901226 RFP CUPA Consultation Services€¦ · Web viewEXHIBIT D – INSPECTION SAMPLE TEMPLATES STATEMENT OF WORK. INTENT. It is the intent of these specifications, terms and conditions

**IMPORTANT NOTICE**

The format of this RFP has been simplified. Only the following pages require signatures:

1. Exhibit A – Bid Response Packet, Bidder Information and Acceptance pagea. Must be signed by Bidder

2. Exhibit A – Bid Response Packet, SLEB Partnering Information Sheeta. Must be signed by Bidder b. Must be signed by SLEB Partner if subcontracting

to a SLEB

Please read EXHIBIT A – Bid Response Packet carefully, INCOMPLETE BIDS WILL BE REJECTED. Alameda County will not accept submissions or documentation after the bid response due date.

COUNTY OF ALAMEDAREQUEST FOR PROPOSAL No. 901226

for

Certified Unified Program Agency (CUPA) Consultation Services

For complete information regarding this project, see RFP posted at http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp or

contact the County representative listed below. Thank you for your interest!

Contact Person: John Butchart, Procurement & Contracts Specialist

Phone Number: (510) 208-9602

E-mail Address: [email protected]

RESPONSE DUEby

2:00 p.m.on

November 7, 2014at

Alameda County, GSA–Procurement & Support Services1401 Lakeside Drive, Suite 907

Oakland, CA 94612

Alameda County is committed to reducing environmental impacts across our entire supply chain. If printing this document, please print only what you need, print double-sided, and use recycled-content paper.

1401 Lakeside Drive, Suite 907 Oakland, CA 94612Phone: 510-208-9600 Website: http://www.acgov.org/gsa/departments/purchasing/

Revision 2014-03-25

http://www.acgov.org/gsa/departments/purchasing/

http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp

COUNTY OF ALAMEDAREQUEST FOR PROPOSAL No. 901226

SPECIFICATIONS, TERMS & CONDITIONSfor

Certified Unified Program Agency (CUPA) Consultation Services

TABLE OF CONTENTSPage

I. STATEMENT OF WORK 4A. INTENT 4B. SCOPE4C. BIDDER QUALIFICATIONS 4D. SPECIFIC REQUIREMENTS 5E. DELIVERABLES / REPORTS 6

II. CALENDAR OF EVENTS 7F. NETWORKING / BIDDERS CONFERENCES 7

III. COUNTY PROCEDURES, TERMS, AND CONDITIONS 8G. CONTRACT EVALUATION AND ASSESSMENT 13H. NOTICE OF RECOMMENDATION TO AWARD 13I. TERM / TERMINATION / RENEWAL 14J. QUANTITIES 14K. PRICING 14L. AWARD 15M. METHOD OF ORDERING 16N. INVOICING 17O. ACCOUNT MANAGER / SUPPORT STAFF 17

IV. INSTRUCTIONS TO BIDDERS 18P. COUNTY CONTACTS 18Q. SUBMITTAL OF BIDS 18R. RESPONSE FORMAT 21

ATTACHMENTS

EXHIBIT A - BID RESPONSE PACKETEXHIBIT B - INSURANCE REQUIREMENTSEXHIBIT C - VENDOR BID LISTEXHIBIT D – INSPECTION SAMPLE TEMPLATES

Specifications, Terms & Conditionsfor Certified Unified Program Agency (CUPA) Consultation Services

I. STATEMENT OF WORK

A. INTENT

It is the intent of these specifications, terms and conditions to select an approved prequalified vendor to provide technical consultation services for the Certified Unified Program Agency (CUPA) Program for the Alameda County Department of Environmental Health (ACDEH).

The County intends to award a three-year contract (with option to renew) to the bidder(s) selected as the most responsible bidder(s) whose response conforms to the RFP and meets the County’s requirements

B. SCOPE

Under the California Health & Safety Code, Chapters 6.5, 6.67, 6.91, & 6.95, are the description of the responsibilities of the Certified Unified Program Agency (CUPA) with regard to clandestine lab cleanup, California Accidental Release Program (Cal ARP), hazardous waste generators, tiered permits, and Hazardous Materials Business Plans (HMBP). Alameda County’s Environmental Health Department, in its role as the CUPA, will review plans and inspect eligible facilities under these programs. Property contamination caused by clandestine labs is remediated under the Department’s oversight as well.

The scope of services to be performed by qualified vendors will include, but may not be limited to the following:

1. Review of Cal ARP technical documentation, audit and inspection of facilities to insure compliance, and provide enforcement actions on noted violations if required; and

2. Certified Industrial Hygienist (CIH) cleanup oversight of clandestine lab site contamination, issue warning notice, notice of order and liens; review and approve work plans for methamphetamine contamination assessment and remediation; issue no further action/clearance letters.

C. BIDDER QUALIFICATIONS

Vendors participating in this Request for Proposal (RFP) must be pre-qualified by the County according to the requirements and submittals of Request for Interest Pre-Qualification (RFI P/Q) No. 901226. Qualified vendors were determined by submission

RFP No. 901226Page 4


and completion of the RFI P/Q No. 901226 Prequalification Checklist, Questionnaire, and References. Only those Vendors who qualified through the prequalification process and are deemed acceptable by the County are eligible to submit a proposal response to this RFP.

1. Bidder shall be regularly and continuously engaged in the business of providing Certified Unified Program Agency (CUPA) Consultation services for at least seven (7) years.

2. Bidder shall have experience in conducting California Accidental Release Program (Cal ARP) reviews, audits, public notifications, plan checks and inspections of Cal ARP facilities.

3. Bidder shall be a Certified Industrial Hygienist (CIH) possessing the requisite skills to make informed decisions on the future safe habitability of properties impacted by clandestine lab wastes. Properties involved in illegal production of drugs, such as methamphetamine, will require regulatory oversight to insure that environmental hazards are removed or abated.

4. Bidder shall possess all permits, licenses and professional credentials necessary to perform services as specified under this RFP.

D. SPECIFIC REQUIREMENTS

1. CAL ARPa. Conduct Cal ARP reviews, audits, public notifications, plan checks, and

inspections of all CUPA facilities;

b. Conduct Hazardous Materials Business Plans (HMBP) reviews, plan checks, and inspections of CUPA facilities;

c. Conduct Tiered Permits reviews, plan checks, and inspections of CUPA facilities;

d. Conduct follow-ups (including complaints) on CUPA facilities;

e. Conduct routine and enforcement inspections on CUPA facilities;

f. Conduct hazardous waste generator waste inspections on Large Quantity Generator (LQG) and Recyclers;

g. Review Spill Prevention Countermeasure Control (SPCC) plans;



h. Contractor to follow ACDEH CUPA inspection, compliance, and enforcement procedures as described in the sample Cal ARP reports provided in Exhibit D-Inspection Samples

2. Cleanup Oversighta. Review methamphetamine contaminated site assessments;

b. Review remediation plans for methamphetamine contaminated sites;

c. Issue liens and clean up orders and clearances on methamphetamine contaminated sites; and

d. Contractor to follow Methamphetamine Lab Cleanup Guidelines and Procedures as described in the sample methamphetamine cleanup reports provided in Exhibit D—Inspection Samples.

E. DELIVERABLES / REPORTS

5. The Cal ARP reports are to be completed after conducting an inspection.

6. The Methamphetamine cleanup reports are to be completed after letters are written to approve remediation plans, issuing liens and closure letters.

7. Inspection Report Summary/Summary of Violations and Inspection Comments are to be completed after visiting the facilities and an inspection is needed

8. Tiered Permit Inspection Checklist

9. Hazardous Waste Generator Inspection Checklist

10. Generate and submit reports, report summaries and checklists as appropriate (see Exhibit D).



II. CALENDAR OF EVENTS

EVENT DATE/LOCATIONRequest Issued September 25, 2014 Written Questions Due by 5:00 p.m. on October 15, 2014Networking/Bidders Conference #1

(Online conference option enabled for remote participation)

October 14, 2014 @ 10:00 a.m.

at: General Services Agency1401 Lakeside Drive Room 1107, 11th FloorOakland, CA 94612

OR remotely @ http://gsaalamedacounty.adobeconnect.com/admin/show-event-catalog

Networking/Bidders Conference #2 October 15, 2014 @ 2:00 p.m.

Dublin Public Library Program Room200 Civic PlazaDublin, CA 94568

Addendum Issued October 24, 2014Response Due November 7, 2014 by 2:00 p.m. Evaluation Period November 10-13, 2014Vendor Interviews November 14, 2014Board Letter Recommending Award Issued

November 26, 2014

Board Consideration Award Date

December 16, 2014

Contract Start Date December 24, 2014

Note: Award and start dates are approximate.

A. NETWORKING / BIDDERS CONFERENCES

11. The bidders conference held on October 14, 2014 will have an online conference option enabled for remote participation. Bidders can opt to participate via a computer with a stable internet connection (the recommended Bandwidth is 512Kbps) at http://gsaalamedacounty.adobeconnect.com/admin/show-event-


http://gsaalamedacounty.adobeconnect.com/admin/show-event-catalog





catalog. In order to get the best experience, the County recommends that bidders who participate remotely use equipment with audio output such as speakers, headsets, or a telephone. Bidders may also attend this conference in person.

12. Networking/bidders conferences will be held to:

a. Provide an opportunity for Small Local Emerging Businesses (SLEBs) and large firms to network and develop subcontracting relationships in order to participate in the contract(s) that may result from this RFP.

b. Provide an opportunity for bidders to ask specific questions about the project and request RFP clarification.

c. Provide bidders an opportunity to receive documents, etc. necessary to respond to this RFP.

d. Provide the County with an opportunity to receive feedback regarding the project and RFP.

13. All questions will be addressed, and the list of attendees will be included, in an RFP Addendum following the networking/bidders conference(s).

14. Potential bidders are strongly encouraged to attend networking/bidders conference(s) in order to further facilitate subcontracting relationships. Vendors who attend a networking/bidders conference will be added to the Vendor Bid List. Failure to participate in a networking/bidders conference will in no way relieve the Contractor from furnishing goods and/or services required in accordance with these specifications, terms and conditions. Attendance at a networking/bidders conference is highly recommended but is not mandatory.

III. COUNTY PROCEDURES, TERMS, AND CONDITIONS

All proposals that pass the initial Evaluation Criteria which are determined on a pass/fail basis (Completeness of Response, Financial Stability, and Debarment and Suspension) will be evaluated by a County Selection Committee (CSC). The County Selection Committee may be composed of County staff and other parties that may have expertise or experience in CUPA consultation services. The CSC will score and recommend a Contractor in accordance with the evaluation criteria set forth in this RFP. Other than the initial pass/fail Evaluation Criteria, the evaluation of the proposals shall be within the sole judgment and discretion of the CSC.

All contact during the evaluation phase shall be through the GSA–Procurement & Support Services department only. Bidders shall neither contact nor lobby evaluators




during the evaluation process. Attempts by Bidder to contact and/or influence members of the CSC may result in disqualification of Bidder.

The CSC will evaluate each proposal meeting the qualification requirements set forth in this RFP. Bidders should bear in mind that any proposal that is unrealistic in terms of the technical or schedule commitments, or unrealistically high or low in cost, will be deemed reflective of an inherent lack of technical competence or indicative of a failure to comprehend the complexity and risk of the County’s requirements as set forth in this RFP.

Bidders are advised that in the evaluation of cost it will be assumed that the unit price quoted is correct in the case of a discrepancy between the unit price and an extension.

As a result of this RFP, the County intends to award a contract to the responsible bidder(s) whose response conforms to the RFP and whose bid presents the greatest value to the County, all evaluation criteria considered. The combined weight of the evaluation criteria is greater in importance than cost in determining the greatest value to the County. The goal is to award a contract to the bidder(s) that proposes the County the best quality as determined by the combined weight of the evaluation criteria. The County may award a contract of higher qualitative competence over the lowest priced response.

The basic information that each section should contain is specified below, these specifications should be considered as minimum requirements. Much of the material needed to present a comprehensive proposal can be placed into one of the sections listed. However, other criteria may be added to further support the evaluation process whenever such additional criteria are deemed appropriate in considering the nature of the goods and/or services being solicited.

