specify)
XI~1-CEEiTIFICATION (see instructions)
'i l1 NATURE OF BUSINESS (provide a brief description!
AI ROSPACE / RESE AR G il , DLVEL OP M L NT , TEST , AND MAN UFACTIIRL OF GUIDE D
MI " ,SILE PROPUL IUN UNITS, FRUPUI _`~ ION NJIT PARTS AND '-, PA LL VLHILLL PROPULSION
UNITS AND PART) . RU( KI- TDYNL ALSO iJ1SP TN THE FIELD Or LASER RL-EP1',I~II &
OLVLLOPMENT AND WATER JET PROPULSION Y`_>TI MS .
D . PHO NE
Is the name listed InItem V I I I • A 8110 thebwner?
NON O66 .' .
IX . INDIAN LAN D
Is the facility located on Indian lands
OYES N O5 2
a ara a ;.t.r.r - r~
tlli~s p~llcaUo topographicmap of he;area extending to atle8st one mile beyond property boundaries . The map must show
irle of the ci~1}~ the locationof each of its existing and pro posed intake and discharge structures, each of its hazardous waste
itt, storage , o~,isposaCfacilities; and each well where it injects fluids underground. Include all springs, : fivers and other surface
tidies in the =le a . $ee lrutrlictipns or'precise requrements .
d am farm/tar with the information submitted in this application and alldiar ne anmsonally ex('ynaerpenalty„of /aw that /have pey :of'ihose persons imrriediately responsible for obtaining the information contained in theii' rnquabased,pn my'n r itd hatr
tfofr l `believe jhat the Information is true, accurate and complete, l am aware that there are significant penalties for submitting
fonr>agtion; 7neldinp fhe possibility of fine and imprisonment.C DATE SIGNE D
A . NAME .e: OFFICIAL T12 Lf . ( type or prinff
S .R . LAFFLA MDIRECTOR, LNVIRONMI=NTAI_
r !G' . ::_S
B .. . SI G N..A T V .R .E.
HDMSe00034280
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S
DU P
B . PROCESS DESIGN CAPACITYA . PRO- FOR W
W CESS 2 . UNIT OFFICIAL mmM
W CODEOFME A
1 . AMOUNT SUREUSE W
Z
(f rY ]Z (from list aptcif5l (enter _ONL
Zabove ) code) JJ Z
v
X11 6
5 0 2 600 G 5
X T 0 3 2O E
I ET 0 4 10 T-0- -H
~n ET 0 l l
3
tl :fl . )`i It
1 0
PAGE 1 n
e un r .,<~c,, .ura, unlrForm Approved 0MB No 158-S3000.1
rr11 e 12characrersim chlEC TION AGENCY I EPA ID . NUMBE R
MENTAL PRO TtJ .S ENVIRON tt
HAZARDOUS WASTE PERMIT APPLICATION~~~ Consolidated Pecrmlts Program
I;A(
(Flits in(orrnahnn is reburrcd under Sec hnn IcC elf R (
RCRA IFOR OFFICIA L USE ONL Y
DATE RECEIVE D
(vr•m o & daxi .. .APPLICATION__APPROVED
ih y'II. FIRST OR REVISED APPLICATION facttVr
Place an " X" in the appropri ate box in A or B below (mark onewhether this is the first application you are submitting for your facilit
y
box only ) to indicate s
application and you already know your facility's EPA I .D . Number, or if this is a revised applic von, enter you r
revlsecl application . If this is your first app
EPA I .D . Number in Item I above .- (i`m ;rl~'L' Item h
lace an 'X •' below and Provuta the ar, rim wte date )
A FIRST APPLICATION (p
---
L`i .for delu :lfiort of ' ,'sl .;Irrlt,• far iii
.,- J~NL`° I ACILITVFOR NEW F ACILITI
- ],IL, E%lSTING FACILITY I5/ torts E THE DAI LI D
Lo-rnpu
c(e ittrnbe•l,rn• PRO
Vt., :ma d day OPERA
7, ., .4 d<.ti) Mo. oAv
N TION GAN OR 15BEOPERA ION B FA L ITIE`-: . PROVIDE THE DATE rn o
10 BLGINyq MO. OAV
» ~ 1e
(V
OPERATION BEGAN N OR THE DATE CDNSt RrJ C-TION COMMENCE E
, Q (use theboxes to the
. 11) EXPECTED
Store :
CONTAINER (barrel, drum, TANK
WASTE PIL E
SUHF ACE IMPOUNDMENT
QI Osal :
INJECTION WELLLANDFIL L
LAND APPLICATIONOCEAN DISPOSAL
SURFACE IMPOUNDMEN T
ESS
S04
D79 GALLONS OR LITER S
D80 ACRE-FEET (the volume that
would cover one acre to a
depth of one foot) ORHECTARE-METER
D81 ACRES OR HECTARESD82 GALLONS PER DAY O R
LITERS PER DA Y
083 GALLONS OR LITERS
COMMENTS
PRO- APPROPRIATE UNITS OFCESS MEASURE FOR PROCES S
- QESICN CAPACITY
Treatment
TANK
SURFACE IMPOUNDMENT
INCINERATO R
OTHER (1,6e fovph~slcu ,thermal or biulOR aI treaitment
Ilcal ,
processes not occurring in tanks .
