DSHW-2024-007084

UTAH DEPARTMENT OF
DIVISION OF SOLID AND
Dennis R. Downs, Director
SQG Program
P. O Box 144880
Salt Lake City, UT 84114-4880
(801)-s38-6170
HAZARDOUS WASTE GENEHATOR EVALUATION FORM
FacilityName: fVzkzs .y'sz/o 'i ePAtD Numb", lt2z# a?g?g/
Street Address: .fO E -/A40r'/City:^/eG-f,,a ZiPCode:,FFZZ/
County: 4./€-{,2,Contacl person z ,,Vo/ 4ft,a phone Number:TZ- ogz"{
.*.{ar'<
ENVIRONMENTAL QUALITY
HAZAHDOUS WASTE
Generator Status:
lnspectors i ./
Other Personnel:
Number of Employees ' Q Date of Visit:B-./y'- ?7
WASTE STREAIVI, GENERATION PROCESS GENERATION RATE
PER MONTH
HAZARDOUS
WASTE CODE
PROPERLY
MA}.IAGED ?
{-e %tz/
Total Quantity of Hazardous
Waste Generated per Month:
t zzf,b*r,
RESPONSE NECESSAFIY:NO HESPONSE DUE BY:
CoMMENTS: /,fr5 C-t// fri -2*- fnz<Z+ &sr-.*+/
This compliance evaluation notes areas where your hazardous waste management practices may not meet the
regulatory requirements of the Utah Solid and Hazardous Waste Management Rules. lf a "Response Due Date' is
indicated, you must take the actions, summarized in this audit, in order to come into compliance and notify this office
lN WBlTlNg by the indicated daE.-.Please be advised, that if we do not receive written documentation of these
corrective actions by the response due date; you may be subject to further regulatory action, including administrative
penalties.
lf you have further questions, or would
contact them during business hours at
the top of this page.
RECEIVED BY:INSPECTOR:
Naffie, Printed:Narne, Printed
Signature:Signature:
Title:
like to discuss these issues with the inspectors or their supervisor, you may
[phone]. ltems that must be submitted may be mailed to the address at
Date:
(}c*Mr&4 Title: Compliance Officer
Date '
(ff..-lle) XY7. Companv. Fmolovee Training I,og
Datc: April 9, 1997
Timc: l0:00 arn to I l:00 am
Discussion lead by: John Dorve, Health and Saftey Coordinaror
Topics discussed:
Hazardous Wastc Accumulation Timc
a. Do not store hazardous wastes for longcr rtran 180 days on site.
b. hbcl cach containcr or tan-k with the words "Hazardous Was(e".
Use and Managcmcnt of Containers
a. Maintain a log wccldy on thc hazardous wxtc con(aincrs, arc thc
containcrs closcd, labclcd, dated and in good condition. If not, plcase
contact the emergeri'cy coordinator in order ro rectify the problcm.
Other topics as discusscd.
r[.
I.
'rr[.
a.
b.
E*ployee Name (Plcasc Print)E*ployee Signature
TI{IS IS ONLY AN EXAMPLE AI.{D MUST BE ADAPTED SPECIFICALLY TO YOUR
TACILITY AI.{D TRAINING FOR\4{T.
f:\s h w\h w b\rp o wc rshr?\ra i n. I oc
UTAH DIVISION OF SOLID
AND HAZAFIDOUS WASTE
SMALL QUANTITY GENERATOR
COMPLIANCE EVALUATION FOBM
hems that are marked "NO" on the line in the left-hand column are not in compliance with the Utah Solid
Regulations and require your immediate attention. hems marked "OK" meet the minimum requirements
marked "NA" do not apply to your facility.
Page 2 of 3
Facility and Date
and Hazardous V/aste
of the regulations. hems
il- Q -+ 8315-s-2 DETEBMTNATT.N oF wHETHEB A *ASTE rs HAzARDous
ct.
b.
c.
d.
o
orW
d
w
d%_oK
ACTToN NEEDED: .4ar ,4//*.42f ruZ,PrU4/4
H315.3 NOTIFICATION AND EPA HAZAHDOUS WASTE IDENTIFICATION NUMBEHS:
ll you generate between 100 and 1000 Kgs (220-2200 pounds) of hazardous waste per month or up to 1 Kg of acutely
hazardous waste, you are classified as a Small Quantity Generator (SOG), and you must notily the Executive Secretary ci
the Utah Solid and Hazardous Waste Control Board and obtain an EPA lD number. This is accomplished by notifying the Utah
Division of Solid and Hazardous Waste.
ll you are a small quantity generator, you must obtain an EPA l0 Number in order to offer hazardous waste lor managemeni lo
a lransporter or to a treatmenl, storage and disposal lacility (TSDF) that has an EPA lD Number.