Each of the Evaluation Criteria below will be used in ranking and determining the quality of bidders’ proposals. Proposals will be evaluated according to each Evaluation Criteria, and scored on the zero to five-point scale outlined below. The scores for all Evaluation Criteria will then be added, according to their assigned weight (below), to arrive at a weighted score for each proposal. A proposal with a high weighted total will be deemed of higher quality than a proposal with a lesser-weighted total. The final maximum score for any project is five hundred fifty (550) points, including the possible fifty (50) points for local and small, local and emerging, or local preference points (maximum 10% of final score).



The zero to five-point scale range is defined as follows:

0 Not AcceptableNon-responsive, fails to meet RFP specification. The approach has no probability of success. If a mandatory requirement this score will result in disqualification of proposal.

1 PoorBelow average, falls short of expectations, is substandard to that which is the average or expected norm, has a low probability of success in achieving objectives per RFP.

2 Fair Has a reasonable probability of success, however, some objectives may not be met.

3 Average

Acceptable, achieves all objectives in a reasonable fashion per RFP specification. This will be the baseline score for each item with adjustments based on interpretation of proposal by Evaluation Committee members.

4 Above Average / Good

Very good probability of success, better than that which is average or expected as the norm. Achieves all objectives per RFP requirements and expectations.

5 Excellent / Exceptional

Exceeds expectations, very innovative, clearly superior to that which is average or expected as the norm. Excellent probability of success and in achieving all objectives and meeting RFP specification.

The Evaluation Criteria and their respective weights are as follows:

Evaluation Criteria WeightA. Completeness of Response:

Responses to this RFP must be complete. Responses that do not include the proposal content requirements identified within this RFP and subsequent Addenda and do not address each of the items listed below will be considered incomplete, be rated a Fail in the Evaluation Criteria and will receive no further consideration.

Responses that are rated a Fail and are not considered may be picked up at the delivery location within 14 calendar days of contract award and/or the completion of the competitive process. Pass/FailFinancial Stability (See Exhibit A – Bid Response Packet) Pass/FailDebarment and Suspension: Pass/Fail



Bidders, its principal and named subcontractors are not identified on the list of Federally debarred, suspended or other excluded parties located at www.sam.gov.

B. Cost:The points for Cost will be computed by dividing the amount of the lowest responsive bid received by each bidder’s total proposed cost.

While not reflected in the Cost evaluation points, an evaluation may also be made of:1. Reasonableness (i.e., does the proposed pricing

accurately reflect the bidder’s effort to meet requirements and objectives?);

2. Realism (i.e., is the proposed cost appropriate to the nature of the products and services to be provided?); and

3. Affordability (i.e., the ability of the County to finance the services.

Consideration of price in terms of overall affordability may be controlling in circumstances where two or more proposals are otherwise adjudged to be equal, or when a superior proposal is at a price that the County cannot afford. 25 Points

C. Relevant Experience:Proposals will be evaluated against the RFP specifications and the questions below:1. Do the individuals assigned to the CUPA program have

relevant experience on similar programs?2. Are résumés complete and do they demonstrate

backgrounds that would be desirable for individuals engaged in the work the CUPA program requires?

3. How extensive is the applicable education and experience of the personnel designated to work on the CUPA Program? 8 Points

D. Current or Former Inspection Reports: Current or former inspection reports listed below will be evaluated against the specifications of the RFP:

1. CAL Arp (3 points)2. Methamphetamine Cleanup (3 points) 6 Points


http://www.sam.gov/


E. References (See Exhibit A – Bid Response Packet) 10 PointsF. Overall Proposal 15 PointsG. Oral Presentation and Interview:

The oral presentation by each bidder shall not exceed sixty (60) minutes in length. The oral interview will consist of standard questions asked of each of the bidders and specific questions regarding the specific proposal. The proposals may then be re-evaluated and re-scored based on the oral presentation and interview. 10 Points

H. Understanding of the ProgramProposals will be evaluated against the RFP specifications and the questions below.

1. Has proposer demonstrated a thorough understanding of the purpose and scope of the CUPA Program?(4 points)

2. How well has the proposer identified pertinent issues and potential problems related to the CUPA program? (4 points)

3. Has the proposer demonstrated that it understands the deliverables the County expects it to provide, as related to Exhibit D of the Bid Response Packet and the summary reports required under section E, “Deliverables/Reports” of this RFP? (4 points)

12 PointsI. Methodology:

Proposal methodology will be evaluated against the RFP specifications, including the questions below:

-Does the methodology depict a logical approach to fulfilling the requirements of the RFP?-Does the methodology match and contribute to achieving the objectives set out in the RFP?

1. CAL ARP (7 points)2. Cleanup Oversight (7 points)

14 points

SMALL LOCAL EMERGING BUSINESS PREFERENCE

Local Preference: Points equaling five percent (5%) of Five Percent (5%)



bidder’s total score, for the above Evaluation Criteria, will be added. This will be the bidder’s final score for purposes of award evaluation.Small and Local or Emerging and Local Preference: Points equaling five percent (5%) of bidder’s total score, for the above Evaluation Criteria, will be added. This will be the bidder’s final score for purposes of award evaluation. Five Percent (5%)

A. CONTRACT EVALUATION AND ASSESSMENT

During the initial sixty (60) day period of any contract, which may be awarded to Contractor, the CSC and/or other persons designated by the County will meet with the Contractor to evaluate services performance and to identify any issues or potential problems.

The County reserves the right to determine, at its sole discretion, whether:

15. Contractor has complied with all terms of this RFP; and

16. Any problems or potential problems with the proposed services were evidenced which make it unlikely (even with possible modifications) that such or services have met the County requirements.

If, as a result of such determination, the County concludes that it is not satisfied with Contractor, Contractor’s performance under any awarded contract and/or Contractor’s services as contracted for therein, the Contractor will be notified of contract termination effective forty-five (45) days following notice. Contractor shall be responsible for the removal of equipment/system and shall return County facilities to their pre-installation or original at no charge to the County. The County will have the right to invite the next highest ranked bidder to enter into a contract. The County also reserves the right to re-bid this project if it is determined to be in its best interest to do so.

B. NOTICE OF RECOMMENDATION TO AWARD

17. At the conclusion of the RFP response evaluation process (“Evaluation Process”), all bidders will be notified in writing by e-mail or fax, and certified mail, of the contract award recommendation, if any, by GSA – Procurement & Support Services. The document providing this notification is the Notice of Recommendation to Award.

The Notice of Recommendation to Award will provide the following information:



a. The name of the bidder being recommended for contract award; and

b. The names of all other parties that submitted proposals.

18. At the conclusion of the RFP response evaluation process, debriefings for unsuccessful bidders will be scheduled and provided upon written request and will be restricted to discussion of the unsuccessful offeror’s bid.

a. Under no circumstances will any discussion be conducted with regard to contract negotiations with the successful bidder.

b. Debriefing may include review of successful bidder’s proposal with redactions as appropriate.

19. The submitted proposals shall be made available upon request no later than five (5) calendar days before approval of the award and contract is scheduled to be heard by the Board of Supervisors.

C. TERM / TERMINATION / RENEWAL

20. The term of the contract, which may be awarded pursuant to this RFP, will be three (3) years.

21. By mutual agreement, any contract which may be awarded pursuant to this RFP, may be extended for an additional two-year term at agreed prices with all other terms and conditions remaining the same.

D. QUANTITIES

Quantities listed herein are annual estimates based on past usage and are not to be construed as a commitment. No minimum or maximum is guaranteed or implied.

E. PRICING

22. All pricing as quoted will remain firm for the term of any contract that may be awarded as a result of this RFP.

23. Unless otherwise stated, Bidder agrees that, in the event of a price decline, the benefit of such lower price shall be extended to the County.

24. Any price increases or decreases for subsequent contract terms may be negotiated between Contractor and County only after completion of the initial term.



25. All prices quoted shall be in United States dollars and "whole cent," no cent fractions shall be used. There are no exceptions.

26. Price quotes shall include any and all payment incentives available to the County.

27. Bidders are advised that in the evaluation of cost, if applicable, it will be assumed that the unit price quoted is correct in the case of a discrepancy between the unit price and an extension.

28. Federal and State minimum wage laws apply. The County has no requirements for living wages. The County is not imposing any additional requirements regarding wages.

F. AWARD

29. Proposals will be evaluated by a committee and will be ranked in accordance with the RFP section entitled “Evaluation Criteria/Selection Committee.”

30. The committee will recommend award to the bidder who, in its opinion, has submitted the proposal that best serves the overall interests of the County and attains the highest overall point score. Award may not necessarily be made to the bidder with the lowest price.

31. Small and Emerging Locally Owned Business: The County is vitally interested in promoting the growth of small and emerging local businesses by means of increasing the participation of these businesses in the County’s purchase of goods and services.

As a result of the County’s commitment to advance the economic opportunities of these businesses, Bidders must meet the County’s Small and Emerging Locally Owned Business requirements in order to be considered for the contract award. These requirements can be found online at:

http://acgov.org/auditor/sleb/overview.htm

For purposes of this bid, applicable industries include, but are not limited to, the following NAICS Code: 541620.

A small business is defined by the United States Small Business Administration (SBA) as having no more than the number of employees or average annual gross receipts over the last three (3) years required per SBA standards based on the small business's appropriate NAICS code.


http://www.sba.gov/



An emerging business is defined by the County as having either annual gross receipts of less than one-half (1/2) that of a small business OR having less than one-half (1/2) the number of employees AND that has been in business less than five (5) years.

32. The County reserves the right to reject any or all responses that materially differ from any terms contained in this RFP or from any Exhibits attached hereto, to waive informalities and minor irregularities in responses received, and to provide an opportunity for bidders to correct minor and immaterial errors contained in their submissions. The decision as to what constitutes a minor irregularity shall be made solely at the discretion of the County.

33. The County reserves the right to award to a single or multiple Contractors.

34. The County has the right to decline to award this contract or any part thereof for any reason.

35. Board approval to award a contract is required.

36. A contract must be negotiated, finalized, and signed by the recommended awardee prior to Board approval.

37. Final Standard Agreement terms and conditions will be negotiated with the selected bidder. Bidder may access a copy of the Standard Services Agreement template can be found online at:

http://www.acgov.org/gsa/purchasing/standardServicesAgreement.pdf

The template contains minimal Agreement boilerplate language only.

G. METHOD OF ORDERING

38. A written PO and signed Standard Agreement contract will be issued upon Board approval.

39. POs and Standard Agreements will be faxed, transmitted electronically or mailed and shall be the only authorization for the Contractor to place an order.

40. POs and payments for products and/or services will be issued only in the name of Contractor.

41. Contractor shall adapt to changes to the method of ordering procedures as required by the County during the term of the contract.


http://www.acgov.org/gsa/purchasing/standardServicesAgreement.pdf


42. Change orders shall be agreed upon by Contractor and County and issued as needed in writing by County.

H. INVOICING

43. Contractor shall invoice the requesting department, unless otherwise advised, upon satisfactory receipt of product and/or performance of services.

44. County will use best efforts to make payment within thirty (30) days following receipt and review of invoice and upon complete satisfactory receipt of product and performance of services.

45. County shall notify Contractor of any adjustments required to invoice.

46. Invoices shall contain County PO number, invoice number, remit to address and itemized products and/or services description and price as quoted and shall be accompanied by acceptable proof of delivery.

47. Contractor shall utilize standardized invoice upon request.

48. Invoices shall only be issued by the Contractor who is awarded a contract.

49. Payments will be issued to and invoices must be received from the same Contractor whose name is specified on the POs.

50. The County will pay Contractor monthly or as agreed upon, not to exceed the total RFP quoted in the bid response.

51. Contractor shall invoice the requesting department, unless otherwise advised, upon satisfactory receipt of product and/or performance of services.

I. ACCOUNT MANAGER / SUPPORT STAFF

52. Contractor shall provide a dedicated competent account manager who shall be responsible for the County account/contract. The account manager shall receive all orders from the County and shall be the primary contact for all issues regarding Bidder’s response to this RFP and any contract which may arise pursuant to this RFP.

53. Contractor shall also provide adequate, competent support staff that shall be able to service the County during normal working hours, Monday through Friday. Such representative(s) shall be knowledgeable about the contract, products offered and able to identify and resolve quickly any issues including but not limited to order and invoicing problems.



54. Contractor account manager shall be familiar with County requirements and standards and work with the Environmental Health Services Agency to ensure that established standards are adhered to.

55. Contractor account manager shall keep the County Specialist informed of requests from departments as required.

IV. INSTRUCTIONS TO BIDDERS

A. COUNTY CONTACTS

GSA–Procurement & Support Services is managing the competitive process for this project on behalf of the County. All contact during the competitive process is to be through the GSA– Procurement & Support Services department only.

