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• WASHINGTON STATE DEPARTMENT OF ECOLOGY 

# DangerousWaste Aniiwtl·

# .Re
.ort

Book 1 1995 Forms and Instructions .for treatment, storage, disposal and recycling facilities

September 1994 Printed on recycled paper 94-1078

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• WASHINGTON STATE DEPARTMENT OF ECOLOGY



# .Danae r

# ousWaste**~tUilRe** 

# sort**··'<~~~~~i~~~';\:;~iJ~;,,,1J** '-



## Book 1 1995 Forms and Instructions

for treatment, storage, disposal and recycling facilities

Note: Along with this book offorms you should have received 

### Book 2: Guidebookand Codes. Many ofthe technical terms in this section and in the forms are defined in the Definitions section, pages 21-26, of 

### Book2: 

### Guidebookand Codes. If you need further clarification or if you did not receive 

### Book2: 

### Guidebook and Codes, contact Ecology at 206/407-6170.



### 001 

# - .'SIIII"DI s r s r t D ( , , I 1 • f I' D f 

### [ COL 0 GY The Department of Ecology is an Equal Opportunity and Affirmative Action employer and shall not discriminate on the basis of race, creed, color, national origin, gender, marital status, sexual orientation, age, religion or disability as defined by applicable state and/or federal regulations or statutes. If you have special accommodation needs or want more information, please contact Dave DuBreuil at (206) 407-6721 (voice) or (206) 407-6006 (TDD).- ---------- ---- --------- 

### ---



# .. 

# TABLE OF CONTENTS

Introduction
...........................•...................................................... 1 

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What is the Dangerous Waste Annual Report? 1 Why did I receive this packet? 1 Do I need to complete these forms? 1 What if I think I received these forms in error? 1 When to submit the 1995 Annual Report forms 2 Where to go for help , 2 How are these forms different from the Annual Report forms that I completed in the past? 2 Ecology's authority to collect this information 3 Overview ofthe 1995 Dangerous Waste Annual Report Forms packet 3 Page numbering your submittal : ; 4 Typing the forms ..; : ; 4 Certification ; 4 Submitting computer-generated facsimiles ofthe forms 5 Documents useful in completing these forms : 5 What's next? 6 

# 0 Helping Ecology improve these forms : 6 Worksheet #1: Defining YourStatus ..••....................•.•...............•....•.....•...•....••....•.•.................•...... 7 Worksheet #2: Determining Which Forms to Complete 10 General Site Information (GSI) Form ..•..•••.............•.•••.•.....•••....•.....•.......••......•................•..........•. 13 Generation and Management Form (GM) Form .........•.•.............................•....•....•....... 23 Off-Site Identification Information (01) Form ..•....•............•..••...•......•.........•...••..................•........... 41 Waste Received (WR) Form ..•.•..............................•......... ...............•........................................... 45 Capacity Information (el) Form 53


# o**---~~ ------..;;;;--;;;;..-::.;;;;;.--="-=.;;.=..""--~-------------=-..,.-~---------------**  - BOOK 1: 19.95 FORMS AND INSTRUCTIONS

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# • DANGEROUS WASTE' ANNUAL REPORT I NTROD 'U CT ION



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• What is the Dangerous Waste Annual Report? The Washington Department of Ecology (Ecology) Dangerous Waste Annual Report is an annual report of dangerous waste generation and management activities in Washington. Handlers of dangerous waste-s-e.g., generators and management facilities-are required to use these forms to report their activities to Ecology every year. These 1995Annual Report forms replace and are very different from the oldAnnual Report forms (the Form 4 and Form 5) that generators and' treatmentlstorage/disposalJrecycling (TSDR) facilities completed in the past (pre-1995). This form packet is designed to collect data to meet Ecology's information needs regarding dangerous waste generation and management activities in the State 'ofWashington, including information requirements imposed by the United States Environmental Protection Agency (EPA). Ecology intends this forms packet to meet its information needs comprehensively and at the same time to streamline some aspects of the Annual Report submission for the reporting community. 

### Why did I receive this packet? Allcompanies with an active EPNState Identification (10) Number (WA ) receive an Annual Report mailing each year. You are required to report back to Ecology using these forms even 

### if you did notgenerate or manage any dangerous waste during 1995. Youmust at least complete the General Site Information (GSI) Form to inform Ecology ofwhether you conducted any dangerous waste handling activities during 1995. Some facilities will need to complete one or two other forms in addition to the GSI Form. 

### Do I need to complete these forms? If you have an active EPNState ID Number, you will need to complete at least one ofthe five enclosed forms. Those companies required to report are:'

• Dangerous Waste Generators
• Dangerous Waste Treatment, Storage, or

Disposal Facilities (TSDs)
• Dangerous Waste Recycling Facilities (as

specified in WAC 173-303-120)
• Dangerous Waste Transporters
• Bumers/MarketerslBlenders ofdangerous waste

fuels The worksheets, Worksheet #1: Defining Your :...'; Status and Worksheet#2: Determining Which/': Forms to Complete, pages 7-9 and pages 10-1

## r.?"; respectively,

### willhelp you determine first what;'; , your regulatory status is (i.e., as a dangerous waste generator or a TSDR) and then which forms you must complete. 

### What if I think I received these forms in error? Ifyou believe you do not need to complete the Annual Report forms, please call Ecology at 206/407-6170 so that the agency can correct its records. Please recycle the unused reporting packet or return it to Ecology. ..'.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 1DANGEROUS WASTE ANNUAL REPORT 

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# G When to submit the Annual Report forms

.The completedforms are due back to Ecology with a postmarkofno laterthan March I, 1996. Submit completed forms by mail to: Washington Department ofEcology Hazardous Waste Information PO Box 47658 Olympia, WA 98504-7658 You may express deliver the forms to Ecology, if you wish. Use the following street address for deliveries: Washington Department ofEcology Hazardous Waste Information 300 Desmond Drive Lacey,WA 98503 Upon written request and reasonable justification, Ecology may grant an extension to the reporting deadline ofup to 30 days. Written requests for extension must be received by February IS, 1996, at the above address. 

### Where to go for help Ecology has developed a number ofways to help you complete the forms. 1. Workshops. Ecology will be holding a number ofworkshops to guide you through the process ofcompleting the forms. For more information on attending a workshop, contact Ecology at 206/407-6170. 2. AGuidebook. Included with this form book is Book 2: Guidebook and Codes, which should help you through the forms. Book 2: Guidebook and Codes has:

• Helpful Hints to assist you with the forms; • Worksheets designed to help you address specific

aspects of the forms;

• Definitions to define the technical terms that you

will run across when completing the forms; and • Codes that you will need to complete the forms. 3. Worksheets. Following this section are two worksheets that should help you figure out: • how to describe yourselfto Ecology (i.e., are

you a generator, a TSDR facility, etc.); and • which forms to complete. 4. TelephoneAssistance. You may call Ecology at 206/407-6170 if you have questions about completing the forms. 

### How are these forms different from the Annual Report forms that I completed in the past? These hew forms are the result of an effort to meet a number of Ecology's essential information . needs, including requirements to provide certain

types of information to EPA. Youshould keep in mind that these forms are different from the old Form4**a~d** old Form S.in anumber of ways: l.These forms request Medium Quantity Generators and Large Quantity Generators (MQGs and LQGs) to report not only the quantity and. type of waste generated but also how thewaste was generated and how thewaste was managed on-site and/or off-site. 2.These forms collect information on the waste

treatment, disposal, and recycling capacity of commercial dangerous waste treatment, storage, disposal, and recycling facilities (referred to in the forms as TSDR facilities). 3.These forms collect somewhat more extensive

general siteinformation than you have provided in the Annual Report in the past. This information will be used to enhance Ecology's "baseline" understanding of your site and of which persons at your site Ecology should contact about different issues. 

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2 BOOK 1: 1995 FORMS AND INSTRUCTIONSINTRODUCTION 

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• Ecology's authority to collect this information The Washington Administrative Code (WAC) 173-303-220 and 173-303-390, authorizes Ecology to collect information regarding the generation and management ofdangerous wastes. Further, Ecology is required by EPA to collect information on the generation and management ofhazardous wastes, as implemented through the federal Biennial Report {Form 8700-13). 

### Overview of the 1995 Dangerous Waste Annual Report Forms packet The 1995 Dangerous Waste Annual Report Forms packet is made up oftwo books:

• Book 1: Forms and Instructions Book 1 contains the forms that you will have to complete and instructions on how to complete them. It contains five forms, but few facilities will have to complete all five forms. Book 1 includes worksheets that will help you determine which forms you will need to complete. General Site Information (GSI) Form All facilities need to complete this form. This form asks questions about your facility, such as the name ofthe facility; the name, address, and telephone number ofa contact person at the facility; and the regulatory status ofyour facility. Please note that the GSI Form will onlybe used for the 1995 reporting year. In subsequent years, when Ecology mails the Annual Report forms to . you, the agency will provide you a pre-printed RegistrationVerification Report (Verification Report), which will contain the general information that you reported in the previous reporting year. You will simply need to verify that the information contained on the Verification Report is current, indicate any changes as necessary, certify the information, and send the form back to Ecology with any otherAnnual Report form(s) required of you . Ecology will use the Verification Report in lieu of updated Notification reporting. In the future, you will only have to submit a revised Notification Form ifthe ownership ofyour site changes, and to withdraw or cancel an EPA/State ID Number. Otherwise, the Verification Report will serve to update Ecology's information about your site in lieu ofa revised Notification Form. Ecology believes this approach 

### Will lower your overall reporting burden. Generation and Management (GM) Form LQGs and MQGs have to complete this form. You are to complete one GM Form for each waste stream generated at your facility. Copy the GM . Form answer sheet (and continuation sheet) for each waste stream generated at your facility. Section A ofthis form asks descriptive questions
. about the waste stream, such as the type ofWaste stream generated and whether the waste stream is a residual from management ofanother dangerous waste stream. ... Section B ofthis form asks questions about IDe management ofthe waste stream, such as where the waste stream was managed (on-site or off-site) and how it was managed. Section C ofthis form asks questions aboutyour efforts to minimize the waste

# streambeing reported. Off-Site Identification Information (01) Form All facilities that either sent waste off-site or received waste fromoff-site must complete this 01 Form.
.. This form collects the name, address, and EPA/ State ID Number ofall dangerous waste handlers with whom you interacted in sending waste offsite or in receiving waste from off-site. For example, if you are a generator, it collects information on any transporters you used to move waste off-site to a management facility and on the off-site management facilities you used to treat! recycle/dispose ofyour waste. Ifyou are a TSDR facility, you would provide information on any

BOOK 1: 1995 FORMS AND INSTRUCTIONS 3DANGEROUS WASTE ANNUAL REPORT 

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off-site generators from whom you received waste, and any transporters you used to receive the waste. Waste Received (WR) Form Facilities that receivedangerous waste from offsite must complete this form. These include facilities that receive wastes from off-site and then ship them off-site without any treatment. Youare to complete one WR Form for each waste stream received by your facility. Copy the WR Form answer sheet (and continuation sheet) for each waste stream received by your facility. This form asks questions about the waste stream received, such as how much waste was received, the type ofwaste received, from whom the waste was received, and how the waste was managed at your facility. Capacity Information (Cl) Form All facilities that, in 1995, treated, disposed of, or recycled dangerous waste on a commercial basis are required to complete this form. This means that you were paid by a generator or another facility, from a different location and under different ownership than your own site, to treat, dispose of, and/or recycledangerous waste. You are to complete one form for each unique management system at your facility. Copy the CI Form answer sheet for each system. This form asks questions about your management system, such as what type ofsystem it is, how much capacity it has, and how much waste was managed in the system in 1995.

• Book2: Guidebook and Codes As described above, this book is designed to assist you in completing the forms. It includes a series ofHelpful Hints to answer specific questions as you work through the forms. It also has three Worksheets to help you complete specific aspects ofthe forms. In addition, it contains a Definitions section and all ofthe 

### Codes that you need to complete the forms. 

### Page numbering your submittal Once you have completed all forms required of you, compile your forms in the same order as they are presented in this book (i.e., GSJ Form first, followed by the Generation and Management (GM) Form, the Off-site Identification Information (Ol) Form), the Waste Received (WR)Form, and the Capacity Information (Cl) Form. Do NOT include any of the worksheets as part of your submittal; these are for your use only.

.Once you have compiled your forms in the correct order, complete the page numbering space at the lower right corner ofeach page. The first page of the GSI Form should be numbered" 1': Number each subsequent page consecutively (i.e., 2, 3, 4, etc.). Attach page 59 ofthis book as the last page ofyour submittal; you should also manually number this page. In the space provided above the Certification on the last page of the GSI Form, enter the totalnumber ofpages that you are submitting. 

### Typing the forms Ecology requests that forms be typed. If you cannot type the forms, please print legibly in blue or black ink. Forms completed in pencilwill be rejected. 

### Certification Your completed forms must be returned to Ecology with the signature, in ink, ofan appropriate representative ofyour site.Youshould determine who that representative should be, based on the person's knowledge of your site's waste activities. [Permitted TSDRs should refer to WAC 173- 303-810(12) for guidance on designating the appropriate representative.] Any forms that do not have a signature in the Certification section will be returned. 

