# Appendices to Regulatory Impact Analysis of EPA's Proposed Regulations for the Management of Hazardous Waste
Pharmaceuticals at Healthcare Facilities

June 2015i 

## TABLE OF CONTENTS

APPENDICES:



## Appendix A. Identification of Waste Streams in the 2009 Biennial Report Database that are not

Hazardous Waste Pharmaceuticals A-1



## Appendix B. Annual Generation of Hazardous Waste and Hazardous Waste Pharmaceuticals by Industry

and Generator Status B-1



## Appendix C. Annual Cost Impacts by State C-1



## Appendix D. Annual Costs per Model Facility by Cost Type and Scenario D-1



## Appendix E. Regression Based Approach for Estimating Hazardous Waste Generation for LQG Hospitals E-1



## Appendix F. Occurrence of APIs in Finished Drinking Water F-1A-1 

## APPENDIX A. IDENTIFICATION OF WASTE STREAMS IN THE 2009 BIENNIAL
REPORT DATABASE THAT ARE NOT HAZARDOUS WASTE
PHARMACEUTICALS

As described in Chapter 2, this RIA relies on data from EPA’s 2009 Biennial Report (BR) database to estimate the annual generation of hazardous waste pharmaceuticals for both hospitals and reverse
distributors. Because the BR database does not include a clear identifier for hazardous waste pharmaceuticals, such waste streams were identif ied based on other variables included in the BR database. As an initial step in this process, this RIA first identified several waste streams generated by hospitals and reverse distributors that most likely are not hazardous waste pharmaceuticals. The approach used in this RIA for identifying th ese waste streams and excluding them from the BR data is as follows:

1. Exclude remediation wastes . Wastes are considered “remediation wastes” if they:

 Have the word “remediation," “cleanup," “clean? up," “media," and/or “soil” in the waste description field; or

 Have form code W301; or

 Are represented by source codes G41 through G49, as shown below in Exhibit A-1.

EXHIBIT A-1. SOURCE CODES FOR REMEDIATION WASTES

SOURCE CODE SOURCE CODE DESCRIPTION



### G41 Closure of hazardous wast e management unit under RCRA

G42 Corrective action at a solid waste management unit under RCRA

G43 Remedial action or emerge ncy response under Superfund

G44 State program or voluntary cleanup

G45 Underground storage tank cleanup

G49 Other remediation (specify in comments)



## 2. Exclude construction wastes . Wastes are considered construction wastes if they have the word “construction,” and/or “demolition" in the waste description field.

3. Exclude paint wastes . Wastes are considered paint wastes if they have Source Code G06, Form Code W209, Form Code W211, Form Code W604, or the waste description includes the word “paint”.A-2 

## 4. Exclude waste oil and battery wastes . Wastes are oil and battery wastes if they have Source Code G16, Form Code W206, Form Code W309, or the word “battery” or batteries” is in the waste description.

5. Exclude pesticide wastes . Wastes are pesticide wastes if they have Form Code W401 or the word “pesticide” in the waste description.

6. Exclude tank sludge wastes . Wastes are tank sludge wastes if they have Source Code G14.

7. Exclude certain pollution control and waste management process residuals :

 Source Code G21 – Air pollution control devices (baghouse dust or ash from stack scrubbers or precipitators; vapor collection, etc.)

 Source Code G23 - Wastewater treatment (sludge, filter cake, etc., including wastes from treatment before discharge by NPDES or POTW or by UIC disposal)

 Source Code G24 - Solvent or product distilla tion or recovery (sludge, waste solvent, bottoms, from recovery/recycling of used produc t) or waste descriptions containing the
word “distillation”.

 Source Code G26 - Leachate collection (from landfill operations or other land units)

 Source Code G27 - Hazardous residual from tr eatment or recovery of universal waste

8. Exclude mercury-containing equipment wastes . Wastes are mercury-containing equipment if they have Form Code W320 or the words “the rmometer”, “sphygmomanom eter”, “thermostat”, “fluorescent”, or “flourescent” in the waste description.

9. Exclude lead-containing equipment wastes . Wastes are lead-containing equipment if they contain the words “lead apron’ or “lead shield” in the waste description or the combination of
EPA Waste Code D008 and the words “apron”, “shield” or “el ectronic” in the waste description.

10. Exclude silver wastes from X-rays and development of X-rays and photographs . Silver wastes
include EPA Waste Code D011 and the words “x?ray”, “xray”, “developer”, photo”, “film”, or “fixer” in the waste description.

11. Exclude solvent wastes . Wastes are solvent wastes if they include EPA Waste Codes F002, F003, or F005 or any of the following words in the waste description: “solvent”, “refrigerant”, “Chloroform”, “methanol”, “acetone”, “methylene chloride”, “xylene”, “ethanol”, “isopropanol”, “toluene”, or “acetonitrile”. Wastes containing the words “formaldehyde” or “formulin” were not excluded in this step.