The evaluation phase of the competitive process shall begin upon receipt of sealed bids until a contract has been awarded. Bidders shall not contact or lobby evaluators during the evaluation process. Attempts by Bidder to contact evaluators may result in disqualification of bidder.

All questions regarding these specifications, terms and conditions are to be submitted in writing, preferably via e-mail by 5:00 p.m. on October 2, 2014.

John Butchart, Procurement & Contracts SpecialistAlameda County, GSA– Procurement & Support Services1401 Lakeside Drive, Suite 907Oakland, CA 94612E-Mail: [email protected]: (510) 208-9602

The GSA Contracting Opportunities website will be the official notification posting place of all Requests for Interest, Proposals, Quotes and Addenda. Go to http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp to view current contracting opportunities.

B. SUBMITTAL OF BIDS

56. All bids must be SEALED and must be received at the Office of the Purchasing Agent of Alameda County BY 2:00 p.m. on the due date specified in the Calendar of Events.

NOTE: LATE AND/OR UNSEALED BIDS CANNOT BE ACCEPTED. IF HAND DELIVERING BIDS PLEASE ALLOW TIME FOR METERED STREET PARKING OR PARKING IN AREA PUBLIC PARKING LOTS AND ENTRY INTO SECURE BUILDING.


http://www.acgov.org/gsa_app/gsa/purchasing/bid_content/contractopportunities.jsp


Bids will be received only at the address shown below, and by the time indicated in the Calendar of Events. Any bid received after said time and/or date or at a place other than the stated address cannot be considered and will be returned to the bidder unopened.

All bids, whether delivered by an employee of Bidder, U.S. Postal Service, courier or package delivery service, must be received and time stamped at the stated address prior to the time designated. The Procurement & Support Services department's timestamp shall be considered the official timepiece for the purpose of establishing the actual receipt of bids.

57. Bids are to be addressed and delivered as follows:

Certified Unified Program Agency (CUPA) Consultation ServicesRFP No. 901226Alameda County, GSA– Procurement & Support Services1401 Lakeside Drive, Suite 907 *Oakland, CA 94612

Bidder's name, return address, and the RFP number and title must also appear on the mailing package.

*PLEASE NOTE that on the bid due date, a bid reception desk will be open between 1:00 p.m. – 2:00 p.m. and will be located in the 1st floor lobby at 1401 Lakeside Drive.

58. Bidders are to submit one (1) original hardcopy bid (Exhibit A – Bid Response Packet, including additional required documentation), with original ink signatures, plus five copies of their proposal. Original proposal is to be clearly marked “ORIGINAL” with copies to be marked “COPY”. All submittals should be printed on plain white paper, and must be either loose leaf or in a 3-ring binder (NOT bound). It is preferred that all proposals submitted shall be printed double-sided and on minimum 30% post-consumer recycled content paper. Inability to comply with the 30% post-consumer recycled content recommendation will have no impact on the evaluation and scoring of the proposal.

Bidders must also submit an electronic copy of their proposal. The electronic copy must be in a single file (PDF with OCR preferred), and shall be an exact scanned image of the original hard copy Exhibit A – Bid Response Packet, including additional required documentation. The file must be on disk or USB flash drive and enclosed with the sealed original hardcopy of the bid.



59. BIDDERS SHALL NOT MODIFY BID FORM(S) OR QUALIFY THEIR BIDS. BIDDERS SHALL NOT SUBMIT TO THE COUNTY A SCANNED, RE-TYPED, WORD-PROCESSED, OR OTHERWISE RECREATED VERSION OF THE BID FORM(S) OR ANY OTHER COUNTY-PROVIDED DOCUMENT.

60. No email (electronic) or facsimile bids will be considered.

61. All costs required for the preparation and submission of a bid shall be borne by Bidder.

62. Only one bid response will be accepted from any one person, partnership, corporation, or other entity; however, several alternatives may be included in one response. For purposes of this requirement, “partnership” shall mean, and is limited to, a legal partnership formed under one or more of the provisions of the California or other state’s Corporations Code or an equivalent statute.

63. All other information regarding the bid responses will be held as confidential until such time as the County Selection Committee has completed its evaluation, an recommended award has been made by the County Selection Committee, and the contract has been fully negotiated with the recommended awardee named in the recommendation to award/non-award notification(s). The submitted proposals shall be made available upon request no later than five (5) calendar days before the recommendation to award and enter into contract is scheduled to be heard by the Board of Supervisors. All parties submitting proposals, either qualified or unqualified, will receive mailed recommendation to award/non-award notification(s), which will include the name of the bidder to be recommended for award of this project. In addition, award information will be posted on the County’s “Contracting Opportunities” website, mentioned above.

64. Each bid received, with the name of the bidder, shall be entered on a record, and each record with the successful bid indicated thereon shall, after the award of the order or contract, be open to public inspection.

65. California Government Code Section 4552: In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2, commencing with Section 16700, of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder.



66. Bidder expressly acknowledges that it is aware that if a false claim is knowingly submitted (as the terms “claim” and “knowingly” are defined in the California False Claims Act, Cal. Gov. Code, §12650 et seq.), County will be entitled to civil remedies set forth in the California False Claim Act. It may also be considered fraud and the Contractor may be subject to criminal prosecution.

67. The undersigned Bidder certifies that it is, at the time of bidding, and shall be throughout the period of the contract, licensed by the State of California to do the type of work required under the terms of the Contract Documents. Bidder further certifies that it is regularly engaged in the general class and type of work called for in the Bid Documents.

68. The undersigned Bidder certifies that it is not, at the time of bidding, on the California Department of General Services (DGS) list of persons determined to be engaged in investment activities in Iran or otherwise in violation of the Iran Contracting Act of 2010 (Public Contract Code Section 2200-2208).

69. It is understood that County reserves the right to reject this bid and that the bid shall remain open to acceptance and is irrevocable for a period of one hundred eighty (180) days, unless otherwise specified in the Bid Documents.

C. RESPONSE FORMAT

70. Bid responses are to be straightforward, clear, concise and specific to the information requested.

71. In order for bids to be considered complete, Bidder must provide responses to all information requested. See Exhibit A – Bid Response Packet.

72. Bid responses, in whole or in part, are NOT to be marked confidential or proprietary. County may refuse to consider any bid response or part thereof so marked. Bid responses submitted in response to this RFP may be subject to public disclosure. County shall not be liable in any way for disclosure of any such records. Please refer to the County’s website at: http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm for more information regarding Proprietary and Confidential Information policies.


http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm

EXHIBIT ABID RESPONSE PACKET

RFP No. 901226 – Certified Unified Program Agency (CUPA) Consultation Services

To: The County of Alameda

From: (Official Name of Bidder)

AS DESCRIBED IN THE SUBMITTAL OF BIDS SECTION OF THIS RFP, BIDDERS ARE TO SUBMIT ONE (1) ORIGINAL HARDCOPY BID (EXHIBIT A – BID RESPONSE PACKET), INCLUDING ADDITIONAL REQUIRED DOCUMENTATION), WITH ORIGINAL INK SIGNATURES, PLUS FIVE (5) COPIES AND ONE (1) ELECTRONIC COPY OF THE BID IN PDF (with OCR preferred)

ALL PAGES OF THE BID RESPONSE PACKET (EXHIBIT A) MUST BE SUBMITTED IN TOTAL WITH ALL REQUIRED DOCUMENTS ATTACHED THERETO; ALL INFORMATION REQUESTED MUST BE SUPPLIED; ANY PAGES OF EXHIBIT A (OR ITEMS THEREIN) NOT APPLICABLE TO THE BIDDER MUST STILL BE SUBMITTED AS PART OF A COMPLETE BID RESPONSE, WITH SUCH PAGES OR ITEMS CLEARLY MARKED “N/A”

BIDDERS SHALL NOT SUBMIT TO THE COUNTY A RE-TYPED, WORD-PROCESSED, OR OTHERWISE RECREATED VERSION OF EXHIBIT A – BID RESPONSE PACKET OR ANY OTHER COUNTY-PROVIDED DOCUMENT

ALL PRICES AND NOTATIONS MUST BE PRINTED IN INK OR TYPEWRITTEN; NO ERASURES ARE PERMITTED; ERRORS MAY BE CROSSED OUT AND CORRECTIONS PRINTED IN INK OR TYPEWRITTEN ADJACENT, AND MUST BE INITIALED IN INK BY PERSON SIGNING BID

BIDDER MUST QUOTE PRICE(S) AS SPECIFIED IN RFP.

BIDDERS THAT DO NOT COMPLY WITH THE REQUIREMENTS, AND/OR SUBMIT INCOMPLETE BID PACKAGES, SHALL BE SUBJECT TO DISQUALIFICATION AND THEIR BIDS REJECTED IN TOTAL

IF BIDDERS ARE MAKING ANY CLARIFICATIONS AND/OR AMENDMENTS, OR TAKING EXCEPTION TO POLICIES OR SPECIFICATIONS OF THIS RFP, INCLUDING THOSE TO THE COUNTY SLEB POLICY, THESE MUST BE SUBMITTED IN THE EXCEPTIONS, CLARIFICATIONS, AMENDMENTS SECTION OF THIS EXHIBIT A – BID RESPONSE PACKET IN ORDER FOR THE BID RESPONSE TO BE CONSIDERED COMPLETE

Exhibit A – RFP No. 901226Page 1

BIDDER INFORMATION AND ACCEPTANCE

1. The undersigned declares that the Bid Documents, including, without limitation, the RFI/PQ, RFP, Addenda, and Exhibits have been read.

2. The undersigned is authorized, offers, and agrees to furnish the articles and/or services specified in accordance with the Specifications, Terms & Conditions of the Bid Documents of RFP No. 901226 – Certified Unified Program Agency (CUPA) Consultation Services.

3. The undersigned has reviewed the Bid Documents and fully understands the requirements in this Bid including, but not limited to, the requirements under the County Provisions, and that each Bidder who is awarded a contract shall be, in fact, a prime Contractor, not a subcontractor, to County, and agrees that its Bid, if accepted by County, will be the basis for the Bidder to enter into a contract with County in accordance with the intent of the Bid Documents.

4. The undersigned acknowledges receipt and acceptance of all addenda.

5. The undersigned agrees to the following terms, conditions, certifications, and requirements found on the County’s website:

Bid Protests / Appeals Process [http://www.acgov.org/gsa/departments/purchasing/policy/bidappeal.htm]

Debarment / Suspension Policy[http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm]

Iran Contracting Act (ICA) of 2010[http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm]

General Environmental Requirements[http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm]

Small Local Emerging Business Program[http://acgov.org/auditor/sleb/overview.htm]

First Source [http://acgov.org/auditor/sleb/sourceprogram.htm]

Online Contract Compliance System[http://acgov.org/auditor/sleb/elation.htm]

General Requirements [http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm]

Proprietary and Confidential Information[http://www.acgov.org/gsa/departments/purchasing/policy/proprietary.htm]




http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm

http://www.acgov.org/gsa/departments/purchasing/policy/genreqs.htm

http://acgov.org/auditor/sleb/elation.htm

http://www.acgov.org/gsa/departments/purchasing/policy/compliance.htm

http://acgov.org/auditor/sleb/sourceprogram.htm

http://www.acgov.org/gsa/departments/purchasing/policy/first.htm


http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm

http://www.acgov.org/gsa/departments/purchasing/policy/environ.htm

http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm

http://www.acgov.org/gsa/departments/purchasing/policy/ica.htm

http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm

http://www.acgov.org/gsa/departments/purchasing/policy/debar.htm

http://www.acgov.org/gsa/departments/purchasing/policy/bidappeal.htm

http://www.acgov.org/gsa/departments/purchasing/policy/bidappeal.htm

5. The undersigned acknowledges that Bidder will be in good standing in the State of California, with all

the necessary licenses, permits, certifications, approvals, and authorizations necessary to perform all obligations in connection with this RFP and associated Bid Documents.

6. It is the responsibility of each bidder to be familiar with all of the specifications, terms and conditions and, if applicable, the site condition. By the submission of a Bid, the Bidder certifies that if awarded a contract they will make no claim against the County based upon ignorance of conditions or misunderstanding of the specifications.

