DSHW-2024-009282

UtaQepartment of Environmentfluality .4.-o,Division of Solid and Hazardous Whste /ffiX /
Den*gt,lJ::[m"" ffi YP.O.Box144E80 ry \ /\
Salt Lake City, Utah E4114-4EE0 V \
HAZARDOUS WASTE GENERATION EVALUATION FORM
FiCilityName: Dohcr nal rncrvi r C TH C*EPA !D Number:Si6cteooiffilt-o -LJ 5co n-)i Citv:Sr. i+ tel<e iZip:8V tay
County: So t I L.r [eo_ i Contact Person :i rercphone#: 9'T 3 -- +1 lqGeneratorStatus: i Numberof Employees: pcrui Te ,^k1,"|'oateolVlsit: i l - t7_-, Oll,inspCfior$-L+ook r^rs /Cf,Lu e- t-*s
Other Personnel: ''1I<]11 y1'/e,m'tg-Ec-t) rE S h* - Ja\cr lt-f,* r, .{ r
Waste Stream/Generati on
Process
Generation Rate Per
Month
Hazardous Waste Gode Properly
Managed?
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j)crtt e'-+\L p n-,-ctS
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Doce i D oo8 I>ei ?
\o361 bayo
Total Quantity of Hazardous
Waste Generated Per Month
ltf PBv"*els'-'p t r i\,"c, ^+ h
REsPoNsE NEGESSARY: t=tS- No
COMMENTS:
RE'P'NSE DUE BY lL - i L-c 3
--?
This compliance evaluation noles 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 actions summarized in this audit
in order to come into compliance ano tt5lrY THIS oFFlcE flqffilNGTfifiEifidicated date. i,lease 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. Please include your EPA ld number with your correspondence.
lf you have further questions or would like to discuss these issues with the inspectors or their supervisor, you may contact them dudng business
RECEIVED BY:INSPEGTOR:
Name, printed:Name, Printed:
Signature:
Title:
U '!,r
Date:
Signature:
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Page 2
Example of Employee Training Log (this is only an example and must be adapted specifically to your
facility)
XYZ Companv Emplovee Trainins Los
Date: 4pi19,2002
Time: 10:00 am to 11:00 am
Discussion lead by: John Doe, Health and Safety Coordinator
Topics Discussed
l.Hazardous \Maste Accumulation Time
a. Do not store hazardous wastes for longer than 180 days on site.
b. Label each container or tank with the words "Hazardous Waste."
Use and Management of Containers
a. Maintain a log weekly on the hazardous waste containers; are the containers closed, labeled,
dated and in good condition. If not, please contact the emergency coordinator in order to
rectify the problem.
Other topics as discussed
a.
b.
il.
III.
Employee Name (Please Print)
1.
Bmployee Signature
2.
3.
4.
f5.
Ni(")
page 3
UTAH DEO SMALL QUANTITY GENERATOR EVALUATION FORM
Items that are marked "NO" on the line in the Ieft hand column are not in compliance with the Utah Solid and Hazardous
Waste Regulations and require your immediate attention. ltems marked "OK" meet the minimum requirements of the
regulations. ltems marked "NA" do not apply to your facility.
1. R315.5.2 DETERMINATION OF WHETHER A WASTE IS HAZARDOUS 40 CFR 262j1
AcroNr.reeoEo' (D1t *-trrnr Sl-rvensrin S38-6, *ti
R315-3 NOTIFICATION AND EPA HAZARDOUS WASTE IDENTIFICATION NUMBERS 4OCFR 262.12y'
lf you generate between 1 00 and 1 000 Kgs (2OO-22OOlbs) of hazardous waste per month or up to 1 Kg of acutely hazardous \
waste, you are classified as a Small Ouantity Generator (SQG) and you must notify the Executive Secretary of 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 at [phone].
ll you are a small quantity generator, you must obtain an EPA ld Number in order offer hazardous waste lor management to a
transporter or to a treatment, storage and disposal lacility (TSQF) that has an EPA ld Number.
ACTION NEEDED: i\
,
a'("-[* u'v]\ t r.;.J6.--) v-\<ft-"o t' e 1ur
t,
C) (s. R31s-s-4 MANTFESTS 40 cFR26z.2o-2g Ct v- w1
@". Only use approved manilest lorm 87Oo-22and 8700-22A when otfering hazardous wastes for transport to a TSDF or use the manifest of the
. , ) state that the TSDF is located in, if required by that state.I < U. Designate another facility or instruct a transportef to rsturn wastes if they are undeliverable.s}D*-iirl ffiair apprilaore sedions of the manifei.<a - - - --
AL* Use a contractual disposal agreement only if a generation rats is less than 1000 Kg/month (SQG or less).