12. Exclude mixed infectious or radioactive wastes . Exclude wastes with the words “infectious” or “radioactive” in the waste description.

13. Exclude formaldehyde and formal wastes – chemicals used to preserve specimens . Exclude all wastes with the words “formaldehyde” or “formalin” in the waste description.A-3 

## 14. Exclude laboratory analytical wastes – u sed chemicals from laboratory operations . Wastes are laboratory analytical wastes if they have Source Code G22.

After completion of the steps above and review of waste descriptions, the following steps were
added:

15. Exclude additional mercury wastes . Waste streams were assumed to contain mercury if they include any of the following te rms in the BR waste description: “mercury” AND “retort” “amalgam”
“bulb” “mercury” AND “lamp” “mercury” AND “gauge” “mercury” AND “guage” “mercury” AND “drain” “mercury” AND Source Code G15 “mercury” AND Source Code G19 “mercury” AND “instrument” “mercury” AND “debris” “mercury” AND “dental” “waste elemental mercury” “waste liquid mercury”

16. Exclude additional lead wastes . Waste streams were assumed to contain lead if they include any of the following terms in the BR waste description:
“lead” AND “bite”
“lead” AND “debris” “lead” AND “glass” “bullet” AND “floor sweeping” “lead” AND “floor sweeping”
“lead contaminated”
“water with lead”

17. Exclude additional photographic/x-ray wastes . Waste streams were assumed to fall in this category if they include any of the fo llowing terms in the BR waste description:
“film”
“fixer”

18. Exclude fuels . Waste streams with any of the followi ng descriptors in the BR waste description
were excluded:
“fuel”
“oil”A-4 

## “gasoline”
“diesel” “propane” “gas filter”

19. Exclude other miscellaneous wastes . Wastes containing any of the following terms in the BR waste description field were also excluded.
“incinerator ash”
“radiation shield”
“lab” AND “machine” “calibration” AND “gas” “maintenance” AND “gas”
“PCB” “tank sludge”
“scale remover” “dental repair” “rubber rejuvenator”
“blanket conditioner” “pepper spray”
“roof tar”
“anti-freeze”
“still bottoms” “slag”
“dross”
“metal scale”

20. Exclude cleaner wastes . Waste streams were assumed to fall in this category if they include any of the following terms in the BR waste description:
“cleaner” “part washer” “laundry detergent” “cleaning solution” “cleaning product”
“clean” AND “maintenance”
“clean” AND “rinse water” “gun patch”

The number of BR waste records and the associated hazardous waste tonnage removed by each step is presented in Exhibit A-2.A-5 EXHIBIT A-2. NUMBER OF WASTE RECORDS AND HAZARDOUS WASTE TONNAGE REMOVED BY
EACH EXCLUSION STEP

EXCLUSION
STEP EXCLUSION STEP DESCRIPTION NUMBER OF WASTE
STREAMS EXCLUDED HAZARDOUS WASTE EXCLUDED (TONS)



### 1 Remediation Waste 55 436.7

2 Construction Waste 4 45.3

3 Paint Waste 382 8,620.4

4 Waste Oil and Batteries 73 43.2

5 Pesticides 11 74.7

6 Tank Sludge 7 2,935.5

7 Pollution Control and Waste Management Residuals 46 67.3

8 Mercury-containing Equipment 63 39.2

9 Lead-containing Equipment 25 4.1

10 Silver Waste 49 93.3

11 Solvent Waste 1,717 2,702.6

12 Infectious or Radioactive Waste 22 60.9

13 Formaldehyde and Formalin Waste 98 270.9

14 Laboratory Analytical Waste 1,442 721.0

15 Additional Mercury Waste 67 7.3

16 Additional Lead Waste 16 17.7

17 Additional Photographic/X-Ray Waste 3 0.1

18 Fuels 34 7.7

19 Other Miscellaneous Waste 21 145.5

20 Cleaners 21 4.4

TOTAL EXCLUDED 4,156 16,298B-1 

## APPENDIX B. ANNUAL GENERATION OF HAZARDOUS WASTE AND HAZARDOUS
WASTE PHARMACEUTICALS BY INDUSTRY AND GENERATOR
STATUS

To provide additional detail on the generation data included in Chapte r 2, this appendix presents the estimated generation of hazardous waste and hazar dous waste pharmaceuticals by industry and RCRA generator status for the universe of facilities affected by the rule. These data are presented in Exhibit B-1 (hazardous waste in aggregate) and Exhibit B-2 (hazardous waste pharmaceuticals).

