DSHW-2018-004321 - 0901a0688081cb2d

State TX Zip Code 75201 Country LISA
Street Address 2828 NORTH HARWOOD, SUITE 1300
City, Town, or Village DALLAS
Dv of Waste Management
and Rad:ation Control
MAY 0 7 2M _on 06+32.1 0.# 2050-0024; Expires 05/31/20 0
United States Environmental Protection Agency
RCRA SUBTITLE C SITE IDENTIFICATION FORM

1. Reason for Submittal (Select only one.)
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)
jjjJ Site was a TSD facility and/or generator of > 1,000 kg of hazardous waste, > 1 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)
EI Notifying that regulated activity is no longer occurring at this Site EJ Obtaining or updating an EPA ID number for conducting Electronic Manifest Broker activities
Submitting a new or revised Part A Form
2. Site EPA ID Number u T R o o o o 1 4 3 o st
3. Site Name
HOLLY ENERGY PARTNERS - SALT LAKE RELIEF TANK
4. Site Location Address
Street Address 651 SOUTH REDWOOD RD - ENTRANCE TO CHEVRON FACILITY
City, Town, or Village NORTH SALT LAKE CounW DAVIS
State UT Country USA Zip Code 84054
5. Site Mailing Address 0 Same as Location Address
6. Site Land Type
j Private County DDistrict Federal ElTribal II Municipal State II Other
7. North American Industry Classification System (NAICS) Code(s) for the Site (at least S-digit codes)
A. (Primary) 486910 C.
B. D.
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page 1 of "7
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
8. Site Contact Information 0 Same as Location Address
First Name MELANIE MI A Last Name NOLAN
Title ENVIRONMENTAL SPECIALIST
Street Address 1602 W. MAIN
City, Town, or Village ARTESIA
State NM Country USA Zip Code 88210
Email [e-mail]
Phone [phone] Ext Fax
9. Legal Owner and Operator of the Site
A. Name of Site's Legal Owner ElSame as Location Address
Full Name
SLC PIPELINE LLC
Date Became Owner (mm/dd/yyyy)
1 2/7/2017
Owner Type ZPrivate County District Federal Tribal Municipal State Other
Street Address 2828 NORTH HARWOOD ST., SUITE 1300
City, Town, or Village DALLAS
State TX Country USA Zip Code 75201
Email [e-mail]
Phone [phone] Ext Fax
Comments
B. Name of Site's Legal Operator El Same as Location Address
Full Name
SLC PIPELINE LLC
Date Became Operator (mm/dd/yyyy)
12/7/2017
Operator Type arivate County District Federal Tribal Municipal State Other
Street Address 2828 NORTH HARWOOD, SUITE 1300
City, Town, or Village DALLAS
State TX Country USA Zip Code 75201
Email [e-mail]
Phone [phone] Ext Fax
Comments
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page 2 of-7
D018 D001
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
Zy N 1. Generator of Hazardous Waste—lf "Yes", mark only one of the following—a, b, c
LJ 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.
LJ b. SQG 100 to 1,000 kg/mo (220-2,200 lb/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.
j c. VSQG Less than or equal to 1.00 kg/mo (220 lb/mo) of non-acute hazardous waste.
If "Yes" above, indicate other generator activities in 2 and 3, as applicable.
ti B 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.
i:jy 1 N 3. Mixed Waste (hazardous and radioactive) Generator
[jjJv 1 N 4. Treater, Storer or Disposer of Hazardous Waste—Note: A hazardous waste Part B permit is required for these activities.
y i N 5. Receives Hazardous Waste from Off-site , N
I
LI 6. Recycler of Hazardous Waste
LJ a. Recycler who stores prior to recycling
LJ b. Recycler who does not store prior to recycling
y 1 N 7 Exempt Boiler and/or Industrial Furnace—If "Yes", mark all that apply.
LJ a. Small Quantity On-site Burner Exemption
LI 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.
D001 D018
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page 3 of...?
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
11. Additional Regulated Waste Activities (NOTE: Refer to your State regulations to determine if a separate permit is required.)
A. Other Waste Activities
y i N 1. Transporter of Hazardous Waste—If "Yes", mark all that apply.
II a. Transporter
b. Transfer Facility (at your site)
y 1 N 2. Underground Injection Control
y I N 3. United States Importer of Hazardous Waste
ny 171N 4. Recognized Trader—If "Yes", mark all that apply.
LJ a. Importer • LJ b. Exporter
LJ y i N 5. Importer/Exporter of Spent Lead-Acid Batteries (SLABs) under 40 CFR 266 Subpart G—If "Yes", mark all that apply. LJ a. Importer
LJ b. Exporter
B. Universal Waste Activities
LJ y i N 1. Large Quantity Handler 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.
LJ a. Batteries
LI b. Pesticides
EI c. Mercury containing equipment
LJ d. Lamps
e. Other (specify) LI f. Other (specify)
g. Other (specify)
Y ,/ N 2 Destination Facility for Universal Waste Note: A hazardous waste permit may be required for this
activity.
C. Used Oil Activities LJ y 1 N 1. Used Oil Transporter—If "Yes", mark all that apply.
a. Transporter
EI b. Transfer Facility (at your site)
LJy i N 2. Used Oil Processor and/or Re-refiner—If "Yes", mark all that apply.
LJ a. Processor
LJ b. Re-refiner
y i N 3. Off-Specification Used Oil Burner
LJ y ,/ N 4 Used Oil Fuel Marketer—If "Yes", mark all that apply.
D a. Marketer Who Directs Shipment of Off-Specification Used Oil to Off-Specification Used Oil Burner
f J b. Marketer Who First Claims the Used Oil Meets the Specifications
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page of
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(a)(23), (24), or (27)? If "Yes", you
must fill out the Addendum to the Site Identification Form for Managing Hazardous Secondary Material.
E3Y IDN
B. Are you notifying under 40 CFR 260.43(a)(4)(iii) 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.
LJY N
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 ID Number OMB# 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.
IDY i N 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.
EJ1. College or University
EJ2. Teaching Hospital that is owned by or has a formal written affiliation with a college or university
LJ 3. Non-profit Institute that is owned by or has a formal written affiliation with a college or univer-
y i N B. Withdrawing from 40 CFR 262 Subpart K for the management of hazardous wastes in laboratories.
13. Episodic Generation
EY N 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.

