DSHW-2018-004890 - 0901a06880832fa5

5/30/2018 RCRAInfo Review Source Record Div of Waste Management
and Radiation Control
MAY 3 0 2018 95(4 w-zo - 0046 9 o
UTAH STATE UNIVERSITY ECOLOGY 1779 E 1900 N - NORTH LOGAN UTR000014340
CENTER
Review Source Record
General Information Revision History Details iM
Received Date Non-notifier Extract to Public?
05/30/2018 Yes
Accessibility Acknowledgement Flag
1. Reason for Submittal
Obtaining or updating an EPA ID number for an on-going regulated activity that will continue for a period of time. (Includes HSM
activity) [Source N]
2. Site ID
EPA ID Activity Location
UTR000014340 UT
3. Site Name
Name
UTAH STATE UNIVERSITY ECOLOGY CENTER
4. Site Location
Street Number
Zip
84341
Street 1
1779 E 1900 N
City, Town or Village
NORTH LOGAN
Street 2
State
UTAH
Country
UNITED STATES
County State District
CACHE
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5. Site Mailing Address
Street Number Street 1 Street 2
8315 OLD MAIN HILL
Zip City, Town or Village State
84322 LOGAN UTAH
Country
UNITED STATES
6. Site Land Type
Land Type
State
7. North American Industry Classification System (NAICS)
Primary NAICS
611310 - COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Other NAICS
8. Site Contact Person
First Name Middle Initial Last Name
GARY LARSEN
Title Email
HAZARDOUS WASTE MANAGER [e-mail]
Phone Number Extension Fax
435-797-2763 435-797-3864
8a. Site Contact Address
Street Number Street 1 Street 2
8315 OLD MAIN HILL
Zip City, Town or Village State
84322 LOGAN UTAH
Country
UNITED STATES
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9a. Legal Owner
Type Name Address Date
State UTAH STATE UNIVERSITY 8315 OLD MAIN HILL, LOGAN, UT 84322 01/01/1890
9b. Legal Operator
Type Name Address Date
State UTAH STATE UNIVERSITY 8315 OLD MAIN HILL, LOGAN, UT 84322 01/01/1890
10. Type of Federal Regulated Waste Activity
A. Hazardous Waste Activities
1. Generator of Hazardous Waste
(Federal)
3 - Very Small Quantity Generator
Generator of Hazardous Waste
(State)
F - Same as federally defined
2-3. Other Generator Activities
None Selected
4. Treater, Storer, or Disposer of
Hazardous Waste
None Selected
5. Receives Hazardous Waste from
Off-site
None Selected
6. Recycler of Hazardous Waste
None Selected
7. Exempt Boiler and / or Industrial
Furnace
None Selected
B. Waste Codes for Federally Regulated Hazardous Wastes
A. Hazardous Waste Codes (Federal)
D-Codes:
0001 0002 D003 D004 D005 D006 D007 D008 0009 D010 D011 0018 D022
F-Codes:
F001 F002 F003 F004 F005
U-Codes:
U009
C. Waste Codes for State Regulated (non-Federal) Hazardous Wastes
B. Hazardous Waste Codes (State)
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None Selected
11. Additional Regulated Waste Activities
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 C. Used Oil Activities
1. Large Quantity Handler of 1. Used Oil Transporter 3. Off-Specification Used Oil
Universal Waste None Selected Burner
None Selected None Selected 2. Used Oil Processor and / or Re-
2. Destination Facility for refiner 4. Used Oil Fuel Marketer
Universal Waste None Selected None Selected
None Selected
D. State Activities
Your State does not have any State defined activities.
12. Eligible Academic Entities with Laboratories
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
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 Addendum for Episodic Generator.
Yes
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Episodic Event
Episodic Event Type
PLANNED EXCESS CHEMICAL INVENTORY REMOVAL
Beginning Date End Date
06/25/2018 08/23/2018
Emergency Contact
First Name Middle Initial Last Name
GARY LARSEN
Phone Extension Email
435-797-2763 [e-mail]
Waste
Waste
Quantity Codes
Description (lbs) Waste Codes (Federal) (State)
FORMALIN/ETHANOL 8000 D001,D002
AND SPECIMENS
LAB PACK 400 D001,D002,D003,D005,D006,D007,D008,D009,D010,D011,F001,F002,F003,F004
MERCURY ARTICLES 100 D009,U009
MERCURY 75 D009
CONTAMINATED
DEBRIS
14. LQG Consolidation of VSQG Waste
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
15. Notification of LQG Site Closure for a Central Accumulation Area (CAA) (optional) and Entire Facility
LOG Site Closure of a Central Accumulation Area or Facility
No
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16. Notification of Hazardous Secondary Material (HSM) Activity
Are you reporting HSM activities?
No
17. Electronic Manifest Broker
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
18. Comments
Internal Comments
REQUEST FOR EPA ID NUMBER AND NOTIFICATION OF PLANNED EPISODIC EVENT.
Public Comments
19. Certification
First Name M.I. Last Name Title Date Signed
GARY LARSEN HAZARDOUS WASTE MANAGER 05/30/2018
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