DSHW-2018-004005 - 0901a0688081091a

Street Address 233 S Patterson
City, Town, or Village Springfield
State Missouri Country USA Zip Code 65802
Div of Wasta,Managerre
and Radiation Control
MAY -7 2018
OMB# 2050-0024; Expires 05/31/2020
United States Environmental Protection Agency
RCRA SUBTITLE C SITE IDENTIFICATION FORM

1. Reason for Submittal (Select only one.) - o - o 5
Obtaining or updating an EPA ID number for an on-going regulated activity that will continue for a period of
time. (Includes HSM activity)
Submitting as a component of the Hazardous Waste Report for (Reporting Year) 0 Site was a TSD facility and/or generator of > 1,000 kg of hazardous waste, >3. kg of acute hazardous
waste, or > 100 kg of acute hazardous waste spill cleanup in one or more months of the reporting year
(or State equivalent LQG regulations)
111 Notifying that regulated activity is no longer occurring at this Site
111 Obtaining or updating an EPA ID number for conducting Electronic Manifest Broker activities
fJ Submitting a new or revised Part A Form
2. Site EPA ID Number
LL o o o 9 o
3. Site Name
O'Reilly Auto Parts # 2723
4. Site Location Address
Street Address 631 East 3300 South
City, Town, or Village Salt Lake City