14. LQG Consolidation of VSQG Hazardous Waste Z EJY 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) fj1 Y / N LQG Site Closure of a Central Accumulation Area (CAA) or Entire Facility.
A. Central Accumulation Area (CAA) 0. Entire Facility
B. Expected closure date: mm/dd/yyyy
C. Requesting new closure date: mm/dd/yyyy
D. Date closed : mm/dd/yyyy fjJ 1. In compliance with the closure performance standards 40 CFR 262.17(a)(8)
LI 2. Not in compliance with the closure performance standards 40 CFR 262.17(a)(8)
16. Notification of Hazardous Secondary Material (HSM) Activity
17. Electronic Manifest Broker
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page 5 of
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
18. Comments (include item number for each comment)
19. Certification I certify under penalty of law that this document and all 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. I 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 270.11).
Signature of legal owner, operator or authorized represe ' Date (mm/dd/yyyy)
5/7/2018
Printe Name (First, Middle Initial Last)
MELANIE A. NOLAN
Title
ENVIRONMENTAL SPECIALIST
Email
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
ADDENDUM TO THE SITE IDENTIFICATION FORM:
EPISODIC GENERATOR
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
ONLY fill out this form if:
• You are an SQG or VSQG generating hazardous waste from a planned or unplanned episodic event, lasting no
more then 60 days, that moves the generator to a higher generator category pursuant to 40 CFR 262 Subpart L.
Note: Only one planned and one unplanned episodic event are allowed within one year; otherwise, you must
follow the requirements of the higher generator category. Use additional pages if more space is needed.
Episodic Event
1. Planned
shutdowns
2. Unplanned
IIII Excess chemical inventory removal • Accidental spills
12 Tank cleanouts • Production process upsets
III Short-term construction or demolition II Product recalls
NI Equipment maintenance during plant • "Acts of nature" (Tornado, hurricane, flood, etc.)
• Other III Other
3. Emergency Contact Phone
214-605-8303
4. Emergency Contact Name
MELANIE NOLAN
5. Beginning Date 4/23/2018 mm/dd/yyyy) 6. End Date (0— 1-1T (mm/dd/yyyy)
Waste 1
7. Waste Description
CRUDE OIL TANK BOTTOMS SLUDGE
8. Estimated Quantity (in pounds)
2100LBS
9. Federal and/or State Hazardous Waste Codes
D001 D018
Waste 2
7. Waste Description
CONTAMINATED PPE, RAGS AND DEBRIS
8. Estimated Quantity (in pounds)
300LBS
9. Federal and/or State Hazardous Waste Codes
D018
Waste 3
7. Waste Description 8. Estimated Quantity (in pounds)
9. Federal and/or State Hazardous Waste Codes
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page:a of —)
5/U/2018 State ot Utah Mail - EIJA IL) Number
Carlee Christoffersen <[e-mail]>
EPA ID Number
1 message

Carlee Christoffersen <[e-mail]>
To: "Nolan, Melanie A." <[e-mail]>
Melanie,

Thu, May 10, 2018 at 2:40 PM
This is to acknowledge you have filed a RCRA Subtitle C Site Identification Form for waste generated at the following
address:
HOLLY ENERGY PARTNERS - SALT LAKE RELIEF TANK
651 SOUTH REDWOOD ROAD
NORTH SALT LAKE, UTAH 84054
The EPA Identification Number for this site is UTR000014308.
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]
WASTE MANAGEMENT
RADIATION CONTROL
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 84114-4880, including copies of documents relevant to your
request.
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