DSHW-2018-006231 - 0901a06880868ecb

tk o o o o
Street Address 10530 SOUTH COUNTY RD. #33
City, Town, or \tillage MYTON CountY DUCHESNE
State UT Country USA Zip Code 84062
Lai
4. Site Name
NEWFIELD PRODUCTION COMPANY
5. Site Location Address
Street Address
City, Town, or Village
State ,Country

Zip Code

OK. I, crr0-1
Div of Waste Management
and Radlation Control
JUN 2 0 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.) s 0 -OO 13
Obtaining or updating an EPA ID number for an on-going regulated activity that will continue for a period of
time. (Includes HSM activity)
D Submitting as a component of the Hazardous Waste Report for (Reporting Year)
III 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)
EJ Notifying that regulated activity is no longer occurring at this Site 0 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
3. Site Mailing Address Same as Location Address
4. Site Land Type
1:Private 0County istrict OFederal DTribal Municipal State El Other
5. North American Industry Classification System (NAICS) Code(s) for the Site (at least 5-dIgit codes)
A. (Primary) 211120 C.
B. D.
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page _ of _
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
8. Site Contact information El Same as Location Address
First Name AARON mi Last Name FROYD
Title PRODUCTION LEAD
Street Address
City, Town, or Village ,
State Country Zip Code
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
NEWFIELD PRODUCTION COMPANY
Date Became Owner (mm/dd/yyyy)
Owner Type
arivate OCounty DDistrict Federal Tribal Municipal D State Other
Street Address
City, Town, or Village
State Country Zip Code
Email
Phone Ext Fax
Comments
B. Name of Site's Legal Operator El Same as Location Address
Full Name
NEWFIELD PRODUCTION COMPANY Date Became Operator (mm/c1d/yyyy)
Operator Type arivate [County I2l District 111 Federal Tribal Municipal State Other
Street Address ‘.
City, Town, or Village
State Country Zip Code
Email
Phone Ext Fax
Comments
EPA Form 870O-12, 8700-13 AM, 8700-23 Page of
0001
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
Dy 1:1 N 1. Generator of Hazardous Waste—If "Yes", mark only one of the following—a, b, c
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.
i 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.
El c. VSQG 1 Less than or equal to 100 kemo (220 lb/mo) of non-acute hazardous waste.
If "Yes" above, indicate other generator activities in 2 and 3, as applicable.
a N 2. Short-Term
processes).
Generator (generates from a short-term or one-time event and not from on-going
If "Yes", provide an explanation in the Comments section. a EIN 3. rVlixed Waste (hazardous and radioactive) Generator
Y ZN 4. Treater, these activities. Storer or Disposer of Hazardous Waste—Note: A hazardous waste Part B permit is required for
Ely ON 5. Receives Hazardous Waste from Off-site
ily ON 6. Recycler of Hazardous Waste
El a. Recycler who stores prior to recycling ti b. Recycler who does not store prior to recycling Of ON 7. Exempt Boiler and/or Industrial Furnace—If "Yes", mark all that apply.
D a. Small Quantity Dn.:site Burner Exemption
jJ 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
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
Qv D N 1. Transporter of Hazardous Waste—If "Yes", mark all that apply.
0 a. Transporter
111 b. Transfer Facility (at your site)
El, 0 N Underground Injection Control
,.
2.
Dy 0 N 3, United States Importer of Hazardous Waste
Elf WI N 4, Recognized Trader—If "Yes", mark all that apply.
a. Importer
b. Exporter ,
y i N 5. Importer/Exporter of Spent Lead-Acid Batteries (SLABs) under 40 CFR 266 Subpart G—If "Yes", mark all that apply.
El a. Importer
fJ b. Exporter
8. Universal Waste Activities
0 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.
El a. Batteries
b. Pesticides
D c. Mercury containing equipment El d. Lamps
e. Other (specify)
0 f. Other (specify)
g. Other (specify)
al y ,/ N 2. Destination Facility for Universal Waste Note: A hazardous waste permit may be required for this
activity.
C. Used Oil Activities Dy 0 N 1. Used Oil Transporter—lf "Yes", mark all that apply.
I:1 a. Transporter
JJ b. Transfer Facility (at your site)
Dy 0 N 2. Used Oil Processor and/or Re-refiner—If "Yes", mark all that apply.
0 a. Processor 0 , b. Re-refiner
Dy 1 N 3. Off-Specification Used Oil Burner
Dy El N 4. Used Oil Fuel Marketer—If "Yes", mark all that apply.
ET- a. Marketer Who Directs Shipment of Off-Specification Used Oil to Off-Specification Used Oil Burner
0 b. Marketer Who First Claims the Used Oil Meets the Specifications
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page _ of _
EPA ID Number OMB# 2050-0024; Expires 05/31/2020
ON A. Are you notifying under 40 CFR 260.42 that you will begin managing, are managing, or will stop manag- , mg hazardous secondary material under 40 CFR 260.30, 40 CFR 261A(a)(23), (24), or (27)? If "Yes", you
must fill out the Addendum to the Site Identification Form for Managing Hazardous Secondary Material.
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.
12. Eligible Academic Entities with Laboratories—Notification for opting into or withdrawing from managing laboratory hazardous
wastes pursuant to 40 CFR 262 Subpart K.