Count/ Salt Lake
State Utah Country USA Zip Code 841013
5. Site Mailing Address Same as Location Address
6. Site Land Type
OPrivate OCounty ElDistrict Federal ribal •Municipal OState 0 Other
7. North American industry Classification System (NA1CS) Code(s) for the Site (at least 5-digit codes)
A. (Primary) 44131 C.
B. D.
EPA Form 870042, 8700-13 A/B, 8700-23 Page _ of _
EPA ID Number OMB* 2050-0024; Expires 05/31/2020
8. Site Contact information Same as Location Address
First Name Tasha MI Last Name Nlarks
Title Store Manager
Street Address 631 East 3300 South
City, Town, or Village Salt Lake City
State Utah Country USA zip Code 84108
Email mgr [e-mail]
Phone [phone] Ext Fax
9. Lega Owner and Operator of the Site
A. Name of Site's Legal Owner El Same as Location Address
Full Name
Brickyard Retail LLCI Steven Usdan
Date Became Owner (mm/ddhyyy)
Owner Type
oarivate OCounty II District ElFederal 0 Tribal 6 Municipal 0 State Dother
Street Address 5670 Wilshire Blvd., Suite 1250
City, Town, or Village Los Angeles
State California Country USA Zip Code 90036
Email [e-mail]
Phone [phone] Ext Fax [phone]
Comments
B. Name of Site's Legal Operator Same as Location Address
Full Name
O'Reilly Auto Enterprises, LLC
Date Became Operator (mm/ddiyyyy)
2/17/2017 ,
Operator
arivate
Type
II County District oFederal 0 Tribal OMunidpal State 1111 Other
Street Address 233 $ Patterson
City, Town, or Village Springfield
State Missouri Country LISA Zip Code 65802
Email [e-mail]
Phone [phone] Ext .. Fax [phone]
Comments
EPA Form 8700-12, 8700-13 A/13, 8700-23 Page _
F005 F003 F002 FOO1 D035 0001
EPA ID Number OMB# 2050-.0024; Expires 05/31/2020
10. Type of Regulated Waste Activity (at your site)
Mark "Yes" or "No" for all current activities (as of the date submitting the form); complete any additional boxes as instructed.
A. Hazardous Waste Activities a EJN 1. Generator of Heaardous Waste—If "Yee, mark only one of the following—a, b, c
EJ a. LQG -Generates, in any calendar month (includes quantities imported by importer site) 1,000 kg/mo (2,200 lb/mo) or more of non-acute hazardous waste; or
- Generates, in any calendar month, or accumulates at any time, more than 1 kg/mo
(2.2 lb/mo) of acute hazardous waste; or
• Generates, in any calendar month or accumulates at any time, more than 100 kg/mo
(220 lb/mo) of acute hazardous spill cleanup material.
b. SQG 100 to 1,000 kg/mo (220-2,200 tb/mo) of non-acute hazardous waste and no more than
1 kg (2.2 lb) of acute hazardous waste and no more than 100 kg (220 lb) of any acute
hazardous spill cleanup material.
0 c. VSQG Less than or equal to 100 kg/mo (220 lb/mo) of non-acute hazardous waste.
If "Yes° above, indicate other generator activities in 2 and 3, as applicable.
Jv 1 N 2. Short-Term Generator (generates from a short-term or one-time event and not from on-going
processes). If "Yes", provide an explanation In the Comments section. a N 3. Mixed Waste (hazardous and radioactive) Generator
13 vf N 4. Treater, Storer or Disposer of Hazardous Waste—Note: A hazardous waste Part B permit is required for these activities.
y yi N 5. Receives Hazardous Waste from Off-site
D, i N 6. Recycler of Hazardous Waste
..... a. Recycier who stores prior to recycling E b. Recycler who does not store prior to recycling Ely i N 7. Exempt Boiler and/or industrial Furnace—If "Yes", mark all that apply.
a. Small Quantity On-site Burner Exemption
13 b. Smelting, Melting, and Refining Furnace Exemption
B. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes
handled at your site. List them in the order they are presented in the regulations (e.g. D001, D003, F007, U112). Use an
additional page if more spaces are needed.
C. Waste Codes for State Regulated (non-Federal) Hazardous Wastes. Please list the waste codes of the State hazardous
wastes handled at your site. List them in the order they are presented in the regulations. Use an additional page if more
spaces are needed.
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page of
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
11. Additional Regulated Waste Acthritles (NOTE: Refer to your State regulations to determine if a separate permit is required.)
A. Other Waste Activities l:Jy i N 1. Transporter of Hazardous Waste—If "Yes", mark all that apply.
D a. Transporter
1111 b. Transfer Facility (at your site)
Dy MI N 2. Underground Injection Control
y 19 N I United States Importer of Hazardous Waste
ny. [71N 4. Recognized Trader—If "Yes", mark all that apply.
a. Importer
1111 b. Exporter
ny mi N 5. Importer/Exporter of Spent Lead-Acid Batteries (SLABs) under 40 CFR 266 Subpart G—If "Yes", mark all that apply.
a. Importer
b. Exporter
B. Universal Waste Activities
Dv Ei N 1. Large Quantity Handier of Universal Waste (you accumulate 5,000 kg or more) - If "Yes" mark all that apply. Note: Refer to your State regulations to determine what is regulated.
m a. Batteries
El b. Pesticides
ip c. Mercury containing equipment
- 0 d. Lamps
e. Other (specify)
111 f. Other (specify)
0 g. Other (specify)
al 1 N 2. Destination Facility for Universal Waste Note: A hazardous waste permit may be required for this
activity.
C. Used Oil Activities
Dy [3 N 1.. Used Oil Transporter—If "Yes", mark all that apply.
0 a. Transporter
b. Transfer Facility (at your site)
y i N 2. Used Oil Processor and/or Re-refiner—lf "Yes", mark all that apply.
a. Processor
0 b. Re-refiner
y / N 3. Off-Specification Used Oil Burner
II 0 N 4. Used Oil Fuel Marketer—lf "Yes", mark all that apply.
U a. Marketer Who Directs Shiprnent of Off-Specification Used Oil to Off-Specification Used Oil Burner
111 b. Marketer Who First Claims the Used Oil Meets the Specifications
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page
13. Episodic Generation
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. If "Yes", you must fill out the Ad-
dendum for Episodic Generator.
jJv N
EPA ID Number OME# 2050-0024; Expires 05/31/2020
12. Eligible Academic Entities with Laboratories—Notification for opting into or withdrawing from managing laboratory hazardous
wastes pursuant to 40 CFR 262 Subpart K.
Oy EiN A. Opting into or currently operating under 40 CFR 262 Subpart K for the management of hazardous
wastes in laboratories—lf "Yes", mark all that apply. Note: See the item-by-item instructions for defini-
tions of types of eligible academic entities. jj 1. College or University
II 2. Teaching Hospital that is owned by or has a formai written affiliation with a college or university
0 3. Non-profit Institute that is owned by or has a formal written affiliation with a college or univer-
la v N B. Withdrawing from 40 CFR 262 Subpart K for the management of hazardous wastes in laboratories.
14. LQG Consolidation of VSQG Hazardous Waste
OY N Are you an LQG notifying of consolidating VSQG Hazardous Waste Under the Control of the Same Person
pursuant to 40 CFR 262.17(f)? If "Yes", you must fill out the Addendum for LQG Consolidation of VSQGs
hazardous waste.

