EPA Form 6700

- 03 OMB Control No. 20XX

- XXXX

Approval expires XX/XX/XX

The public reporting and record keeping burden for this collection of information is estimated to average 30 minutes per

response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested

methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Colle ction Strategies

Division, U.S. Environmental Protection Agency ( 2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control

number in any correspondence. Do not send the completed form to this address.

*Please Note: This is a complete list of the questions found in this survey

. Depending on how the

respondent answers the subsequent questions asked will vary.

Data Tracking Form for Stand

- Alone Anaerobic Digesters

Project/Facility Information

1. Please provide the following information about your Project/Facility.

Project/Facility Name

S treet address

C ity/Town

State

Zip code

Phone Number

2. Please provide the following information for the c ontact person for facility operations

Name

Title

Email Address

P hone number

3. Please provide the c ontact a ddress (if d ifferent from Facility Address)

Street add ress

City/Town

State

Zip code

Type of Stand

- Alone digester

4. Which of the following choices best describes your facility?

a. Multi

- source Food Digester

b. Industry dedicated digester

c. Other

Facility o peratin g status:

5. Please identify the status of your facility

a. Planning stage / Design stage/Permitting process

b. Under construction

c. OperationalEPA Form 6700

- 03 d. Temporary shut

- down

e. Ceased o peration

f. Other

6. What is the targeted date for your facility to be operational?

7. What date did your facility become operational?

8. What date did your facility temporarily shut

- down?

9. What is the targeted date for your facility to re

- start operations?

10. What date did your facility cease operations?

11. Please state the reason your facility ceased operations.

Facility Total Capacity

12. Is the total capacity ava ilable at your facility for processing feedstocks measured in gallons per

year or tons per year?

13. Please provide the total capacity of your facility in the units identified above.

14. During year the 2015 , how many months was your facility operational?

15. Does your facility accept and process food

- based feedstocks?

16. What was the total volume of food

- based materials received in liquid form and processed at

your facility during the 2015 calendar year ? Please express your answer in gallons.

17. What was the total weight of food

- based materials received in solid form and processed at your

facility during the 2015 calendar year ? Please express your answer in tons.

18. Does your facility accept and process non

- food

- based feedstocks?

19. What was the total volume of non

- food

- based materials received in liquid form and processed

at your facility during the 2015 calendar year ? Please express your answer in gallons.

20. What was the total weight of non

- food

- based materials received in solid for m and processed at

your facility during the 2015 calendar year ? Please express your answer in tons.

Types of Feedstocks

21. Please identify the specific types of feedstocks that are processed in your digester. Check all

that apply.EPA Form 6700

- 03 a. Beverage processing indust ry waste

b. Crop residues

c. Crude glycerine

d. De

- icing fluid

e. Fats, oils and greases (FOG)

f. Food processing industry waste

g. Food service waste, pre & post

- consumer

h. Fruit/vegetative wastes

i. Lab (or Pharma) wastes

j. Litters

k. Manures

l. Mixed yard waste

m. Paper mill wastes

n. Rendering wastes

o. Retail food waste

p. Septage

q. Source

- separated commercial, institutional or residential organic wastes

r. Wastewater solids (sludge)

s. Other (please specify)

22. Are your tipping fees equal for all materials?

23. Which of the following ranges best represents your tipping fees for processing liquid materials?

a. N/A

– Facility does not process liquid feedstock.

b. Business Confidential/Prefer not to say

c. $0.00

- $0.05 per

d. $0.06

- $0.10 per gallon

e. $0.11

- $0.20 per

f. $0.21

- $0.50 per gallon

g. $0.51

- $1 per gallon

h. > $1 per gallon

24. Which of the following ranges best represents your tipping fees for processing solid materials?

a. N /A

– Facility does not process soli d feedstock.

b. Business Confidential/Prefer not to say

c. $0

- $10 per ton

d. $11

- $20 per ton

e. $21

- $30 per ton

f. $31

- $40 per ton

g. $41

- $50 per ton

h. $51

- $60 per ton

i. $61

- $70 per ton

j. $71 or more per ton

25. You indicated that you collect the following types of feedstocks. The feedstocks identified in

your answer to question 21 above will be listed on this page. Are the feedstocks liquid (withEPA Form 6700

- 03

tipping fees in dollars per gallon) or solid (with tipping fees in dollars per ton) or both?