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4 BOOK 1: 1995 FORMS AND INSTRUCTIONS, INTRODUCTION 

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• Submitting computer-generated ,facsimiles of the forms You may use computer-generated forms in place of some ofthe forms provided in the Annual Report packet' Specifically,you may submit computer-generated GM, WR and 01 Forms. Ecology does not recommend submitting a computer-generated GSI Form, as that form will only be used during 1995. With respect to the CI

, Form, Ecology does not believe that many firms will need to complete that form and so it has not developed a sample format. (Ifyour facility is interested in submitting a computer-generated CI Form, then you should format it identically to the CI Form provided on page 57.) Youwill no longerbe required to obtain Ecology's prior approval ofyour proposed computergenerated facsimile, because Ecology is including in 

### Book2: 

### Guidebookand Codes samples of the acceptable computer-generated format. Refer to pages 51-55 of

### Book2: 

### Guidebookand Codes for the sample formats for the GM, WR, and 

### OJ Forms. Youshould re-create as closely as possible the sample formats provided. If you are submitting computer-generated forms, you should note that the information that you would normally continue in the Comments ' Section on the regular paper forms may be continued within the answer space in your computer-generated form. (For example, on the paper GM Form, space is provided for 6 EPA waste codes in question A-3; any additional codes must be provided in Section D, Comments. In your computer-generated forms, however, you may provide as many EPAwaste codes as necessary in the space created for question A-3.) You may, ofcourse, use the Comments section in the computer-generated format for any comments that are not specific to an individual question.Youshould note the followingguidelines in preparing and submittingyour computer-generated forms. • Use 8.5" by 11" paper. • Use blue or black ink. • Ifyou are using continuous-feed paper, separate the print-out into individual sheets with the side holes removed.

• Number all pages ofyour submittal according

to the guidelines on page 4. • Be sure that each page has the appropriate form

header, as indicated in the sample formats. • Be sure that your facility's site name and EPN

State ID Number is provided on each page. Firms with automated information management systems should note that Ecology 

### will be develop- ' ing a new internal dangerous waste information management system. With that new system, expected to be on-line in late 1995 for use with the 1995 reporting cycle (i.e., these Annual Report forms that you submit in March 1996), Ecology would encourage you to submit electronic ' reports. This would be done by preparing 

### flat files ofyour Annual Report information. These flat files could 

### beprovided to Ecology on diskette. Beginning in August 1994, you may request from Ecology general guidance on how such flat 

### files. could be prepared for the 1995 Annual Reporte-r 

### CallEcology at 206/407-6170 to request that information. 

### Documents useful in completing**th~se** 

### forms Asyou prepare your 1995 Dangerous Waste Annual Report forms, you may find the following documents useful. • A copy ofyour most recent Notification Form

(Form 2). • Records ofdangerous waste quantities generated, accumulated, or managed.

• Dangerous waste manifest forms. • Results oflaboratory analyses ofyour wastes

(e.g., waste profiles).

• Contracts or agreements with the off-site

facilities that manage your wastes. • Copies ofpermits for your on-site waste

management systems.
• Copies ofMaterial Safety Data Sheets (MSDSs).

BOOK 1: 1995 FORMS AND INSTRUCTIONS 5

### What's next? DANGEROUS WASTE ANNUAL REPORT 

### Helping Ecology improve these fonns 

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1. 

### Look at the two worksheets

### following this section. • Worksheet #1: Defining YourStatus (page 7) will

help you determine whether you need to complete these forms and, if you do, into which regulatory status category or categories you fit. • Worksheet #2: Determining Which Forms to

Complete (page 10) will help you figure out which forms you must complete. 

### Theseworksheets are designed to help you. You shouldNOT submitthem to Ecology.
2. Readtheinstructions at thebeginningofeach form.

This icon identifies areas in the instructions that you should read particularly closely. In many cases, the icon highlights a change from how you have completed the old Form 4 and Form 5 in the past. 

### 3. Completethe forms. • Make sure you only 

### fill out the forms that are

required ofyou. UseWorksheet #2 (pages lOII) to determine this. • Use Book 2: Guidebook andCodes as you work

through the forms. The forms' instructions will refer you to Helpful Hints, Worksheets, Definitions, and Codes that will help you to complete the forms. • Call Ecology at 206/407-6170 if you have any

questions. If you have thoughts on how Ecology Cansimplify and improve the clarity and "usability" ofthese forms and their instructions, please call Ecology at 206/407-6170. Ecology welcomes your comments and suggestions.



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6 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# • WORKSHEET #1 

# DEFINING YOUR STATUS



# •

• This Worksheet isforyouruse only. 

## Do NOTsubmitthis Worksheet 

## to Ecology. Before completing this worksheet, you will want to know the following: • the definition ofa dangerous waste (defined in

the Definitions section of

### Book2: 

### Guidebook and Codes and described in Helpful Hint #1 on page 3 of

### Book2: 

### Guidebook and Codes), and • the Quantity Exclusion Limit (QEL) of the

waste(s) you generate (discussed in Helpful Hint #4 on page 5 of

### Book2: 

### Guidebookand Codes and listed on pages 47-49 of

### Book2: Guidebookand Codes). 

## In determining your generator status, you should note the following: • Yourregulatory status, for compliance purposes, as a Large, Medium, or Small Quantity Generator (LQG, MQG, SQG) may change from one calendar month to the next, depending on how much dangerous waste, of what Quantity Exclusion Limit, you generate in a : givenmonth or accumulate at any time. • The Quantity Exclusion Limit (QEL) of a waste

is the quantity, by weight, at which the waste becomes regulated under the requirements for MQGs and LQGs, per WAC 173-303-081. There are two different QELs: • 220pounds • 2.2pounds The QEL List, on pages 47-49 of

### Book2: 

### Guidebookand Codes, identifies which dangerous wastes are subject to the 220-pound QEL and which to the 2.2-pound QEL.You need to know which QELs apply to your wastes so that you will know whether the quantities of waste you generate and/or accumulate make you a regulated generator. • Youmust understand how to countyour

generation, accumulation, and recycling. . Ecology,as ofthe printing ofthese forms, IS developing new guidance to generators on how to countgeneration and recycling ofdangerous wastes. If you have not received this guidance by the beginning of 1995, please call Ecology at 206/407-6170 to request a copy. • Youmust take into account the dangerous

wastewaters you generate when you determine. your generator status. When you count your .;;., wastewaters, you may need to convert the

-•..: quantities you count into pounds to determine': the QEL(s) ofthe wastewaters (see Helpful Hint #6, on page 7 of

### Book2: 

### Guidebookand Codes•. for help on converting from gallons/liters to pounds). • Yourreporting status-that is, your generator

status for purposes ofcompleting theAnnual. Reportforms-is defined based on the greatest quantity ofdangerous wasteyou generated in anyone calendarmonth oraccumulated at any 

### timein 1995. For example, if you were an LQG for one calendarmonth in 1995, you are considered an LQG for the entire year for purposes ofcompletingtheAnnual Report forms. That is, if you generated more than 2,200 pounds in any one month in 1995-even if you did not generate that much waste in any other month in 1995-you must complete the Annual Report forms as an LQG for the entire year. .\

BOOK 1: 1995 FORMS AND INSTRUCTIONS 7·DANGEROUS WASTE ANNUAL REPORT 

### Now determine if you are a generator, a treatment/storage/disposal (TSD) facility, or a recycling facility. It is possible to be more than one-i.e., you may be both 

### a generator and a TSD. As you review the following criteria for determining your generator status, remember that your status, for purposes of completing the Annual Report forms, is defined according to the greatest

### quantity of wastes of common QELs that you generated in anyone month in the year and/or accumulated at any given time during the year. Am I a Large Quantity Generator (LQG)? If any ofthe following criteria apply to you, check the box. In anyone calendar month in 1995, did I generate: 

# o 2,200 pounds or more ofdangerous wasters) with a QEL of220 pounds, or 

# o 2.2 pounds or more ofdangerous waste(s) with a 

### QEL of2.2 pounds? AND/OR, at any time in 1995, did I accumulate: 

# o 2,200 pounds or more ofdangerous waste(s) with a QEL of220 pounds, or 

# o 2.2 pounds.or more ofdangerous waste(s) with a QEL of2.2. pounds?
IfI checkedany ofthe above boxes, then I am a Large Quantity Generator.
Am I a Medium Quantity Generator (MQG)? If any ofthe following criteria apply to you, checkthe box:
. In anyone calendar month in 1995, did I generate: 

# o 220 pounds or more, but less than 2,200 pounds, ofdangerous waste(s) with a QEL of 220 pounds? AND/OR, at any time during 1995, did I accumulate: 

# o 220 pounds or more, but less than 2,200 pounds, ofdangerous wastets) with a QEL of 220 pounds?
IfI checked either ofthe above boxes, then I am a Medium Quantity Generator. 

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8 BOOK 1: 1995 FORMS AND INSTRUCTIONS

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• WORKSHEET #1


### Am I a Small Quantity Generator (SQG)? If any ofthe followirig criteria apply to you, check the box. In each calendar month in 1995, did I generate: 

# o less than 220 pounds ofdangerous waste(s) with a QEL of220 pounds, or 

# o less than 2.2 pounds ofdangerous waste(s) with a QEL of2.2 pounds? AND/OR, at 

### alltimes during 1995, did I accumulate: 

# o less than 220 pounds ofdangerous waste(s) with a QEL of220 pounds, or 

# o less than 2.2 pounds ofdangerous waste(s) with a QEL of2.2 pounds? IfI checkedany ofthe above boxes, then I 

### am a Small Quantity Generator.
. 

### Am I a Treatment, Storage, or Disposal Facility (TSD)?If the following criterion applies to you, check the box. 

# o My facility has filed a PartA application or has a Part B permit for the Treatment, Storage, or Disposal ofdangerous waste as required underWAC 173-303-800 to 840. (Do not check this box if your treatment activity is through permit-by-rule activity, per WAC 173-303-802, or "treatment-by;" generator:'These terms are defined in the Definitions section of

### Book2: 

### GuidebookandCodes.) IfI checked this box, then I 

### am a TSD.


### Am I a Commercial Recycling Facility? 

### Ifthe following criterion applies to you, check the box. (Note that this does not include those generators that recycletheir own wastes on-site.) 

# o My facility recycles dangerous waste received from off-site, as described underWAC 173-303-120. IfI checked this box, then I 

### am a recycling facility. 

### Am I a Transporter? If the following criterion applies to you, check the box. 

# o I transport dangerous waste as described underWAC 173-303-240. IfI checked this box, then I 

### am a transporter. Sites that are Transporters only (i.e., did not meet any ofthe criteria above forgenerators, TSDs, and recyclers) should complete only the General Site Information Form. 

### If you fit into any of these categories, continue on to· Worksheet #2 to determine 

### which forms you must complete. If you do NOTfit into any of these categories, but you 

### do have an active EPA/State ID Number, you are required to complete 

### onlythe 

### General Site Information Form. You may proceed to that form, beginning on page 13, now. BOOK 1: 1995 FORMS AND INSTRUCTIONS 9

# WORKSHEET #2 DETERMINING WHICH FORMS TO COMPLETE

This Worksheet isforyouruse only. 

## Do NOTsubmit this Worksheet to Ecology.

Which forms do you need to complete? Use the information from Worksheet #1 to help you determine which forms you need to complete.
.



## . 0 I am a Large Quantity Generator. 

### I must completethefollowing forms: • the General SiteInformation Form; • the Generation and Management Form; and • the Off-Site Identification Information Form. 

# o I am a Medium Quantity Generator. 

### I must completethefollowing forms: • the General SiteInformation Form; • the Generation and Management Form; and • the Off-Site Identification Information Form. 

# o I am a Small Quantity Generator. 

### I must complete onlythe General Site Information Form. 

# C)



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10 BOOK 1: 1995 FORMS AND INSTRUCTIONS

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• WORKSH EET #2 

### Q I am a Treatment/Storage/Disposal Facility. I must Complete thefollowing forms: • the General Site Information Form; and • the Generation and Management Form; and**'~** the Off-Site Identification Information Form. IfI received wastefrom off-site, then I must also completetheWaste Received Form. 

### IfI am a commercialTSD, then I mustalso complete the CapacityInformation Form. (Please see the definition ofcommercial in the Definitions section of

### Book2: 

### Guidebookand Codes.) 

### Q I am a Commercial Recycling Facility. I must complete thefollowing forms: • the General Site Information Form; • the Generation and Management Form; • the Waste Received Form; • the Capacity Information Form; and • the Off-Site Identification Information Form. 

### Q I am a Transporter 

### only. I mustcomplete ONLYthe General Site Information Form.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 11

# • GENERAL SITE INFORMATION FORM INTRODUCTION



# •

• Who needs to complete this form? All companies/agencies with an active EPNState ID Number (e.g., WA ) at any time during 1995 must complete this form. They include, but are not limited to:

• Dangerous Waste Generators;
• Dangerous Waste Treatment, Storage, and

Disposal Facilities (TSDs);
• Dangerous Waste Recycling Facilities;
• Dangerous Waste Transporters;
• Dangerous Waste Fuel Burners/Blenders/

Marketers; and • Used Oil Burners/Blenders/Marketers. Youwill complete this form only for 1995. In subsequent years (e.g., 1996 and on), Ecology instead willprovide you with a "Verification Report" (instead ofthe GSI Form) that will have, pre-printed on it, the general site information that you reported the previous year. You will be asked to edit that pre-printed Verification Report to reflect any changes in the information, certify the information, and return the form to Ecology.The Verification Report will prevent your having to complete and re-submit the same general site information each year; you will only be required to report any changes and to certify your Annual Report data anew. 