7. Patent indemnity: Vendors who do business with the County shall hold the County of Alameda, its officers, agents and employees, harmless from liability of an nature or kind, including cost and expenses, for infringement or use of any patent, copyright or other proprietary right, secret process, patented or unpatented invention, article or appliance furnished or used in connection with the contract or purchase order.

8. Insurance certificates are not required at the time of submission. However, by signing Exhibit A – Bid Response Packet, the Contractor agrees to meet the minimum insurance requirements stated in the RFP. This documentation must be provided to the County, prior to award, and shall include an insurance certificate and additional insured certificate, naming the County of Alameda, which meets the minimum insurance requirements, as stated in the RFP.

9. The undersigned acknowledges ONE of the following (please check only one box):

Bidder is not local to Alameda County and is ineligible for any bid preference; OR

Bidder is a certified SLEB and is requesting 10% bid preference; (Bidder must check the first box and provide its SLEB Certification Number in the SLEB PARTNERING INFORMATION SHEET); OR

Bidder is LOCAL to Alameda County and is requesting 5% bid preference, and has attached the following documentation to this Exhibit:

Copy of a verifiable business license, issued by the County of Alameda or a City within the County; and

Proof of six (6) months business residency, identifying the name of the vendor and the local address. Utility bills, deed of trusts or lease agreements, etc., are acceptable verification documents to prove residency.


Official Name of Bidder:

Street Address Line 1:

Street Address Line 2:

City: State: Zip Code:

Webpage:

Type of Entity / Organizational Structure (check one):

Corporation Joint Venture

Limited Liability Partnership Partnership

Limited Liability Corporation Non-Profit / Church

Other:

Jurisdiction of Organization Structure:

Date of Organization Structure:

Federal Tax Identification Number:

Primary Contact Information:

Name / Title:

Telephone Number: Fax Number:

E-mail Address:

SIGNATURE:

Name and Title of Signer:

Dated this day of 20


BID FORM

COST SHALL BE SUBMITTED ON EXHIBIT A AS IS. NO ALTERATIONS OR CHANGES OF ANY KIND ARE PERMITTED. Bid responses that do not comply will be subject to rejection in total. The cost quoted below shall include all taxes and all other charges, including travel expenses, including all administrative and support costs and is the cost the County will pay for the three-year term of any contract that is a result of this bid.

Quantities listed herein are annual estimates based on past usage and are not to be construed as a commitment. No minimum or maximum is guaranteed or implied.

Bidder hereby certifies to County that all representations, certifications, and statements made by Bidder, as set forth in this Bid Form and attachments are true and correct and are made under penalty of perjury pursuant to the laws of California.

All CUPA Services as described in the Specific

Requirements and Deliverables/Reports Sections of this RFP

AVERAGE NUMBER OF HOURS PER

YEAR*(A)

HOURLY RATE TO BE CHARGED

(B)

ANNUAL TOTAL COST

(A x B)

Year 1 832 $

Year 2 832 $

Year 3 832 $Three Year Cost Total $


REQUIRED DOCUMENTATION AND SUBMITTALS

All of the specific documentation listed below is required to be submitted with the Exhibit A – Bid Response Packet in order for a bid to be deemed complete. Bidders shall submit all documentation, in the order listed below and clearly label each section with the appropriate title (i.e. Table of Contents, Letter of Transmittal, Key Personnel, etc.).

1. Table of Contents: Bid responses shall include a table of contents listing the individual sections of the proposal and their corresponding page numbers. Tabs should separate each of the individual sections.

2. Letter of Transmittal: Bid responses shall include a description of Bidder’s capabilities and approach in providing its services to the County, and provide a brief synopsis of the highlights of the Proposal and overall benefits of the Proposal to the County. This synopsis should not exceed three (3) pages in length and should be easily understood.

3. Exhibit A – Bid Response Packet: Every bidder must fill out and submit the complete Exhibit A – Bid Response Packet.

(a) Bidder Information and Acceptance:

(1) Every Bidder must select one choice under Item 9 of page 3 of Exhibit A and must fill out, submit a signed page 4 of Exhibit A.

(b) SLEB Partnering Information Sheet:

(1) Every bidder must fill out and submit a signed SLEB Partnering Information Sheet, (found on page 9 of Exhibit A) indicating their SLEB certification status. If bidder is not certified, the name, identification information, and goods/services to be provided by the named CERTIFIED SLEB partner(s) with whom the bidder will subcontract to meet the County SLEB participation requirement must be stated. Any CERTIFIED SLEB subcontractor(s) named, the Exhibit must be signed by the CERTIFIED SLEB(s) according to the instructions. All named SLEB subcontractor(s) must be certified by the time of bid submittal.

(c) References-intentionally omitted:

(1) The references that Bidders already submitted in their response to RFP No. 901226 will be part of the evaluation criteria and will be checked after the bid response due date.

(2) Bidders are strongly encouraged to notify all references, if they have not already done so, that the County may be contacting them to obtain a reference.

(3) The County may contact some or all of the references provided in order to determine Bidder’s performance record on work similar to


that described in this request. The County reserves the right to contact references other than those provided in the Response and to use the information gained from them in the evaluation process.

(d) Exceptions, Clarifications, Amendments:

(1) This shall include clarifications, exceptions and amendments, if any, to the RFP and associated Bid Documents, and shall be submitted with your bid response using the template on page 12 of this Exhibit A – Bid Response Packet.

(2) THE COUNTY IS UNDER NO OBLIGATION TO ACCEPT ANY EXCEPTIONS, AND SUCH EXCEPTIONS MAY BE A BASIS FOR BID DISQUALIFICATION.

4. Key Personnel: Bid responses shall include a complete list of all key personnel associated with the RFP. This list must include all key personnel who will provide services/training to County staff and all key personnel who will provide maintenance and support services. For each person on the list, the following information shall be included:

(a) The person’s relationship with Bidder, including job title and years of employment with Bidder;

(b) The role that the person will play in connection with the RFP;(c) Address, telephone, fax numbers, and e-mail address; (d) Person’s educational background; and(e) Person’s relevant experience, certifications, and/or merits.

5. Description of the Proposed Services: Bid response shall include a description of the terms and conditions of services to be provided during the contract term including response times. The description must: (1) specify how the services in the bid response will meet or exceed the requirements of the County; (2) explain any special resources, procedures or approaches that make the services of Bidder particularly advantageous to the County; and (3) identify any limitations or restrictions of Bidder in providing the services that the County should be aware of in evaluating its Response to this RFP.

6. Current or Former Inspection Report: A current or former inspection report for both Cal ARP and Methamphetamine cleanup will be evaluated and is part of the criteria under Item D, “Current or Former Inspection Reports”, in the Evaluation Criteria section of this RFP. If the Cal ARP report was already submitted in Bidder’s response to RFI/PQ No. 901226, then Bidder must provide a sample of a current or former Methamphetamine Cleanup report; if the Methamphetamine Cleanup report was already submitted in Bidder’s response to RFP No. 901226, then they must provide a sample of a current or former Cal ARP report. Examples of each are provided in Exhibit D.


7. Financial Statements

(a) Most recent Dun & Bradstreet Supplier Qualifier Report. For information on how to obtain a Supplier Qualifier Report, contact Dun & Bradstreet at http://www.dnb.com/government/contractor-management-portal.html; ORAudited financial statements for the past three (3) years.


http://www.dnb.com/government/contractor-management-portal.html

SMALL LOCAL EMERGING BUSINESS (SLEB)PARTNERING INFORMATION SHEET


In order to meet the Small Local Emerging Business (SLEB) requirements of this RFP, all bidders must complete this form as required below.

Bidders not meeting the definition of a SLEB (http://acgov.org/auditor/sleb/overview.htm) are required to subcontract with a SLEB for at least twenty percent (20%) of the total estimated bid amount in order to be considered for contract award. SLEB subcontractors must be independently owned and operated from the prime Contractor with no employees of either entity working for the other. This form must be submitted for each business that bidders will work with, as evidence of a firm contractual commitment to meeting the SLEB participation goal. (Copy this form as needed.)

Bidders are encouraged to form a partnership with a SLEB that can participate directly with this contract. One of the benefits of the partnership will be economic, but this partnership will also assist the SLEB to grow and build the capacity to eventually bid as a prime on their own.

Once a contract has been awarded, bidders will not be able to substitute named subcontractors without prior written approval from the Auditor-Controller, Office of Contract Compliance (OCC).

County departments and the OCC will use the web-based Elation Systems to monitor contract compliance with the SLEB program (Elation Systems: http://www.elationsys.com/elationsys/index.htm).

BIDDER IS A CERTIFIED SLEB (sign at bottom of page)

SLEB BIDDER Business Name:

SLEB Certification #: SLEB Certification Expiration Date:

NAICS Codes Included in Certification:

BIDDER IS NOT A CERTIFIED SLEB AND WILL SUBCONTRACT % WITH THE SLEB NAMED BELOW FOR THE FOLLOWING GOODS/SERVICES:

SLEB Subcontractor Business Name:

SLEB Certification #: SLEB Certification Expiration Date:

SLEB Certification Status: Small / Emerging

NAICS Codes Included in Certification:

SLEB Subcontractor Principal Name:

SLEB Subcontractor Principal Signature: Date:

Upon award, prime Contractor and all SLEB subcontractors that receive contracts as a result of this bid process agree to register and use the secure web-based ELATION SYSTEMS. ELATION SYSTEMS will be used to submit SLEB subcontractor participation including, but not limited to, subcontractor contract amounts, payments made, and confirmation of payments received.

Bidder Printed Name/Title:____________________________________________________________________________

Street Address: _____________________________________________City_____________State______ Zip Code______

Bidder Signature: Date:


http://www.elationsys.com/elationsys/index.htm



CURRENT REFERENCES

RFP No. 901226 – CUPA Consultation Services

(Intentionally Omitted)


FORMER REFERENCES

RFP No. 901226 – CUPA Consultation Services

(Intentionally Omitted)


EXCEPTIONS, CLARIFICATIONS, AMENDMENTS


Bidder Name:

List below requests for clarifications, exceptions and amendments, if any, to the RFP and associated Bid Documents, and submit with your bid response.

The County is under no obligation to accept any exceptions and such exceptions may be a basis for bid disqualification.

Reference to: DescriptionPage No. Section Item No.

p. 23D 1.c. Vendor takes exception to…

*Print additional pages as necessary


EXHIBIT BINSURANCE REQUIREMENTS

Insurance certificates are not required at the time of submission; however, by signing Exhibit A – Bid Packet, the bidder agrees to meet the minimum insurance requirements stated in the RFP, prior to award. This documentation must be provided to the County, prior to award, and shall include an insurance certificate and additional insured certificate, naming the County of Alameda, which meets the minimum insurance requirements, as stated in this Exhibit B – Insurance Requirements.

