DSHW-2018-003830 - 0901a06880807873

HAZARDOUS WASTE INSPECTION REPORT
WASTE MANAGET{gNT
8 RADIATION CONTROL
INSPECTION REPORT FOR:
DATE OF INSPECTION:
FACILITY ADDRESS:
FACILITY COUNTY:
FACILITY CONTACT:
EPA ID #:
CURRENT NOTIFICATION:
TYPE OF INSPECTION:
PARTICIPANTS:
TIME IN/TIME OUT
REPORT PREPARED BY:
WEATHER CONDITIONS:
APPLICABLE REQUIREMENTS:
FACILITY DESCRIPTION:
St. Marks Hospital
March 2I.2OI8
1200 East 3900 South
Salt Lake City, Utah 84124
Salt Lake County
Mark Davies, Director Plant Operations
[phone]
urD072998032
LQG
CEI
Mark Davies. St. Marks
Shane Frank, St. Marks
John Jones, St. Marks
Denny Schantz, DWMRC
Jon Parry, DWMRC
1300 hrs. / 1600 hrs.
Jon Parry
Partly Cloudy, -61oF
R315 of the Utah Administrarive Code
St. Mark's Hospital is a licensed, 300 plus bed full service hospital, which covers about 635,000
square feet of active space. The hospital has been at its present location since about 1982 and
has more than 1500 employs and volunteers.
The facility is located in a mixed residential / commercial neighborhood on flat terrain. No
surface water was observed near the hospital.
CREDENTIALS. PURPOSE AND SCOPE:
The inspectors met with and presented their credentials to Mr. Mark Davies, Director of Plant
Operations. The inspectors explained that this was a routine hazardous waste compliance
evaluation inspection. The purpose of which was to evaluate St. Marks compliance status with
respect to applicable rules. The scope of the inspection would include a review of pertinent
documents and a tour of the facility's hazardous waste generation and management areas.
MANAGEMENT ACTIVITIES :
St. Marks generates the following hazardous waste streams. The amounts are based on their
most recent biennial report.
o D011 filter socks, - 2 gallons per year
o P.U.D.'s, RCRA regulated medications, -3 pounds per year
o D01l blood lab solvents, - 7 gallons per year
o D001 solvents, -6 gallons per year
o P001, P075, P0188,U010, - 2 pounds per year
Solvent and silver wastes are generated in the blood lab. P, U, and some characteristic wastes
are generated in the pharmacy, at nursing stations or in the patient's rooms and are managed in
satellite containers.
Listed wastes consist almost entirely of drug residues in otherwise empty containers.
Consequently, the hospital uses l0 gallon satellite containers but the contents consist mostly of
packaging rather than actual hazardous waste.
Once the satellites are full they are transferred to the facility's 90 day storage area which is in a
locked shipping container.
Inspectors educated the hospital on the new Generator Improvement Rule and informed them of
the need for additional labeling as to the nature of the hazard on waste containers. The hospital
committed to ordering additional labeling for accumulation and satellite containers.
lnspector also discussed the requirements for a quick reference guide for the facility's
contingency plan. The hospital stated that they would develop the guide when they updated the
plan. Inspectors suggested that should happen within the year.
NARRATIVE:
Inspectors conducted the records review in Mr. Davies office. The facility's records and plans
were in adequate. The Hospital has many required plans and procedures and what isn't available
in one plan is available in others.
After the paper work review inspectors visited a patient's room, nursing station and pharmacy
and observed typical satellite containers. Containers were closed and labeled but lacked an
indication as to the nature of the hazard. The hospital stated that they would order appropriate
labels.
Inspectors visited the blood lab and noted that the satellite there had additional appropriate
labeling.
Finally, the inspectors visited the maintenance facility and 90 day area. Containers were closed
and in good condition but require the additional labeling as well.
COMPLIANCE STATUS: (also see attached checklist)
St. Marks has committed to ordering additional labeling and developing their contingency plan
quick reference guide in a timely manner.