### What information does this form collect? ' This form collects information about your site, such as the name ofyour business; the name, address, and phone number of a contact at the site; and the regulatory status of your site (e.g., generator or TSDR). 

### What information 

### will I need to complete this form? You will need general information about dangerous waste activities at your site. Completing Worksheet #1 on page 7 should help you identify these activities. You also will need general information regarding your site's regulatory status, the names and addresses ofsite contacts, and some general information regarding the site itself.' 

### Helpful Hints CompleteWorksheet #1, beginning on page 7, before completing this form. The following documents should'help you: • copies ofyour most recent Notification Form

(Form 2) on which you notified Ecology and EPAofyour dangerous waste generation and management activities; and .'copies ofyour dangerous waste shipment

manifests (ifrelevant). Be sure to complete the "Please Enter" box at the top ofthe pages ofthe answer sheet. Fill in your EPNState ID Number and site name (as entered in question A-2 of the GSI Form). Do not enter any information in the spaces marked "For Ecology Use Only."

BOOK 1: 1995 FORMS AND INSTRUCTIONS 1314 DANGEROUS WASTE ANNUAL REPORT

. - -. 

### _.**~---** ---**~-** -_. -- -
--- BOOK 1: 1995 FORMS AND INSTRUCTIONS 

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# • GENERAL SITE INFORMATION FORM ANSWERS PLEASE ENTER: EPA/State 10 number:

_ Site name:

_
FOR ECOLOGY USE ONLY:

. . 

## A.·

_. SitelnformatiorJ-, .,

...-.

### -----------------~---~-"'i Date received: ,...------------ A-1. What is your EPA/State ID Number? WA

_ --.: -..:...

_ A-2. What Is the name of this site (i.e., the company/agency to which the EPA/State ID Number is assigned)? If your company has more than one site by the same name in Washington, provide a site identifier here (e.g., ACME-Everett v.ACME-Auburn).

_ 

# • A-3. What is your Washington Department of Revenue Tax Registration Account Number (also known as the United Business Identifier-UBI)? (Pleaseenter the nine digits only; do not enter any letters preceding the number. This number is assigned to your business's Tax Registration Account by the Department ofRevenue. Contactyour fiscal office or the Department ofRevenue if you do not know your registration number. Do notuse your federal tax number here. Ifyou are a tax-exempt agency,enter "NA"in the first two spaces and leave the other spaces blank; the Department ofRevenue will construct a number for you for dangerous waste feepurposes only, and Ecology will maintain records of that number internally.)

For the name and address information requested below, ifyou need to repeat a particularname or address for more than one question,you may simply specify "Same as question

### XX"(e.g., ifthe location address in question A-S is the same as the mailing address in questionA-4,write"Same as A-4" in the space for questionA-S). Please read questions A-4through A-II 

### beforecompleting any ofthe information. This will help you avoid havingto correctportions oftheform. Do 

### notleave any ofthefollowing questions 

### blank-you must at least write "Sameas..." on the first line of each question. A-4. What is the mailing address for the company/agency? (i.e., where should Ecology send future form packets and correspondence?) 

# • . Street Address or PO Box -,...-

_ City,State, Zip Code

_


### Page BOOK 1: 1995 FORMS AND INSTRUCTIONS 15DANGEROUS WASTE ANNUAL REPORT
A-5. What Is the location address of the company/agency at this site? (i.e., enter the street address or geographic location. Ifa street address is not available, please provide nearby cross-streets for.reference; you may also use Township, Section, and Range information. Do not provide PO Box or rural mail route address.) StreetAddress -,--

_ City, State, Zip Code

_ County -,--

_ A-6. Who Is the legal owner of the company/agency? (Please provide information regarding the person, company, or agency that owns this business.)
. Name

_ StreetAddress or PO Box _'---

_ City, State, Zip Code

_ County

_ Phone (

__ )

_ A-7. Has the owner of the company/agency changed since you last reported? 

# C)



# o o No (Ifno, skip to A-S.) 

### DYes (If

### yes, answerA-7.a.) A-7.a. Please provide the date on which the ownership changed. (mm/dd/yy)

__ /

__ /

__ Ifthe ownership ofthe business has changed since you last reported a Notification Form (Form 2) or the Annual Report forms, you will be required to complete a new Notification Form. Please 

### callEcology at 206/407-6737. A-8. Who is the operator of the company/agency responsible for the dangerous waste handling activity? (Please provide information regarding the company or agency responsible for the overall operation ofthis business.) Name

---------------- Street Address or PO Box

_ City, State, Zip Code

_ County

_ Phone (

__ )

_ Page _. _ 

# o

16 BOOK 1: 1995 FORMS AND INSTRUCTIONS." 

# • GENERAL SITE INFORMATION FORM 

# ----------------------1 PLEASE ENTER: . A-9. Who owns the property (real estate) on which the company/agency is located? (Please provide information regarding the person, company, or agency that owns this property.) EPA/State 10 number:

_ Site name:

_



# • Name and Title --:.. ---:-

_ Street Address or PO Box --:-_ City, State, Zip Code

_ County L,

_ Phone (

__ )

_ A-10. Whom should Ecology contact on-slte regarding site visits and inspections of the company/ agency?
.(Ifthe individual whom Ecology should contact is not located on-site, enter the correct address and phone number for that individual's location.) Name and Title

_ Street Address or PO Box -:--_ City, State, Zip Code

_ County

_ Phone (

__ )

_
A-ll. Whom should Ecology contact if clarification is needed on this form? Name and Title

_ Street Address or PO Box

_ City, State, Zip Code
.. _ County ----.

_ Phone (

__ )

_
A-12. Please enter the four-digit Standard Industrial Classification (SIC) code that best describes the principal products or services rendered at this site. (Ifmore than one code applies, please enter the primary SIC code-the code that best describes your business's products or services-in the . space for the primary number below. This is the SIC code under which your business is registered with

the Washington Department ofRevenue. You may list up to three other relevant SIC codes in the additional spaces below. A list ofSIC codes can be found on pages 27-38 ofBook 2: Guidebook and Codes. 

# • 1. (primary) 

### 2.

_ 

### 3.

__.__ 4.

_ 

### Page BOOK 1: 1995 FORMS AND INSTRUCTIONS 17DANGEROUS WASTE ANNUAL REPORT 

## B.**:-.:~lteDangerous·** Waste
. 

## Activity Information . 8-1. Did the company/agency generate dangerous waste in 1995? 

## D No (If no, answer 8-1.b.) 

## D Yes (If yes, answer 8-1.a.) 8-1.a. What is yourgenerator status? (Check one box. If you are not sure ofyour generator status, refer to Worksheet #1 beginning on page 7.) 

### D Large Quantity Generator (proceed to 8-2) 

### D Medium Quantity Generator (proceed to 8-2) 

### D Small Quantity Generator: Maximum accumulation or monthly generation quantity: pounds (NOTE: Small Quantity Generators who are not required to report for other reasons-s-e.g., because they are a TSDR-now mqy skip to the Certification on page 21 and return only this GSI Form to Ecology. SQGs are not required toprovide any additional information on this or any otherAnnual Report form.)
. 8-1.b. lithe company/agency did NOTgenerate dangerous waste In 1995, please indicate the reason{s) below. (Check all reasons that apply.) 

### D· We never generated dangerous waste. 

### D We generate dangerous waste only occasionally and did not generate waste in 1995. 

### D We are a dangerous waste transporter only. 

### D We have gone out of business. Date closed: (ml1l/dd/yy)

__ /

__/

__ 

### D The waste we generate is exempt from state and federal dangerous waste regulation. 

### D Other (please specify):

_



### Page 

# o



# o

o

18 BOOK 1: 1995 FORMS AND INSTRUCTIONSB-2. 

# • GENERAL SITE INFORMATION FORM

### --~-------------------f PLEASE ENTER: Doesthe company/agency treat, store, recycle, EPA/State 10 number: .....,.. _ or dispose of dangerous waste? (This does Dot include treatment-by-generator activity and permit- Site name: ------------ by-rule activity [see the Definitions section of

### Book2: Guidebookand Codes). Information on treatment-bygenerator and permit-by-rule activity will be captured
. in the GM Form for those generators conducting on-site treatment activities. Generators conducting eitherpermit-by-rule or treatment-by-generator activity but no other treatment, storage, recycling, or disposal activity should answer "No" to this question.) 

# o Yes (If yes, answer 8-2.a.) 

# 1 oNo (If no, LQGs should skip to Section C, below. All other sites should skip to Section D, Comments, on page 

### 20, if appropriate; otherwise, skip to the Certification on page 21.) 8-2.a. Is the company/agency exempt from reporting its dangerous waste treatment, storage, recycling, and disposal activities?
. 

# o Yes (If yes, specify one of the following.)
. 

# o No (If no, skip to Section C.) 

# •
c. o We manage only exempt wastes. 

# o We closed prior to 

### 1995; no dangerous waste treatment, storage, recycling, or disposal activities occurred during 

### 1995
.. 

# o We did not treat, pre-treat, store, recycle, or dispose of dangerous waste during 

### 1995..: 

# o Other (please specify).

_ 

### Site-Wide Waste Minimization ·Activity InfOrmcltio·n";: -: ,"
.... COMPLETE THIS SECTION ONLY FOR ODD 

## (e.g. 1995, 1997) REPORTING YEARS. LQGs and TSDRs must complete this section, If you are not an LQG or a TSDR, proceed to Section D, Comments (page 20), ifappropriate, or to the Certification (page 21). Ecologyis required by EPA to collect the following information every otheryear (biennially, during the odd reporting years-e.g., 1995, 1997). These questions replace the EPAWaste Minimization Report that you have received in the past from EPA.Ecology recognizes the limitations ofthe waste minimization questions contained in this form and in the GM Form and is collecting this information solely for provision to EPAas per EPA requirements. As a matter ofpolicy in the State ofWashington, Ecology will rely on the Pollution Prevention Plan and Progress Reports for information through which to analyze businesses' pollution prevention and waste minimization efforts. Please refer to the definitions ofsource reduction and recycling (see the Definitions section of

### Book2: 

### GuidebookandCodes) to help you complete this section.

Did this company/agency begin or expand a source reduction activity during 1994 or 1995? These questions refer to site-wide waste minimization activities. The questions on the GM Form are waste stream-specific. 

# • C-1.. DYes 

# o No BOOK 1: 1995 FORMS AND INSTRUCTIONS 19DANGEROUS WASTE ANNUAL REPORT
e-2. Oldthis company/agency begin or expand a recyclingactivity dUring 1994 or19951 

# o

DYes ONo e-3. Oldthis company/agency systematically Investigate opportunities for source reduction or recyclingduring 1994 or 19951 

### DYes 

# o No

Use this section to provide any additional comments, information, or explanation, 

### ifnecessary. In your comments, always provide the reference to the specific question number (e.g.,A-7).


# o

o

20 BOOK 1: 1995 FORMS AND INSTRUCTIONS" 

# •
'.

• GENERAL SITE,INFORMATION FORM

___ ..... PLEASE ENTER: EPA/State 10 number:

_ Site name:

_ Upon completion ofaUrequiredforms. pleaseprovide' the following information. First mark which formes) you are submitting 

### in this package. Then indicate the total number ofpages in your submittal. 

# o General Site Information Form 

# o Generation and Management Form 

# o Off-Site Identification Information Form 

# o Waste Received Form 

# o Capacity Information Form

__ Total number of pages submitted 

### [Refer to the instructions "Page numbering yoursubmittal" (page 4)

### for instructions on how to number thepages of yoursubmission. After you compileandmanually numberallof thepages ofyoursubmittalincludingthe "last

### page"on

### page59, 

### enterin 

### thespaceprovided the totalnumberof pages beingsubmitted. Then complete and signthe Certification below.

## J Thefollowing mustbe signedby an authorized representative ofthe company/agency. This certification languageis requiredunder EPNs BiennialReport. Ecologyis required to implement reporting requirements at least as stringent

### as those 

### in thatreport. 

### I certifyunderpenalty of law that thisdocument and allattachments wereprepared under

### mydirection or' supervision in 

### accordance with a systemdesigned toassure that qualifiedpersonnel properlygatherand . evaluatethe information submitted. Basedon 

### myinquiryof theperson orpersons who managethe system, or thosepersons directly responsiblefor gatheringthe information, the information submittedis, to the bestof 

### my knowledge andbelief, true, accurate, andcomplete. I am awarethat therearesignificantpenaltiesfor submitting false information, includingthepossibility offine and imprisonment for knowingviolations. Signature (in ink)

_ Name (print/type)

_ Date

_ Title

_

BOOK 1: 1995 FORMS AND INSTRUCTIONS 21

# • GENERATION AND 

# MANAGEMENT FORM I NTROD UCT10 N



# •

• Who needs to complete this form? All LQGs,MQGs, and TSDRsmust complete this Generation and Management (GM) Form. (Small Quantity Generators do nothave to complete this form. SQGs should complete only the General SiteInformation (GSI) Form, beginning on page 13.) See the Definitions section of

### Book2: 

### GuidebookandCodes, for definitions ofLQG and MQG.

. Also refer to Worksheet #1 on page 7 and

Worksheet #2 on page 10, which you already prepared, to determine whether this GM Form applies to your generator status. 