&-e. Keep copies ol contractual agreements for three years after service ends.
ACTION NEEDED:Y1n,c e{i
R315.5.5 RECORD KEEPING 40 CFR 262.40
Keep copies ol manifests for three years.
Keep all records, including determination of generation rates, waste characterization documentation, disposition, etc., for three years.
ACTION NEEDED:
ffii
K-
N r. R3rs-5-7 ExcEpnoN REeoRTTNG 40 cFR 262-4;2-:m;. iii$Fi;";;; return senerator's copy ol;;"ir;"i;ith-,(6*r") senerator must submit a tetter statins so and a copy ot the
manifest to the Executive Secretary of the Utah Solid and nDzrdms Waste Control Board.
AcTloN ueeogo: --\e.t, ;# 3
#:
Cll. zcflT;.'R31 5.5.1 O ACCUMULATION TIME
Do not store hazardous wastes for longer than 180 days or 27O days, if applicable, without a permit.
Do not exceed 6000 Kg of hazardous wastes stored at your facility at any time.
Mark the date the accumulation period began on each container of hazardous waste. Satellite accumulation containers are the
exception.
Label each tank and container with the words'|I@EQQUSWE[!" while it is being use to accumulate hazardous wastes.
Designate and authorize an smergsncy coordinator (s)rilho-rs (are) readily available by some means at all times.
Post the following information next to each telephone at the facility: name and telephone number of the emergency coordinator(s)
location(s) or fire extinguishers, spill control equipment, lire alarms, telephone number of the local fire department (or equivalent
emergency responss for facility).
Ensure that all employees are lamiliar with hazardous waste handling and emergency procedures.
thathavethepotentialofinvolvinghazardouswaste(s)'
AcroNueeoeo, L..ke,t f d,.{-r At( h4ttivrri.'us r,;'i.sJt-
(*ovr'Tct(\€rJ
sPtLL RESPONSE (THESE RULES ARE FOUND !N R31s-9)
Take appropriate action to minimize threats to human health and the environmsnt by notifying the Utah State Department of
Environmental Quality at [phone] or 1 (800) 572-il00 (24 hour number) if more than 1 Kg of acutely hazardous waste,
100 Kg of hazardous waste, 25 gallons of used oil or material which when spilled becomes hazardous waste, as specilied in notify
the National Response Center when applicable and provide the appropriate information listed in R315-9, in the spill report.
R315.5.9 PACKAGING, LABELING MARKING AND PLACARDING
Package, label and mark waste in accordance with DOT 49 CFR prior to shipment.
ACTION NEEDED:
b.
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ACTION NEEDED:
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Today's date:
i
Page 4
These are only examples that will help you to comply with the regulations. You must gg!4! the
following information and it make specific to your facility.
SEE #L0c
Letters to: r' Your Hospital
Youf locai Potice Department
\ lour local Fire Department
Dear Sir or Madame:
In accordance with 40 CFR 265 Subpat C, it is required that we notify you that we generate hazardous
waste(s). The waste(s) that we generate is (are) ...(examples might be: waste paints, paint sludges, *, \ , ti
We make every effort to properly manage our wastes, but in the event of an emergency we may require
your assistance. In the event of an unforeseen emergency, you may be required to respond.
Your name and title
Your company name
1*"*"t See fflc and 7f
IN CASE OF AN EMERGENCY DIAL 9II
EMERGENCY COORDINATOR IS CARL CAREFUL. BXT 2536
FIRE EXTINQUISHERS LOCATION MARKED ON THE WALL
SPILL CONTROL EQUIPMENT LOCATED AT TIME CLOCK
M;":il11'I8ilIft i^HrivrPs
DATE:
Page 5
UTAH DEO SMALL QUANTITY GENERATOR EVALUATION FORM
o( g. usE AND MANAGEMENT oF coNTATNERS (THESE RULES ARE FoUND rN 40 cFR 26s.170 (suBpART 1)
G". Hold hazardous wastes in cantainers that are in gpod condiiion.
-ti-E b Store hazardous wastes in containers that are odnpatible with the waste.iTX c ". Keep hazardous waste contrainers in a completely closed condition except when adding or removing wastes.*) -\|.1QO. Do not open, handle or store contiainers ol hazardous waste in a manner which may cause a release.
" t{O e. lnspect containers of hazardous wastg at lease weekly to look for signs of leakage or deterioration. A log should be kept.