The following page contains the minimum insurance limits, required by the County of Alameda, to be held by the Contractor performing on this RFP:

*** SEE NEXT PAGE FOR COUNTY OF ALAMEDA MINIMUM INSURANCE REQUIREMENTS ***

Certificate C-2 Page 1 of 1 Form 2003-1 (Rev. 09/10/13) Exhibit B – RFP No. 901226

Page 1

EXHIBIT BCOUNTY OF ALAMEDA MINIMUM INSURANCE REQUIREMENTS

Without limiting any other obligation or liability under this Agreement, the Contractor, at its sole cost and expense, shall secure and keep in forceduring the entire term of the Agreement or longer, as may be specified below, the following minimum insurance coverage, limits andendorsements: TYPE OF INSURANCE COVERAGES MINIMUM LIMITSA Commercial General Liability

Premises Liability; Products and Completed Operations; ContractualLiability; Personal Injury and Advertising Liability; Abuse, Molestation,Sexual Actions, and Assault and Battery

$1,000,000 per occurrence (CSL)Bodily Injury and Property Damage

B Commercial or Business Automobile LiabilityAll owned vehicles, hired or leased vehicles, non-owned, borrowed andpermissive uses. Personal Automobile Liability is acceptable forindividual contractors with no transportation or hauling related activities

$1,000,000 per occurrence (CSL)Any AutoBodily Injury and Property Damage

C Workers’ Compensation (WC) and Employers Liability (EL)Required for all contractors with employees

WC: Statutory LimitsEL: $100,000 per accident for bodily injury or disease

D Professional Liability/Errors & OmissionsIncludes endorsements of contractual liability and defense andindemnification of the County

$1,000,000 per occurrence$2,000,000 project aggregate

E Endorsements and Conditions:1. ADDITIONAL INSURED: All insurance required above with the exception of Professional Liability, Commercial or BusinessAutomobile Liability, Workers’ Compensation and Employers Liability, shall be endorsed to name as additional insured: Countyof Alameda, its Board of Supervisors, the individual members thereof, and all County officers, agents, employees, volunteers,and representatives. The Additional Insured endorsement shall be at least as broad as ISO Form Number CG 20 38 04 13.2. DURATION OF COVERAGE: All required insurance shall be maintained during the entire term of the Agreement. In addition,Insurance policies and coverage(s) written on a claims-made basis shall be maintained during the entire term of the Agreementand until 3 years following the later of termination of the Agreement and acceptance of all work provided under the Agreement,with the retroactive date of said insurance (as may be applicable) concurrent with the commencement of activities pursuant tothis Agreement.3. REDUCTION OR LIMIT OF OBLIGATION: All insurance policies, including excess and umbrella insurance policies, shallinclude an endorsement and be primary and non-contributory and will not seek contribution from any other insurance (or selfinsurance)available to the County. The primary and non-contributory endorsement shall be at least as broad as ISO Form 20 0104 13. Pursuant to the provisions of this Agreement insurance effected or procured by the Contractor shall not reduce or limitContractor’s contractual obligation to indemnify and defend the Indemnified Parties.4. INSURER FINANCIAL RATING: Insurance shall be maintained through an insurer with a A.M. Best Rating of no less than A:VIIor equivalent, shall be admitted to the State of California unless otherwise waived by Risk Management, and with deductibleamounts acceptable to the County. Acceptance of Contractor’s insurance by County shall not relieve or decrease the liability ofContractor hereunder. Any deductible or self-insured retention amount or other similar obligation under the policies shall be thesole responsibility of the Contractor.5. SUBCONTRACTORS: Contractor shall include all subcontractors as an insured (covered party) under its policies or shall verifythat the subcontractor, under its own policies and endorsements, has complied with the insurance requirements in thisAgreement, including this Exhibit. The additional Insured endorsement shall be at least as broad as ISO Form Number CG 2038 04 13.6. JOINT VENTURES: If Contractor is an association, partnership or other joint business venture, required insurance shall beprovided by one of the following methods:– Separate insurance policies issued for each individual entity, with each entity included as a “Named Insured” (coveredparty), or at minimum named as an “Additional Insured” on the other’s policies. Coverage shall be at least as broad as in theISO Forms named above.– Joint insurance program with the association, partnership or other joint business venture included as a “Named Insured”.7. CANCELLATION OF INSURANCE: All insurance shall be required to provide thirty (30) days advance written notice to theCounty of cancellation.8. CERTIFICATE OF INSURANCE: Before commencing operations under this Agreement, Contractor shall provide Certificate(s)of Insurance and applicable insurance endorsements, in form and satisfactory to County, evidencing that all required insurancecoverage is in effect. The County reserves the rights to require the Contractor to provide complete, certified copies of allrequired insurance policies. The required certificate(s) and endorsements must be sent as set forth in the Notices provision.

Certificate C-2 Page 1 of 1 Form 2003-1 (Rev. 09/10/13) Exhibit B – RFP No. 901226

Page 2

EXHIBIT CVENDOR BID LIST


Below is the Vendor Bid List for this project consisting of vendors who have been prequalified for RFP No. 901226, and/or been issued a copy of this RFP. This Vendor Bid List is being provided for informational purposes to assist bidders in making contact with other businesses as needed to develop local small and emerging business subcontracting relationships to meet the requirements of the Small Local Emerging Business (SLEB) Program: http://www.acgov.org/gsa/departments/purchasing/policy/slebpref.htm.

RFP No. 901226 - Certified Unified Program Agency (CUPA) Consultation Services

Business Name Contact Phone Address City St EmailJB & ASSOCIATES Sukla De 510-304-5446 1900 ORO DRIVE FREMONT CA [email protected] ENVIRONMENTAL SYSTEMS, INC. (NES) John Balobeck 925-570-6571 21C ORINDAY WAY,

#378 ORINDA CA [email protected]

Exhibit C – RFP No. 901226Page 1

mailto:[email protected]

http://www.acgov.org/gsa/departments/purchasing/policy/slebpref.htm

EXHIBIT D

COUNTY OF ALAMEDARFP No. 901226

forCertified Unified Program Agency (CUPA) Consultation Services

INSPECTION SAMPLES

The following listed are samples of the reports and checklists that are required for the CUP consultant:

REPORTS

1) California Accidental Release Program (Cal ARP)

2) Methamphetamine Cleanup

REPORT SUMMARIES

1) Inspection Report Summary/Summary of Violations and Inspection Comments

CHECKLISTS

1) Tiered Permit Inspection Checklist

2) Hazardous Waste Generator Inspection Checklist

Exhibit D

Page 1 of 36

ALAMEDA COUNTYDEPARTMENT OF ENVIRONMENTAL HEALTH

Certified Unified Program Agency (CUPA)1131 Harbor Bay Parkway, Alameda, CA 94502-6577

Phone: (510) 567-6700; Fax (510) 337-9335CAL ARP PROGRAM Risk Management Plan

Program LEVEL 2

Formal Evaluation Review Checklist

Facility Name: ___________________________________________________________

Location: __________________________________ City: ____________Zip: _________

Mailing Address: ___________________________City: _____________Zip: _________

Contact Person: ____________________________ Phone: ________________________

Consultant: ________________________________ Phone: _______________________

DOCUMENT LOG

Initial Submittal Date: __________________________Initial Notice Date: _____________________________Revision Submittal Date: ________________________RMP Completeness Review Date: _________________Public Notice Date: _____________________________45-Day Review Period: __________________________Final RMP Evaluation Review Date: _______________

ACTIVITY LOGDate Activity Time (Hrs)_____________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

GENERAL REQUIREMENTS

2735.4 PROCESS 1. Are processes correctly identified?2. Are program 1, 2, & 3 applied correctly?

Exhibit DPage 2 of 35

Comments: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2735.6 Management System

(a) Does the stationary source have an RMP management system?(b) Has a qualified person/position been assigned responsibility of RMP?(c) Has an organization chart or similar document been defined and documented for persons

other than the person identified in section (b)?

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2740.1 Registration Information

a) Stationary source name, street, city, county, state, zip code, latitude and longitude, method for obtaining latitude and longitude, and description of the location;

b) Dun & Bradstreet number;c) Name and Dun & Bradstreet number of corporate parent company;d) Name, telephone number and mailing address of the owner or operator;e) Name and title of the person or position with overall responsibility for RMP elements and

implementation and (optional) e-mail address;f) Name, title, telephone number, e-mail address (if one exists) and 24-hour telephone number of the

emergency contact;g) For each covered process, the name and CAS number of each regulated substance held above the

threshold quantity in the process, the maximum quantity of each regulated substance or mixture in the process (in pounds) to two significant digits, the NAICS code that most closely corresponds to the process and the Program level of the process;

h) The stationary source USEPA identifier;i) The number of full-time employees at the stationary source;j) Whether the stationary source is subject to Section 5189 of Title 8 of CCR;k) Whether the stationary source is subject to Part 355 of Title 40 of CFR;l) The permit number, if the stationary source is subject to Title V of CAA;m) The date of the last safety inspection of the stationary source by a federal, state or local

government agency and the identity of the inspecting entity.n) The name, mailing address and telephone number of the contractor that prepared the RMP (if any).o) Optional Fields:

1) Source or parent company e-mail address, homepage address and the telephone number for public inquiries;

2) Local Emergency Planning Committee;3) OSHA Voluntary Protection Program status; and,4) Type of, and reason for, any changes being made to a previously submitted RMP.

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


__________________________________________________________________

CCR 2745.2 Qualified Person Certification

(a)(1) Has Certification by a qualified person and owner /operator been submitted?

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2775.1 Recordkeeping

Are records of RMP implementation maintained for 5 years?

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

HAZARD ASSESSMENT

CCR 2750.2 Offsite Consequence Analysis Parameters

Have the following endpoint been used for analyses of OCAP:

(a) Endpoints. Have the following endpoints been used:

(1) Correct toxic endpoints for Table 1 (only) substances; (2) Correct toxic endpoints for Table 1 & 3 (both); (3) Correct toxic endpoints for table 3 (only); (4) Correct Table 2 flammable endpoints. Endpoint varies based on the following:

i. Explosion. An overpressure of 1 psi.ii. Radiant heat/exposure limit. A radiant heat of 5kw/m2 for 40 seconds.iii. Lower flammability limit. A lower flammability limit as provided in NFPA documents or other

generally recognized sources.

(b) Windspeed /atmospheric stability class: Has the owner or operator used:

1.5 meter/second and F atmospheric class; Other minimum selected and it is acceptable; Acceptable typical condition selected for alternative.

(c) Ambient temperature/ humidity:Did the owner or operator use:

a. Highest daily maximum temperature in the previous three years or 25°C and (77° F);

b. Typical Temperature for alternative scenarios;c. Average humidity for site or 50% humidity used;d. Typical humidity for alternative scenarios?


(d) Height of release: Was the following considered when analyzing the worst-case release?

e. Release at ground level (0 feet);f. Release height optional for alternative.

(e) Surface roughness: The owner or operator shall use either:

g. Urban topography (many obstacles in the area);h. Rural topography (no obstacles in the immediate area).

(f) Dense or neutrally buoyant gases: Did the owner or operator ensure that the tables or models used for dispersion analysis account for gas density?

(g) Temperature of released substance: For worst-case, liquids other than gases liquefied by refrigeration only shall be considered

to be released at the highest daily maximum temperature based on the last three years.For alternative release, process temperature or ambient temperature may be used for the release.

Comments: _________________________________________________________________________________________________________________________________________________________________________________________

CCR 2750.3 Worst-Case Release Scenario Analysis The owner or operator shall analyze and report in the RMP:

a. (2) (A) One worst-case scenario for all toxics;(B) One worst-case scenario for all flammables;(C) Additional worst-case if necessary;

b. (1) Greatest amount in single vessel;(2) Greatest amount in a pipe;

c. (1) Toxic gases at ambient temp/pressurized - 10 min.(2) Toxic gases as refrigerated liquids/ambient pressure.

Depth <1 cm - release in 10 min.Depth >1 cm - forms liquid pool.

d. (1) Toxic liquid instantaneously spilled. Pool 1 cm deep. or, actual surface characteristics.(2) Volatilization rate accounts for:

Highest daily maximum temperature (past 3 yrs). Temperature of substance. Concentration of substance (if mixture/solution).

(3) Rate of release to air determined correctly.e. Flammable gases - vaporizes, vapor cloud explosion.f. Section 2750.2 parameters used.g. Consideration of passive mitigation.h. Factors in selecting a worst-case scenario. Consideration of scenarios giving greater

distance to endpoint.


i. Solids. Owner or operator shall assume: One-hour release

> Wind speed limit of 1.5 m/s and F stability atmospheric stability.

Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2750.4 Alternative Release Scenario Analysis The owner or operator shall at least identify:

a. One alternative scenario for each toxic;One alternative scenario for all flammables;

b. (1) for each scenario required select:(A) More likely to occur release scenario;(B) Release that reaches an endpoint offsite.

(1) Scenarios considered should include:(A) transfer hose releases due to splits or sudden hose uncoupling;(B) process piping release from failure of flanges, joints, welds, valves and valve

seals, and drains or bleeds;(C) process vessel or pump releases due to cracks, seal failure, or drain, bleed, or

plug failure;(D)vessel overfilling and spill, or over pressurization and venting through relief

valves or rupture disks; and(E) shipping container mishandling and breakage or puncturing leading to spill.

c. Section 2750.2 parameters used.d. Consideration of mitigation- active or passive mitigation systems may be considered if it

withstands the event that triggered the release.e. Used appropriate factors for determining scenarios.

Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________CCR 2750.5 Defining Offsite Impacts to the Population The owner or operator shall use and submit in the RMP:

a. Population within circle estimated?b. Population identified?c. Correct data used?d. Two significant digits used?

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2750.6 Defining Offsite Impacts to the Environment Owner or operator shall:

a. List environmental receptors within circle in the RMP.Exhibit D

Page 6 of 35

b. Use local USGS data or other data source containing USGS data.Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2750.7 Offsite Consequence Analysis Review and Update Owner or operator shall review and update the:

a. OSCA review/update every 5 years?b. Changes in processes, quantities stored or handled, or any other aspect of the SS that might

increase or decrease the distant to endpoint by a factor or two or more, necessitate an update and submit a revised RMP within 6 months.