### How is this form different from the old Form 4? 1. Collectinginformation on the 

### nature, source, and

### managementofyour dangerous waste streams

• The old Form 4 collected information on the

quantities and types ofdangerous waste you generated during the reporting year. • This new GM Form collects more extensive,

coded information on the dangerous waste generated at your site. For each waste stream, it collects information on: • the nature ofthat waste stream (in terms of

the waste description, the waste designation, the waste codes, the waste radioactivity, the waste form, and the waste origin); • the source of the waste stream (that is, the

process by which the waste was generated); and • the management that the waste stream was

given (that is, the type of system-s-e.g., solvent recovery system or aqueous treatment system-through which the waste was managed, whether on-site or off-site). 2. Collecting 

### managementinformation • The old Form 4 collected information on the

generation ofdangerous waste. • The old Form 5 collected information on any

on-site management ofthe waste you generated. Youreported this on-site management by

. listing monthly totals in the manifest information section ofthe form . • This new GM Form collects information on

how your dangerous waste streams were managed, whether on-site or off-site. You

### will provide this information on the GM Form only. Youwill not need to report generation ofthe waste on one form (i.e. the old Form 4) and management ofthe waste on another (i.e. the old Form 5), as you did under the old system. Further, ifyou managed the waste stream onsite, you will provide a single annual aggregate quantity, rather than monthly totals. Note that, for purposes ofthese new Annual Report forms, Ecology is seeking management information only for treatment, recycling, extended storage and/or disposal ofdangerous wastes. Youwill not report accumulation anywhere on the Annual Report forms. (Remember that you must still comply with the accumulation requirements ofWAC 173-303- 200 and 201.) 3. Collecting the 

### waste description • The old Form 4 required very elaborate waste

descriptions, including the names and concentrations of waste constituents. • This new GM Form allows you to describe your

waste stream in the manner in which you recognize it: your waste description may be as simple or as elaborate as you see fit. Ecology will rely on the other coded information collected in the form to obtain an understanding ofthe waste stream you are generating. BOOK 1: 1995 FORMS AND INSTRUCTIONS 23DANGEROUS WASTE ANNUAL REPORT 

# o

i 

## I I 

# t- - 4. Collectinginformation on waste

### generated and "",nagedduring the reportingyear • The old Form 4 determined your total annual

generation by requiring you to report two types ofinformation: 

### • all wastes shipped off-site for management

(or generated and managed on-site, in monthly totals); and 

### • all wastes remaining on-site (without management) at the end ofthe year. The second piece ofinformation required generators to do an on-site audit at the end of the year to quantify the wastes remaining on-site.
.• This new GM Form requests a single piece of information: "total amount ofthis waste stream managed in 1995."To determine that number, generators relying on off-site management

### will report the sum of

### allmanifested shipments to management during 1995. Generators conducting on-site managementwould continue to sum the quantities ofwaste entering on-site treatment/disposal/recycling systems or on-site extended storage to obtain a single annual aggregate quantity. The benefit of this new data element is that it ties the "quantity" information reported in the**An~ual** Report directly to the method through which most generators account for their wastes-that is, by recording their manifest data. Bylinking the Annual Report to your generation andmanagement, this new GM Form should bemore straightforward for you to complete. Furthermore, you no longer will have to conduct an end-of-year audit ofwaste remaining on-site for purposes ofcompleting the Annual Report. 5. Collecting 

### manifestdata, • The old Form 4 collected manifest information

from TSDRs, LQGs and MQGs. • This new GM Form requires manifest information only from LQGs and TSDRs. • MQGs now are required only to provide the

annual aggregate quantity ofeach waste stream they managed in 1995. • LQGsand TSDRs 

### will continue to provide manifest information for shipments of waste off-site for management. Youshould note that the organization ofthisinformation isdifferent from previous years. Manifestinformation is now organized by the waste stream being shipped, notby the facilityto which the waste stream was sent. Thus, for each waste stream,you will provide specificdescriptiveinformation and then will listallshipments of the waste stream to other facilities for management. 

### What information do I need to complete this form? To complete thisGM Form, you need detailed information on the dangerous wastegenerated at 

### your site.For each wastestream that you identify, you need to know how it

### wasgenerated, how much was managed in 1995,and where and how it

### wasmanaged. 

### Helpful Hints

• Questions andAnswers: This form is in two

parts: a question sheet and an answer sheet. The answer sheet is perforated. You may wish to separate it from this book and lay it alongside the questions as you answer them. Fill out one answer sheet for each waste stream generated at your site. For both the answer and the continuation sheets, besure to complete the "Please Enter" box at the top of the pages of the answer sheet. Fill 

### in your EPA/State ID Number and site name (as entered in questionA-2 ofthe GSI Form). Do not enter any information in the spaces marked "For Ecology Use Only."Then make as many copies ofthe sheets as you will need for eachwaste stream.

• Howto identify a dangerous waste stream: See

"What isa dangerous waste?", Helpful Hint #1 on page 3 of

### Book2: 

### Guidebookand Codes, for help in identifying a dangerous waste. Use the following guidelines to identify an individual waste stream: • A single waste stream may have severalwaste

codes (questions A-3 and A-4). Waste Codes are identified in WAC 173-303. 

# o

o

24 BOOK 1: 1995 FORMS AND INSTRUCTIONSGENERATION AND MANAGEMENT FORM 

# •

•

• • A single waste stream will designate either as dangerous waste (OW) or extremely hazardous waste (EHW), notboth (question A-5). Thus, 

### ifyou generate a waste stream that is sometimes EHW and is OW at other times, these are actually separate waste streams and shouldbe reported on separate GM Forms. • A single waste stream will 

### beeither a mixed

radioaetivewaste or not (question A-6). Mixed radioactive wastes (see the definition in the Definitions section of

### Book2: 

### Guidebookand Codes) should never be combined with non-radioactive dangerous wastes. Thus, a mixed radioactive waste streamwill always be reported on its own GM Form. • In most cases, a waste stream should have

only one source (question A-7). Sourcecodes

.are listed on page 39 of

### Book2: 

### Guidebookand Codes. An example is A07. vapor degreasing. • A waste stream should. have only one form

(question A-8). Waste form codes are listed on pages 40-41 of

### Book2: 

### Guidebookand Codes. An example is BIOI, aqueous waste with low solvents. • Each dangerous waste stream should have one

origin (question A-9). For example, the waste's origin may be recurrent or from a non-recurrentactivity. Origin codes are listed in question

### A-9 and on page 42 of

### Book 2: Guidebook and Codes. Please note that Ecology asks you to use your best judgment in defining the individual waste streams you generate. Ecology recognizes that the complexities ofdangerous waste generation and management are sometimes difficult to portray in the context ofa standardized form with a series of standardized codes. In certain instances, the coding scheme may not allow you to portrayyour waste in a fully accurate manner. Follow the guidelines listed above to the best ofyour ability when identifying a waste stream at your site and assigning what you believe to be the best codes to describe that waste stream. If you generate a dangerous waste stream, manage it on-site, and then generate a dangerous waste residual from this management, you have generated two separate waste streams and need to complete two separate GM Forms. For example, you generate a dangerous sludge. Youdewater it at your site. A dangerous waste filtercake results from the dewatering. This filtercake isshipped off-site for landfill. Youneed to complete two GM Forms: l.On the first GM Form, describe the sludge.

Indicate that the waste's origin (question A-9) is from recurrent generation (origin code i); and that its management (question B-3) is sludge dewatering (system code MIOI). 2.On the second GM Form, describe the

filtercake. Indicate that the waste's origin is as a residual from managing a previously existing
. dangerous waste (origin code v); and that its management is off-site landfill (system code M132) .

• Which wastes to report:

• DO report all dangerous wastes generated

and then managed on-site during 1995. • DO report all dangerous waste shipped off-.

site during 1995 for management within the United States.
. . • DO report all dangerous wastes that were
.

managed in RCRAinterim status orpermitted and RCRAexempt (i.e., permit by rule, treatrnent-by-generator-see below) systems.

• Which wastes NOT to report:

• DO NOT report excluded wastes as defined

by Chapter 173-303 WAC (e.g., do not report TSCA [ToxicSubstances Control Act, 40 CFR Parts 700-799] wastes such as PCBs unless they also classify as dangerous waste). • DO NOT report wastes that were generated

during 1995 but were not managed on-site or shipped off-site during 1995. • Lab packs: If you generate a lab pack waste

stream, refer to Worksheet #3 on page 11 of 

### Book2: 

### Guidebookand Codes for instructions on how to complete the GM Form for that waste stream.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 25DANGEROUS WASTE ANNUAL REPORT 

# o

• Countingyour dangerous wastes: At the time

ofprinting ofthis Annual Report forms package, Ecology is developing new guidance for generators on counting dangerous wastes recycled on-site or managed on-site under treatment-by-generator and permit-by-rule activities. You will need to refer to this guidance as you calculate your waste generation quantities for two purposes: for determining your generator status on a monthly basis; and for· determining how to complete the Annual Report forms. The guidance will be available in late 1994. 

### Ifyou have not received this guidance by the beginning of 1995, please contact Ecology at 206/407-6170 to request a copy.

• Reporting treatment-by-generator activities:

Ecology, in Technical Information Memorandum (TIM) 86-3, has set forth guidance on how generators may conduct certain types ofdangerous waste treatment activities on-site without first obtaining review, written approval, or a permit from Ecology. Specifically, the guidance addresses filtration,separation, evaporation, carbon adsorption, elementary neutralization, and solidification. You are allowed to conduct such treatment activities on-site without a permit if you follow the instructions in the TIM. Ifyou are unsure whether you are handling a waste stream

. according to the treatment-by-generator guidance, please refer to TIM 86-3, dated July 1993, available from Ecology at 206/407-6700. For specific questions on treatment-by-generator activity, please call your Ecology regional office. As you complete the GM Form, you will be asked whether you manage the waste stream on-site or off-site. If you answer "on-site," then you will be asked to indicate whether that onsite management activity is conducted according to the treatment-by-generator guidance.

• Reporting permit-by-rule activities: WAC 173-

303-802 states that particular facilities or activities managing dangerous wastes are deemed to have a dangerous waste permit if they meet certain conditions identified in the rule. Ifyour facility is conducting the activities identified in WAC 173-303-802 according to the requirements identified therein, then you are conducting a permit-by-rule activity and may continue to manage your wastes in that manner without applying to Ecology for a dangerous waste facility permit. Activities that may qualify as permit-by-rule are:

• ocean disposal barges andvessels-a-the

owner/operator ofa barge or vesselthat accepts dangerous waste for ocean disposal is considered to have a permit-by-rule 

### ifhe/she complies with the requirements identified in WAC 173-303-802;
. • undergroundinjectionwells-an owner/

operatorwho has an Underground Injection Control (VIC) permit is considered to have a permit-by-rule to manage dangerous waste in the well provided that he/she complies with the requirements identified in WAC 173-303- 802;

• publiclyowned treatmentworks (POTW)-

the owner/operator ofa POTW is considered to have a permit-by-rule ifhe/she complies with the requirements identified in WAC 173- 303-802; and

• totally enclosed treatmentfacilities or

elementaryneutralization orwastewater treatment units-the owner/operator ofa totally enclosed treatment facility or an elementary neutralization or wastewater treatment unit that treats dangerous wastes is considered to have a permit-by-rule to manage dangerous wastes ifhe/she complies with the requirements identified in WAC 173- 303-802. As you complete the GM Form, you will be asked whether you manage the waste stream on-site or off-site. Ifyou answer "on-site:' then you will be asked to indicate whether that on-site management activity is conducted under a permit-byrule. 

# o

O

.**~.** 26 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# •

•

• GENERATION AND MANAGEMENT FORM

• Reporting storage/transferactivities: If you

are conducting storage/transfer of a dangerous waste stream (see the definition ofstorage/ transfer in the Definitions section of

### Book2: Guidebookand Codes), then you should follow these special instructions for storage/transfer of the waste stream on the 

### GMform: • For question A-7. source code, assign code

A80, indicating that the waste is a storage/ transfer. • For question A-9, origin code, assign code 

### iv,

indicating that the waste is a storage/transfer. Complete the other questions of the form as appropriate, given the nature of the waste stream and your handling ofit.

• Reporting extended storage: If you hold a

RCM storage permit, please reviewWorksheet #6 on page 17 of

### Book2: 

### 'Guidebook and Codes, before completing this form. • Waste shipments to foreign countries: Refer to

Helpful Hint #8 on page 9 of

### Book2: 

### Guidebook and Codes for guidance on how to report shipments ofdangerous waste to foreign countries
.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 27

# GENERATION AND MANAGEMENT FORM QUESTIONS

This is a question sheet. Record your answers on the separate answer sheet! (One answer sheet for each dangerous waste stream managed during 1.995.) Please read allof the instructions before completing the answer sheet. Before completing the answer sheet, enter your EPA/State ID Number and site name where indicatedon the answersheet before making as many copies of the answer sheet as you will need to report all of your waste streams. Each dangerous waste stream should be reported on a separate answer sheet.

