DSHW-2024-005050

Review Source Record
MEDLINE INDUSTRIES 1820 S. 5200 WEST - SALT
LAKE CITY - 84104
UTP000001725
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p_handler_id=UTP000001725&p_activity_locatio
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1. Reason for Submittal
2. Site ID
3. Site Name
4. Site Location
General Information
Received Date
03/01/2024
Non-notifier Extract to Public?
Yes
Accessibility Acknowledgement Flag
Notifying that regulated activity is no longer occurring at this Site. [Source D]
EPA ID
UTP000001725
Activity Location
UT
Name
MEDLINE INDUSTRIES
Location Address
Street
Number
1820
Street 1
S. 5200 WEST
Street 2
Zip
84104
City, Town or Village
SALT LAKE CITY
State
UTAH
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5. Site Mailing Address
6. Site Land Type
7. North American Industry Classification System (NAICS)
8. Site Contact Person
Country
UNITED STATES
County
SALT LAKE
State District
View on Map Geographic Information
Coordinate Type
Decimal Degrees
Latitude
40.730427
Longitude
-112.015607
Use Lat/Long as Primary
Address
No
These coordinates have been provided by an automatic geocoding service. Please click View on Map and
confirm that these coordinates are accurate.
Street
Number
1820
Street 1
S. 5200 WEST
Street 2
Zip
84104
City, Town or Village
SALT LAKE CITY
State
UTAH
Country
UNITED STATES
Land Type
Private
Primary NAICS
423450 - MEDICAL, DENTAL, AND HOSPITAL EQUIPMENT AND SUPPLIES MERCHANT WHOLESALERS
Other NAICS
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8a. Site Contact Address
8b. Additional Contacts
9a. Legal Owner
9b. Legal Operator
First Name
JOE
Middle Initial Last Name
MOROZIN
Title
WAREHOUSE MANAGER
Email
[e-mail]
Phone Number
801-604-5213
Extension Fax
Preferred Language
ENGLISH
Street
Number
1820
Street 1
S. 5200 WEST
Street 2
Zip
84104
City, Town or Village
SALT LAKE CITY
State
UTAH
Country
UNITED STATES
Type Name Address Action
COMPLIANCE REBECCA BROWN 42500 WINCHESTER ROAD, TEMECULA,
CA 92590
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Type Name Address Date Action
Private MEDLINE INDUSTRIES, LP 1820 S. 5200 WEST , SALT LAKE
CITY, UT 84104
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Type Name Address Date Action
Private MEDLINE INDUSTRIES, LP 1820 S. 5200 WEST , SALT LAKE
CITY, UT 84104
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10. Type of Federal Regulated Waste Activity
A. Hazardous Waste Activities
11. Additional Regulated Waste Activities
1. Generator of Hazardous
Waste (Federal)
N - Not a Generator
Generator of Hazardous
Waste (State)
F - Same as federally defined
2. Short Term Generator
None Selected
3. Treater, Storer, or Disposer
of Haz Waste
None Selected
4. Receives Hazardous Waste
from Off-site
None Selected
5. Recycler of Hazardous
Waste
None Selected
6. Exempt Boiler and / or
Industrial Furnace
None Selected
B. Waste Codes for Federally Regulated Hazardous Wastes
A. Hazardous Waste Codes (Federal)
None Selected
C. Waste Codes for State Regulated (non-Federal) Hazardous Wastes
B. Hazardous Waste Codes (State)
None Selected
A. Other Waste Activities
1. Transporter of Hazardous
Waste
None Selected
2. Underground Injection
Control
None Selected
3. United States Importer of
Hazardous Waste
None Selected
4. Recognized Trader
None Selected
5. Importer/Exporter of
SLABs
None Selected
B. Universal Waste Activities
1. Large Quantity Handler
of Univ Waste
None Selected
C. Used Oil Activities
1. Used Oil Transporter
None Selected
2. Used Oil Processor and /
or Re-refiner
3. Off-Specification Used Oil
Burner
4. Used Oil Fuel Marketer
None Selected
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12. Eligible Academic Entities with Laboratories
13. Episodic Generation
14. LQG Consolidation of VSQG Waste
2. Destination Facility for
Universal Waste
None Selected
None Selected None Selected
D. Pharmaceutical Activities
Operating under 40 CFR 266 Subpart P for the management of hazardous waste pharmaceuticals.
None Selected
Withdrawing from operating under 40 CFR 266 Subpart P for the management of hazardous waste
pharmaceuticals.
No
E. State Activities
Your State does not have any State defined activities.
1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of
hazardous wastes in laboratories.
2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in
laboratories.
No
Are you an SQG or VSQG generating hazardous waste from a planned or unplanned episodic event,
lasting no more than 60 days, that moves you to a higher generator category pursuant to 40 CFR Part
262 Subpart L? If "Yes", you must fill out the Addendum for Episodic Generator.
No
Are you an LQG notifying of consolidating VSQG hazardous waste under the control of the same
person pursuant to 40 CFR 262.17(f)?
No
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15. Notification of LQG Site Closure for a Central Accumulation Area (CAA) (optional) and Entire Facility
16. Notification of Hazardous Secondary Material (HSM) Activity
17. Electronic Manifest Broker
18. Comments
Internal Comments
Public Comments
19. Certification
LQG Site Closure of a Central Accumulation Area or Facility
No
Are you reporting HSM activities?
No
Are you notifying as a person, as defined in 40 CFR 260.10, electing to use the EPA electronic manifest
system to obtain, complete, and transmit an electronic manifest under a contractual relationship with a
hazardous waste generator?
No
First Name M.I.Last Name Title Date Signed Action
Rebecca A Brown EHS Manager 03/01/2024 
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