26. You indicated that you receive and process the feedstocks identified below in liquid form

. The

feedstoc ks identified in your answer to question 21 above will be listed on this page. Which of

the following ranges best represents your tipping fee for these liquid feedstocks?

a. Prefer not to say

b. $0.00

- $0.05 per gallon

c. $0.06

- $0.10 per gallon

d. $0.11

- $0.20 per gallon

e. $0.21

- $0.50 per gallon

f. $0.51

- $1 per gallon

g. > $1 per gallon

27. You indicated that you receive and process the feedstocks identified below in solid form. The

feedstocks identified in your answer to question 21 above will be listed on this page. Which of

the following ranges best represents your tipping fee for these solid feedstocks?

a. Prefer not to say

b. $0

- $10 per ton

c. $11

- $20 per ton

d. $21

- $30 per ton

e. $31

- $40 per ton

f. $41

- $50 per ton

g. $51

- $60 per ton

h. $61

- $70 per ton

i. $71 or more per ton

28. Please identify the sources of the feedstocks that are processed at your facility. Check all that

apply.

a. Airports

b. Biodiesel production

c. Corporate complexes

d. Farmers Markets

e. Food/Beverage Processors

f. Fruit/Vegetable Farms

g. Grocery Stores/Supermarkets

h. Healthcare

i. Hospitality

j. Industrial

k. Laboratories/Pharmaceutical Companies

l. Livestock Farms

m. Municipal/Residential

n. Prisons

o. Restaurants and Food Service

p. Retail StoresEPA Form 6700

- 03 q. Schools

r. Sports and Entertainment Venues

s. Wastewater Treatment Plants

t. Other (please specify)

29. Please describ e any pre

- processing/de

- packaging that is occurring at your facility.

30. Please identify the following specifications for your digester.

a. Temperature range

b. Wet or Dry

c. Batch or continuous

d. Number of stages

31. How would you describe your digester? (select all that apply)

a. Continuous Stirred Tank Reactor

b. High Rate Bioreactor

c. Plug Flow

d. Complete Mix

e. Covered Lagoon

f. Induced Blanket Reactor

g. Hydraulic Self

- Stir Reactors

h. Hybrid

i. Fixed Film

j. Unknown

k. Other (please specify)

Product End

- Uses

32. Please provide the average biogas production volume at your facility during calendar year 2015

in one of the units identified below.

a. SCFM

b. SCFD

c. SCFY

d. Other

33. Is the biogas produced at this facility used onsite or sold?

34. Please identify how the biogas produc ed at this facility is used. It could be used onsite by the

facility or offsite by a purchaser. Check all that apply.

a. Produce mechanical power

b. Produce heat and electricity (CHP)

c. Produce electricity (including net metering)

d. Produce electricity (sold to grid)

e. Fuel boilers and furnaces to heat digesters

f. Fuel boilers and furnaces to heat other spaces

g. Compressed to vehicle fuels: used for company fleet/personal vehiclesEPA Form 6700

- 03 h. Compressed to vehicle fuels: sold to customers

i. Renewable natural gas (processed in order to inject to pipeline)

j. Other (please specify)

35. Are you able to utilize all of the biogas produced?

36. Do you flare the excess biogas?

37. Do you have a gas purification system?

38. What type of gas purification system do you have?

39. What is removed by your gas purification system? Check all that apply.

a. Moisture

b. Sulfur

c. Siloxanes

d. Carbon Dioxide

e. Compressed Gas

f. Other (please specify)

40. Do you beneficially re

- use the solid digestate you produce? (Select all that apply)

a. Yes, de

- watered/dried and land applied

b. Yes, land applied as is with no dewatering or drying

c. Yes, composted into a reusable or salable product

d. Yes, processed into other salable products (e.g., flower pots)

e. No, landfilled

f. No, incinerated

g. Other (please specify)

41. I f any digestate was disposed of in landfills or incinerated in 2015, please specify the amount in

tons or gallons (if known).

42. Is the de

- watered/dried digestate further treated prior to land application?

43. Please indicate what the further treatment is and why it is necessary.

44. How do you manage the liquid digestate you produce? Check all that apply.

a. Beneficially reused as fertilizer via land application

b. Recirculated through digester

c. Discharged to a wastewater treatment plant

d. Other (please specify)

45. Is the l iquid digestate further treated prior to land application?EPA Form 6700

- 03

46. Please indicate what the further treatment is and why it is necessary.

47. Do you recover nutrients from your digestate?

a. No

b. Yes, phosphorous recovery by chemical precipitation (e.g., struvite)

c. Yes, ammonia recovery

d. Other (please specify)