EXHIBIT B-1. ANNUAL GENERATION OF HAZARDOUS WASTE BY INDUSTRY AND RCRA GENERATOR STATUS (TONS)

NAICS FACILITY TYPE LQG SQG CESQG ALL
GENERATORS 

### 44611 Pharmacies 5,320 5,650 1,470 12,400
54194 Veterinary Clinics 1,840 2,360 1,130 5,330
6211 Physicians’ Offices 20,500 18,400 8,610 47,500

6212 Dentists’ Offices 400 4,700 5,580 10,700

6213 Other Health Practitioners (e.g., chiropractors) 0 13,000 4,940 17,900

6214 Outpatient Care Centers 3,500 3,980 1,050 8,530

6219 Other Ambulatory Health Care Services 590 1,460 330 2,380

622 Hospitals 21,600 5,960 430 28,000
6231 Nursing Care Facilities 600 1,840 620 3,070

623311 Continuing Care Retirement Communities 81 230 260 570

Subset of 92219 Medical Examiners and Coroners' Offices 720 440 50 1,210

Various NAICS Reverse Distributors 1,270 17 4 1,290

TOTAL 56,500 58,000 24,500 139,000 Note: The values reported in this exhi bit reflect all of the hazardous waste ge nerated by facilities affected by the rule. These values include hazardous waste pharmaceut icals as well as other hazardous wastes generated by these facilities.B-2 EXHIBIT B-2. ANNUAL GENERATION OF HAZARDOUS WASTE PHARMACEUTICALS BY INDUSTRY AND RCRA GENERATOR STATUS (TONS)

NAICS FACILITY TYPE LQG SQG CESQG ALL
GENERATORS 

### 44611 Pharmacies 1,280 1,360 350 2,990
54194 Veterinary Clinics 440 570 270 1,280
6211 Physicians’ Offices 4,940 4,410 2,070 11,400

6212 Dentists’ Offices 95 1,130 1,340 2,570

6213 Other Health Practitioners (e.g., chiropractors) 0 3,120 1,190 4,300

6214 Outpatient Care Centers 840 960 250 2,050

6219 Other Ambulatory Health Care Services 140 350 78 570

622 Hospitals 6,680 1,840 130 8,650
6231 Nursing Care Facilities 150 440 150 740

623311 Continuing Care Retirement Communities 20 56 62 140

Subset of 92219 Medical Examiners and Coroners' Offices 170 110 12 290

Various NAICS Reverse Distributors 1,200 16 3 1,220

TOTAL 15,900 14,400 5,920 36,200C-1 

## APPENDIX C. ANNUAL COST IMPACTS BY STATE

As a supplement to the cost impacts presented in Ch apter 3, this appendix presents the incremental costs of each policy option by state. These estimates are presented in Exhibit C-1 using a discount rate of 7 percent.

EXHIBIT C-1. ANNUAL COSTS OF EACH POLICY OPTION INCREMENTAL TO THE BASELINE, 7 PERCENT DISCOUNT RATE (MILLIONS OF 2011$)

STATE COSTS INCREMENTAL TO
FULL COMPLIANCE BASELINE COSTS INCREMENTAL TO
PARTIAL COMPLIANCE BASELINE
MORE
STRINGENT

OPTION PREFERRED
OPTION LESS
STRINGENT

OPTION MORE
STRINGENT

OPTION PREFERRED
OPTION LESS
STRINGENT

OPTION 

### Alabama $0.72 $0.59 $0.56 $2.45 $2.31 $2.29
Alaska $0.11 $0.09 $0.09 $0.39 $0.37 $0.37
Arizona $0.87 $0.69 $0.66 $2.92 $2.73 $2.69
Arkansas $0.53 $0.43 $0.41 $1.77 $1.66 $1.64
California $5.06 $4.03 $3.80 $17.03 $15.97 $15.73
Colorado $0.77 $0.62 $0.58 $2.60 $2.44 $2.41
Connecticut $0.51 $0.41 $0.38 $1.72 $1.61 $1.59
Delaware $0.13 $0.10 $0.10 $0.44 $0.41 $0.40