## ;.:~·-~.DesCiiptiori;Of-DangerousWasteStream --**-~**.

. - .. _."

.... ".' - .....'";;.. . Ifyourwaste stream is a«lab pack," please reviewWorksheet#3, on page 11 ofBook2: Guidebook and Codes, before completingthis form. Ifyou hold a ReRA storagepermit, please reviewWorksheet#6 on page 17 ofBook2: Guidebookand Codes, before completingthis form. A-1. What is your "profile" code? (Optional.) This data element is provided for your optional use to help you track the waste profiles or waste streams that you report on the Annual Report. You may enter any desired information that will help you relate the waste streams you generate and manage in your facility to how you report in the Annual Report. This data element is provided solely for your use; Ecology will not use this information in any way. A-2. Briefly describe the dangerous waste stream reported on this form. Please describe the waste stream as you best recognize it (e.g., "solvent-contaminated rags";"electroplating wastewater"; "stabilized solid generated from stabilizing wastewater treatment sludge"; etc.) Note that Ecology no longer is requiring extremely detailed.and specific waste descriptions. Ifyou wish to provide a detailed waste description, you may,but it is not required. If you do so, you should attempt to limit the length ofyour description to 70 characters, including spaces; althoughyou may prepare a longer description, Ecology will only record in its information system the first 70 characters. A·3. Which EPA hazardous waste code(s) is associated with this waste stream? Do not enter Washington state-only dangerous waste codes in this section. EnterWashington state-only codes under question A-4. 

# o



# o

I 

## l 28 EPAhazardous waste codes are provided in WAC 173-303-081 through 083 and WAC 173-303-090. Enter up to six codes. Ifyou need to list more than six codes, continue in Section D, Comments; please reference 

# 0 question A-3 in yourcomments.
BOOK 1: 1995 FORMS AND INSTRUCTIONS

# • r

GENERATION AND MANAGEMENT FORM
A-4. Which Washington state-only dangerous waste code(s) are associated with this waste? Do not enter EPAwaste codes in this section. Enter EPAcodes under question A-3. Washington state-only dangerous waste codes are referenced in Helpful Hint #2 (page 4 of

### Book2: 

### GuidebookandCodes) and are provided in WAC 173-303-104(3). If these codes apply to your waste, enter up to two in the spaces provided. If you need to list more than two codes, continue in Section D, Comments; please reference question A-4 in your comments. A-5. What is the designation of this waste stream? Indicate whether the waste is designated Dangerous Waste (OW) or Extremely Hazardous Waste (EHW). Helpful Hint #1, on page 3 of

### Book2: 

### Guidebookand Codes, will help you designate yourwastes perWAC 173-303.
. A-6. Is this a "mixed radioactive" waste? 

# • A-7. Mixed radioactive wastes are wastes that are both:

• dangerous as defined by WAC 173-303-080 through 173-303-104 (see«What is a dangerous waste?",

Helpful Hint#1 on page 3 of

### Book2: 

### Guidebookand Codes); and • radioactive as defined by the Atomic Energy Act. Radioactive waste thatis not mixed with a dangerous waste should notbe reported on this form . Which source code best identifies the production, service, management process, or clean-up'

. activity associated with the generation of this waste stream? select one.

Source codes can be found on page 39 of

### Book2: 

### Guidebookand Codes. The source code describes the process (e.g., painting, degreasing, clean-up) associated with the generation of this waste stream. Please select the code thatbest describes the source of this waste stream. Ecology recognizes that it may be possible to assign a number ofsource codes to an individual waste stream. Ecologyasks you to identify just one source code in this report.



# • A-8. Which form code best describes the form of this waste stream? Select one. Form codes can be found on pages 40-41 of

### Book2: 

### Guidebookand Codes.
. The form code describes the form of the waste stream (for example, mixed lab packs, scrubber water, oily sludge). Please select the one code that best describes the form ofthis waste stream. Ecology recognizes

.that it may be possible to assign a number of form codes to an individual waste stream. Ecology asks you to identifyjust one form code in this report.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 29DANGEROUS WASTE ANNUAL REPORT
A·9. What Is the origin of this waste stream? Select one. Select the one option that best describes the origin ofthis waste stream. i. The waste streamis recurrent: it was generated on-site from 

## aproduction process, a service activity, or a routine cleanup (including off-specification or spent chemicals). ii. The waste stream is non-recurrent: it is the result ofa spill cleanup, equipment decommissioning, or other remedial cleanup activity. iii. The waste stream is a residual derived from the management ofa non-dangerous waste. tv. The waste stream is a storage/transfer: it was received from off-site and was not treated, recycled, or disposed on-site before being shipped off-site. (See the Definitions section of

### Book2: 

### Guidebookand Codes for the definition of 

### storage/transfer.) v. The waste stream isa residual derived from the management ofa previously existing dangerous waste stream. If you specify this origin code, please goto question A-9.a. In general, you should define yourwaste stream with only one origin code. An exception to this is as follows:

Your facility receives a waste stream from off-site that it also generates itself. Youcombine your facility's waste with that received from off-site before sending the aggregated waste stream off-site for management. In other words, your facility is transferring waste as well as shipping off-site its own waste, but it is doing so within a single shipment. In this case, you should assign two origin codes to the waste stream. To do so, enter "Comments" in the space provided for question A-9. Then, in Section D, Comments, you should specify two origin codes-the origin code i for your recurrent generation, and the origin code 

### iv for the storage/transfer waste-and estimate the percentages ofeach in the annual aggregate quantity shipped off-site. A-9.a. If you specified origin code vin question A-9 (l.e., the waste is a residualfrom management of a previously existing dangerous waste stream), enter the system code for the management system that generated the waste. System codes can. be found on pages 43-44 of

### Book2: 

### Guidebookand Codes. For example, ifthe waste stream reported on this form is a filtercake from the drying ofa wastewater treatment sludge, enter system code MIDI, the code for sludge dewatering
. 

## .B.**···~WaSteManagementActivities.~·.·** 

## .. .. .,

•• _. v , • •• -' ':'. ", - _.:.":::;-:, .' -" '-.
This section collects information on the management-treatment, storage, disposal and recycling-of dangerous waste. Do not report accumulation activity in this section. If the waste stream received consecutive treatment by morethan one type ofmanagement, only report the first activity on this form.. If in treating the waste stream a dangerous wasteresidual is generated, then

that residual constitutes a new waste stream that must be reported on a separate GM Form answer sheet. For example, a dangerous waste sludge is incinerated, producing a dangerous waste ash. The ash is then landfilled. You should report only the dangerous sludge on this answer sheet and report only the incin-
. eration in this section. The generation ofthe ash should be reported as a separate waste stream on a separate GM Form answer sheet; that answer sheet should report the management ofthe ash as "landfill." 

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30 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# •

• GENERATION AND MANAGEMENT FORM
B-1. What was the total amount of this waste stream managedin 1995, and what is the unit of measure? This data element is new and different from the information Ecology collected in the past. Previously, to obtain a picture ofannual generation, Ecology requested that generators report two pieces ofinformation: the amount ofwaste managed (for on-site management, this meant the monthly or batch quantities managed; for off-site management, this meant the volumes reported on the shipment manifests); and the amount ofwaste remaining on-site on December 31 ofthe reporting year. ' Ecology now is requesting that you provide only one pieceofinformation: the total amount ofthis waste streamthatwas managed in 1995. If you managethis waste stream on-site, you should indicate the total volume of the waste stream that entered youron-site management system in 1995. If you sent this waste stream off-site for management, you should sumthe quantities of this waste streammanifested in 1995. Check the appropriate code for the unit ofmeasure used: ST=ShortTons; MT=Metric Tons; P=Pounds; K=Kilograms; G=Gallons; L=Liters; and C=Cubic Yards. Youmustuse the same unit ofmeasure when responding to questions B-3 and B-4. If you select G, L, or 

### Cigo to question B-l.a. If you select ST, MT, P, or K, skip to question B-2., 8-1.a. If the waste stream is measured in gallons, liters, or cubic yards, what is Its density? Answer this question only ifyou specified G, L,or C, in question B-1. ' Densityinformation for the constituent chemicals in the waste isprovided on Material SafetyData _.;.<,' Sheets. Youshouldestimate the density of the waste stream based on that or otherinformation availableto you. If you do not provide a density,the density ofwater (8.34pounds/gallon) 

### will be assumed for wastes measured in gallons or liters; the density ofsoil (2,700pounds/cubic yard) will be assumed for wastes measured in cubic yards. Besure to choose a density unit ofmeasure 

### (e.g.Ibs/gal).



# • 8-2. Was this dangerous waste stream managed (treated, recycled, or disposed of) on-slte or offsite in 1995? ' 1.This dangerous waste stream was managed on-site (this includes permit-by-rule and treatment-bygenerator activity) • answer B-3 and then skip to B-6. 2.This dangerous waste stream was managed off-site • skip B-3 and answer B-4. 3. Part of this waste stream was managed on-site and part was managed off-site • answer both B-3

andB-4. Remember-ifthe waste stream was first managed on-site and its residual was managed off-site, you should report only the on-site management here. The residual is a separate waste stream, and its generation and management should be reported on a separate GM Form answer sheet. As you complete the remaining questions in this section, please note the following:

• Ifyou manage the waste stream entirely on-site, then the quantity (or quantities) that you enter in

question B-3 should equal the quantity that you entered in question B-1.
• Ifyou manage the waste stream entirely off-site, then the quantity (or quantities) that you enter for

question B-4 should equal the quantity that you entered in question B-1.
• Ifyou manage the waste stream both on-site and off-site, then the quantities that you enter in questions

B-3 and B-4 together should equal the quantity that you entered in question B-1. BOOK 1: 1995 FORMS AND INSTRUCTIONS 31DANGEROUS WASTE ANNUAL REPORT


### B-3. If all or part ofthis dangerous waste stream 

### was managed on-slte, howmuch was managed on-slte and howwas It managed?

The old Form 4/Form 5 structure. in whichyou listed monthly generation/on-site management totals, no longer applies. 

### Ifyou managed this waste stream on-site, you now 

### will only need to provide an annual aggregate quantityfor each method in which the waste streamwas managed on-site. Do not attempt to list monthly generation/management quantities anywhere 

### else in this GM Form oron the WRForm.
. Space is provided on the answer sheetto report management ofthis waste streamon-site by one system type. Ifyou need additional space-i.e., to report a second on-site management method-use Section D, Comments; reference question B-3 in your comments. Only report on additional management method(s) in the Comments section for those circumstances when you managed the waste on-site one way part ofthe time and anotherway anothertime. Do notattempt to report sequentiDImanagement of the waste stream (i,e., neutralization followed by chemical precipitation). Rather, continue in the Comments only 

### ifthe waste stream

### was managed on-site by entirelydifferent systems, ratherthan in two sequential systems. Please refer to Worksheet #4, on pages 12-13 of

### Book2: 

### Guidebookand Codes, for help 

### in identifying a management system. Afteryou have reviewed that worksheet, select the appropriate system code from the list on pages 43-44 of

### Book2: 

### Guidebookand Codes. Use the unit ofmeasure from question B-1.
8-3.a. Indicate whether this waste stream was managed according to the treatment-bygenerator guidance. Refer to the discussion oftreatment-by-generator on page 26. If you do not know whetheryou are managing the waste stream according to treatment-by-generator, select "DK" for "Don't Know."
B-3.b. Indicate whether this waste stream was managed under a permit-by-rule. Refer to the discussion ofpermit-by-rule on page 26. If you do not know whetheryou are managing the waste stream according to permit-by-rule, select"DK" for "Don't Know." 

# (J



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32 BOOK 1: 1995 FORMS AN D INSTRUCTIONS

# •

••



# • GENERATION AND MANAGEMENT FORM


### 8-4. Indicate the amount of this waste stream that was managed at off-site facilities in 1995. Do not attempt to report on-site management ofthis waste stream here. Only report on-site management in question B-3.
. Provide the following information:
t. The EPA/StateID Number ofthe location to which you directly shipped this waste stream. If, for example, you shipped this waste to a waste broker, be sure to indicate the broker rather than the facility to which the brokerultimately shipped your waste stream. ii. The system code for how this waste stream was managed at the facility identified in item i (system codes are listed on pages 43-44 ofBook2: Guidebook and Codes). Youshould contact the facility 

### ifyou· have questions about which system code to assign. 

### Be careful in completingthis information! Be sure to specify the management that the facility identified in item 

### iprovided this waste stream. 

### If, for example, you sent this waste stream to a broker, provide the system code for the type ofmanagement thatthe brokerprovided the waste stream. If, for example, the broker sorted the waste stream and 

### then sent it on to a landfill, do 

### notspecify the system

code for landfill; rather, indicate that the brokerconducted a storage/transfer-system code M141. storage/transfer. In otherwords. always specify the direct, rather than the ultimate, management ofthe waste stream-that is, that management provided by the

### firstfacility to which you shipped the waste stream. iii. The total quantity ofthe waste stream that was sent in 1995 to the facility specified under itemi for the management identified in item ii .above (use the same unit ofmeasure from question B-1).

tv. The percent ofthis waste stream that was recycled by the facilityidentified in item 

### i. This column is optional. It is provided if you wish to obtain a recycling credit for the portion ofthis waste stream that was recycled in 1995. Please refer to Worksheet #5, on pages 14-16 ofBook 2: Guidebook and Codes, for detailed information on whether you qualify for a recyclingcredit and. if so, how to obtain the credit. If the facilityidentified in i managed the waste stream in different manners during the year, then do the following:

• "ditto" the EPA/State ID Number of the facility to whom you sent the waste on two or more lines (as

many as are needed to capture the different types ofmanagement that different portions ofthe waste received);

• enter one system code in each row;

• enter in each row the quantity of waste that went to the system code identified in 

### ii; and • if applicable enterthe percent ofthe waste that was recycled in the system code identified in iii. Spaces are provided to identify up to four off-site facilities. Ifyou need additional lines, please continue in Section D,Comments. Reference question B-4 in your comments. Ifyou are an LQG or a TSDR, proceed to question B-5. Ifyou are an MQG, skip to Section D, Comments. ifappropriate, otherwise. you have now completed this form
.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 33DANGEROUS WASTE ANNUAL REPORT 

# o B-5. Please provide the following Individual off-slte shipment information for this waste stream. (OnlyLQGs and TSDRs are required to complete this question.) Provide the following information. If you need to repeat information on multiple lines (for example, many shipments to a single facility), you may use ditto (") marks to represent the repeated information. i. The shipment date. ii
. The manifest document number. 