ACTION NEEDED:
o/( 3.R315-5.4 MANIFESTS
Only use approved manifest torm 87QO-22 and 87OO-22A when offering hazardous wastes tor transport to a TSDF or use ihe
manilest ol the state that the TSDF is located in, if required by that state.
Designate another lacility or instruct a lransporter to return wastes il they are undeliverable.
Fill out all applicable sections of the manilest.
Use a conlractual disposal agreemenl only il a generation rate is less than 1000 Kg/month (SQG or less).
Keep copies of contraclual agreements for three years atter service ends.
ACTION NEEDED:
2.
d.
b.
{oz Za
4.H315.5.5 RECORD KEEPING
a. Keep copies of manilests for three years.
b. Keep all records, including determination of generation rates, r./aste characterization
years.
documentation, disposition, etc., for three
ACTION NEEDED:
rZ24 5.H31 5.5.7 EXCEPTION REPORTING
lf TSDF does not return generators' copy of manifest wilhin
and a copy of the manifest to the Executive Secretary of the
60 days, a generator must submit a letter stating so
Utah Solid and Hazardous Waste Control Board.
d.
ACTION NEEDED:
6. R315.5-9 PACKAGING, LABELING, MARKING AND PLACARDING
a. Package, Label and mark waste in accordance with DOT 49 CFR prior to shipment.
ACTION NEEDED:
7. R315.5.10 ACCUMULATION TIME
a. Do not slore hazardoLs wastes lor longer than 18Q days, or 270 days if applicable, without a permit.
b. 0o not exceed 6000 Kg of hazardous wastes stored at your facility at any time.
c. Mark the date the accumulation period began on each container of hazardous wasles. Satellite accumulation containers are
the exception.
Label each tank and container with the woTds "HAZARDOUS WASTE" while it is being used lo accumulate hazardous wasies.
Designate and authorize an emergency coordinator(s) who is(are) readity available by some means at all times.
--t Post the lollowino information nen to each telephone at the facility: Name and telephone number of the emergency
coordinator(s) location(s) of fire extinguishers, spill control equipment and fire alarms, telephone number of the local fire
department (or equivalent emergency response lor facility).
S. Ensure that all employees are lamiliar with hazardous waste handling and emergency procedures.
h. The emergency coordinator must respond appropriately to emergencies that have lhe potential of invotving hazardous ,aaste(s).
ACTION NEEDED:
Thcse are only examplcs thai'rvill hclp
foUorving hforpation for and maJre it
To day's dat,e
you comply rrith ths rcgulutions, ),ou must ADAPT'tha
specific ro YOUR [acility
see #10 e
Lccters ro:Your Hospital
Your Jocal Policc Dcpartmcn(
Your local Fire Dcpanmcnt,
t'
Dcar Sir or Madamc,
In accordance with 40 CFR 265 Subpart C, we arc rcquirid ro nori.fo you thar wc gcncra(c
h@!swastc(s).Thcwastc(s)rhatwc8cncratcisiarc)..cxamplismish.b.-;@
Mcthyl Erhyl Kctonc, Acctone, othcr solvcnrs, acids, bascs, Istcd rvastcs, c(c.
Wc makc cvcry cffort to propcrly rnanagc our wastc, bui in rf,c cvcn( of an cmcrgcncy wc rlay
rcquirc your assistancc. In thc cvcnt of an unforsgcn cmcrgcncy, would you bc ablc to rcspond?
.''
Your Name and Title
ABC Company
#7e and 7f
G IN CASE OF EMERGENCY, DiAL 911
6 EMERGENCY COORDINATOR IS CARL
CAREFUL EXT. 2536
6 FIRE EXTINGUISHERS' LOCATiON MARIGD ON.V/ALL
: TIME CLOCK
UNIVERSALWASTE,
MERCIJRY -COI.{TAININ
LAMPS
UTAH DIVISION OF SOLID
AND HAZARDOUS WASTE
SMALL QUANTITY GENERATOR
COMPLIANCE EVALUATION FOHM
Page 3 of I'
Facility and date
sPtLL HESPONSE (THESE BULES AHE FOUND lN R31s-e)
Take appropriate action 1o minimize threals to human heahh and the environment by notifying the Utah Slate Department ol
Environmental Quality at [phone] or 1-800-572-6400 (24 hour number) if more than 1 Kg of acutely hazardous waste
or 100 Kg of hazardous waste or material which when spilled becomes hazardous waste, is spilled as specilied in 40 CFR
261.33(e). Nolify rhe National Response Center when applicable and provide the appropriate information, [sted in R315-9(c). in
lhe spill report.