surface impoundments or irlclner-
atom. Describe the processes in
the space provided ; Item III-C.)
Tel GALLONS PER DAY ORLITERS PER DA Y
T02 GALLONS PER DAY ORLITERS PER DA Y
T03 TONS PER HOUR O R
METRIC TONS PER HOUR ;GALLONS PER HOUR ORLITERS PER HOU R
T04 GALLONS PER DAY ORLITERS PER DAY
UNIT OFMEASUR E
UNIT OF MEASURE CODE
ACRE - FEET. A
HECTARE- METE R . . . . . . F
ACRES ; . B
HECTARES . . . . . . . . . O .
UNIT OF UNIT OF
MEASUREMEASURE
CODE UNIT OF MEASURE ___ CODEUNIT OF MEASU R E
GALLONS . . . . . . . . . . . . . . G LITERS PER DAY . . . . .
L TONS PER HOUR . . . . . D
CUBI C C5YARDS .
. . . - - Y METRIC TONS PER HOUR . . . . . . W
CUB C GALLONS PER HOUR . . . . . . . . . . E
CUBIPER
DAY U LITERS PER HOURH
GALLON
S METER S
EXAMPLE FOR COMPLETING ITEM III (shown in line numbers X-1 and X-2 below) A facility has two storage tanks, one tank can hold 200 gallons and
other can hold 400 gallons . The facility also has an incinerator that can burn up to 20 y,illons per hour .
r!A
c f f
O S I G N CAPACIO R
CIALISE
NL Y
ft,/f -ru If" JS uP , u uctd for Ir e
u . . . . i ]. 7s. Tn 1]. 7n -.-
B . R VISED APPLICATION (place m,n .V'• below and complete Item I about)
1 . FACILITY HAS INTERIM STATU S
III . PROCESSES - CODES AND DESIGN CA PACITIESare rovided fo
r ess toe usee sa prrocessCwillllrbe used that
is not ncludedlIII thelist ofcodes below, thencode(s) no the space providbes t ed
. describe s
A . PROCESSS DOEfo e
le iee needed theelist Of process
mnesar , entering codesih press (including its design capacity) in the space provided on the form (Item 111-0 .
descrbe teoc
For each code enter0d in column A enter the capacity of the process .
B . PROCESS DESIGNCAPACITY - the wut of1 . AMOUNT - Enter the amount . enter the codefruln the list of unit measure codes below that d
For each amount entered in column BIl 1 ,2 . 2. UNIT OF MEASURE - units of measure that ate listed below should be used .
measure used . Ohly thePRO- APPROPRIATE UNITS O FCESS MEASURE FOR PROCES SCODE- DESIGN A_AC TY
GALLONS OR LITER S
GALLONS OR LITER SCUBIC YARDS O R
CUBIC METER S
GALLONS OR LITERS
A. PRO-CESSCODE
ont listabove)
1 ~ r
1 . AMOUR I
F 5 CONTINUE ON REVER S
HDMSe00034281
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Continued from the fron t
II I . PROCESSES (continued)ESCRIBIN G OTHER PROCESSES (eoiie'' T1-l ) FOR EACH PROCESS ENTERED HER F
ACE FOR ADDITIONAL PROCESS CODES OR FOR DSPINCLUDE DESIGN CAPACITY .
