DSHW-2025-001471

uTAIEpARTM ENT oF ENvriluna eNTAL euALrw
DIVISION OF SOLID AND HAZARDOUS WASTE
Dennls R. Downs. Director
SQG Program 't
P. O Box 144880
Salt Lake City, UT 841 14-4880
(801)-538-6170
HAZARDOUS WASTE GENERATOR EVALUATION FORM
Facility Name:EPA ID N umoer unoo z {3Y 73 O
street Mdress. J&4 UJ tt)d S city:SLC zipcode, gY/o
County:SL Contact Person: Phone Number: , ? 4- ryq
Number of Employees: Date of vlsllz /O '- 6 * 7 ?Generator Status:
lnspectors:
Other Personnel:
WASTE STREAT\,I / GENERATION PROCESS
Total Quantity of Hazardous
Waste Generated per Month:
RESPONSE NECESSARY:
COMMENTS: D.d, ata.rb u) e kr lto* -
RESPONSE DUE //-- 6 *qg
5
Do^t I^,h'L .,ffik,
GENERATION RATE
PER MONTH
HAZARDOUS
WASTE CODE
PROPERLY
MA}IAGED ?
Lcu*a ub/'t
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 WRITING by the indicated date. 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. Please include your EPA number with your borrespondence.
lf you have further questions, or would like to discuss these issues with the inspectors or their supervisor, you may
contact them during business hours at [phone]. ltems that must be submitted may be mailed to the address at
the top of this page.
RECEIVED BY:INSPECTOR:
Name, PrintedName, Printed;
Signature:Signature:
Title: ComDlianc
Date:Date:
Off icer
Page 2 of 6
@xampte) XYZ Companv Emplovee Training Log
Date: April 9, 1997
Time: 10:00 am to 11:00 am
Discussion lead by: John Doe, Health and Safety Coordinator
Topics discussed
Herardous Waste 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."
tr. 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.
m. Other topics as discussed.
Employee Name (Please Print)
1.
2.
3.
Employee Signature
BTIIIS Is OIYLY AN EXAMPLE AND MUST BE ADAPTED SPECIF'ICALLY TO
YOUR FACILITY AND TRAINING FORMAT.
Iterns that
Hazardous Waste Reg u lations
O urAH DrvrsroN oF soLe Page 3 of 6
AND HAZARDOUS WASTE
SMALL QUANTITY GENERATOR
COMPLIANCE EVALUATION FORM
are marked "NO" on the line in the left-hand column are not in compliance with the Utah Solid and
and require your immediate attention. ltems marked "OK" meet the minimum requirements ol the
regulations. ttems marked "NA" do not apply to your lacitity.
1.R315-5.2 DETERMINATION OF WHETHER A WASTE IS HAZARDOUS
ACTION NEEDED:
L
+L-
Tb
&
tb
-LIu
2.R315-3 NOTIFICATION AND EPA HAZARDOUS WASTE IDENTIFICATION NUMBERS:
lf you generate between 100 and 1000 Kgs (220-2200 pounds) of hazardous waste per month or up to 1 Kg ol acutely
hazardous waste, you are classified as a Smal! Quantity Generator (SOG), and you must notify the Executive Secretary ol
the Utah SolitJ and Hazardous Waste Control Board and obtain an EPA lD number. This is accomplished by notitying the Utah
Divisbn ol SoliJ and Hazardous Waste.b. lf you are a small quantity generalor, you must obtain an EPA lD Number in order to otfer hazardous waste lor management to
a lransporter or to a treatment, storage and disposal facillty fl'SDF) that has an EPA lD Number.
ACTION NEEDED:
3.H315.5.4 MANIFESTS
Only use approved manifest lorm 87OO-22 and 8700-22A when offering hazardous wastes for transport to a TSDF or use the
manifest ol the state that the TSDF is located in, if required by that state.
Designate another facility or instruct a transporter to return wastes if they are undeliverable.
Fill out all applicable seclbns ol the manifest.
Use a conlractual disposal agreemenl only il a generation rate b less than 1000 Kg/month (SQG or less).
Keep copies of contractual agreements lorlhree years atter service ends.