Comments: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2750.8 Offsite Consequence Analysis Documentation Owner or operator shall maintain:

Worst-case scenario data, assumptions, methodologies; Alternative scenario data, assumptions, methodologies; Documentation of quantity, rate, duration; Methodology (model) utilized; Data used to estimate population/environmental receptors.

Comments: _________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________CCR 2750.9 Five-Year Accident History Owner or operator shall include:

a. All accidental releases from a covered process that resulted in death, injures or significant property damage on site, offsite deaths, injuries, evacuation, sheltering in place, property damage or environmental damage.

b. For each accidental release described the following data shall be submitted, to accuracy of two significant figure: 1. Date, time and approximate duration of release;2. Regulated substance(s) involved;3. Estimated quantity released in pounds;4. Type of release event and it’s source;5. Weather condition, if known;6. On-site impacts;7. Known off-site impacts;8. Initiating events and contributing factors if known9. Whether off-site responders were notified, if known10. Operational or process changes that resulted from investigation of release.

Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


Emergency Response

CCR 2765.1 Emergency Response Applicability Owner or operator whose employees will not respond to accidental releases of regulated substances need to meet the following:

b. (1) Coordinate with community plan.(2) Coordinate with fire agencies for flammables.(3) Have procedures for notifying emergency responders.

Comments: _______________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2765.2 Emergency Response ProgramEmergency response program shall include the following:

a. (1) Response Plan;(i) Procedures for informing/interfacing w/agencies/public;(ii) Documentation of first aid/med monitoring treatment;(iii) Post incident response procedures.

(2) Procedures for equipment use, inspection, testing, maintenance,(3) Training in Incident Command System;(4) Procedures to review and update plan;

c. Coordination w/community emergency response plan.Comments: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PROGRAM 2 REQUIREMENTS

CCR 2745.3 Executive Summary An executive summary shall include a brief description of the following elements: a) The accidental release prevention and emergency response policies at the stationary source;b) The stationary source and regulated substances handled;c) The worst case release scenarios and alternative release scenarios, including administrative controls

and mitigation measures to limit the distances for each reported scenario;d) The general accidental release prevention program and chemical specific prevention steps;e) The five year accident history;f) The emergency response program;g) Planned changes to improve safety.

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


CCR 2755.1 Safety Information The owner shall compile and maintain the following:

a. (1) MSDS’s,(2) Maximum intended inventory of equipment,(3) Safe upper/lower temp, pressures, flows, compositions,(4) Equipment specifications,(5) Codes/standards used to design, build, and operate the process.

b. Designed according to good engineering practices?c. Safety information updated for major process changes?

Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________CCR 2755.2 Hazard Review a. Hazard review shall identify:

1. Hazards w/process, regulated substances, 2. Opportunities for equip malfunctions/human errors, 3. Safeguards in use or needed, 4. Steps used or needed to detect or monitor releases.

b. Is review method appropriate?c. Was review conducted according to industry standards?d. Were external events considered?

►Were external events such as site security related to sabotage, terrorism, and theft discussed?►Were external events such as site security related to potential for adjacent facilities to impact the process discussed?

e. Review documented and problems resolved?f. Review updated with major changes, or every 5 years?g. Review issues resolved before process startup of a changed process?

Comments: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2755.3 Operating Procedures a. Written operating procedures?b. Procedures include:

(1) initial startup, (2) normal operations, (3) temporary operations, (4) emergency shutdown and operations, (5) normal shutdown, (6) startup following a normal or emergency shutdown or a major change that requires a

hazard review, (7) consequences of deviations and steps required to correct or avoid deviations, (8) equipment inspections?


c. Procedures updated whenever a major change occurs or prior to startup of the changed process?d. Are written prevention programs such as EAP/ERP/PM program, Incident Investigation, and Safety

Programs updated annually or whenever a major change occurs or prior to startup of the changed process?

Comments: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2755.4 Training a. Documentation ensuring employee training/competency testing?b. Refresher training at least every 3 years?c. Frequency of training determined in consultation w/employees?e. Training in updated/new procedures prior to startup after change?

Comments: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2755.5 Maintenance Written and implemented procedures?Training of maintenance employees:

Hazards of the process, How to avoid or correct unsafe conditions, Procedures applicable to employees job tasks?

Training of maintenance contractor employees?Ongoing inspections/testing of equipment?

Date of most recent review or revision of MP and date of most recent equipment inspection or test. CCR 2745.6(h).

The owner or operator shall document each inspection and test that has been performed on process equipment. The documentation should identify:

The date of the inspection or test, The name of the person who performed it, The serial number of other identifier of the equipment, and A description of the inspection or test performed and the results.

Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________CCR 2755.6 Compliance Audits The owner or operator shall certify that they have evaluated compliance with the provision of this section and shall conduct the following:

Triennial audits to verify compliance with prevention program requirements;


Audit conducted by knowledgeable person;Audit report with findings completed;Audit follow up to ensure correction of deficiencies;Maintain the last two audits on file.

Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2755.7 Incident Investigation a. Incident investigation done for serious releases, near misses, and minor releases.b. Incident investigation within 48 hours.c. Written investigation summary:

(1) date of incident; (2) date investigation began;

(3) incident description; (4) contributing factors; (5) investigation recommendations.

d. Prompt resolution and documentation of investigation findings.e. Findings reviewed with affected employees.f. Investigative summaries retained for 5 years.

Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2745.6(l) External events analysis information The owner or operator shall submit the following external events analysis information. 1) The types of human and natural caused external events considered in the hazard review.2) The scope or magnitude of each external event considered.3) For each external event with a potential to create a release of a regulated substance that will

reach an endpoint offsite, apply sections (e)(1) through(e)(6).4) The date of the most recent field verification that equipment is installed and maintained as

designedComments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CCR 2745.10 RMP Updates The owner or operator of the stationary source shall review and update the RMP


1) Within five years of its initial submission or most recent update whichever is later. 2) No later than three years after a newly regulated substance id first listed by USEPA or OES.3) No later than the date on which a new regulated substance is first present in an already covered

process.4) No later than the date on which a regulated substance is first present above a threshold quantity in a

new process.5) Within 6 months of a change that requires a revised PHA or hazard review6) Within 6 months of a change that requires a revised offsite consequence analysis7) Within 6 months of a change that alters the Program level that applies to any covered process.

Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTHCERTIFIED UNIFIED PROGRAM AGENCY (CUPA)

TIERED PERMIT INSPECTION CHECKLIST Conditionally Authorized

Facility Name:__________________________________ Date of Inspection: _____________________________________Facility Address: Inspector:

REQUIREMENTS H&SC SECTION

COMMENTS

A. NOTIFICATION 1) Maintain on site copy of most recent Notification. 25200.3(e) & (k) Ref. 22CCR66270.11 2) Maintain on site copy of most recent Authorization. 3) Permit each treatment unit (TU) in proper tier. 25200.3(e) 4) Identify each TU on form DTSC 1772. 25200.3(e)(3) 5) Keep current the information on form DTSC 1772. 25200.3(e) 6) Show location of each TU on plot plan/map. 25200.3(e) 7) Complete submittal of notification documents. 25200.3(e) 8) Pay all required fees. 9) Comply with POTW pretreatment standards. 25200.3(c)(7)10) Submit annual waste reduction certification. 25200.3(c)(2) Ref. H&SC25202.9

B. CA OPERATIONS 1) Use only processes listed in treatment of waste. 25200.3(a) Ref. 67450.11 2) Treat only wastes listed for the process used. 25200.3(a) 3) Treat only waste generated on site. 25200.3(c)(8) 4) Maintain on site a written waste analysis plan. 25200.3(f) 5) Address noted deficiencies in waste analysis plan. 25200.3(c)(6) 6) Maintain on site a written inspection schedule. 25200.3(c)(5) 7) Address noted deficiencies in inspection schedule. 25200.3(c)(5) 8) Maintain an up-to-date inspection log or summary. 25200.3(c)(5) 9) Keep inspection records for three years.10) Maintain on site a current Contingency Plan. 25200.3(f)11) Address noted deficiencies in Contingency Plan. 25200.3(f)

12) Maintain on site documents on investigation, cleanup, abatement or other remedial action.

25200.3(c)(3)

13) Maintain on site documents on convictions, judgments, settlements or orders from any enforcement action.

25200.3(e)(3)

14) Maintain on site documents on treatment, including operating instructions and record of dates, amounts,

and types of wastes treated in each unit.

25200.3(c)(6)

15) Limit volume of waste treated within tier limits. 25200.3(b)(1)16) Manage residual material from treatment properly. 25200.3(b)(4)17) Provide containment for treatment containers. 25200.3(c)(4) Ref. CCR66264.17518) Certify treatment containers every 2 years.

19) Document unauthorized or accidental releases from treatment unit in past 3 years.

Ref. 22CCR66265.31

20) Secure treatment area with 24-hr entry control.21) Maintain treatment unit in good order.22) Post “No Smoking” signs.23) Maintain on site records of tank system integrity.24) Submit Financial Assurance statement/instrument. Ref. 22CCR67450.1325) Address deficiencies noted in Fin. Assurance checklist.26) SEE ATTACHED INSPECTION NARRATIVE.

Note:

Name/Signature of Facility Representative Date

ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH1131 HARBOR BAY PARKWAY, ALAMEDA, CA 94502 (510) 567-6700 FAX (510) 337-9335


http://www.acgov.org/aceh

Hazardous Waste Generator Inspection Checklist (Page 1 of 3)Facility ID# Facility Name Site Address

Inspector

Inspection Date

EPA ID # # of Employees Handling Hazardous Waste

HAZARDOUS WASTE GENERATOR STATUS:

CESQG SQG NON-RCRA LQG RCRA LQG

POST INSPECTION PROGRAM STATUS:

NO VIOLATIONS OBSERVED MINOR MINOR-CORRECTED CLASS II CLASS I

ViolationCode Authority Requirement Compliance Status

NVO V N/A RV

HA

ZA

RD

OU

S W

AST

E

RE

CO

RD

KE

EPI

NG

W000 CHSC 25189.5(a) Authorized/proper disposal of hazardous wastes. ○ ○W001 22 CCR 66262.12 Has an active EPA ID Number. ○ ○W002 ALCO Title 6 6.92.050 Has a valid ACDEH Operating Permit. ○ ○W003 22 CCR 66262.11 Proper characterization/testing of waste streams. ○ ○W004 22CCR 66262.40(a) A generator shall keep records of any test results, waste analyses, or other determinations for at least

three years from the date that the waste was last sent to on-site or off-site treatment, storage, or disposal. ○ ○

CE

SQG

/SQ

G T

RA

ININ

G

RE

QU

IRE

ME

NT

S W005 22 CCR 66262.34(d)(2)

At all times, there shall be at least one employee either on the facility premises or on call (i.e., available to respond to an emergency by reaching the facility within a short period of time) with the responsibility for coordinating all emergency response measures. This emergency coordinator shall be thoroughly familiar with all aspects of the facility's contingency plan, all operations and activities at the facility, the location and characteristics of waste handled the location of all records within the facility, and the facility layout. In addition, this person shall have the authority to commit the resources needed to carry out the contingency plan.

○ ○

W006 22 CCR 66262.34(d)(2)

The generator must post the following information next to the telephone, the name and telephone number of the emergency coordinator; Location of fire extinguishers and spill control material, and, if present, fire alarm; and the telephone number of the fire department, unless the facility has a direct alarm.