TWO AIR STRI PP I NG TOWEP. r TFP'1`J FO R
CONTAMINATED GPO iND41AILI ,
UV/PEROXIDATION SYSTE(F
GROUNDWATER
STESW AIV . DESCRIPTION OF HAZARDOUS art D for each listed hazardous waste you w11 handle . If youS u4 R p,A. EPA HAZA D U WA TE NUMBER - Enter the four-digit num er tro m
enter the four-digit number(s) from 40 CFR, Subpart C that describes the characteris-t DSub par ;handle hazardous wastes which are not listed in 40 CF-R ,tics and/or the toxic contaminants of those hazardous wastes :
ESTIMATED ANNUAL QUANTITY - For each listed waste entered in column A estimate the quantity of that waste that will be handled on an annual' the total annual quantity of all the non-listed waste(s) that will be handled
ma eAB es ibasis . For each characteristic or toxic contaminant entered in colum n
which possess that characteristic or contaminant .
C . UNIT OF MEASURE -codes are:
For each quantity entered in column B er ter the unit of measure code. Units of measure which must be used and the appropriat e
ENG11S1iU~i1L4F EylEASUR FPOUNDS . . . . P
TONS . . . . . . . . . . . . . . . . . • T
If facility records use any other unit of measure for quantity, the units o f
account the appropriate density or specific gravity of the waste .
D. PROCESSES
MEIa1G-UNIT OF tEA IRE; --- CODE
KILOGRAMS ... . . . . . . . . . . K
METRIC TONS . . . . . . . . . . . . . . . . . . . . . . M
measure must be converted into one of the required units of measure taking int o
1 . PROCESS CODES :For listed hazardous waste : For each listed hazardous waste entered in column A select the code(s) from the list of process codes contained in Item III
ili ty .to indicate how the waste will be stored , treated, and /or disposed of at the fa c
ntaminant entered in column A, select the code(s) from the list of process codestoxic cistich ooraracternon- listed hazardous wastes : For each cForcontained in Item III to indicate all the processes that willbe used to store, treat, and/or dispose of all the non-listed hazardous wastes that posses s
that characteristic or toxic contaminant .Note : Four spaces are provided for entering process codes . If more are needed : (1) Enter the first three as described above, (2) Ente
the line number and the additional code(s) .f on pa e 4i fe g ,c rextreme right box of Item IV-D(1 ) ; and (3) Enter in the space pro v
2 . PROCESS DESCRIPTION: If a code is not listed for a process that will be used, describe the process in the space provided on the form .
'000' in th e
NOTE : HAZARDOUS WASTES DESCRIBED BY MORE THAN ONE EPA HAZARDOUS WASTE NUMBER - Hazardous wastes that can he described by
the form as follows :d ib d onescr emore than one EPA Hazardous Waste Number shall b e
1 . Select one of the EPA Hazardous Waste Numbers and enter it in column A . On the same line complete columns B,C, and D by estimating the total annual
quantity of the waste and describing all the processes to be used to treat, store, and/or dispose of the waste .
2. In column A of the next line enter the other EPA Hazardous Waste Number that can be used to describe the waste, In column D(2) on that line enter
"included with above" and make no other entries on that line .
3 . Repeat step 2 for each other EPA Hazardous Waste Number that can be used to describe the hazardous waste .
EXAMPLE FOR COMPLETING ITEM IV (shown in line numbers X- 1, X-2, X-3, and X-4 below) - A facility will treat and dispose of an estimated 900 pounds
per year of chrome shavings from leather tanning and finishing operation . In addition, the facility will treat and dispose of three non -listed wastes . Two wastes
are corrosive only and there will be an estimated 200 pounds per year of each waste . The other waste is corrosive and ignitable and there will be an estimated
a nd f i l lin -l ll bdi .lew is (i usa100 pounds per year of that waste . Treatme nt will be in an incinerator an d
C . UNIT D . PROCE SSES
of MEA-W HAZAR D .I B. ESTIMATED ANNUA LZ WASTE NO` QUANTITY OF WASTE su7E I . PROCESS eoDes 2 . PROCESS DESCRIPTION
0 I Q Tenter (enter) (lie code le rot entered in DO))
J Z 1 rentercode) cod"
X- 1
X-2
X-3
X-4 1 D 0
900
400
0
100
T1 T
T03DY r)~
T O : Dr ' 0-1`l ---- r
T 0 3 1) S l)
ill( /11ii el tt itlt d/' Ir r
EPA Form 3510.3-(6.80) PAGE 2 OF 5
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Corn ued iron page 2 . t
Form Aof,0,vci OMB No . 158-S80004
rompletrno i ( yau have rlrorc than 7G v.asCes to /rLrr, N
FOR OFFICIAL USE ON07E PhoroCOPY this page Ge o
r f~ ~nr. .Irni!r l ir e
PA J . D . NUMBER icnt e
14
OF MEA-SURE(entercode)
D. PROCESSES
2 . P ROCFSS DESCRIPTION11)
(i(a rude is no t
T01 D81 D8 3T
18
B. ESTIMATED ANNUALQUANTITY OF WAST E
0 ~0 ! 31
T- T_-j I- -~ -
WI C
IV DESCRIPTION OF HAZARDOUS WASTESontinued)
C UNIT
EPA Form 3510 -3 (6-80)
I fJCI_UDr W l T'rI /A301J
I NU U )t ) A ITH ADUV E
INCLUDE) ,JITH A30V E
*ANNHl\L U Af{ I I TIY
I D TIL[ U Ni'!'1 -\f,11)UNT
f?~C, EMOVL.D .