ISSUES:
None noted n
INsPECToRsIGNATURE: I /- "nn Llfzrf z<>r Bm
Cl cle Site Nome Siie ID
2017 ST. MARK'S HOSPITAL uTD072998032
GM 1 Wsst+ Chargcteristiff
A. Description of hazardous w,rsle
NA3077 HAZARDOUS WASTE, SOLID, NOS (SILVER) SILVER SOCKS
B. EPA Hazardous Wqste Codc(s)
Dol I
D. Source Code
Glt
E. Form Code
w001
F, Waste Minimization Code
X
G. Ouantitr
2.O
UOM
GALLONS
Density
7.27 lbslgal
On-site Generation ud Maaagemnt of Hmdour Wmts
Off-site Shipment of Hmdous Waste
Site I
NVD980895338
C. Manqpement Method Code
Hl4l 2.0
Commentg
Manifest@'s 010,{20501 - 009450479
GM 2 Waste Charscteristics
A. DescriDtion of hazardous waste
UN329I WASTE REG MEDICAL WASTE NOS 6.2 PCII
B. EPA Hazardous Waste Code(s)
P00 t. P075, Pl 88, U0 r0, u058, u059
C. State HazardoLts Waste Code(s)
D. Source Code
cll
E. Form Code
w005
F. Waste Minimization Code
x
G. Ouantit\
3.0
UOM
POUNDS
PsljJ)
On-site Cen€ration and Maoagement of Haardous Waste
Off-site Shipment of Hmdous Waste
Site I B. EPA lD of faaluv ro which wasre was shipped
uTD98l552l77 H040
D. Total Ouantitr Shipped
3.0
Comments
Manifest#'s 01030722E
GM f, Waste Chamcteristics
UNI993 WASTE FLAMMABLE LIQUIDS NOS ALIPHATIC HYDROCARBON SHANDON XYLENE SUBS
D0l I
C. State Hazarclous Waste Code(s)
D. Source Code
cll
Ma na s etnent M et hod Coale E. Form Code
w00l x
G. Ouantitr
7.O
UOM
GALLONS
PstiJt
7.27 lbslgal
On-site Generation and Manag€ment of Haardous Waste
Off-site ShiDment of He{dous W6te
Site t
uTD98l552l77
C. Manaeenent Method Code
H040 210.0
Comments
Manifesr#'s010420406-009450820-009450770-009450707-009450638-009450574-009450483
Page I ol2
GM 4 Weste Charrcteristics
UNI993 WASTE FLAMMABLE LIQUIDS NOS ALIPHATIC HYDROCARBON SHANDON XYLENE SUBS
D00l
D. Source Code
Gll
E. Form Code
w001
F. Waste Minimization Code
X
C. Ouantit\
6.0
UOM
6ALLONS
Densitv
7.27 lbs/gal
On-site Generation md Management of Hazardous W6te
Off-site ShiDment of Haandous Waste
Site I
NED98 l 72 35 t 3
C. Manaeenent Method Code
H040 6.0
Coments
Manifest#'s 0 I 0420'162 - 010420705 - 0 I 0420638 - 0 I 042058 1 - 0 I 0420508
GM 5 Waste Chemcterisdcs
A. Description of hazardous waste
UN23 I 5 POLYCHLORINATED BIPHENYLS, LIQUID P PGII
D00 I
D. Source Code
G15
E. Form Code
w205
F. Waste Minimization Code
x
G. Ouantit\
400.0
UOM
KILOCRAMS
Density
On-site Genemtion md Milagemenl of Hmdous Waste
Off-site Shipmenr of Hffidous Waste
Site I B. EPA ID offacilitvtowhich w,asteu'as shioped
rDD073 I 14654 Hl32 400.0
Coments
Manifest# 010420542 Oily liquid removed from trusfom€r rhat has been removed from seryice.
GM 6 Waste Cheracterlstlc
UN329I WASTE RECULATED MEDICAL WASTE N,O.S.6.2 PCII
P00 I . P075. Pl E8. U0 I 0
D. Source Code
Gil
Manogement Method Code E. Form Code
w005 x
G. Ouantitt
2.O
UOM
POUNDS
P-z!!JJJ
On-site Generation and Mgnagerent of Hazardous Wrote
Off-site ShiDment of Hmdous Waste
Site I
TXD982290 140
C. ManaPement Method Code
H040 2.0
Coments
Manifest#01031519t
Page 2 of 2
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TVASTE MAN.AGEIIEHT
T PADIATIOII COTITPOL
site: f,, tvqg<S Hgprul_EPA #: e-rbltr)?cz>
Hazardous Waste Inspection
Manifest Checklist
Requirements ManifestsRbviewed
Manifest Number (box 4)&cAt446o FU2 41c.+tqcr6trtf.4p4zczoq Fct iia3o72?,RFtEGenerator EPA ID#
Appendix to R3l5-262 (box l)- aE-- cr-- 6k--OK
Generator information:
Mailing Address (box 5)
Phone Number
_aK
- oF_
-Srgf,r<{a;r €
- C2t<
-*\
-w
-oA
-oK*
- ft.fucltJ.Q.
- OF_
-oK
-oK
'l'ransporter #l information:
Company Name (box 6)
EPA ID# (box 6)
- S-r{f-11*-r 6-
-aF_
- c4Att tt0fl.9
- ol1'-
I'ransnorter #2 information:
Company Name (box 7)
IIPA ID# (box 7)
N/A
- 213t6:1rp€-Y
r+4\J, l4bl4,T'1-OA
- a_?
_od
-oA
- oE--&-
- 5ot I c./-
- tJ/A
- cfi af#rCrttx{.