### iii. The internal tracking code, optional. This is provided for your optional and internal use. Ecology has created this column in response to comments from members of the regulated community that such a column would help them to relate their internal waste tracking systems to the information they provide on their Annual Report forms. This column allows you to enter any internal information or code that your company may wish to use to track shipments. Ecology does not require you to provide this information and will not use it in any way. Please use this column ifand how you see fit. 

### iv. The EPA/State ID Number of the facility to which you directly shipped the waste (please review the caveat under item ii ofquestion B-4). v. The quantity ofthis waste stream in this shipment to the facility identified in item iv (use unit of measure from question B-1). Note that the shipment quantities thatyou list here should, in aggregate, equal the quantity (or quantities) you identified in question B-4. Spaces are provided to list up to 18 shipments ofthis waste stream. If you sent this waste stream off-site in, more than 18 shipments in 1995, please use the continuation sheet (page 39) to provide the additional information under question B-5. Or see page 5 for instructions on providing a'computer-generated 

# 0
answer sheet. )


### 8-6. If you are an LQG or TSDR, did 

### new activities undertaken during 1995 result in minimization of this waste stream? 

### COMPLETE THIS QUESTION ONLY FOR ODD 

## (e.g. 1995, 1997) REPORTING YEARS.

Only LQGs and TSDRs should complete this question. Please note that this question, and those in Section C, Waste Minimization Activities, refers to waste minimization ofthe specific waste stream

thatyou are reporting on the answer sheet. Furthermore, these questions refer to new waste minimization activities undertaken for that waste stream during 1995 only. Thus, these questions have a different scope than those on the GSI Form, which asked you to indicate whether your site overall began orexpanded any source reduction or recycling activity during 1994 or 1995. If you are a TSDR that has assigned the waste stream, under question A-9, an origin code of 

### iv (i.e., storage/transfer), then you should automatically answer "No" to this question. (See the Definitions section of

### Book2: 

### Guidebookand Codes for the definition ofstorage/transfer.) Ifyou have assigned any other origin code to the waste stream, then you should answer this question "Yes" or "No" as appropriate, given your activities associated with that waste stream. For assistance in completing this question, please refer to the definition ofwasteminimization in the Definitions section of

### Book2: 

### Guidebook and Codes. If you answer "Yes" to this question, then you are required to complete Section C, Waste Minimization Activities. If you answer "No," skip to Section D, Comments, ifappropriate; otherwise, you have completed

### C-~) this form. 34 BOOK 1: 1995 FORMS AND INSTRUCTIONSGENERATION AND MANAGEMENT FORM 

# • ;c.· -Waste 

## Minimization Activities**.-~** .



# •

• COMPLETE THIS SECTION ONLY FOR ODD 

### (e.g. 1995, 1997) REPORTING YEARS. If you are an LQGor TSDRand you answered "Yes" to question B-6, you must complete this section. As explainedin the GSI Form on page 19, Ecology is required by EPAto collect biennially (i.e. for the odd years) waste minimization information that previouslyhad been collected through EPA's WasteMinimization Report. For assistance in completing these questions, please refer to the definitions ofwasteminimization, source reduction, and recycling, in the Definitions section of

### Book2: 

### Guidebookand Codes. C-l. What activities were implementedIn 1995 to achieve waste minimization results for the waste stream described in Section A? Onlyreportthose activities thatyou implemented (began) in 1995. Do NOT report ongoingwaste minimization activities (i.e., those activities thatyou began in years priorto 1995 andthatyou are continuing). Waste minimization activity codes are provided on pages 45-46 of

### Book2: 

### Guidebookand Codes. Review that list and select the codes that represent activities implementedin 1995 for this waste stream. 

### Ifyou need to provide more than four codes, please continue in Section D, Comments; reference question C-I in your comments. C-2. Did the waste minimization activity (or activities) that you undertook for this waste stream either increase the toxicity of the waste stream; or increase the quantity or toxicity of emissions into air, water, or land? Ifthe activity(or activities)that you identified in question C-I had either of the effects described,answer''Yes.'" C-3. How much was recycled in 1995 due to newactivities? Ifyou reported a recyclingactivity in question C-I (waste minimization activity codes WOl and W02), answer this question. If you did not report a recycling activity in question C-I, skip to question C-4. If you reported a recycling activity, enter the quantity ofthis dangerous waste stream that was recycled during 1995 because ofrecycling activities implemented in 1995. Report the quantityin the same unit of measure used in Section B. Count both on-site and off-site recycling,but do not include quantities recycled in systems that you used before 1995. Do not include closed-loop recycling, as that is to be reported as a**sour~e** reduction activity. C-4. What was the quantity of source reduction in 1995? Ifyou reported a source reduction activity in question C-I (codes WII-W99), answer this question. If you did not report a source reduction activity, you may skip to Section D, Comments, ifappropriate; otherwise, you have completed this form. If you did report a source reduction activity, enteryour best estimate ofthe quantity ofthe waste stream that you avoided generating in 1995 as a result ofthe source reduction activities you reported. Reportthe quantity in the same unit ofmeasure used in Section B. Enter "NA" in this box if you undertook a source reduction activity,but it did not result in a reduction of the quantity generated of this waste stream. BOOK 1: 1995 FORMS AND INSTRUCTIONS 35DANGEROUS WASTE ANNUAL REPORT

Use the comments section on the answer sheet to provide any additional comments, information, or explanations, as necessary. In your comments, always provide the reference to the specific question number (e.g., A-7). 

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36 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# • GENERATION AND MANAGEMENT FORM ANSWER SHEET
Please enteryour EPNState ID number and site name at right, before making as many two-sided copies of this answer sheet as you 

### will need to report 

### all ofyour waste streams. Then complete one answer sheet for each waste stream. PLEASE ENTER: EPA/State 10 number: Site name:

FOR ECOLOGY USEONLY: Date received:



# •

• " 

### A.DeScription 

## of Dangerous Waste Stream A-1. A-2.

A-3. A-4. A-5. OEHW Dow 

### A-6. ONo DYes 

### A-7. A 

### A-8.8 A-9. 

### 0 i 

# o ii 

# o ii i 

### 0 iv 

# o v(If v, answer 

### A-9.a.) A-9.a. M 

### B.Waste Management Activities

- ,'- .. " -, 

### 8-1. OST OMT OP OK OG OL 

# o C (If 

### G, L, or 

### C, answer 

### 8-1.a.) 8-1.a. 

# o Lbs/gal 

### 0 Specific Gravity 

# o Lbs/yd3 

### 8-2. DOn-site DOff-site 

### 0 Both. 

### 8-3. M

__ 

### 8-3a. 

### 0 Yes

### 0 No 

### 0 OK 

### B-3b. 

### 0 Yes

### 0 No 

### 0 OK 

### 8-4. 

### t. Receiving Facility ,10 ii
. System Code iii. Quantity iv. Recycling Percent M M M M 

### Page _ BOOK 1: 1995 FORMS AND INSTRUCTIONS 37DANGEROUS WASTE ANNUAL REPORT


### 8-5. If additional space is required, use continuation sheet on the following page. 

# l' i. Date Shipped ii. Manifest Document iii. Intemal Tracking iv. Receiving Facility v. Quantity Shipped 

## f (mm/dd) Number Code (optional) EPA/State 10 

# i

I

, 

### 8-6. DYes D No 

## C. Waste Minimization Activities 

# e-1. w w· ·w 'w 

# can Yes':O 

### No" " ., 

# c-a. c-s, D. Comments

.. ...

. ',**~.** .. p •••• 

# . .'. . ...

: 

### Page 

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38 BOOK 1: 1995 FORMS AND INSTRUCTlO'NS

# • GENERATION AND 'MANAGE,MENT FORM ANSWER SHEET (CONTINUED)

8-5. (Continued) PLEASE ENTER: EPA/State 10 number:

_ Site name:

_



# •

• i. Date Shipped (mm/dd) ii
. Manifest Document Number iii. Internal Tracking Code (optional) iv. Receiving Facility EPA/State 10 v. Quantity Shipped



### Page

_

. BOOK 1: 1995 FORMS AND INSTRUCTIONS 39

# • OFF-SITE IDENTIFICATION INFORMATION FORM INTRODUCTION



# •

• Who needs to complete this form? All Large Quantity Generators, Medium Quantity Generators, Treatment/Storage/Disposal Facilities, and RecyclingFacilities that sent dangerous waste off-site or received dangerous waste from off-site during 1995must complete this Off-Site Identification Information (01) Form. 

### What information does this form collect? The 01 Form collects the EPA/State ID Number, name, and address of all off-site installations and transporters with whom you interacted in 1995 in the process ofsending dangerous waste off-site or receiving dangerous waste from off-site. 

### What information do I need to complete this form? Tocomplete this form, you need to know the EPA/ State ID Number, name, and address of all off-site installations to which you shipped dangerous waste or from which you received dangerous waste and all transporters that you used during 1995. Do not provide information regarding generators of Household Hazardous Waste or Conditionally Exempt Generators (called Small Quantity Generators in Washington) from which you received waste. 

### Helpful Hints Before completing the form, be sure to complete the "Please Enter" box at the top of the page. Fill in your EPA/State ID Number and site name (as entered in question A-2 ofthe GSI Form). Do not enter any information in the spaces marked "For Ecology Use Only." Then make as many copies of the answer sheet as you will need. For each off-site installation or transporter, provide the following information: • EPA/State ID Number (remember, ifthe offsite entity is from a foreign county and does not have an EPA/State ID Number, use the "FC" designation as described in Helpful Hint #8 on page 9 of

### Book2: 

### Guidebookand Codes) • Name • Address (city and state associated with the EPA/

State ID Number, and Country ifappropriate)
• Handler type (e.g., generator, transporter, or

TSDR) as defined by their relationship to your site. Select all that apply to the installation or transporter: e.g., the given entity might both transport (mark 

### Transponer)-and manage (mark 

### TSDR)your waste. 

### Ifyou are a generator, and the transporter ofyour waste has been provided by the TSD, you may not have full name and address information for' the, transporter. In that case, you may providejustthe EPA/State ID Number ofthe transporter. Use the 

### Comments section to continue any entry andlor to clarify any information provided. Reference the comment by entering the site name and indicating the information point being continued (i.e., EPA/State ID Number, name, address, or handler type).

BOOK 1: 1,995 FORM S AN 0 INSTRUCTIONS 41

# • OFF-SITE IDENTIFICATION INFORMATION "FORM ANSWER SH EEl
Please enteryour EPNState ID number and site name at right, before making as many copies ofthis two-sided answer sheet as you 

### willneed. PLEASE ENTER: EPA/State 10 number:

_ Site name:

_
FOR ECOLOGY USE ONLY: Date received:

_



# •

• Please complete this fonn if your facility received dangerous waste from off-site or shipped dangerous waste off-site during 1995.

EPA 10 Number: Name: -
Address:
Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR EPA 10 Number: Name:
Address:
Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR " EPA 10 Number: Name:
Address:
Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR Comments:



### Page BOOK 1: 1995 FORMS AND INSTRUCTIONS 431 DANGEROUS WASTE ANNUAL REPORT

EPA 10 Number: Name:
Address: Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR EPA 10 Number: Name: Address:
Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR EPA 10 Number: Name:
Address: Handler type: (Check all that apply.) 

# o Generator 

### [J Transporter 

# o TSOR EPA 10 Number: Name: Address: Handler type: .(Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR EPA 10 Number: Name: Address:
Handler type: (Check all that apply.) 

# o Generator 

# o Transporter 

# o TSOR

### Page

_ 

# c

o



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44 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# • WASTE RECEIVED FORM INTRODUCTION



# •

• Who needs to complete this form? Alltreatment, storage, disposal, and recycling facilities (TSDRs) that receivedangerous waste from off-site must complete this Waste Received (WR) Form. This includes TSDRs thatreceive dangerous waste from off-site and then ship 

### it offsite without first providing it any kind oftreatment-s-i.e., TSDRs that conduct storage/transfer ofdangerous wastes. 