CONTINUE ON REVERS E
HDMSe00034283
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Continued rorn the fron t
DESCRIPTION OF HAZARDOUS WASTES (continued)IV .
E . USE THIS SPACE TOLIST ADDITIONAL PROCESS CODES FROM ITEMDi I) ON PAGE 3 .
EPA I .D . from page t ))TrN I
F C Al 8 90 0 10 (;
V . FACILITY DRAWING -t include in the space provided on page 5a scale drawing of the facility (see instructions for more detail) .
uf li sties mac iAll existin g
Vi . PHOTOGRAPH S
facilities must include photographs (aerial orground-l evel) that clearly delineate all existing structures ; existing storage ,ti nAll i s gex
treatment or disposal areas (see instruct ions for more detail) .eastof f ,r gutur etreatment and disposal areas ; and sites o
FACILITY GEOGRAPHIC LOCATIONVII .LATITUDE (degrees , minutes , & seconds ) LONGITUDE ( degrees, minute s, & seconds )
3 4 1 4 05 N T 1 B 4 0 2 7 WBS Gb 6i btl 6D ] 1
VIII . FACILITY OWNE R
A If the facilityowner is also the facility operator as listed in Section VIII on Form 1, " General Information ", place an "X" in the box to the left and
skip to Section IX below .
B . If the facility owner is not the facility operator as listed In Section I I I on Furl, 1, complete the following item s
I .NAML OF FACIL tTY'S LEGAL OWNER2 PHONE NO ~ : r . n h' ,~ no 1
E A~R(iN A~_X ~-,- 1~Ifl fiPAI F AnM 1 N1`,1RA ID N---sa
3 . STREET OR P .O .BOX 4 . CITY OR TOWN 5 . ST. 6 . ZIP COD E
5 633 CANOGA AV ENU E CANOGA PARK CA- 9 1 3 0 3
IX. OWNER CERTIFICATIO Ncertify under penalty of law that l have personally examined and am familiar with the information submitted in this and 2h attachei i
documents, and that baser) on my inquiry of those individuals immediately responsible for obtaining the rnforrnattion, / beliese tI ar tn c
submitted information is true, accurate, and complete. lam aware that there are significant penalties for submitting false intirr'I W101 7
including the possibility of fine and imprisuntnent .., N
ME 0nrtni or t~t, B. 51G ATURE C DA DATE .`~I.
A NA
/Hi1Ll~C l
:'~51 /90DENNIS A . c-~
X. OPERATOR CERTIFICATION
If ce rt ify under penalty flaw that / have personally examined and am familiar with the information submitted in this .inii i// irrached
documents, and that based on my inquiry of those individuals immediately responsible for obtaining the infor ma tion / i r hare to .t ;h l' (Ii'
submitted information is true, accurate, and complete, lam aware that there ar e significant p enalties toe submitting take inter" 1
including the possibility of fine )nd imprisonment:
A . NAME (P r- ( B Si(, NA i U R E
S .R . LA I- F LA M
EPA Form 3510-3 (6-801 PAGE 4 OFCONTINUE ON PAG E
HDMSe00034284
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CortrtueU 4rorr Daa[ 4 .ro/.1.11 . H{l/J 1 .1
EPA Form 3510-3(6=80) PAGE 5 O F
HDMSe00034285