-oK
-o(
_atAxs rf4&8
_ c'lz-
-c,t-f/*/o i./,(AF
._ oy_
4H AR{*ylffE
- O'L
_ oy-
- or.-
_ 6f._
-'3orJ
- F Gur>prs)
-ftr't fo'75 FI*
Oee tlt5? v6t
Desienated Facilitv information:
Name and Address (box 8)
IIPA ID# (box 8)
Phone Number (box 8)
-ell Krrffi2uN(;
- or-
-olz-
- D.iL
-eK
_ trlL_
-OA-M't
Waste Shipnins requirements:
DOT Description (Including proper
name, Ilazard class, and ID #) (box 9b)
(box 9a "X" if hazardous materials)
Containers: No & Type (box l0)
Total Quantity (box I l)
Unit - WtAr'ol @ox 12)
Waste Codes (box l3)
_oK_
-OL
-ot-
_0k_
_ ltuT &t-]t.>ttjblt> l,r)'.':2 h/t]1
Special l{andline Instructions
(box l4)-q(- bk:-%-oK^
M an ife st Ce rti fi catio ns:
Generator's Signature (boxl5)
International Shipments (box l6)
Transporter's Signature (box l7 )Discrepancy Indication (box l8)
Hazardous Waste Report Management
Method Codes (box 19)
- o(<
-o(
-o€
-oK-x_
H r+t
-oK-q-_+Nl/.:
- H/A
-oA-oL
- k/A
-_(^<
H04t)
_ok'-
- oK_
- N/x
--ok-
Ho4oFacility Signature (box 20)
- oF\Cf-*ERffiR
- lA|r6Ler{'Y - oF-,-*_
Final Obsen'ations and Comments:
Commoncontainercodes:DM-metaldrum\barrel;DF.fib"'bu.'el
box\carton(includes roll-offs) Common Unitsof Measure: G-gallons;P -pounds; T-tons; y- cubicyards)w
January 2018 Page I of I Inspectors Initials
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1_V-- a";., 11'
WASTE }IANAGEMEHT
& RADIATIOH CONTFOL
3f /l*fs EPA #:
Hazardous Waste Inspection
Satellite Accumulation Checklist
<55 gallons
INSPECTION ITEM CITATION COMMENTS
Is the satellite accumulation area at or near the
point ofgeneration?
R3 I 5-262-l 5(a)?6
Is the satellite area under the control ofthe
operator ofthe process generating the rvaste?R3 I 5-262-l 5(a)
7ut
Does the generator have the accumulation
container labeled rvith the u'ords "hazardous
u'aste"?R3 I s-262-l 5(a)(5)(i)tlQt
The generator can not store more than 55
gallons ofhazardous rvaste or I quart of
acutely hazardous waste at the satellite
accumulation area.
R3l5-262-15(a)
C*^\-, r,^ \ rtr< lonkuK {Lrn
I X-^nlJ L..4,{e\ t,c.,l,- }
4-\ d-a tr=t-- ,wor k )6.\
,l^i.^..A,rtajtl p
Are the containers in good condition, and
being managed in a rvay so it does not leak
or soill?
R3 I 5-262-l 5(a)(l )76
Is the hazardous rvaste stored in containers that
are compatible rvith the uaste?R3 I 5-262-l 5(a)(2)loc
Is the accumulation container being
maintained in a closed condition except
rvhen rvaste is being added or removed, or
rvhen temporary venting is necessary' for
proper operation ofequipment or to prevent
dangerous situations such as pressure
buildup?
R3 I 5-262-l 5(a)(4)10:
Does the generator have the accumulation
containers marked rvith an indication of the
hazards of its contents?
R3 I 5-262-l 5(a)(s)(ii)
S+ rv1a,r65 *. l\ hpd- L ,+(\
Zo.^to ,h q,{ ! , t,- , }L^, na Lrr-r=,17 [,,t,+ Z"a.<c\
Is the generator conectly labeling and moving
hazardous waste, in excess ofthe 55 gallon or
I quart limits, to a 90-day storage area within
72 hours of exceedins the limit?
R3l5-262-15(aX6 Xi)'r n'
Januarv 2018 Page I of I lnspectors Initials
IYAS7E HAt{AG€14€N7;i PADiATICi{ CONTPO!
EPA #:
Hazardous Waste Inspection
90 Day Storage Site
>55 gallons
INSPECTION ITEM CITATION COMMENTSl. Is the container labeled rvith the
rvords "Hazardous Waste"?
2. Is the container marked or labeled
rvith an indication ofthe hazards of
the contents?
3. Is the date upon rvhich accumulation
began clearly marked and visibly for
inspection?
4. Is that date <:90 days old?
R3 I s-262- I 7(a)(s)(i)(A)
R3 I s-262- I 7(a)(s)(i)(B)
R3 I s-262- I 7(a)(s)(i)(C)
P.315-262-17(a)
l4t
./.. ll ,^. l-, 6 = ,n'a L,nl ,!-
+t-< h,t t-r {. u
7 a(
1-4
4. Is there a Preparedness and Prevention
Plan for this site or the facility as a rvhole,
including this site? (see separate Check l,ist)
R3 ls-262-17(a)(6)
R3l5-262-250 thru 256 ?q
5. Operated to minimize chance of Spill or Fire?
6. Spill and Fire control equipment?
7. Emergency communication device: Internal?
Emergency communication device: External?