○ ○

W007 22 CCR 66262.34(d)

Employees thoroughly familiar with proper waste handling and emergency procedures relevant to their responsibilities. ○ ○

CO

NT

AIN

ER

MA

NA

GE

ME

NT

W008 22 CCR 66262.34(a)(1)(A) Containers or tanks provided and suitable for storage of hazardous waste. ○ ○

W009 22 CCR 66262.171 Containers not leaking. ○ ○W010 22 CCR

66265.173(a) Containers kept closed unless removing or adding waste. ○ ○W011 22 CCR 66262.171 Containers in good condition (not rusted or defective). ○ ○W012 22 CCR

66262.173(b) Containers handled, transferred and stored in a manner to prevent rupture and leaking. ○ ○W013 22 CCR 66262.172 Containers compatible with contents. ○ ○W014 22 CCR

66262.31-34Containers and/or portable tanks labeled as “Hazardous Waste” and w/accumulation start date, generator name and address, contents, hazards and physical state. ○ ○

W015 22 CCR 66261.7 Containers > 5 gallons managed properly when empty (dated when emptied, recycled, and returned to vendor within 1 year; if held EHS, must be triple-rinsed with proper disposal of rinsate). ○ ○

HO

USE

KE

EPI

NG

/SPI

LL

PR

EV

EN

TIO

N W016 22 CCR 66265.35 Adequate aisle space is provided. ○ ○W017 22 CCR

66265.32(b) Has access to phone, alarm or 2 way radios for emergency response. ○ ○W018 22 CCR

66265.32(c) Has portable fire extinguishing equipment available. ○ ○W019 22 CCR

66265.32(c) Spill control and mitigation materials available (absorbents, rags, etc.) ○ ○W020 22 CCR 66265.33 Emergency equipment (fire extinguishers, spill prevention, alarm equipment, etc.) tested and maintained

as necessary (fire extinguishers assessed annually). ○ ○W021 22 CCR 66262.31

Facilities shall be maintained and operated to minimize the possibility of a fire, explosion, or any unplanned sudden or non-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water which could threaten human health or the environment.

○ ○W022 22 CCR 66265.174 Storage area inspected weekly. ○ ○W023 22 CCR 66265.177 Separation of incompatible materials. ○ ○

Compliance status is evaluated for each item on this Checklist as follows: NVO= No Violations Observed V = Violation N/A = Not Applicable RV = Repeat Violation





Hazardous Waste Generator Inspection Checklist (Page 2 of 3)Facility ID# Facility Name Facility Address

Compliance status is evaluated for each item on this Checklist as follows:NVO = No Violations Observed V = Violation N/A = Not Applicable RV = Repeat Violation




NVO V N/A RV

USE

D

OIL W024 22 CCR

66266.130

Proper handling, labeling, management and recycling of used oil filters (drained, labeled as “Drained Used Oil Filters” with accumulation start date and disposed of every 6 months if > 1 ton or annually if < 1 ton.

○ ○

RE

CY

CL

AB

LE

M

AT

ER

IAL

S W025 22 CCR 66266.81

Proper handling, labeling, management and recycling of spent automotive lead acid batteries (must be stored on a non-reactive surface, disposed of every 6 months if > 1 ton or annually if < 1 ton; disposal records required only when more than 10 batteries are generated, stored or disposed of at one time; damaged batteries must be labeled as such with an accumulation start date).

○ ○W026 CHSC

25143.9(a) Proper handling, labeling and management of any excluded recyclable materials. ○ ○W027 CHSC

25143.10(c)Completion of the UPCF Recyclable Materials Report every two years if recycle on-site >100kg/27 gallons per month of recyclable material (in lieu of hazardous waste disposal for that material). ○ ○

RE

CO

RD

-K

EE

PIN

G W028 22 CCR 66262.23 Hazardous waste manifests, bills of lading and/or consolidated manifests completed properly. ○ ○

W029 22 CCR 66262.40 Hazardous waste manifests, bill of lading and/or consolidated manifests kept for 3 years. ○ ○

UN

IV.

WA

STE

W030 22 CCR 66273.30-41

Universal Waste

Proper handling, labeling, management and recycling of universal wastes (mercury thermostats/switches/lamps, non-auto batteries, CRT’s, aerosol cans, fluorescent lights, etc.). Must label waste, document accumulation date, keep < 5000 kg (SQG’s only) at any time, send to collection, disposal or recycling facility and retain receipts for 3 years.

○ ○

AC

CU

MU

LA

TIO

N T

IME

W031 22 CCR 66262.34(a) LQG 90 days: Hazardous waste disposed of every 90 days from the first day of accumulation

(required if they generate ≥ 1000 kg/270 gallons per month). ○ ○

W03222 CCR

66262.34(d)(1)(2)(3)

SQG, 180 or 270 days

A generator of less than 1,000 kilograms of hazardous waste in any calendar month may accumulate hazardous waste onsite for 180 days or less, or 270 days or less if the generator transports the generator's own waste, or offers the generator's waste for transportation, over a distance of 200 miles or more, for offsite treatment, storage, or disposal and is not a storage facility. The quantity of hazardous waste accumulated onsite never exceeds 6,000 kilograms; the generator complies with the requirements of 40 Code of Federal Regulations section 262.34(d), (e) and (f); the generator does not hold acutely hazardous waste or extremely hazardous waste in an amount greater than one kilogram for more than 90 days.

○ ○

W03322 CCR

66262.34(b)(1) and CHSC 25123.3(c)

CESQG 90 days from date 100 kg

reached

Hazardous waste disposed of within 90 days of accumulating 100 kg/27gallons (eligible only if they generate <100 kg/27 gallons per month) ○ ○

W034 22 CCR 66262.34(e) Satellite Storage:

Hazardous waste is disposed of at least once a year (even if <100 kg/27 gallons accumulated) OR within 90 days of accumulating 55 gallons whichever comes first (eligible for satellite rule only if waste accumulated at/near point of generation and meet labeling and storage conditions).

○ ○


http://www.cyberregs.com/cgi-exe/cpage.dll?pg=x&rp=/pseudo.htm&sid=2010031015530634923&aph=1&Hi=4&qy=crematorium&hlc=00FF00&srchm=1&cid=alam&uid=alevi&clrA=0663B2&clrV=0663B2&clrX=0663B2&ref=/indx/ST/ca/st/r/22/4p5/st_ca_st_r_22_4p5_chapter12.htm&pseudo=UN1%2C%2CCFR%2CCFR_40_262%2Cg=5~c=34~h=~i=%2C(f)#g=5~c=34~h=~i=~(f)

http://www.cyberregs.com/cgi-exe/cpage.dll?pg=x&rp=/pseudo.htm&sid=2010031015530634923&aph=1&Hi=4&qy=crematorium&hlc=00FF00&srchm=1&cid=alam&uid=alevi&clrA=0663B2&clrV=0663B2&clrX=0663B2&ref=/indx/ST/ca/st/r/22/4p5/st_ca_st_r_22_4p5_chapter12.htm&pseudo=UN1%2C%2CCFR%2CCFR_40_262%2Cg=5~c=34~h=~i=%2C(e)#g=5~c=34~h=~i=~(e)

http://www.cyberregs.com/cgi-exe/cpage.dll?pg=x&rp=/pseudo.htm&sid=2010031015530634923&aph=1&Hi=4&qy=crematorium&hlc=00FF00&srchm=1&cid=alam&uid=alevi&clrA=0663B2&clrV=0663B2&clrX=0663B2&ref=/indx/ST/ca/st/r/22/4p5/st_ca_st_r_22_4p5_chapter12.htm&pseudo=UN1%2C%2CCFR%2CCFR_40_262%2Cg=5~c=34~h=~i=%2C(d)#g=5~c=34~h=~i=~(d)



Hazardous Waste Generator Inspection Checklist (Page 3 of 3)Facility ID# Facility Name Facility Address




ViolationCode Authority Requirement

Compliance StatusNVO V N/A R

V


HW

TA

NK

S

W035 22 CCR 66265.195

HAZARDOUS WASTE ABOVEGROUND STORAGE TANKS (AST’S)The owner or operator shall inspect, where present, at least once each operating day:(1) overfill/spill control equipment (e.g., waste-feed cutoff systems, bypass systems, and drainage systems) to ensure that it is in good working order; (2) the aboveground portions of the tank system, if any, to detect corrosion or releases of waste; (3) data gathered from monitoring equipment and leak-detection equipment, (e.g., pressure and temperature gauges, monitoring wells) to ensure that the tank system is being operated according to its design; (4) the construction materials and the area immediately surrounding the externally accessible portion of the tank system including secondary containment structures (e.g., dikes) to detect erosion or signs of releases of hazardous waste (e.g., wet spots, dead vegetation); and (5) for uncovered tanks, the level of waste in the tank, to ensure compliance with 40 CFR 265.201(c).

○ ○

W036 22 CCR66262.31-34 Stationary tanks labeled as “Hazardous Waste” and marked with accumulation start date. ○ ○

STR

EA

MS

WA

STE

Used oil Dry Cleaning Solvents Aqueous Parts cleaner Used Oil Filters Ethylene glycol / antifreeze / coolant Used Dispenser Fuel Filters Oily sludge Universal Waste Paint waste Contaminated Absorbents

_________________________________________________________________________________________Facility Representative Signature Printed Name Date



ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH1131 HARBOR BA PARKWAY, ALAMEDA, CA 94502 (510) 567-6700 FAX (510) 337-9335

Facility ID# Facility Name Facility Address

Inspector Inspection Date





NVO V N/A RV

HM00 ALCO Title 6 6.92.050 Has a valid ACDEH Operating Permit. ○ ○

HM01 CHSC 25503.5

A business shall establish and implement a business plan for emergency response to a release or threatened release of a hazardous material in accordance with the standards prescribed in the regulations adopted pursuant to Section 25503, if the business handles a hazardous material or a mixture containing a hazardous material that has a quantity at any one time during the reporting year that is any of the following:(A) Equal to, or greater than, a total weight of 500 pounds or a total volume of 55 gallons.(B) Equal to, or greater than, 200 cubic feet at standard temperature and pressure, if the substance is compressed gas. (Note: If a HMBP has not been submitted, then code items HM02 through HM07 will be in violation).

○ ○

HM02 19 CCR 2729.2(a)(1) Adequate submission/completion of Business Activities & Owner/Operator Identification forms. ○ ○

HM03 19 CCR 2729.2(a)(2) Adequate submission/completion of chemical inventory forms. ○ ○HM04 19 CCR 2729.5c

Annual submission of the Business Activities form, Owner/Operator Identification form and chemical inventory forms when required by EPCRA (if storing > 10,000 pounds of a hazardous material or an amount ≥ the TPQ or 500 lbs [whichever is less] for an extremely hazardous material).

○ ○HM05 19 CCR 2729.2(a)(3) Adequate submission/completion of site map. ○ ○HM06 CHSC 25504 Adequate submission/completion/retention of written Contingency Plan. ○ ○HM07 CHSC25505(e)(2) HMBP is maintained on-site and/or is accessible. ○ ○HM08 CHSC 25504(c) &

19 CCR 2732Initial employee training program for hazardous materials/emergency response has been implemented within 6 months of hire. ○ ○

HM09 CHSC 25504(c) &19 CCR 2732

Annual hazardous materials/emergency response refresher component of the employee training program has been implemented. ○ ○

HM10 19 CCR 2731(c) MSDS (Material Safety Data Sheets) are accessible. ○ ○HM11 19 CCR 2731(c) Emergency shutoffs for chemical processes or equipment are labeled. ○ ○HM12 19 CCR 2731(c) Emergency equipment (such as fire extinguishers, spill prevention & alarm equipment)

tested & maintained as necessary (e.g. fire extinguishers assessed annually). ○ ○HM13 19 CCR 2731(c) Spill control and spill mitigation materials are available (e.g. absorbents, rags, or shop

vacuum). ○ ○HM14 19 CCR 2731(c) All containers are kept closed unless in use. ○ ○HM15 19 CCR 2731(c) All containers are in good condition. ○ ○HM16 19 CCR 2731(c) Containers stored in a manner to prevent rupture, leaking or structural deterioration. ○ ○HM17 19 CCR 2731(c) Containers are compatible with contents. ○ ○HM18 19 CCR 2731(c) Containers are properly labeled. ○ ○HM19 22 CCR 66261.7 Containers of hazardous materials are disposed of properly when empty. ○ ○HM20 19 CCR 2731(c) All spills promptly addressed to prevent discharge to air, soil or surface water. ○ ○HM21 19 CCR 2731(c) Storage area is maintained to separate incompatible materials. ○ ○AST00 CHSC 25270.4.5(a) Facility storing petroleum in eligible ASTs (total capacity >1320 gallons) has a Spill

Prevention Control and Countermeasure Plan (SPCC) on site. ○ ○

_________________________________________________________________________________________Facility Representative Signature Printed Name Date




COUNTY OF ALAMEDA INSPECTOR__ _____________, Page of )

SITE ADDRESS: ___________________________________________ZIP CODE: ___________Notification received from : [ ] Law Enforcement [ ] Property Owner [ ] Other Case Agent Agency Case # Phone (c) Phone (w)

Property InformationSite Name Address City State Zip Site Phone No.( ) Lat Long APN# Property owner on-Scene at Time of Incident Yes No Property Manager Name: Phone Number:

Property Owner (Attach a copy of the County Assessor Ownership record.) Name Address City State Zip Phone No.( )

Property Description Single Family Duplex Apartment Mobil Home Motel Other . Owner occupied Rent Vacant Single Story Multi Story # of bedrooms . # of Bathrooms .Garage: 1 Car 2 Car 3 Car Other .