ACTION NEEDED:
R315.5-5 RECORD KEEPING
Keep copies of manifests for three years.
Keep all records, including determinatbn of generatbn
years.
ACTION NEEDED:
rates, waste characterizatbn documentatbn, disposilbn, etc., for three
a.
b.
c.
d.
e.
0L 4.#i
5.R315.5.7 EXCEPTION REPORTING
ff TSDF does not return generators' copy of manifest within
and a copy of the manifest to the Executive Secretary of the
ACTION NEEDED:
60 dayS, E generator must submit a letter stating so
Utah SollC and Hazardous Waste Control Board.
flttv 6. F315.5-9 PACKAGING, LABELING, MARKING AND PLACARDINGa. Package, Label and mark wasle in accordance with DOT 49 CFR prior to shipment.
ACTION NEEDED:
7. l^ R315-5-10 ACCUMULATTONTTME' '+f il ;;i=; Lardous wasles for longer than 1 80 days, or 270 days if applicable, without a permit.
^o
d$'V" ,
b.' I Do nol exceed 6000 Kg ol hazardous wastes stored al lour facility at any time.c. Mark the date the accumulation period began on each coniainer o( hazardous wastes. Satellite accumulatbn conlainers are
the exception.d. Label each tank and container with lhe words'HAZARDOUS WASTE" while it is being used to accumulate hazardous wasles.
e. Designate and authorize an emergency coordinator(s) who is(are) readity available by some means at all times.l. Post the lolbwing inlormatbn nexl to each telephone al the facility: Name and telephone number of the emergency
coordinator(s) location(s) ol lire extinguishers, spill control equipment and lire alarms, telephone number ol the local lire
departmenl (or equivalenl emergency response lor facility).
S. Ensure thal all employees are lamiliar with hazardous wasle handling and emergency procedures.h. The emergency coordinator must respond appropriately to emergencies that have the potential of invotving hazardous waste(s).
ACTION NEEDED:ban
arud( f fu't.t /rt, lo
'l/,(4 1
Page 4 of 6
,?^* the following inro..n",ion 'These are only examples that will help yr
for and make it specific to YOUR facility.
Today's date
Irtters to: Your Hospital
Your local Police Department
Your local File Department
Dear sir or Madame
In accordance with 40 DFR 265 Subpart C, we are required to notify you that we generate hazardous waste(s). The
waste(s) that we generate is (are)...examples might be; paint wastes, paint sludges, Methyl Ethyl Ketone, Acetone,
other solvents, acids, bases, listed wastes, etc.
We make every effort to properly manage our waste, but in the event of an emergency we may require your assistance.
In the event of an unforseen emergency, would you be able to respond?
Your Name and Title
ABC ComPanY
#keandIf
!S IN CASE OF EMERGENCY DIAL 91 13€ EMERGENCY COORDINATOR !S CARL CAREFUL-
EXT. 2536[S FIRE EXTINGUISHERS'LOCATION MARKED ON
WALL5A SPILL CONTROL EQUIPMENT LOCATED AT TIME
CLOCK
UilTI'ENSAIWASTE
TENCUNY-COMill]{G
DATC
SEE #10e
Page 5 of 6
AND HMARDOUS WASTE
SMALL QUANTITY GENERATOR
COMPLIANCE EVALUATION FORM
l,b 8. sptLL RESPONSE OHESE RULES ARE FOUND lN R31s-9)&Take appropriate actbn to minimize threats to human health and lhe environment by notifying the Utah State Department ol
Environmental Quality at [phone] or 1-800-572-6400 ( 24 hour number) il more than 'l Kg ol acutety hazardous wasie
or 100 Kg of hazardous wasle or malerial which when spilled becomes hazardous waste, is spilled as specified in 40 CFR
261.33(e). Notity the NationalResponse Center when applicable and provUe the appropriate information, listed in R315-9(c), in
the spill report.
ACTION NEEDED:
usE AND MANAGEMENT OF CONTATNERS TTHESE RULES ARE FOUND rN 40 CFR 26s SUBPART D
HoH Hazardous Wastes in containers thal are in good conditbn.
Store hazardous wasles in containers that are compatible with the waste.