Sufflcient Aisle and Access snace?
R31s-262-251
R31s-262-2s2(c)
R31s-262-252(a)
R3rs-262-2s2(b)
tr3r5-262-255
q4
'(*teel
8. Is there a Contingency Plan for this site or
the facilitl' as a *'hole, including this sitc?
(sec separate Check List)
9. a. Description ofactions that should be taken?
b. Name & Phone # for Eniergency Coordinator?
c. Primary and alternate evacuation routes?
d. List of emergency equipment & location?
R3 I 5-262-l 7(a)(6)
R315-262-260 thru 265
P.3t5-262-261(a)
R3l5-262-261(d)
R3t5-262-261(f)
R3l5-262-261(e)
I
?p\
bC
"l -\'Q P}t-r.z \
Ilave personnel at this site Successfully
completed up to date Personnel Training on
I{zW Handling & Fire & Spill Response?
Is the training documented?
(see separate Check List)
R3 I s-262-l 7(a)(7)(i)
R3 I 5-262-l 7(a)(7)(v)
o(-.
6t_
Are the containers accumulating and holding
hazardous rvaste in good condition?
Are they compatible rvith the HzW in them?
R3 | 5-262-l 7(a)(l)(ii)
R3t5-262-17(aXlXii0
ue\
16
Is the generator maintaining his/her containers
in a closed condition except *'hen adding or
removing waste from the container?
R3 I 5-262- I 7(a)( I )(iv)(A vl J\
Containers holding hazardous lvaste must not
be opened, handled and/or stored in a manner
rvhich could cause it to leak.
R3 ls-262- I 7(a)( l)(iv)(B
&_
Is the generator inspecting his/her containers
at least rveekly, and do the inspections look for
leaks, deterioration, and any factor that may
cause a release ofhazardous waste?
R3 I 5-262-l 7(a)(1)(v)Yr
No ignitable or reactive HzW rvithin 50 feet of
the facility's property line.R3 1 s-262- I 7(a)( I XviXA L
Ianuary 2018 Page I of I Inspectors rnitiils &f
^lSite Name' 5#flh'4't{
.*' tt;e Yl:
1"Wfr
9/AST€ HANAGSMENT
8,. pADtATtOII COr{tFoL
EPA ID:Date: 51zrl /S
INSPECTION ITEM CITATION ,'GOMMENTS. .,:,,,.:,i
Waste Determination:
l. Has the ge nerator determined
rvhether his/her solid rvaste is a
hazardous rvaste?
2. Has a rvaste determination been done
for each u'aste stream?
R3t5-262
R3l5-262-tl
40 cFR262.t I
R3l5-261-3
40 cFR 261
YO\
1n\
3. Has the generator notified of
regulated activity and obtained an
EPA ID# in accordance rvith the
requirements of Section 3010 of
RCRA?
R3 I s-262- I 0(a)( 1 )(iii)(c
R3l5-262-18(a)
40cFR262 l0(d)(lXiiiXC)
40 CFR 262 l8(a)
7?r
Manifest:
l. Is the generator using a lJniform
Hazardous Waste Manifest for its
shipments of hazardous rvaste?
2. Did the generator designate a facility
permitted to handle its waste?
3. Was an alternate facility designated?
4. Did the generator use the correct
manifest?
R3l5-262-20(a)(l)
40 CFR262.20(a)(1.
R3 l5-262-20(b)
40 cFR 262.20(b)
R3t5-262-20(c)
R315-262-20(a)(r)
40 CFR 252.20(aXl:
t( nl
of es
t4.o
1er
Manifest requirements for the Generator
l. Did the generator sign the manifest
certification by hand?
2. Did the generator obtain a handuritten
signature from the initial transporter and
the date ofacceptance?
3. Did the generator retain a copy ofthe
manifest in accordance with
F.3l5-262-40(a)?
R3ls-262-23(a)(l)
40 CFR 262.23(aXl)
R3rs-262-23(a)(2)
40 CFR252.23(aX2)
R3 I 5-262-23(a)(3)
{0 CFR 262.2J(a)(3)
70(
\as
.( Z(
Recordkeeping:
1. Is the generator maintaining signed
copies of the hazardous lvaste manifest
for three years?
R3 I 5-262-40(a)
{0 CFR 262.40(a
t(ar
2. Is the generator maintaining copies
ofeach Biennial Report and all
Exception Reports for a period of at
least three years?
R3 l 5-262-40(b)
40 cFR 252.40(b)10)
fanuary 2018 Inspector's Initials Page I of2
Site Name:EPA ID:Date:
3. Is the facility maintaining records
sufficient to determine quantities and
disposition ofhazardous waste or other
determinations, test results, or waste
analyses made in accordance with
R3l5-262-l l(D for a period ofat least
three years from the date oflast shipment?
R3 l5-262-40(c)
r0 CFR 252.10(c)qo/
Biennial Reporting
Has the generator submitted complete
Biennial Report(s)?