15. Notification of LQG Site Closure for a Central Accumulation Area (CAA) (optional) OR Entire Facility (required)
Y ti N LQG Site Closure of a Central Accumulation Area (CAA) or Entire Facility.
Aa Central Accumulation Area (CAA) al Entire Facility
B. Expected closure date: mm/dd/yyyy
C. Requesting new closure date: mm/dd/yyyy
D. Date closed : rnm/dd/yyyy
0 1. In compliance with the closure performance standards 40 CFR 262.17(a)(8)
0 2. Not In compliance with the closure performance standards 40 CFR 262.17(a)(8)
16. Notification of Hazardous Secondary Material (HSM) Activity
N A. Are you notifying under 40 CFR 260.42 that you will begin managing, are managing, or will stop manag-
ing hazardous secondary material under 40 CFR 260.30, 40 CFR 261.4(8)(23), (24), or (27)? If "Yes", you
must fill out the Addendum to the Site Identification Form for Managing Hazardous Secondary Material.
DY ,./ N B. Are you notifying under 40 CFR 260.43(a)(4)(lli) that the product of your recycling process has levels of
hazardous constituents that are not comparable to or unable to be compared to a legitimate product or
Intermediate but that the recycling is still legitimate? If "Yes", you may provide explanation in Comments
section. You must also document that your recycling Is still legitimate and maintain that documentation on
site.
17. Electronic Manifest Broker
DY EIN Are you notifying as a person, as defined in 40 CFR 260.10, electing to use the EPA electronic manifest sys-
tem to obtain, complete, and transmit an electronic manifest under a contractual relationship with a haz-
ardous waste generator?

EPA Form 8700-12, 8700-13 A/8, 8700-23 Page of _
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
18. Comments (include item number for each comment)
19. Certification l certify under penalty of law that this document and ail attachments were prepared under my direction or su-
pervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gath-
ering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. l am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations. Note: For the RCRA Hazardous Waste Part A permit Application, all owners and operators must sign (see 40
CFR 270.10(b) and 270.14
Sig re of legal owner • perator Or authorized representative
WILOa ¿KV
Date (mm/cid/yyyy)
5/4/2018
Printed Name (First, Middle initial Last}
Unnea F. Rainey
Title
Environmental Reg. Compliance Special's
Email [e-mail]
Signature of legal owner, operator or authorized representative Date (mm/dd/yyyy)
Printed Name (First, Middle initial Last) Title
— _
Email
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page _ of _
4
517/201t3 State ot Utah Mail - EIJA lu Number
Carlee Christoffersen <[e-mail]>

EPA ID Number
1 message

Carlee Christoffersen <[e-mail]> Mon, May 7, 2018 at 12:44 PM
To: Linnea Rainey <[e-mail]>, [e-mail]
Ms. Rainey,
This is to acknowledge you have filed a RCRA Subtitle C Site Identification Form for waste generated at the following
address:
O'Reilly Auto Parts #2723
631 East 3300 South
Salt Lake City, UT 84106
The EPA Identification Number for this site is UTR000014290.
The EPA Number must be included on all shipping manifests for transporting hazardous wastes; on all Biennial
Reports that some generators of hazardous waste must file with the State of Utah, and other hazardous waste
management reports and documents required under the Utah Solid and Hazardous Waste Act and the Utah
Administrative Code.
The EPA Number is site specific. If your company changes physical locations, it is your responsibility, as a generator,
to notify the state and apply for a new EPA ID Number. You can submit a new form to update information regarding
your site at any time.
If you would like to arrange a compliance assistance visit to discuss waste management practices, please contact
Deborah Ng at 801-536-0218.
For questions regarding your EPA ID number or site status please call Carlee Christoffersen at [phone] or reply
to this email.
Thank you,
Carlee Christoffersen l Environmental Program Coordinator
Phone: [phone]
Statements made in this email do not constitute the official position of the Director of the Division of Waste Management and Radiation
Control. If you desire a statement of the Division Director's position, please submit a written request to Director, Division of Waste
Management and Radiation Control, P.O. Box 144880, Salt Lake City, Utah 84114-4680, including copies of documents relevant to your
request.
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