ACTION NEEDED:
s. usE AND MANAGEMENT OF CONTAINERS (THESE RULES ARE FOUND tN 40 CFB 265 SUBPART t)
a. Hold Hazardous.Wastes in containers that are in good condition.
b. Store hazardous wasles in containers that are compatible with lhe waste.
6) -lKeeo hazardous wasle containers in a comolelelv cbsed condition. erceot when addino or removino wastes.
E. Do noi open, handle or storE containers of hazardous wasle in a manner whFh mayEause-E7elEasa- -
e. lnspecl containers ol hazardous waste al least weekly to look lor signs of leakage or deterioration. A log should be kept.
l. Do nol store incompatible hazardous wastes in lhe same container.
g. Do nol store hazardous wEEtes in containers thal previousv heH an incompatible material without cleaning it first.
h. Separate incompatible hazardous wastes by means of a dike, berm or other method.
ACTION NEEDED:
PREPABEDNESSAND PREVENTION TTHESE RULES ARE FOUND rN 40 CFR 26s SUBPABT C)
You musl operale your lacility in such a manner that MINIMIZES lhe possibility ol fire, explosion or any unplanned release.
You must have lhe lolbwing preparednEss and prevenlion equipment unless lhe wastes' you stores do not pose lhe hazards
lhal lhe equipment is designed lo respond to: lnternal communications or alarm capable of in$ruaion, such as an intercom; A
device capable of summoning outside eme€ency assislance (such as a direct alarm to the fire department or a telephone);
portable lire extinguishers; waler at adequate pressure and volume to supply fire fighting needs; Alarms and communication
devices accessible to personnel where they are handling hazardous wastes.
c. You musl maintain and tesl where necessary all communication systems; fire, spill response, decontamination and proleclive
equipment.
d. You must maintain aisle space to allow unobstructed movement of personnel and emergency equipment
1ffi) Make arrangamantc whh h.'al fire police and hos9itals to resoond to emeroency cirr rationc -r ynur lanirrty Mainlaifl
documentalion of notification leners, responses or lack of responses lrom these agencies.
f. Document refusals by authorities 10 emergency arrangemenls.
Nw-%
-oz
%
-d#
OK
#
%a{
4L
&+
LL
ACTION NEEDED:
LAND DISPoSAL RESTBIcTIoNS (LDH) fTHESE HULES AHE FoUND lN 40 cFR 268.7(a)(4))
lf you treat your hazardous wastes to render them non-Land Disposal Reslricted, you must devebp and lollow a writlen waste
analysis plan. This wast€ analysis plan musl be based on a laboralory analysis of the waste, and musl contain all necessary
elements, including frequency. The waste analysis plan must be submined to the Executive Secretary of rhe Utah Solid and
Hazardous Waste Control Board at least 30 days prior to lreatment.
Maintain an assessment of LDR stalus on file lor each hazardous waste generaled at the facility.
A nolice and certilication that each wasle is. either not land disposal restricted, or if it is restricted, that it is land disposable after
treatment, must accompany each manilested shipment of hazardous waste.
Maintain all LDR Documentalion forfrve years afierlhe wasle is shipped otf site.
nciloN NEEDED: - -' '
12. R315.16 UNIVERSAL WASTES, FLUORESCENT LIGHT TUBES
@ +fUorescent light tubes must be recycled or disposed of hazardous waste. Any broken tubes must be managed as a hazardous
waste, but can still be recycled. Do not disposa of tubes in lhe regular trash or in the dumpster.
@. €tadal ehher the wasle tubes or the container holding the tubes "riuNtvERsAL wASTE- MEHcuRY CoNTAINING LAMPS'.
AcroN Neeoeo, Strsf .ane/dzz&;Yz<z 4a4{ Z./<.g
R315.5.13 EXPORTS OF HAZARDOUS WASTE
8315.5.14 IMPOBTS OF HAZAHDOUS WASTE
usE AND MANAGEMENT OF TANK SYSTEMS TTHESE RULES ARE FOUND lN 40 CFR 26s.201SUBPART J)
11.
d.
b.
c.
d.
13.
a-
14.
a.
15.
16.OTHER ACTIONS NEEDED:
CONTAINER MANAGEMENT LOG
DATE Inspectors
Name
Are containers
labeled with the
words
UIIAI,ARDOUS
WASTE'?
Are accumulation
dates marked on
all hazardous
waste containers?
Are hazardous
waste containers
closed and are all
bungs and bung
rings secure?
Are all
Hazardous
waste
containers in
good
cond ition?
If any columns are marked
NO,what was done to bring the
container into compliance?
Yes No Yes No Yes No Yes No