N3l5-262-41
40 cFR 262.41 1et
Exception Reporting
Has the generator been required to
prepare an Exception Report, ifyes
describe the circumstances?
F.3ts-262-42
40cFR262.42
uA0
Packaging, Labeling, Marking, and
Placarding
l. Is the generator packaging his/her
hazardous waste in the appropriate
DOT shipping containers?
2. Are containers labeled and marked in
accordance with appropriate DOT
shipping requirements prior to shipping?
3. Is the generator providing or
offering appropriate placarding to
the initial transporter when
initiating his/her shipment?
R3 1s-262-30
40 cFR 262.30
R3t5-262-31&
R3ts-262-32
10cFR2623r &26232
R3t5-262-33
40 cFR 262.33
7ot
Y''
ynt
Accumulation Times
(See Satellite, 90 Day and Tank
Checklists as applicable)
R3l5-262-17(a)
Also see ch.ecklists for:
Personnel Training,
Preparedness & Prevention,
Contingency Plan & Emergency
Procedures and Manifest
Comments:
fanuary 2018
Inspector's Initials jg Page?of 2
#Site: S+ MA,( h/'
WASTE MANAGEEET{I
8, RADIAT'OH CONTROL
EPA #:
Hazardous Waste Inspection
Personnel Training Checklist
INSPECT,ION ITEM CITATION :... :... .COMMENTS
Facility personnel must successfully complete
classroom instruction, online training or on-
the-job training rvhich teaches them to
perform theirjobs, such that the facility is
operated in compliance rvith the applicable
hazardous waste management requirements.
R3 | s -262- | 7 (a)( 7X iXA)
40CFR262 l7(a)(7XiXA)Io'5
Is the program directed by a person trained in
hazardous waste management procedures?
R3 | 5 -262 - | 7 (a)( 7X iXB)
40CFR262.17 (a)(7XiXB)\o t
Does the training teach facility personnel
hazardous $'aste management and contingency
plan implementation procedures?
R3 | 5 -2 62 - | 7 (a)( 7X iX B )
40cFR262 l7(a)(7XD(B)1ut
Does the training progrant include, at a
minimum, the follorving, rvhere applicable:
l. Procedures for using, inspecting, repairing,
and replacing facility emergency equipment;
2. Key parameters for automatic u'aste cut-off
systems;
3. Communications or alarm svstems:
4. Response to fires or explosions;
5. Response to groundrvater
contamination incidents;
6. Shutdorvn ofoperations; and
R3 | 5 -262- | 7 (a)( 7X i)(c)
40CFR262. I 7(a)(7XiXc)
R3 | s -2a- 1 7 (a\1X iXCX I )
40cFR262 l7(a)(TXiXCXl )
R3 | s -2{fl - | 7 (a)(7XiXCX2)
40CFR262 l(a{7XiXcX2)
R3 | 5 -262- t7 (atlTxiXCX3)
40cFR262 I 7(a)(7XiXCX3)
R3 | 5 -262- t7 (a)(1X iXcX4)
40CFR262. I 7(aX7XD(cX4)
R3t5-262-t7(a\TXiXcXs)
40cFR262 1 7(a)(7XiXcX5)
R3t5-262-t7(a){7XiXCX6)
40CFR262 l(a{ixixcx6)
Have facility personnel successfully completed
the personnel training program rvithin six
months of the date of their employment or
assignment to the facility?
R3 I 5-262- I 7(a)(7)(ii)
4 0 CF R2 62.r 7 (a)(7)( i i)u o' w/.eo &1,
Do the facility personnel receive an annual
revierv oftheir initial trainins?
R315-262-17(aXTXiii)
40 cF R2 62. 1 7 (a)( 7(i i i)lot
January 2018 Page I of2 Inspectors l^itiil, #
Site:EPA #:
Hazardous Waste Inspection
Personnel Training Checklist
Date:
The owner/operator of the facility must
maintain the following documents at the
facility:
I . The job title for each position at the facility
relateifG'ffirdous waste managemen! and
the name of the employee filling each job;
2. A writtenjob description for each position
listed under #l;
j. A written description of the type and
amount ofboth introductory and continuing
training that will be given to the employees
listed in #1, and;
4. Records that document that employees have
the training orjob experience required by
paragraphs 265.16 (a), (b), and (c).
R3 I s-262- t 7(a)(7)(iv)
.17(a)(7)(iv)
R3ls-262-l(a[7[iv[A)
l(a[7)(iv[A)
R3 I s-262-l (a[7)(iv[B)
l(a[7[iv[B)
R3 I s-262-l 7(a[?[iv)(c)
l7(a[7[iv[c)
s-262-l(a[?)(iv[D)
l(a{7)(iv[D)
t+\t 1-r(.r--r: ll
nn-r^ ^. ^ IC | ,6-"'--
Are training records maintained at the facility
for current employees and for at least three
years for employees that have left the
company?
rs-262-17(a)(1)(v)
January 2018 Page2 of2 Inspectors Initials
Site: S# v^&t h'..,EPA #:oate' '5 lrt I J$
Contingency PIan and Emergency Procedures Checklist
9/AStE HAil4€€14eAT{ Rl oraTt o N co ftrRo!