### What information does this form collect? This form collects information on dangerous wastes received by your facility from off-site for treatment, storage, disposal, and/or recycling. It collects information on the type ofwaste received, the amount ofwaste received, and how the waste was managed (i.e., treated, recycled, or disposed) at your facility. If you treated, stored, recycled, and/or disposed of at your site dangerous waste that your site generated, do NOT report that activity on this WR Form. Report your generation and on-site management on the GM Form. Note that this is a change from the old Form 4/Form 5, which had you report your waste generation on the Form 4 and the on -site management ofyour wastes on the FormS. If you conduct a storage/transfer (i.e., passthrough) activity (i.e., if you received a waste from off-site and subsequently shipped it offsite without first providing any form of treatment, recycling, or disposal to the waste), you will report the receipt ofthe waste on this WR Form and the transfer of the waste on the GM Form. Refer to the definition of storage/transfer in the Definitions section ofBook 2: Guidebook and Codes. 

### What information do I need to complete this form? Tocomplete this form, you will need information on the dangerous waste received from off-site by your facility. For each dangerous waste stream, you will need to know how much you received from off-site in 1995, the EPNState ID Number ofthe site(s) from which you received the waste stream, and how the Waste stream was managed (i.e., treated, stored, recycled, and/or disposed) at your facility. (You will need to provide the names and addresses of these entities on the 01 Form.) If you transferred the waste, you will need to know where (i.e.,EPNState ID Number) you sent the waste for management and how it was managed at that receiving facility so that you can complete the GM Form for the transferred waste stream. (You will need to provide the names and addresses ofthese entities on the 01 Form.) 

### Helpful Hints

• Questions andAnswers: This form is in two

parts: a question sheet and an answer sheet. The answer sheet is perforated. You may wish to separate it from this book and lay it alongside the questions as you answer them. Fill out one answer sheet for each waste stream received by your facility. On both the answer and continuation sheets, be sure to complete the "Please Enter" box at the top ofthe sheets with yourEPNState ID Number and your site name (as entered on question A-2 ofthe GSI Form). Do not enter any information in the spaces marked "For Ecology Use Only."Then make as many copies ofthe sheets as you 

### will need for each waste stream.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 45DANGEROUS WASTE ANNUAL REPORT 

# o

• Howto identify a dangerous waste stream:

Use the following guidelines to identify an individual waste stream: • A single waste stream may have several waste

codes. Waste codes are identified in WAC 173-303. Refer to Helpful Hint #1 on page 3 of

### Book2: 

### Guidebookand Codes for help in using WAC 173-303 to designate .your waste and assign waste codes to it. Questions 3 and 4 capture EPAandWashington state-only waste codes, respectively. • A single waste streamwill designate either as

dangerous waste (DW) or extremely hazardous waste (EHW), notboth.Thus, if you receive a waste stream that is sometimes EHW and is DW at other times, these are actually separate waste streams and should be reported on separate WR Forms. Specifythe designation in question 

### 5. " • A single waste stream will be either a mixed

radioactive waste or not (question 6). Mixed radioactive wastes (see the Definitions section of

### Book2: 

### Guidebookand Codes) should never be combined with non-radioactive wastes. Thus, a mixed radioactive waste "stream received from off-site will alwaysbe reported on its own WR Form. • In most cases, a waste stream reported on a

single answer sheet should have only one form (question 7). Waste form codes are listed on pages 40-41 of

### Book2: 

### Guidebook and Codes. Please notethatEcology 

### asks you to use your bestjudgmentin defining the individualwaste streams thatyou receive andmanage. Ecology recognizes thatthe complexities ofdangerous waste generation andmanagement are sometimes difficultto portrayin the contextofa standardizedform with a series ofstandardized codes. In certain instances, the coding scheme may not allowyou to portrayyourwaste in a fully accurate manner. Follow the guidelines listed above to the bestofyour abilitywhen identifying a waste stream atyour site and assigningwhatyou believe to be thebestcodes to describe thatwaste stream. • One answer sheetperwaste stream received: Complete one answer sheet for each waste stream received.**If~** for example, you received the same waste stream from a number of different sites, you only need to complete one answer sheet for the waste stream. For example, you receive stillbottoms ofhalogenated solventfrom several different dry cleaners. The dangerous waste from all the 

### dry cleaners shares a common Form Code (B601 - still bottoms of halogenated solvents or other organic liquids), a commonWaste Code (FOO2 - a listing of specific spent halogenated solvents), and a common designation (DW). The receipt of this same dangerous waste stream from several different generators should be reported on one answer sheet.
.• Whichwastes to report: • DO report.all dangerous wastes received from

off-site during 1995.

• Whichwastes NOT to report:

• DO NOT report excluded wastes as defined

by Chapter 173-303 WAC (e.g., do not report "TSCA [ToxicSubstances Control Act, 40 CFR

Parts 700-799] wastes such as PCBs unless they also classifyas dangerous waste). • Lab packs: If you receivea lab packs waste

stream from off-site for management, refer to Worksheet #3 on page 11 of

### Book2: 

### Guidebook and Codes, for instructions on how to complete the WR Form for that waste stream.

• "HouseholdHazardousWaste: Reporting the

receipt and management ofhousehold hazardous waste is notrequired. Do NOT report receipt ofthese wastes.

• Conditionally Exempt Small QuantityGeneratorWaste: Reporting the receipt and management of dangerous wastes from conditionally exempt generators (i.e., Small Quantity Generators in the State of Washington) is notrequired." Do NOT report receipt ofthese wastes. 

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46 BOOK 1: 1995 FORMS AND INSTRUCTIONS

### • 

# • WASTE RECEIVED FORM



# •

• • Wastes from foreign countries: Refer to Helpful Hint#8, on page 9 of

### Book2: 

### Guidebookand Codes, for guidance on reporting the receipt ofwastes from foreign countries.

• Dangerouswaste residuals: If your facility

received a waste stream from off-site, managed it on-site, and, in managing the waste stream, generated a dangerous waste residual, you should report this activity as follows:

• report the receipt and primarymanagement

ofthe original waste on this WR Form; and

• report the generation of the residual as a new

waste stream on the GM Form. For example, you receive a dangerous waste sludge. Youdewater it. A dangerous waste residual-a filtercake-results from the dewatering. Youthen landfill the filtercake. Youwill need to:

• report the receipt and management (dewatering, system code MlOI) ofthe dangerous waste sludge on this WR Form; and

• report the generation and then management

(landfill) of the filtercake on the GM Form. Note that the source ofthe filtercake, under question A-7 ofthe GM Form, will be "A76, sludge dewatering." The origin ofthe filtercake,under question A-9, will be "residual from the management ofa previouslyexisting dangerous waste," choice v. For question A-9a, you will indicate the system of origin ofthat residual as system code MIOI, dewatering.

• Reporting extended storage: Ifyou hold a

ReRA storage permit and you received waste from off-site for storage, please review Worksheet #6, on page 17 of

### Book2: 

### Guidebook and Codes, before completing this form. 

### Providing recycling credit information to generators Ifyou recycledangerous wastes received at your facility, it is likelythat the generators using your services will contact you to obtain information about the percentage oftheir waste that your facility recycledduring 1995. Ecology asks that you provide them that information. Youmay tell
. them the percentage over the telephone, butyou must also fax or mail to them written material that documents the recyding percentage that you are claiming you achieved with their waste. That written documentation may be in any format most convenient for you, but 

### it must include the following information: thewastedescription, the wasteform code, thepercentrecycledduring 1995, and the name, title, and signatureof an authorizedrepresentative Ofyourfacility. Please note that only the following types of management, denoted by system code, constitute "recycling" for purposes ofthe recycling credit. If your facility did not perform one ofthese types of management on the waste, then you did not "recycle"any ofthe waste for purposes ofthe recyclingcredit and thus cannot provide recycling information to the generator. (For guidance orr applying these system codes to the waste management processes at your facility, refer to Worksheet #4 on pages 12-13 in 

### Book2: 

### Guidebookand Codes.) Metals Recovery MOll High temperature metals recovery MOI2 Retorting MO13 Secondary smelting MOI4 Other metals recovery for reuse (e.g., ion exchange, reverse osmosis, acid leaching, etc.) MO19 Metals recovery-type unknown Solvents Recovery M021 Fractionation/distillation M023 Solvent extraction M024 Other solvent recovery M029 Solvents recovery-type unknown OtherRecovery M031 Acid regeneration M032· Other recovery (e.g., waste oil recovery, non-solvent organics recovery, etc.) M039 Other recovery-type unknown

BOOK 1: 1995 FORMS AND INSTRUCTIONS 47--- - ------ ----- 

# .' 

# WASTE RECEIVED FORM QUESTIONS

This is a question sheet. Record your answers on the separate answer sheet! (One sheet for each dangerous waste stream or dangerous waste residual.) Please complete one answer sheet

### for each 

### dangerous waste stream that was received from off-site during 1995, even if the waste stream was subsequently shipped off-site without first being treated, recycled, or disposed of. Ifyourwaste streamis a "lab pack," pleasereviewWorksheet#3, on page 11 ofBook2: Guidebook and Codes, before completingthis form. 

### Ifyou hold a ReRA storagepermitandyou receivedwastefrom off-sitefor storage. please reviewWorksheet #6, on page 17 ofBook2: Guidebookand Codes before completing

### this form. 1. What Is your "profile" code? (Optional.) 

# ·0

This data element is provided for your optional use to help you track the waste profiles orwaste streams that you report on the Annual Report. You may enter any desired information that will help you relate the 

# 0 waste streams you receive and manage at your facility to how you report in the Annual Report. This data element is provided solely for your use; Ecology will not use this information in any way. 2. Briefly. describe the dangerous waste stream reported on this form. Please describe the waste stream as you best recognize it. Youshould attempt to limitthe length ofyour description to 70 characters,including spaces; although you may prepare a longer description, Ecology will only record in its information system the first 70 characters. 3. Which EPA hazardous waste code(s) 'Is associated with this waste stream? Do NOT enterWashington state-only dangerous waste codes in this section. EnterWashington state-only codes under question 4. EPAhazardous waste codes are listed in WAC 173-303-081 through 083 andWAC 173-303-090. Enterup to six codes. Ifyou need to list more than six codes, continue in the Comments section under question 10; please reference question 3 in your comments. 4. _Which Washington state-only dangerous waste code(s) are associated with this waste stream? Do NOT enter EPA waste codes in this section. Enter EPA codes under question 3. Washington state-only dangerous waste codes are referenced in Helpful Hint #2 on page 4 ofBook 2: Guidebook and Codesand are provided in WAC 173-303-104(3). Ifthese codes apply to your waste stream, 

# 0- enter up to two codes in the spaces provided. If you need to list more than two codes, continue in the _<;<?mments section under question 10; please reference question 4 in your comments. 48 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# • 5. WASTE RECEIVED FORM
What is the designation of this waste stream? Indicate whether the waste is designated Dangerous Waste (DW) or Extremely Hazardous Waste (EHW). Helpful Hint#1, on page 3 of

### Book2: 

### Guidebookand Codes, will help you designate your wastes perWAC 173-303. 

# .' 6. Is this a "mixed radioactive" waste stream? Mixed radioactive wastes are wastes that are both:

• dangerous underWAC 173-303-070 through 173-303-104 (see"What is a dangerous waste?", Helpful

Hint#1 on page 3 of

### Book2: 

### Guidebookand Codes), and

• radioactive as defined by the Atomic Energy Act. Radioactive waste that isnot mixed with a dangerous waste should not 

### bereported on this form. 7. Which 

### form code best describes the form of the waste stream received? Form codes can be found on pages 40-41 of

### Book2: 

### Guidebookand Codes. The form code describes the form ofthe dangerous waste (e.g., mixed lab packs, scrubber water, oily sludge). Please select the one code thatbest describes the form ofthis waste stream. Ecology 

### recognizes that it may be possible to assign a number of form codes to an individual waste stream. Ecology asks you to identify

### justone in this report.



# • 8. What is the total quantity of this waste stream received by your facility In :1.995, and what is the unit of measure? Remember, do not report the receipt ofhousehold hazardous waste or conditionally exempt generator waste. Check the appropriate code for the unit ofmeasure used: ST=ShortTons; MT=Metric Tons; P=Pounds; K=Kilograms; G=Gallons; L=Liters; and C=Cubic Yards. Youmustuse the sameunit ofmeasurewhen responding to question 9. If you select G, L, or C, go to question 8.a. If you select ST, MT, P, or K, skip to question 9. 8.a. If the waste stream is measured In either gallons, liters, or cubic yards, what is 

### Its density? Answer this question onlyif you specified G, L, or C in question 8.

. Density information for the chemicalconstituents of the waste is provided on Material Safety Data Sheets. Use that or other information available to you to determine the density. 