*. t. Do not store incompatible hazardous wastes in the same container.
4-5. Do not store wastes in containers that previously held an incompatible material without cleaning it tirst.6(- h. Separate incompatible wastes by means of a dike, berm or other method
oc,o**==o=r. l2e-ri-p k*}?.r-ious L.uq,sjL ('*,-t'(r...F{'-{. Cf ,*f i*1''i1
c (c*$ c;,l
4_ro. pREpAREDNESS AND pREvENTToN (THESE RULES ARE FoUND rN 40 cFR 26s suBpART c)%.
C) l(b.
a(
".
Ora( d.frMe.
You must operate your facility in such mannEr that MINIMIZES the possibility of fire, explosion or any unplanned release.
You must have the lollowing preparedness and prevention equipment unlEss thE wastes you store do not pose the hazards that the
equipment is designed to respond to: lntEmal communications or alarm capable of instruction (such as an intercom), a device
capable of summoning outside emergency assistance (such as a direct alarm to the lire departrnent or a telephone), portable lire
extinguishers, water a adequate pressure and volume to supply fire fighting needs, alarms and communication devices accessible to
to personnel where they are handling hazardous wastes.
You must maintain and test, where necessary, all communication systems; fire, spill response, decutamination and protective
equipment.
Make maintain aisle space to allor unobstructed movement ol personnel and emergency equipment.
Make arrangements with local fire, police and hospitals to respond to emergency situations at your facility. Maintain documsntration
notilication letters, responses or lack of responses from these agencies.
*l\l.,Jf, f. * Document refusals by'authorities to emergency arrangements.
ACTION NEEDED:
6ftt.
6JLa.
%0.&- G.
LAND DISPOSAL RESTRICTIONS (LDR) (THESE RULES ARE FOUND lN 40 CFR 268.7(a)(4))
ll you treat your hazardous wastes to render them non-Land Disposal Restricted, you must develop and lollow a written waste
analysis plan. This waste analysis plan must be based on a laboratory analysis of the waste and must contain all necessary elements
including frequency. The waste analysis plan must be submitted to the Executive Secretary ol the Utah Solid and Hazardous Waste
Control Board at least 30 days prior to treatrnent.
Maintain an assessment ol LDR status on file for each hazardous waste generated at the facility.
A notice and cedification that each waste is either land disposal restrbted, or if it is restricted, that it is land disposable afiertreatment, must
,, ! accompany each manifested shipment of hazardous waste.
Wa. Maintain all LDR Documentation for five years after the waste is shipped off site.
ACTION NEEDED:
04,r.E.
L/,
R31+16 UNIVERSAL WASTES, FLUORESCENT LIGHT TUBES (<"
High mercury fluorescent light tubes must be recycled or disposed as hazardous wastel Any broken tubes must be managed as a hazardous
waste but can still be recycled..Do not dispose of tubes in the regular trash or in he dumpster.
Label either the waste tubes ner holding the tubes as "UNIVERSAL WASTE-MERCURY CONTAINING LAMPS".
ACTION NEEDED:0 (u tr14*
0( rs. Rg15-s-13 STANDARDS FoR usED olL GENERAToRS
A( a. Use permitted used oil transporter, (name, address and telephone number of transporter).
Ol< b. Storage tanks and associated piping in good condition and labeled lJsed Oil".
4S c. Bum only their own usEd oil in vented space heater with a max. cap. ol 0.5 million BTUs or in (>0.5 cap.heater).
?1,d. Hot drain punctured oil filters. Method of lilter disposal. Discarded in trash or recycled. ll recycled, by whom?
-!Ie. Clean up any used oil spills and any contraminated soil.
ACTION NEEDED:
-14.
OTHER ACTIONS NEEDED:
419103
Pagq 6
Inspector's
Name
Are containers
Iabeled with the
words
IilAZARDOUS
WASTE?
Is accumulation
date marked on
aII hazardous
waste containers
and is that date
Iess than 180
days old?
Are hazardous
waste
containers
closed and are
all bungs and
bung rings
secure?
If any columns are marked
NO describe what was dbne to
bring the container into
compliance?
Date Manifest
number
Total pounds
of hazardous
waste (convert
all amounts to
pounds)
Generator
copy of
manifest
signed by
transporter &
our company
representative
Land
Disposal
Restriction
certification
(LDR) with
matching
, manifesti number
Signed
copy from
disposal
facility
mailed
back to us
within 60
days
Are these
three
forms
stapled
together?
lf any columns are marked NO,
what is being done to bring
manifest file into compliance?
Total
Pounds
Yes No Yes No Yes No Yes No