DSHW-2024-005635

Michael O. I-eavitt
Govcrnor
Dianne R. Nielson, Ph.D.
Executivc Dircctor
Dennis R. Downs
Dircctor
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DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF SOLID AND HAZARDOUS WASTE
288 North 1460 West
P.O. Box 144880
Salt lake Ciry, Utah 84114-4880
[phone] Voice
[phone] Fax
(801) s36-Mr4 T.D.D.
May 2, 1,996
One Hour Martinizing Dry Cleaners
865 South Bluff Street
St. George, UT 84770
Attention: Jerry Roberts, Manager
Dear Mr. Roberts:
This is to acknowledge that you have filed for a Notification of Hazardous Waste Activity.
Your EPA Identification Number is UTR000001511.
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,
N*Jhsnnoo;
Dennis R. Downs
Executive Secretary
Utah Solid and Hazardous Waste Control Board
Please print or type with ELITE type (12 characters per inch) in the unshaded areas only
lEtt$
rluality
Gontinued on ReverseEPA Form 8700-12 (Rev. 11-30-93) Previous edition is obsolete.
Please print or type with ELITE type (12 characters per inch) in the unshaded areas only
A. Gharacteristics of Nonlisted Hazardous Wastes. (Mrk'x' ln ilD boxea conespondlng to tlp chancterlstics ol I
rpnfis&d hazardoua waates yout lnstailafron lnndles; * tkt CFR Parla frl 20 - 26124)
B. Llsted Hazardous Wastes. (* 40 CFn %1.31 - lil; * instructtors lt you ned b tist,nor€ t ran ,2 waste codes.) l
G. Other Wastee. (#b ot other ruasla;s Equidng a tlrlndlet b hew an l.D. numbery * lnstucdons.)
I certify under penalty of law lhat thl3 document and all altachments were pEpared under my dlrectlon or supervlslon in accordance wlth a
systemdesagnodtoa$urcthatqualllledpersonnclproperlygatherandevaluatethelnformatlonsubmltted. Basedonmylnqulryoltheperson
or ponBons who manage thc system, or lhose pcrson3 dlrectly responslble for gatherlng thc Inlormatlon, thc lnformatlon submltted ls, to tho
bestof myknowl€dgeandbellef,true,accurate,andcomplete. lamawarothatthcreareslgnlflcantpenaltlcslorsubmlttlnglalselnlormatlon,
of fine and imorisonment for knowlno vlolations.
Name and Official Title (Type or print)
J*en oBFn{ k,
o?s&)Y AUMF,L,'US{
F#;Drt, /4 Grdri*7/rt
Note: llall completed lorm to the approprlate EPA Regaonal or State Oftlce. (See Sectlon lll olthe booklettor addres*s.) t
Form Approved, OMB No. frS0-Aon Expires 94A-96
GSA No. O246.EPA.OT
EPA Form 87q)-12 (Rev. 11-3G93) Previous edition is obsolete.