### Ifyou do not provide a density, the density of water (8.34 pounds/gallon) will be assumed for wastes measured in gallons or liters; the density of soil (2,700 pounds per cubic yard) will 

### be assumed for wastes measured in cubic yards. Be sure to choose a density unit ofmeasure (e.g.lbs/gal).

BOOK 1: 1995 FORMS AND INSTRUCTIONS 49DANGEROUS WASTE ANNUAL REPORT
9. Please provide the following information for each shipmentof this waste stream received'from ·off-slte. Provide the following information. If you need to repeat information on multiple lines (for example, many shipments received from a single facilityl.you may use ditto (") marks to represent the repeated information. i. the date theshipmentwas received 

### ii. the manifest document number 

### iii.the "internal tracking code," optional. This column is provided for your optional and internal use. Ecology has created this column in response to comments from members ofthe regulated community that such a column would help them to relate their internal waste tracking systems to the information they provide on theirAnnual Report forms. This column allows you to enter any internal information or code which your company may wish to use to track shipments. Ecology does not require you to provide this information and 

### willnot use it in any way. Please use this column if and how you see fit. iv. the EPA/State ID Number ofthe facility from which the waste was received 

### v. the quantity received in this shipment (using the same unit of measure as in question 8) vi. the system code for how your facilitymanaged the waste (refer to Worksheet #4, on pages 12-13 of

### Book 2: Guidebookand Codes, for guidance on selecting the appropriate system code; the full list of system codes is provided on pages 43-44 of

### Book2: 

### Guidebookand Codes). 

# o

If you managed part ofthe shipment one way and another portion a different way (i.e., you need to report 

# 0 two or more different system codes for the management ofa single shipment received), then do the following:

• "ditto" the EPA/State ID Number ofthe facility from whom you received the waste on two or more lines

(as many as are needed to capture the different types ofmanagement that different portions of the shipment received);
. "ditto" the shipment date;

• "ditto" the manifest document number information; • split the overall quantity ofwaste in the shipment among the different lines, as appropriate; and

• identify the single, appropriate system code associated with each quantity, on each line. If you received this waste stream in more than 8 shipments, please continue onto the back of the answer sheet in the space provided on page 52. If you need more space, you may need to make additional copies of the answer sheet, or see page 5 for instructions on providing a computer-generated answer sheet. 

### 10. Use the comments section on the answer sheet to provide any additional comments, information, or explanations, as necessary. In your comments, always provide the reference to the specific question number (e.g., 3). 

# o

50 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# •

•

• WASTE RECEIVED PLEASE ENTER: 

# FORM EPA/State 10 number: 

# ANSWER SHEET Site name: 

### Pleaseenter your EPA/State ID number and site name at right, FOR ECOLOGY USE ONLY: 

### before making as many two-sided copies of this answer sheet Date received: 

### as you 

### willneed to report 

### all ofyour waste streams. Then complete one answer sheet for each waste stream received.



### 1. 

### 2.
3. 

### 4. 

### 5. OEHW DDW 

### 6. DNo DYes 

### 7. B 8. 

### DST DMT Dp OK DG 

### DL 

# o C 

### (If G, L, 

### or C, 

### answer 8.a.) 8.a. 

# o Lbs/gal 

# o Specific Gravity 

# o Lbs/yd 3 

### 9. 

### If additional space 

### is required, use continuation sheet on the back ofthis page.

i. Date Received ii
. Manifest Document iii. Internal Tracking iv. Sending Facility v. Quantity vi. System (rnrn/dd) Number Code (optional) EPA/State 1O Received Code
M M M M M M M M 

### 10.



### Page _ BOOK 1: 1995 FORMS AND INSTRUCTIONS 51.DANGEROUS WASTE ANNUAL REPORT


### 9. (Continued) 

# o

i. Date ReceiVed ii
. Manifest Document (mm/dd) Number iii. Internal Tracking Code (optional) iv. sending Facility EPA/State 10 v. Quantity vi. System Received Code
M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M 

### Page 

# o

(J

52 BOOK 1: 1995 FORMS AND INSTRUCTIO,NS

# • CAPACITY INFORMATION FORM INTRODUCTION



# •

• Who needs to complete this form? All sites that, in 1995, treated,. disposed of, or recycleddangerous waste on a

### commercialbasis are required to complete this Capacity Information (CI) Form. This includes both:

• RCRA-permitted treatment and disposal

facilities; and • facilities that treat.or recycle dangerous waste

but are exempt from requirements to obtain a RCRATreatment, Storage,.or Disposal permit. Commercial management is defined as the offering ofwaste management services to generators or facilities not underthe same ownership as your site who will pay for the service. Do not complete this form 

### ifyour site only treats or disposes of waste generated by your site orby other sites that are part ofyour company or that are underthe same ownership as your company. 

### What information does this form collect? This CI Form collects detailed information about 

### alldangerous waste management systems at your facilitythat were in place, permitted, or under construction during 1995. It collects information about the type ofsystem, its capacity, and how much waste was managed in the system in 1995. Dangerous waste management systems include systems that treat. dispose of, or recycle dangerous waste. This form does not collect information about systems that store dangerous waste. Please do not report storage activity on this form. 

### What information do I need to complete this form? Tocomplete this form, you will need detailed information on the dangerous waste management systems in place at your site, including the capacity ofthe systems and how much waste received commercially entered the systems in 1995. Worksheet#4, on pages 12-13 ofBook2: Guidebook and Codes, 

### will help you identify the management system(s) at your site. Then refer to the list ofsystem codes on pages 43-44 ofBook2: Guidebook and Codes to choose the appropriate system code for each system. 

### Helpful Hints

• Questions andAnswers: This form is in two

parts: a question sheet and an answer sheet. The answer sheet is perforated. You may wish to separate it from this book and lay it alongside the questions as you answer them. Fill out one answer sheet for each separate management system existing at your facility. Be sure to complete the "Please Enter" box at the top ofthe pages ofthe answer sheet. Fill in your EPNState ID Number and site name (as entered . in question A-2 ofthe GSI Form). Do not enter

any information in the spaces marked "For Ecology Use Only." Then make as many copies ofthe answer sheets as you 

### will need--onefor each management 

### system.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 53

# CAPACITY INFORMATION FORM QUESTIONS

This is a question sheet. Record your answers on the separate answer sheet! (One sheet for each dangerous waste management system.) 

# o

.::.,

-' .. 

### A-1. Which system code

### best describes your system? Use yourjudgmentto enterthe one system code that 

### bestdescribes the system. Referto Worksheet '#4, on pages 12-13 of

### Book2: 

### Guidebookand Codes, for guidance on identifying a dangerous waste management system. The complete list ofsystem codes is provided on pages 43-44 of

### Book2: 

### Guidebookand Codes. A-2. Ust the Individual units that currently operate In your system. Provide the unit type for each individual unit in the system. Possibleunit types are: tank, container, incinerator, industrial kiln, furnace or boiler, waste pile, underground injection well,landfill cell, and surface impoundment. 'Space is provided to identify four 

### units. Ifyou need additional space, please use Section C, Comments; reference question A-2 in your answer.



## This section collects information on the maximum commercial capacity and 1995commercial utilization ofyour management system(s). To complete this section, you-will need to understand how to "count" the capacity ofthe system. First, note the terms "maximum commercial capacity" and "1995 commercial utilization." Remember that you are completing this form 

### ifyou offer commercial waste management (treatment, disposal, recycling) services. It is possible that you manage in your management systems 

### bothwaste generated at your site 

### and waste received from off-site for commercial management. You are asked to report on this form two things: the commercial capacity, and the commercialutilization
.

• The commercial capacity is the portion of the system that is available to manage commercial wastes. Thus, ifyou manage wastes generated at your site in the system, then you would subtract that quantity ofwaste from the overall maximum capacity of the system to determine the 

### commercial capacity-the portion ofthe system that is left to manage wastes commercially. 

# o

o

54 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# •

•

• CAPACITY INFORMATION FORM

• The 1995 commercial utilization is the total quantity ofwaste managed commerciallyin the system in 1995. Thus, if you manage in the system wastes generated at your site as well as wastes received commercially, you would identify as the "commercial utilization" only those wastes received commercially thatwere managed in the system in 1995. The method for calculating the maximum commercial capacity depends on whether the management system is a landfill system or a flow system. For a landfill system, maximum commercial capacity is the quantity ofdangerous and non-dangerous waste received commercially that can enterthe system over its remaining lifetime. In estimating this capacity, exclude quantities of non-waste materials used for daily and final cover. Assume the waste is of the same type as that disposed in the system during 1995. Ifthe system includes multiple units or cells, sum the maximum quantities across all units in the system. . For flow systems (i.e., treatment, disposal, and recovery systems through which waste moves without permanently "using up" the capacity), the maximum commercial capacity is the greatest quantity ofwaste received commercially that can enter the system in a year, assuming all ofthe following: - • no change in equipment; • an unlimited supply ofwaste ofthe same typical mix managed in 1995; • willingness to add additional shifts; • necessary routine downtime; • effects ofother management systems sharing the same units and competing for capacity; • limits in current permit will not be exceeded; and

• regulatory limitations. To determine the maximum capacity ofa system, if the system has more than one unit (e.g., more than one tank), you should sum the capacity ofthe individual units. Ifthe units are shared among management systems, the maximum operational capacity should reflect any limitations in capacity caused by shared use ofunits or processes by other management systems. The maximum capacity ofthe shared
. unites) should be proportioned to each ofthe systems ofwhich it is a part, based on the amount ofinfluent into the process contributed by each system. B-1. What is the maximum commercial**capa~lty** of this management system? Using the guidelines above, estimate the maximum capacity ofthe management system to accept ALL wastes, both dangerous wastes and non-dangerous wastes, received commercially in 1995. Select an appropriate unit ofmeasure to represent this capacity: ST=Short Tons; MT=Metric Tons; P=Pounds; K=Kilogranis; G=Gallons; L=Liters; and C=Cubic Yards. You must use the same unit of measurewhen responding to all subsequentquestions. If you select G, L, or C, go to question B-l.a. If you select ST,MT, P, or K, skip to question B-2. B-1.a. If the waste is measured in gallons, liters, or cubic yards, what is 

### Its density? Answer this question only if you specified G, L, or C in question B-1.
.

BOOK 1: 1995 FORMS AND INSTRUCTIONS 55DANGEROUS WASTE ANNUAL REPORT


### 8-2. What Is the maximum commercial capacity of this management system to manage dangerous**w~H1** 

### • Please estimate the maximum capacity ofthis management system to manage only dangerous wastes received commercially. This number may be smaller than thatprovided in question B-1. Usethe same unit ofmeasure as question B-1. 

### 8-3. What was the total quantity of all**w~es-dangerous** 

### and non-dangerous-managed commercially In this management system In 19951 Use the same unitofmeasure as question B-1. 

### 8-4. What was the total quantity of dangerous**w~e** only

### managed commercially in this system in 19951 Your answers to questions B-3 and B-4 may differ and 

### will highlight whetheryour dangerous waste management system is being utilized by wastes thatEcology does not regulate as "dangerous." Use the same unitofmeasure as questionB-1.
. 

# o

8-5. What was the total quantity of non-dangerous**w~e** 

### managed commercially in the dangerous**w~e** 

### portion of the management system In 19951 Some management systems distinguish between those units that manage dangerous waste and those that 

# 0 manage non-dangerous waste. If this is the casewith your system, please estimate the quantity ofnondangerous waste managed in the dangerous-waste portion of the system. Use the sameunit ofmeasure as question B-1. Ifyour system does not distinguish among the units used to manage dangerous and nondangerous wastes, write "NA"in the blank.

Use the comments section on the answer sheetto provide 

### anyadditional comments, information, or explanation, as necessary. In your comments, always provide the reference to the specific question number (e.g., A-2).



# o

I 56 BOOK 1: 1995 FORMS AND INSTRUCTIONS

# •

•

• C

# A

# PAC I TY PLEASE ENTER: 

# I 

# NF

# 0 RM

# AT I 

# 0 

# N F

# 0 RM EPA/State 10number: 

# AN

# S WER 

# S 

# HEET Site name: Please EPNState ID number and site right enteryour name at before making as many copies ofthis answer sheet 

### asyou will 

### FOR ECOLOGY USE ONLY: need. Then complete one answer sheet for each commercial Datereceived: system.

# ~~~~tR~~~;lf~i~)JJ[~ijE~§~~~~~~~fl~~lt~;~{f.~::f:~¥K~~~:?f:'.~;'~~;~;h:~:~·f}:~;:5f~t~~~;&~~~'\~~

A-1. System code: 

### M 

### A-2. Unit type/name Unit type/name Unit type/name Unit type/name

# ·~~·~~g.~~~~i~,~~~~~4i~f~~~~~~1lf~~i~t~~lf~q~~)~~~~f:~r:lt~~I~~4 8-1. 

## 0 ST 

## 0 MT 

## 0 P 

## 0 K 

## 0 G 

## 0 L 

## 0 C (If 

### G, 

### L, or 

### C, answer 

### 8-1.a.) 8-1.a. 

## 0 Lbs/gal 

## tJ Specific Gravity 

## 0**Lbs/yd.~** 

### 8-2. Commercial capacity: 

### 8-3. Quantity of all wastes managed in the system: 

### 8-4. Quantity of dangerous wastes managed in the system: 

### 8-5. Quantity of non-dangerous wastes managed in dangerous waste portion of the system:

# C~:;:~~~;'h~~1~jJ~l~~~r7:f.~~~··~~~i.~:;~~t~~~~~11{i~~I;i~

Page _ BOOK 1: 1995 FORMS AND INSTRUCTIONS 57

# •

•

• END OF REPORT (Attach this page as the last page of your submission.)
.

BOOK 1: 1995 FORM S AND INSTRUCTIONS 

### Page 59