DSHW-2025-001156

Michael O. Lravitt
Govcrnor
Dianne R. Nielson, Ph.D.
Executive Dircctor
Dennis R. Downs
Director
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF SOLID AND HAZARDOUS WASTE
288 North 1460 West
P.O. Box 144880
Salt Lake City, Urah 841l4-4880
[phone] Voice
[phone] Fax
(801) s36-Ml4 T.D.D.
May 16, 1996
Garys Cleaners
818 West Shepard Lane
Farmington, UT 84037
Attention: Tim Flanery, Owner
Dear Mr. Flanery:
This is to acknowledge that you have filed for a Notification of Hazardous Waste Activity.
Your EPA Identification Number is UTR000001586.
The EPA Number must be included on all shipping manifests for transporting hazardous wastes;
on all Biennial Reports that 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 (the Code).
The EPA Number is site specific. If your company changes physical locations, it is your
responsibility, as a generator, to notify the state and apply for a new EPA Number.
If you have any questions please contact Delene Thomas at 538-6170.
Sincerely,
M rv-Jho-^06e/
Dennis R. Downs
Executive Secretary
Utah Solid and Hazardous Waste Control Board
;
Date Received
(For Ofllcial Usc Ontyl
PIcGc rrbrtt fic rnsaucdoastor FilinE Nodfrcaiion b.6rtqfipcmg Uur bnn. Thc5rlomadon ru<lsbcl ltero brrcffuO by lil $aalon &tOof Up flcsourca ConscnartoafrRecrrvery/rI,L
EEPA Notification of
Regulated Waste
Activity
United States Brvircnrnfital Roncilgr
l. lnstallatlon's EPA ID Nurnber (Ma#Y h tha approgtat; borl
n A First llottllcatlon n B. Subsequent ilotlficdonI I I I pompletcitemc)f t5t8 t6
ll. Name of tnstaltatt on (lnclude company and specl?Ic sJle nuncl
Itt. Locailon of lnstallation (Physicat addrcs3 not P,A. Bor w Routc Numbcr)
Street
Strect fcontlnuetii
CIty or Town
lV. tnstallatlon Maitlng Address (Sec instnrdtons)
Street or P.O. Bor
City or Town
fln14tr)"lDl3l?v. lnslallatlon contact (Person to D€ contactsd regardlng waste actMUas ,a s[!,
!!3me /tastltrlrl*
Phonc Numbcr (aru cr,do rnd numbul
vl. tnstaltatlon contaa Address (Sec instnrclonsf
B. Sbeet or P.O. Box
City or Towrr
Vlt. OWncrShlp (Sac instnratons)
A. Namc of lnstallaton,s Legal Owner
Sbcet,'P.O. Bo1 or Route Number
Clty or Toivn
I lllllt;
Fhooe Number
0. Gungc ol Owncr
tndlcator
(Dau Ciangcd)Monn 0av- ' Year
?l ll - lslz lr I;14 1-, [e[r
,l
J pteasg print or tl/pc witr EUTE type (12 characrrs pcr inchl in the trnstrarled arsas onfV
EPA Form 870O-t2 (01-{Nl} Provious cdiUon is obsoteta.REr.6B0 ,-{
farnrgptqrg,. OrrErto.209l.{(trr. €m tO.3, i,
Xo. lng.EB..a?
Contnue on rsrerse
lD - For Ofllcid Uss Olily
Vltl. Typ. of Begulatad W".1" Urity grut X htfic3eyoprrrtr Dorc3 Reter b trrlrrrta**1)
A" Hazardous Waste Activily B. Us€d Oil fud AcilviUes
tru
1. GenerOr (See lnslrlcdarsf To. Greerfian lO$kg/nrc (ZN lbs.)
b. 100 b lm0 kdrno lA - 2.ffi lbs.)
o. Lsss fian 1S kg/mo lfr lbs.)
Transporbr (lndice Mode h bqes 1-5 below)a. For orn msb onty
b. For cqnrnecial rurpos€s
Mode o, Transportron
Tt€atar. Sbrer. Dlspos€r (at lnstallaticn)
N@: A pemit is requirecl for
thF divitf soe insituctidls.
Hazardcns Wasta RleI
e Genefamr Me*atir€ E Eurnar
b. 9{t* Mett&rg
c. Burt€r - Lx[cafrl danie(s] -
Typc of Cocrlnrston Oadco
tr r. lrfltv Boit€r
Ll Z Frsusuhl Boiter
u 3. r?dustial Funreca
T 5. Underground lnffion ConUot
tr 1. Airn z- Hait
EL a. Hernray
il 4. wdBr
t] s. otror - sp€cift
1. Ofl-Spcillcdon Used O[ fud
t] a Generabr Mart<eting b Bumer
I b. Out* ttarrerer
il c. Burnr - Ltdlcato dadcs(s) -
Ty'pe o, Combustion O6ri:a
I t. uffiry Boitsr
t] 2- [drsuial Boiler
t] 3. rrcfi$ilhl Funracs
I'i a Sooc#cation lJssd Cil Fud Marr<eterL-r (dr On-sib &,rmerl Who Hrst Caims
ure Ou M€eul u:e Spesncaion
lL Descrlpdon of Regulated Wastes (Use addtttonat slreets ff necessaryl )
A Clt r.culdc. of l{onlhod l{rrrJ6l6g3 Wertr* Mai('f h thc boxor conlsponding b the daractdslics o, t'tonlisiscl lu:adats
warc! yoqr instaldilrn ,rand... (Saa 4 CFR Pz13 fr|.fr - 81.21)
(Ljst sp€cillc EPA lrazardous wasts number(s) for the EP Toric ccntaminant(s))
1. lgnitable 2 Conosive 3. Readivetffi,, 'ffi 'ffi'
4. EP Toxic
DNO''[l'
Ustcd Hazadour Wastgs. (See 40 CFR 251.31 - 33. See instnrctions il you need b list more than 12 wasa codes.)
5-lm11 Im
Othar Wmtaa (State or otrer wasus raquinng al l.D. number. S€€ instrustons.)
I certlly underpenaltyollawthatlhave personally ezmlned and amlamlllarwtththelntormetlonsubmlttedlnthls
ancl all attacied doatments, ancl that Dased on my lnqulry of tDose lndklduals lmmedlately responslble tot
gptalnlng the lntomatton, I belleve that the submltted lnlormatlon Is tpe, eccurate, ancl completa t am awere
that there are slgnlflcant penattles lor submitilng /alse lntormatlon, lndtudlng tfie possiDflily ol llnes andlmpdsonmenL
,
ffiffiffiffi ffi ffi
5'r\ry Name and Otficial Title (Upe or print)
K.n.,-- €f c*-n1 $rr.s..se-.5-
Date Signeoslz /q*
:
Not?rt l{ail comglotcd lorm to thc aggrogilae EPA f,cgional ot Sfiat Otltc.. (Scc Seclloa fil ot thl booklel lor addreacs.)
Please pnril or type with EUTE type (12 characters p€r inch) in the unstradad at€as only Forn,irycrou.d. Ora8fla W9! Ew r0-Jr-t,- Gllafla qHa-€PA4r-
EPA Form 8700-12 (ol-go) prcvious adluon is obsorate.