,Vote.' t tis checklist is applicabte to LQG's and to HSM handters (except where indicated) who accumulate >6,000 kg (-1g,22g ths)
INSPECTION.ITEM CITATION lr COMMENTS
General Requirements:
Have copies been distributed to all local police and
fire departments, hospitals, and State and local
emergency response teams that may be called upon
for assistance?
R3 | s -262- t7 (a)(6) (LQ c)
R3ts-262-262(a) (LQG)
R3 I 5-26 l-420(c)(2) (HSIt[
I'l a'>
Content ofthe Continsencv Plan:
l. Does the contingency plan describe the
actions facility personnel rvill take to minimize the
hazard to human health or the environment when
responding to fires, explosions, or any unplanned
sudden or non-sudden release ofhazardous rvaste?
2. Does the contingency plan describe
arrangements agreed to b1'local police and fire
departments, hospitals, contractors, and State and
local emergency response teams?
3. Does the contingency plan list the names,
addresses, and phone numbers (office and
home) ofprimary and all other persons
qualified to act as emergency coordinator?
4. I)oes the contingency plan include a list of
all emergency equipment at the facility? The list
must be kept up-to-date, and include the location
and a physical description ofeach item on the list,
and a briefoutline ofthe equipment's capability.
5. Does the contingency plan include an
evacuation plan for the facility? This plan must
include a description ofsignal(s) to be used to
begin an evacuation, evacuation routes, and
alternate evacuation routes.
R3t5-262-261(a) (LQG)
R3 l s-261 -420(b)( I ) (l1sr4
R3t5-262-261(c) (LQc)
R3 I s-26 l -420(bx3) (l/s,1.4
F.tts-262-26t(d) (LQG)
R3 l 5-26 1 -420(bX4) (t/S.{4
R3t5-262-261(e\ (LQc)
R3 l s-261 -420(bX5) (HSM)
R3rs-262-261(0 (r,QG)
R3 r 5-261-420(bX6) (HSM)
"l ot
1"'
i*
?er
\*t
Ifthe facility first became subject to these
provisions after May 30,2017, or has othenvise
amended its contingency plan, has it developed and
submitted a quick reference euidc ofthe.'ni,,rts.'i.-ffi;66responqers r n
R3l5-262-262(a), and state and local emergency
response teams that could be called for assistance?
R3 | s -262-262(b) (r,QG)
Not required - HSM
Ifthe facilitl'has a quick reference guide for its
contingency plan, does it have the following
required elements?:
L Types/names ofhaz wastes and the associated
hazard for each haz \r'aste present at any one time
(e.g., toxic paint rvastes, spent ignitable solvent,
etc. )
2. Estimated maximum amount of each haz rvaste
that ma)' be present at any one time
3. Identification of any haz wastes for which
exposure would require unique/special treatment by
medical or hospital staff
4. Map of the facility shorving where haz wastes are
generated, accumulated and treated, and routes for
accessing these rvastes
5. Street map ofthe facility in relation to
sunounding businesses, schools and residential areas
for the purpose ofgetting to it and/or evacuating
citizens and rvorkers.
6. Locations ofwater supply (fire hydran! flow rate)
7. Identified on-site notification systems (alarms)
8. Name of emergency coordinator and '1/24-hour
emersencv ohone number
This section nol
applicable for HSM
handling
R3 | s -262-2 62 (b)(t ) (L Q G)
R3 | s -262 -262(b)(2) (L Q c)
Rt I s -262 -262(b)(3) (L Q c)
R3 | s -262-262(b)(4) (L Q G)
R3 | s -262 -262(b)(s) (LQ c)
Rt I s -262 -2 62(b\(6) (L Q G)
R3 1 s -262-262(b)(7 ) (L Q G)
R3 | s -262 -262(bX 8 ) (rQG)
fal t It itl.d*t
Ianuary 2018 Page I of3 Inspectors Initials/i
INSPECTION ITEM CITATION I COMMENTS
Does the facility have a least one employee
on-site or on-call at all time rvho is qualified to
act as the emergency coordinator?
Does the contingency plan include procedures
for activation ofthe internal alarm by the
emergency coordhator?
Does the contingency plan include provisions
for notifying the appropriate State and\or local
response agencies?
R3rs-262-264 (LQG)
R3 | s -26r - 420 (e) (H S tv{)
R3 | 5 -262-26 5 (a)(t) (LQc)
R3 | s -261 - 420(0( I Xi) (HSr4
R3 | 5 -262 -26 5 (a) (2) (L Q G)
R3 | s -26r - 420(f)( I XiD (HSnl)
7ut
Does the contingency plan outline the
procedure(s) that the emergency coordinator
will follorv to immediately identify the
character, source, amount, and extent of
released material?
k3r5-262-265(b) (LQG)
t3ts-26t-420(DQ) (HSM 0c
Does the contingency plan include procedures
for the emergency coordinator to follorv in
order to assess possible hazards to human
health or the environment?