Ely oN A. Opting into or currently operating under 40 CFR 262 Subpart K for the management of hazardous
wastes in laboratories—if "Yes", mark all that apply. Note: See the item-by-item instructions for defini-
tions of types of eligible academic entities.

1. College or University

EJ 2. Teaching Hospital that is owned by or has a formal written affiliation with a college or university

EJ 3. Non-profit Institute that is owned by or has a formal written affiliation with a college or univer-

D ON B. Withdrawing from 40 CFR 262 Subpart K for the management of hazardous wastes in laboratories.
13. Episodic Generation

OY 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,

3.4. LQG Consolidation of VSQG Hazardous Waste
Ely oN

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)
_ 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. E1.
Date closed : mm/dd/yyyy
ln compliance with the closure performance standards 40 CFR 262.17(a)(8)
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 tJYN 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/B, 8700-23 Page _ of _
EPA ID Number OMB# 2050-0024: Expires 05/31/2020
18. Comments (include item number for each comment)
DISCARDING EXPIRED PRODUCT
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 property 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(1)) and 270.11).
Si n ture of gal wn r, ope ator or authorized representative
C -
Date (mm/dd/yyyy)
6/20/2018
Printed Name (First, ddle itial Last)
SHON MCKINNON
Title
REGULATORY & ENVIRONMENTAL LEPiii ,
Email [e-mail]
Signature of legal owner, operator or authorized representative Date (mm/cki/yyyy)
Printed Name (First, Middle initial Last) Title
Email
EPA Form 8700-12, 8700-13 A/B, 8700-23 Page _ of _
wommEN -
WAS'TE MANAGEMENT
8. RADIATION CONTROL
b/26/2018 State ot Utah Mail - Une- I ime EPA IU Number
Carlee Christoffersen <cchristoffersen©utah.gov>

One-Time EPA ID Number
1 message
Carlee Christoffersen <[e-mail]>
To: [e-mail]
Hi Aaron,
Tue, Jun 26, 2018 at 9:27 AM
This is to acknowledge you have filed a RCRA Subtitle C Site Identification Form requesting an EPA ID number for a one-
time/short term event for hazardous waste generated at the following address:
Newfield Production Company
10530 County Road
Myton, UT 84052
Your EPA Identification Number is UTP000001602.
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.
Because this EPA ID number is for a one-time/short term event, please let me know when the project is
complete.
If you have any questions please call me 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 84114-4880, including copies of documents relevant to your
request.
httne./kneil nnnnle rnm/mailhi/0/91 ii=28,ik=e1 Rdzi5Rri7e&isver=n1rirnFFnhesn en Anhl=nmail fe 1R0619 12 n7Rview=ntRiseernh=sent&th=1643nh491 1/1