Keep hazardous waste containers in a completely closed conditbn, except when adding or removing wastes.
Do not open, handle or slore containers ol hazardous wasle in a manner which may cause a release.
lnspect containers of hazardous waste at least weekly lo look for signs oI leakage or deterioratbn. A log shouU be kept.
Do not slore incompatible hazardous wastes in the same conlainer.
Do not slore hazardous wastes in containers that prevbusly held an incompatible material without cleaning il lirst.
Separate incompatible hazardous wasles by means of a dike, berm or olher method.
ACTION NEEDED:
O urAH DrvrsroN oF soLrD I
9.
0r.\
E
,k
w
d"v
alb
#
10.
a.
b.
c.
d.
e.
f.
11.
a.
b.
c.
d.
12.
a.
b.
13.
ct.
14.
a.
15.
16.
PHEPAREDNESS AND PREVENTTON FHESE RULES ARE FOUND lN 40 CFR 26s SUBPART C)
You must operate your lacility in such a manner that MINIMIZES the possbility ol fire, expbsbn or any unplanned release.
You must have the lolbwing preparedness and preventbn equipment unless the wasles'you slores do not pose the hazards
that the equipmenl is designed to respond to: lnternal communicatbns or alarm capable of instructbn, such as an intercom; A
devbe capable of summoning outsUe emergency assblancs (such as a direct alarm to the lire departmenl or a lelephone);
porlable fhe exlingubhers; water at adequate pressure and rolume to suppty lire lighting needs; Alarms and communicalbn
devices accessible to personnel where they are handling hazardous wasles.
You must maintain and test where necessary qll communbatbn- systems; fire, spill response, decontaminatbn and protective
equpment. Za h. 4otzt 1 ft^t- 57 r(cZ "
You must maintain aisle space to albw unobslructed move-ment ol personnel and emergency equipment
Make arrangements wilh bcal lire, police and hospilals lo respond to emergency situatbns at )our facility. Maintain
documeniatbn ol notificatbn letters, responses or lack of responses from lhese agencies.
Documenl relusals by authorities to emergency arrangements.
ACTION NEEDED:be"'lL( Na"l tfu
I-AND DISPOSAL RESTRICTIONS (LDB) CTHESE RULES ARE FOUND lN 40 cFR 268.7(a[4)
ll you treat your hazardous wastes to render them non-Land Dbposal Restrbted, you must devebp and follow a written waste
anatysb plan. This waste anatysis plan must be based on a hboraiory anatysis ol lhe waste. and must contain all necessary
elements, including frequenry. The waste anatysis plan must be submitted to lhe Executive Secretary ol the Utah SolU and
Hazardous Waste Control Board at least 30 dals prbrto treatmenl.
Maintain an assessment of LDR status on lile lor each hazadous waste generated at the lacility.
A notbe and cerlilicatbn that each waste b, either not hnd dbposal restricted, or il it b reslrbted, that it b hnd dbposable after
treatment, must accompany each manifested shirment ol hazardous waste.
Maintain all LDR Documentalbn for live years atter the waste b shipped ofl site.
ACTION NEEDED:
R315.16 UNIVERSAL WASTES, FLUORESCENT LIGHT TUBES
Fluorescent light tubes must be recycled or disposed of hazadous waste. Any broken tubes must be managed as a hazardous
waste, bul can still be recycled. Do not dispose of tubes in the regular trash or in the dumpster.
Label eilher lhe wasle tubes or container hoHing the tubes as 'UNIVERSAL WASTE- MERCURY CONTAININGLAMPS".
ACTION NEEDED:
R315.5.13 EXPORTS OF HMARDOUS WASTT
R3.I5.5.14 IMPORTS OF HAZARDOUS WASTE
usE AND MANAGEMENT OFTANK SYSTEMS CTHESE RULES ARE FOUND rN 40 CFR 26s.201 SUBPART J)
r i( ,
OTHER ACTIONS NEEDED:
Page S of 6
CONTAINER MANAGEMENT LOG
Date Inspectors
Name
Are containers
labeled with the
words
3(H\ZARDOUS
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
condition?
If any columns are marked
No,what was done to bring the
container into compliance?
Yes No Yes No Yes No Yes No
\