R3r5-262-26s(c) (LQG)
R3 | 5 -26 | - 420(fX3 ) (HSll)7nt
If it is determined that the incident could
threaten human health or the environment,
outside the facility, the emergency coordinator
nrust notily the appropriate local, State and
Irederal agencies. Does the contingency plan
include provisions for notifying the
appropriate agencies? Do the notification
nleasurss include information to be reported
(name and telephone # ofreporter, name and
address of facility, name and quantity of
material(s) involved, extent of injuries, and
possibility of exposure outside the facility),
and identify the National Response Center
and the State as parties to be notified?
R3ts-262-26s(d) (LQG)
R3 r 5-26 I -420(rX4) (r/Sn/)
'l oJ
Does the plan include procedures to prevent
the spread of the incident to other hazardous
waste/material at the facilitv?
R3|s-262-26s(e) (LQc)
R3 | 5-261-420(tx5) (Hs,r4)\o)
Are measures included to monitor for leaks,
pressure buildup, gas generation, or ruptures in
valves, pipes, or other equipment, rvhen it is
necessary to shut-dorvn operations as a
response to an incident?
R3rs-262-26s(f) (LQG)
R3 | 5 -26 l -420( f)(6) (HS/r/)y\l,+
Does the contingency plan provide procedures to
follor,v to manage the hazardous waste/material
generated as a result ofan incident?
R3ts-262-26s(g (LQG)
R3 | 5 -2 6 t - 420(t)(7 ) (H S M 0L-
Following implementation of the contingency
plan, are provisions included to ensure that in
the affected area(s):
l. No waste that may be incompatible with the
released material is treated, stored, or disposed
of until the cleanup is complete.
2. That all equipment listed in the contingency
plan is cleaned and fit for use prior to
resuming activities at the facility.
R3 1 5 -2 62 -2 6 s (h) (t) (L Q G)
R3 r 5-26 I -420(0(8Xi) (11S/r.1)
R3 | 5 -2 62 -26 s (h)(2) (L Q C)
R3 r 5-261 -420(0(8xii) (HSno
1a-\
Site:EPA #:Date:
Contingency Plan and Emergency Procedures Checklist
Note: this checklist is applicable to LQG's and to HSM handlers (except where indicated) who accumulate >6,000 kg (-13,22g lhs)
January 2018 Page 2 of 3 Inspectors Initials
5;rc; 5t- t!\l-h5 EPA #:
Contingency Plan and Emergency procedures Checklist
"n indi""t"d).ho """umulate >6,ilN kg 1-13,22g tbs)
The contingency plan must include
provisions for recording the incident
requiring implementation of the
contingency plan and specifying
information that witl be recorded and
reported. The requirements are as follows:
l. Will a written report on the incident be
provided to the Utah State Department of
Environmental Quality within 15 days?
2. The following information needs to be
recorded and reported:
a) The name, address, and telephone # ofthe
owner/operator;
b) The name address, and telephone # ofthe
facility;
c) Date, time, and fype of incident;
d) Name and quantity of material(s) involved;
e) Extent of injury, if any;
f) An assessment of the actual or potential
hazard to human health or the environment:
and
g) An estimate of the quantity arid disposition
ofrecovered material(s) that resulted from the
incident.
R3rs-262-26s(i) (LQc)
R3 | 5 -2 6 | - 420(D (e) (HSM)
R3r5-262-265(i) (Lgc)
R3 | s -26 | - 4 20 (f)(e) (H s M)
R3 | 5 -262-26s(iXD ttw (iX7 ) (tpc)
R3 I 5-261-420(fXeXD dn (fx9xvii)
HSM Only: Are all employees thoroughly
familiar with proper waste handling and
emergency procedures relevant to their
responsibilities during normal facility
R3ts-26r-420(g (HSM
January 2018 Page 3 of3 Inspectors Initials
Site:3+ M*A r EPA ID:
Preparedness and Prevention Checklist
Date Z l.tl ig
I1'ASTE MA}.IAGE14EHT
& RADIATION CONTROL
INSPECTION ITEM CITATION COMMENTS
Is the facility maintained and operated to
minimize the possibility of a fire, explosion, or
any unplanned sudden or non-sudden release
ofhazardous lvaste or hazardous rvaste
constituents?
P.3ts-262-2st (LQG)
R3 l 5-262- I 6(bX8Xi) (sOG)
R3 I 5-26 I -4 I 0(a) (HSM.)10t
The faciliq'must be equipped with items (l)-
(4), identified belorv, unless it can be shorvn
that hazardous rvaste managed at the site
rvould not require the particular kitrd of
equipment specified.
l. Does the faciliqv have an intemal
communications or alarm system capable of
providing immediate emergency instruction to
its personnel?
