DSHW-2024-004009

Review Source Record
CVS PHARMACY #10578 11502 SOUTH 4000 WEST -
SOUTH JORDAN - 84095
UTR000013482
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1. Reason for Submittal
2. Site ID
3. Site Name
4. Site Location
General Information
Received Date
01/03/2024
Non-notifier Extract to Public?
Yes
Accessibility Acknowledgement Flag
Obtaining or updating an EPA ID number for an on-going regulated activity that will continue for a period of
time. (Includes HSM activity) [Source N]
EPA ID
UTR000013482
Activity Location
UT
Name
CVS PHARMACY #10578
Location Address
Street
Number
11506
Street 1
SOUTH 4000 WEST
Street 2
Zip City, Town or Village State
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5. Site Mailing Address
6. Site Land Type
7. North American Industry Classification System (NAICS)
84095 SOUTH JORDAN UTAH
Country
UNITED STATES
County
SALT LAKE
State District
View on Map Geographic Information
Coordinate Type
Decimal Degrees
Latitude
40.558509
Longitude
-111.986339
Use Lat/Long as Primary
Address
No
These coordinates have been provided by an automatic geocoding service. Please click View on Map and
confirm that these coordinates are accurate.
Street
Number
1
Street 1
CVS DR MC2340
Street 2
Zip
02895
City, Town or Village
WOONSOCKET
State
RHODE ISLAND
Country
UNITED STATES
Land Type
Private
Primary NAICS
45611 - PHARMACIES AND DRUG RETAILERS
Other NAICS
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8. Site Contact Person
8a. Site Contact Address
8b. Additional Contacts
9a. Legal Owner
9b. Legal Operator
First Name
NICOLE
Middle Initial Last Name
WILKINSON
Title
DIRECTOR, CORPORATE
ENVIRONMENTAL
Email
[e-mail]
Phone Number
401-770-7132
Extension Fax
Preferred Language
ENGLISH
Street
Number
1
Street 1
CVS DR MC2340
Street 2
Zip
02895
City, Town or Village
WOONSOCKET
State
RHODE ISLAND
Country
UNITED STATES
Type Name Address Action
There are no additional contacts to display.
Type Name Address Date Action
Private SPJ, INC.82 JOHN STREET, WESTMINSTER,
MD 21158
10/30/2014 
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10. Type of Federal Regulated Waste Activity
A. Hazardous Waste Activities
11. Additional Regulated Waste Activities
Type Name Address Date Action
Private UTAH CVS PHARMACY, LLC ONE CVS DRIVE, WOONSOCKET,
RI 02895
08/01/2015 
1. Generator of Hazardous
Waste (Federal)
3 - Very Small Quantity
Generator
Generator of Hazardous
Waste (State)
F - Same as federally defined
2. Short Term Generator
None Selected
3. Treater, Storer, or Disposer
of Haz Waste
None Selected
4. Receives Hazardous Waste
from Off-site
None Selected
5. Recycler of Hazardous
Waste
None Selected
6. Exempt Boiler and / or
Industrial Furnace
None Selected
B. Waste Codes for Federally Regulated Hazardous Wastes
A. Hazardous Waste Codes (Federal)
D-Codes:
D001 D002 D007 D009 D010
U-Codes:
U002 U129 U165 U188 U205
C. Waste Codes for State Regulated (non-Federal) Hazardous Wastes
B. Hazardous Waste Codes (State)
None Selected
A. Other Waste Activities
1. Transporter of Hazardous
Waste
None Selected
3. United States Importer of
Hazardous Waste
None Selected
4. Recognized Trader
5. Importer/Exporter of
SLABs
None Selected
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12. Eligible Academic Entities with Laboratories
13. Episodic Generation
2. Underground Injection
Control
None Selected
None Selected
B. Universal Waste Activities
1. Large Quantity Handler
of Univ Waste
None Selected
2. Destination Facility for
Universal Waste
None Selected
C. Used Oil Activities
1. Used Oil Transporter
None Selected
2. Used Oil Processor and /
or Re-refiner
None Selected
3. Off-Specification Used Oil
Burner
4. Used Oil Fuel Marketer
None Selected
None Selected
D. Pharmaceutical Activities
Operating under 40 CFR 266 Subpart P for the management of hazardous waste pharmaceuticals.
Healthcare Facility
Withdrawing from operating under 40 CFR 266 Subpart P for the management of hazardous waste
pharmaceuticals.
No
E. State Activities
Your State does not have any State defined activities.
1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of
hazardous wastes in laboratories.
2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in
laboratories.
No
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 pursuant to 40 CFR Part
262 Subpart L? If "Yes", you must fill out the Addendum for Episodic Generator.
No
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14. LQG Consolidation of VSQG Waste
15. Notification of LQG Site Closure for a Central Accumulation Area (CAA) (optional) and Entire Facility
16. Notification of Hazardous Secondary Material (HSM) Activity
17. Electronic Manifest Broker
18. Comments
Internal Comments
Public Comments
19. Certification
Are you an LQG notifying of consolidating VSQG hazardous waste under the control of the same
person pursuant to 40 CFR 262.17(f)?
No
LQG Site Closure of a Central Accumulation Area or Facility
No
Are you reporting HSM activities?
No
Are you notifying as a person, as defined in 40 CFR 260.10, electing to use the EPA electronic manifest
system to obtain, complete, and transmit an electronic manifest under a contractual relationship with a
hazardous waste generator?
No
This site did not move. The initial application has the incorrect address.
First Name M.I.Last Name Title Date Signed Action
Charles Savage Regulatory Compliance
Specialist
01/03/2024 
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