Property Posted for ContaminationProperty Contamination Indicated Yes No Date: / / . Areas/Rooms Posted . Describe the location of the illegal methamphetamine manufacturing or storage site in relation to the habitable areas of the property:



SITE ADDRESS: ___________________________________________ZIP CODE: ___________Summary Property ObservationsEvidence- The property inspection shall include, but not be limited to, obtaining evidence of hazardous chemical use or storage and documentation of evidence of any chemical stains, cooking activity and release/spillage related to the manufacture of methamphetamine.

Evidence of methamphetamine storage on the property? Yes No How Much Location(s)

o Document the Room/Area(s) of methamphetamine storage on the site map.

Evidence of hazardous chemical/waste storage on site? Yes No Location And Description of Chemicals

o Document the Initial clean-up efforts and the chemicals that were removed from the scene on the HIRT Report, and Hazardous Waste Manifests.

o Document the Room/Area(s) of Chemical storage on the site map.

Evidence of meth lab activity (stains, spillage, laboratory) Yes No Location(s)

Type of Process Used

o Document the Room/Area(s) of methamphetamine storage on the site map.

The length of time the property was used as an illegal methamphetamine manufacturing or storage site. .

The type of methamphetamine process, or precursor processes:

o Active Lab Yes No , Relative Size of Lab

o Former Lab Yes No ,

Signs of contamination outside the property structures Yes No

Did the methamphetamine laboratory activity include the use of:Exhibit D

Page 19 of 35


SITE ADDRESS: ___________________________________________ZIP CODE: ___________Lead Compounds Yes No ,

Mercury Compounds Yes No ,

Any known instance of human chemical exposure, Signs & Symptoms Yes No Document Confidential information on the HIRT Report.



SITE ADDRESS: ___________________________________________ZIP CODE: ___________Complete a visual inspection, and air monitoring survey for each room/area of the property.

Collect samples as outlined in the sampling section of the guidance document, (e.g. single sample for each non suspect room/area, 6+ samples for each suspect room/area.

Instrument Data: CGI ID # PID ID #

Room/Area CGI PID Drager pH Methcheck Sample ResultsPosted: [ ]Yes, [ ]No

Methcheck samp#

Location Result pass/positive

Drug Detected

Det limit

Meth Storage? [ ]Yes, [ ]NoChem/Waste Storage? [ ]Yes, [ ]NoStaining/Spills? [ ]Yes, [ ]NoCooking/Manufacturing? [ ]Yes, [ ]NoObservations:


MethcheckSamp#

Location Result Pass/positive

Drug Detected

Det limit



Methcheck Samp#

Location Result Pass/Positive

Drug Detected

Det limit




SITE ADDRESS: ___________________________________________ZIP CODE: ___________

Room/Area CGI PID Drager pH Sample ResultsPosted: [ ]Yes, [ ]No

MethcheckSamp#

Location Result pass/alarm

Drug Detected

Det limit

Meth Storage? [ ]Yes, [ ]NoChem/Waste Storage? [ ]Yes, [ ]NoStaining/Spills? [ ]Yes, [ ]No LeadCooking/Manufacturing? [ ]Yes, [ ]No Mercur

yObservations: Iodine

Phosphorous


Methcheck Samp#


Drug Detected

Det limit

Meth Storage? [ ]Yes, [ ]NoChem/Waste Storage? [ ]Yes, [ ]No LeadStaining/Spills? [ ]Yes, [ ]No Mercur

yCooking/Manufacturing? [ ]Yes, [ ]No IodineObservations: Phosph

orous


Methcheck Samp#


Drug Detected

Det limit



Phosphorous

Notes








Saber Samp#


Drug Detected

Det Limit



Phosphorous


MethcheckSamp#


Drug Detected

Det limit



Phosphorous


methcheck Samp#


Drug Detected

Det limit



Phosphorous

Notes







CONTRACTORS WILL HAVE ACCESS TO CONFIDENTIAL SITE MAPS THAT ARE NOT FOR PUBLIC DISCLOSURE



SITE ADDRESS: ___________________________________________ZIP CODE: ___________ Additional Information Supporting Determination of Contamination

DEH Follow-upRequest and review of supplemental Reports/Documentation:Law Enforcement Reports Forensic Chemist Reports Review HIRT and Complaint Database History of Drug Manufacturing at the site? Yes No

If not contaminated: Within 3 days remove any property postings. With in 10 days prepare and send a written a report to: / / . Date a copy of the report sent to the Property Owner / / . Date a copy of the report sent to the Local Housing Agency

If contaminated, within 10 days: Record a Lien (costs for Chap. compliance) Issue Order prohibiting use occupancy to:

o All Known Occupantso Persons who have Property interestso Complete Affidavit’s for any failure to Issue o Copy to Local Housingo Post a copy at the Property.

Send a referral to SAM for tracking and follow-up.

Confidential Not For Public Disclosure



SITE ADDRESS: ___________________________________________ZIP CODE: ___________Known Occupants (If Property Posting or Determination of Contamination is possible.)

Name Temp/Cell Phone Temp Address (For Clan Lab Operator also get DOB and CDL#)

Guardian Name

( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) -

Agency Contacts )Agency Name Contact Name Contact Phone Agency Phone Case #

( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) - ( ) -

Notes



SITE ADDRESS: ___________________________________________ZIP CODE: ___________Instructions: Log all time and lab costs for this inspection, determination of contamination. Activities include response, initial clean up, site inspection, and survey, sampling, posting, review of related documents, report preparation, narratives, chronologies, write-ups, meetings, and all other time related to THIS CASE.

(PRIVATE)Date

Specialist's Name Total Time Purpose

Total Time Hrs. Reviewed by:

The cost center is 428V72 (Oracle 1008710 DEH LWQ SAM METH LAB CLEANUP).Lab Sampling Analysis Cost Summary

Date Cost Comments

TOTAL $ Reviewed by:

Lab Costs + (Total Hours X $115.00/HR) = TOTAL COST

= $ TOTAL COST



SITE ADDRESS: ___________________________________________ZIP CODE: ___________ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH

Certified Unified Program Agency (CUPA) 1131 Harbor Bay Parkway • Alameda, CA 94502 -6577 • (510) 567-6700 • (510) 337-9335 FAX

INSPECTION REPORT SUMMARY / SUMMARY OF VIOLATIONSFacility Name: Facility Address:Contact Person: Telephone:Type of Business:

UNIFIED PROGRAM SUMMARY Program Inspection COMMENTS

Program

Hazardous Materials Business PlanRisk Management Plan / CalARPUnderground Storage TankAboveground Petroleum Storage Tank

Does the facility have an SPCC Plan? Hazardous Waste GeneratorUniversal WasteTiered Permit: Permit-by-Rule

Conditionally AuthorizedConditionally Exempt, Specified Waste StreamConditionally Exempt, Small Quantity TreatmentConditionally Exempt, LimitedConditionally Exempt, Commercial Laundry

INSPECTION CHECKLISTS COMPLETED AND ATTACHED

HMBP Inspection Checklist Hazardous Waste Generator Inspection Checklist Tiered Permit Inspection Checklist Underground Storage Tank Checklist(s) Inspection Notes Inspection NarrativeDid a facility representative grant permission for this inspection? YES NO

Submit all required documents, reports and/or plans (including Corrective Action Plan) within _____ days.

All violations noted are to be corrected immediately. Compliance will be verified on or after ___________________.

Failure to comply with requirements established in this inspection report and in all attachments to this report, or in subsequent correspondence may result in the issuance of a Notice of Noncompliance. Noncompliance is punishable by criminal and/or civil penalties under applicable local, state and/or federal laws or regulations.

DATE OF INSPECTION INSPECTOR SIGNATURE OF FACILITY

REPRESENTATIVE

ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTHExhibit D

Page 30 of 35


SITE ADDRESS: ___________________________________________ZIP CODE: ___________ Certified Unified Program Agency (CUPA)

INSPECTION REPORT SUMMARY / SUMMARY OF VIOLATIONSNARRATIVE

Facility Name:

Facility Address:

Date of Inspection Inspector Signature of Facility Representative



SITE ADDRESS: ___________________________________________ZIP CODE: ___________ALAMEDA COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH

CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)TIERED PERMIT INSPECTION CHECKLIST Permit-By-Rule

Facility Name:

Date of Inspection:

Facility Address:

Inspector:

REQUIREMENTS 22CCR Section COMMENTS

A. NOTIFICATION

1) Maintain on site copy of most recent Notification 67450.3(c)(8)(E) 2) Maintain on site copy of most recent

Acknowledgement.67450.3(c)(8)(E)

3) Permit each treatment unit (TU) in proper tier. 4) Identify each TU on form DTSC 1772. 67450.3(c)(1) 5) Keep current the information on form DTSC 1772. 67450.3(c)(2) Ref. 67450.2(b)(1) 6) Show location of each TU on plot plan/map. 7) Complete submittal of notification documents. 67450.2(b)(3) 8) Pay all required fees. 67450.3(c)(3) 9) Comply with POTW pretreatment standards. 67450.4(c)(5)10) Submit annual waste reduction certification. Ref.

H&SC25202.9B.PBR OPERATIONS 1) Use only processes listed in treatment of waste. 67450.3(c)(4) Ref. 67450.11 2) Treat only wastes listed for the process used. 67450.3(c)(4) 3) Treat only waste generated on site. 67450.3(c)(6) 4) Attach permanent label on TU indicating name of

operator or owner, Facility ID and TU serial numbers.67450.3(c)(7)

5) Maintain on site a written waste analysis plan. 67450.3(c)(8)(A) 6) Address noted deficiencies in waste analysis plan. 66265.13(b) 7) Maintain on site a written inspection schedule. 67450.3(c)(8)(B) 8) Address noted deficiencies in inspection schedule. 66265.15(b)(4) 9) Maintain an up-to-date inspection log or summary. 66265.15(d)10) Keep inspection records for three years. 66265.15(d)11) Maintain on site a current Contingency Plan. 67450.3(c)(8)(D)12) Address noted deficiencies in Contingency Plan. 66265.5213) Maintain on site a BAAQMD Permit for TU. 67450.3(c)(8)(F)14) Maintain on site a current Closure Plan. 67450.3(c)(8)(G)15) Address noted deficiencies in Closure Plan. 67450.3(c)(11)(B)16) Maintain on site documents on investigation, cleanup,

abatement or other remedial action.67450.3(c)(8)(H)67450.7

17) Maintain on site documents on convictions, judgments, settlements or orders from any enforcement action.

67450.3(c)(8)(I)

18) Maintain on site documents on treatment, including operating instructions and record of dates, amounts, and types of wastes treated in each unit

67450.3(c)(9)(D)66265.73

19) Provide containment for treatment containers. 67450.3(c)(12) Ref. 66264.17520) File report for onsite recycling that exceeds 100 kg/mo.21) Review claim for recycling exemption.22) Submit / Update a Phase I Env. Assessment Report. 67450.3(c)(9)(D) Ref. H&SC25200.1423) Secure treatment area w/ 24-hr entry control. 67450.3(c)(9)(A)24) Maintain treatment unit in good order. 67450.3(c)(9)(A)



SITE ADDRESS: ___________________________________________ZIP CODE: ___________REQUIREMENTS 22CCR Section COMMENTS

25) Post “No Smoking” signs. 67450.3(c)(9)(A)

26) Maintain on site records of tank system integrity. 67450.3(c)(9)(F)27) Address noted deficiencies in treatment processes: 67450.3(c)(9)

- Thermal Treatment 67450.3(c)(9)(G)- Chemical, Physical

and Biological Treatment 67450.3(c)(9)(H)

28) Submit Annual Report to DTSC. 67450.3(c)(10)29) Submit Financial Assurance statement/instrument.30) Address deficiencies noted in Fin. Assurance checklist.31) SEE ATTACHED INSPECTION NARRATIVE

Note:

Name/Signature of Facility Representative Date


Facility Name: Inspector:

Address:

Inspection Comments

1.

2.

3.

4.

5.

__________________________________________________________ Received by: Signature of Facility Representative Printed Name Date of Inspection