2. Does the facili6'have a device capable of
summoning external emergency assistance to
the facility (phone or trvo-u'ay radio)?
3. Does the facility have portable
extinguishers, fire control equipment
(including special extinguishing equipment
necessary for their facility), spill control
equipment, and decontamination equipment?
4. l)oes the facility have rvater at adequate
volume and pressure to supply lvater hoses, or
foam producing equipment, or automatic
sprinklers. or water spray systems?
F'3ts-262-2s2 (LQG)
R3 l s-262-16(bXsXii) (soc)
R3 I 5-261-410(b) (HSrr4
R31s-262-2s2(a) (LoG)
R3 l 5-262- l 6(bXsXiiXA) (s0G)
R3 l5-261 -41o(bx I ) (i/s,,t1)
R3 l s -262 -2 s 2(b) (r. Q G)
R3 l s-262- l6(bX8XiiXB) (sgc)
R3 l s-26 l -4 l0(b)(2) (HSrf)
R3 | s -262-2s2(c) (t,Q G)
R3 r 5-262- l 6(bX8XiiXC) (s0c)
R3 l 5-26 l -4 l 0(bX3) (Hs'M)
R31s-262-2s2(d) (LQG)
R3 l s-262- l6(bX8XiiXD) (sgc)
R3 l s-26r-4l0(b)(4) @sril)
d-
los
VQJ
ltl
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Are facility contmunications or alarm systems,
fire protection equipment, spill control
equipment, and decontamination equipment
tested and maintained to assure its proper
operation in time of an emergency?
R3ts-262-2s3 (LQG)
R3 r s-262- l6(bX8Xiii) (scc)
R3 l s-261-4 l0(c) (flsn{'r/)
Do facilif personnel have immediate access to
an internal alarm or emergency
communication device, either directly through
visual or voice contact, while managing
hazardous rvaste?
R3ts-262-2sa@) (LQG)
R3 I s-262- I 6(bX8)(iv)(A) (sQc)
R3 I 5-26 r -4 l o(dx I ) (l/Sr4 \os
Is there everjust one employee on the
premises while the facility is operating? If
yes, does that person have immediate access to
device capable of summoning external
emergency assistance?
R3ts-262-2s4(b) (LQG\
R3 I s-262- I 6(bX8)(iv)(B) (spc)
R3 l s-26 1 -4 l 0(d)(2\ WS A ntu{ut \,.} Dv^1-
Jan 2018 Page I of2 Inspector's Initials
Site:EPA ID:
Preparedness and Prevention Checklist
Date
ls aisle space maintained to allow the
unobstructed movement of emergency
personnel or equipment (unless aisle space is
not needed for any ofthese purposes)?
R3t'-262-2ss (LQG)
R3 I 5-262- I 6(bX8Xv) (sgc)
R3 I s-261 -41 0(e) (I/sM)
The facility must arange the following types
of agreements or arrangements with local
organizations (as appropriate):
l. Has the facility made or attempted to make
afrangements to familiarize local police, fire
departments, and emergency response teams
with the layout ofthe facility, character ofthe
hazardous waste(s) managed, locations wherefacility personnel normally work, location offacility entrances and possible evacuation
routes?
2. Has the facility designated primary
emergency authority to a specific police or fire
department, when more than one police or fire
department might respond in the event of an
emergency?
3, Have agreements with State emergency
response teams, emergency responses
contractors, and equipment suppliers been
made?
4. Have arangements been made to
familiarize local hospitals with the properties
ofhazardous waste handled at the facility and
the types ofinjuries or illnesses which could
result from fires, explosions, or releases at the
facilitv?
Rsts-262-2s6(a) (LQG)
R3 | 5-262- t 6(bx8)(vi)(A) (sec)
R3 I 5-26 l-4 I o(fx D (HS M)
R3 1 5 -262-2 s 6(a)(2) (LQc)
R3 I 5-262- I 6(bX8)(vi{A{II) (sec)
R3 r s-26 I -4 I 0(0( I XD (f/SM)
R3 | s -262-2 5 6(a){3) (LQ Q)
R3 I s-262- I 6(bXsXvD(AXIII) (sQc)
R3 l s-26 t-4 I 0(0( I xiD (nsM)
R3 | 5 -262-256(a\r) (LQc)
R3 I s-262-16(bXsXvD(AXD (soc)
r4l0(0(lxiii)(HsM)
R3 | s -262-2 5 6(a)(2) (Lec)
R3 I 5-262- I 6(bX8[vi[A[II) (sec)
I 5-26 l -4 I 0(fX l )(iv) (i/SM)
Ifany State or local authorities have declined
to enter into such arrangements, has thefacility documented the refusal in the
operating recor.d?
R3rs-262-2s6(b) (LgG)
s-262- l(b)(8[vrxB) (s@)
ts-261-4t0(fx2) (HSM)tAo f.A^srtr,
Ian 2018 Page2of 2 Inspector's Initials
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