DSHW-2024-007274

Norman H. Bangerter
Governor
Suzanne Dandoy, M.D.. \{,P.H.
Execuuve I)irer'tor
Keniietir L. Aikerrra
[)t rertrlr
DEPARTMENT OF HEALTH
DIVISION OF EI{URONMENTAL HEALTH
Bureau of Solid & Hazardous Waste
288 North 1460 West, P O. Box 16690
Salt Lake City, Utah 841 '16-0690
(801 ) 538-6170
October 15 , l-9 9 0
Martin Door Mfg.
P.O. Box 27437Salt Lake City, UT 84L27
Attn: Theresa Christiansen, Safety
Dear Ms. Christiansen:
This is acknowledge that you have filed for a Notification of
Hazardous Waste Activity.
Your EPA Identification Number is UTD988068862.
The EPA Number must be included on all shipping manifests fortransporting hazardous wastes; on alI Biennial Reports thatgenerators of hazardous waste must file with the St,ate of Utah andother hazardous waste management reports and documents required
under The Utah So1id and Hazardous Waste Act and the Utah Solid and
Hazardous Waste Adrninistrative Code (UHWMR).
If you have any questions please contact, Delene Thomas at 538-6170.
il
Dennis R. Downs
Executive Secretary
Utah SoIid and Hazardous Wastes
Committee
C3 Dave Schaller, U. S. Environmental
Region VIII Protection Agency,
ftcase pnnr or typ€ wtth ELITE t'ton (l 2 cheracters pat inchl in th€ unshaded sroas only o
united states E$iffi?S:SE f63ffi,ion Asenc"y
Notification of Ha zardous Waste Activity9EPA
Please refer to the lnstructions for
F i ling N ot if i c at ion before comoletino
this form. The information reouesteil
hqre_ is requ_ired by law (Section
3Ol O of thc' Resourde Coniervation
and frecovery Act).
For Official Use On
Comm€nts
lnstallation's EPA lD Number
l. Name of Installation
ll. lnstallation Mailing Address
Street or P.O. Box
Itl. Location of Installation
Street or Route Number
lV. lnstallation Gontact
Name and Title (last, firx" and i,Phone Number larea code and number
A. Name of lnstallation's Leqal Owner B. Ture of Ownershio bnter code)
Vl. Tvoe ol Raoulated Waste Activiw lMark'X' in the aoorooriate boxes. Refer to instuctions.
A. Hazardouc Wastc B. Usad Oil Fuel Astivitiee
ffra. Generator Wtb. Less than l,ooo kg,/mo.
I z. Transporter
I g. Treaterr'Storer,/Disposer
X c. Underground lnjection
fJ S. Market or Burn Hazardous Waste Fuel
(enter'X' and mark' approptiate boxes below)
n ,. Generator Marketing to Burner
X u. other Marketer
fi .. Burner
D O. Off-Specification Used Oil Fuel ffi ffi.-(enter'X' and mark appropriate boxes belbwf L==,
D ". Generator Marketing to Burner
Iu.otherMarketer $[P g,& i(
I ". Burner
I z. specification Used oit Fuet Marketerr.(orr"qri#-H$f]' ,?f
Wrro First Ctaims the oit Meets tht$S0,euti6t $ttlis; ,& fiSf
Vll. Waste Fuel Burning: Type of Combustion Device/enrer'X'inatlappropriateboxestoindic.tetypeolcombustiondevice(s)in
which hazardous waste luel or ol{-specification used oil lucl is burned. See instructions lor delinitions of combustion devices.)
fI a. Utiliry Boiler n B. lndustrial Boiler ffc. lndustriat Furnace
Vlll. Mode of Transoortalion ltransoorters onlv - enter'X' in the aoorooriate boxles
tr e. ni, fI e. Rait d ,.Hishway I D. wate, f, E. othe r (specty)
lX. First or Subseouent Notification
Mark 'X' in the appropriate box to indicate whether this is your installation's first notification o{ hazardous wasto activity or a subsequent
notilication. lI this is not your first notilication, enter your installation's EPA lD Number in the space provided below.
d o. First Notification I B. Subsequent Notification (comptete item C)
C. lnstallation's EPA lD Number
ffiffi
n
ealtrx
rdou$ W
Continuo on reverseEPA Form 87OO-12 (Rev. 11-85) Previous edition is obsolete"
I
t T/A
tion of Hazardous Wastes conun 'rom front
A. Heardour Wrrtcr lrom Nonrpccific Sourcc:. Enter the four-digit numb€r from 4O CFR Pafi 261.31 lor oach listed hazardouc waste
.. lrom nonspocitic &urc.jyour instsllltion hendles. Uso additional sheets il neceasary.
8. Hezrdoul W.rtcs from Spccilic Sourcrr. Enler the four-digir numbcr lrom 4O CFR Pan261.32lor each.listed hazardous waste from
epecific souroas your installalion handles. Usa additional sheets if n€cossary.
C. Commcrcirl Chcmiol Product Hauardour ftst .. Ent.r the four-digit number lrom $ CFR Part 261.33 for each chemical substance
your installation handlos which may be a hazardous wa$e. Use additional sheets it nocesaary.
D. Urt6d lnfccdour Wrrtar. Entor th€ four-digit number from & CFR Part 261.34 tor each hazardous waste hom hospitals. veterinary hos-
pitals, or medical and res€arch laboratories your installation handl6s. Use addirional sheets iI nacessary.
E. Charaqtcrirtics o{ ltlonlirtcd Hazardour Wartc* Mark X' in the boxes corresponding to tho charactoristica of nonlistod hazardous wastes
your installatlon handles. /See 40 CFR Parts 261.21 - 261 .24)
{r. [nitabre fJ z. corrosive
Xl. Certification
I cenify under penalty of law that I have personally examined and am familiar with the information submitted in
this and all attached documents. and that based on my inguiry of those individuals immediately responsible for
obtaining the inf ormation. I believe that the submined information is true, accurate. and complete. I am aware that
thqre are significant pqnalties f or submiding lalse information, including the possibility of fine and imprisonment.
Name and
LnI.].
Official Title (type or print)
l\16^
Date Signed
? *2 l^?o
EPA Form 8 oo-12 (R 1 1-85) Reverse