District of Columbia $0.09 $0.08 $0.07 $0.32 $0.30 $0.30

Florida $3.14 $2.43 $2.30 $10.26 $9.52 $9.39
Georgia $1.34 $1.07 $1.02 $4.48 $4.19 $4.14
Hawaii $0.20 $0.16 $0.16 $0.69 $0.65 $0.64
Idaho $0.27 $0.23 $0.22 $0.94 $0.89 $0.88
Illinois $1.83 $1.42 $1.35 $6.02 $5.60 $5.52
Indiana $0.95 $0.75 $0.71 $3.14 $2.93 $2.89
Iowa $0.53 $0.43 $0.41 $1.79 $1.69 $1.67
Kansas $0.54 $0.46 $0.44 $1.89 $1.80 $1.77
Kentucky $0.72 $0.59 $0.56 $2.46 $2.33 $2.30
Louisiana $0.84 $0.71 $0.68 $2.92 $2.77 $2.74
Maine $0.23 $0.19 $0.18 $0.80 $0.76 $0.75
Maryland $0.82 $0.65 $0.62 $2.75 $2.59 $2.55
Massachusetts $0.90 $0.73 $0.69 $3.05 $2.86 $2.82
Michigan $1.42 $1.14 $1.08 $4.80 $4.51 $4.45C-2 EXHIBIT C-1. ANNUAL COSTS OF EACH POLICY OPTION INCREMENTAL TO THE BASELINE, 7 PERCENT DISCOUNT RATE (MILLIONS OF 2011$)

STATE COSTS INCREMENTAL TO
FULL COMPLIANCE BASELINE COSTS INCREMENTAL TO
PARTIAL COMPLIANCE BASELINE
MORE
STRINGENT

OPTION PREFERRED
OPTION LESS
STRINGENT

OPTION MORE
STRINGENT

OPTION PREFERRED
OPTION LESS
STRINGENT

OPTION 

### Minnesota $0.70 $0.57 $0.54 $2.37 $2.23 $2.20
Mississippi $0.46 $0.38 $0.36 $1.57 $1.49 $1.48
Missouri $0.93 $0.74 $0.70 $3.08 $2.88 $2.84
Montana $0.23 $0.19 $0.18 $0.79 $0.75 $0.74
Nebraska $0.36 $0.30 $0.29 $1.25 $1.18 $1.17
Nevada $0.36 $0.30 $0.28 $1.24 $1.17 $1.16

New Hampshire $0.19 $0.15 $0.14 $0.64 $0.60 $0.60

New Jersey $1.42 $1.13 $1.07 $4.77 $4.48 $4.41
New Mexico $0.28 $0.23 $0.22 $0.95 $0.90 $0.89
New York $3.03 $2.37 $2.24 $9.98 $9.30 $9.17

North Carolina $1.21 $0.93 $0.88 $3.92 $3.62 $3.58

North Dakota $0.16 $0.13 $0.13 $0.55 $0.53 $0.52
Ohio $1.62 $1.30 $1.23 $5.46 $5.13 $5.06
Oklahoma $0.68 $0.56 $0.54 $2.35 $2.22 $2.20
Oregon $0.53 $0.42 $0.40 $1.79 $1.68 $1.66
Pennsylvania $2.02 $1.61 $1.53 $6.74 $6.31 $6.23
Rhode Island $0.17 $0.14 $0.13 $0.58 $0.54 $0.54

South Carolina $0.57 $0.47 $0.44 $1.95 $1.84 $1.81

South Dakota $0.19 $0.17 $0.16 $0.68 $0.65 $0.64
Tennessee $0.98 $0.77 $0.73 $3.23 $3.01 $2.98
Texas $3.47 $2.81 $2.67 $11.75 $11.05 $10.91
Utah $0.41 $0.31 $0.29 $1.29 $1.18 $1.17
Vermont $0.12 $0.10 $0.09 $0.41 $0.38 $0.38
Virginia $0.97 $0.79 $0.74 $3.30 $3.10 $3.06
Washington $0.90 $0.72 $0.68 $3.03 $2.83 $2.79
West Virginia $0.32 $0.27 $0.26 $1.11 $1.05 $1.04
Wisconsin $0.80 $0.63 $0.60 $2.65 $2.48 $2.45
Wyoming $0.11 $0.09 $0.09 $0.39 $0.37 $0.36

TOTAL $45.71 $36.56 $34.69 $153.45 $143.86 $141.96D-1 

## APPENDIX D. ANNUAL COSTS PER MODEL FACILITY BY COST TYPE AND
SCENARIO

As a supplement to the cost results presented in Chap ter 3 of this RIA, this appendix presents the annual costs of each of the waste management activities disc ussed in Chapter 3 by model facility and scenario using a 7 percent discount rate. These costs are presented in Exhibits D-1 through D-16.D-2EXHIBIT D-1. ANNUAL NOTIFICATION COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGenerator Status(under 2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG$0.00 $0.00 $0.00 $0.00 $0.00Hospitals Large 1,719 CESQG CESQG $0.00 $0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Reverse Distributors Small 21 CESQGCESQG $0.00 $0.00 $5.01 $5.01 $5.01Hospitals Small 785 SQG SQG $0.00 $0.00 $5.01 $5.01 $5.01Hospitals Large 1,612SQG SQG $0.00 $0.00 $2.86 $2.86 $2.86Other HealthcareFacilitiesSmall 18,147 SQG SQG $0.00 $0.00 $2.86 $2.86 $2.86Other HealthcareFacilitiesLarge 2,763 SQG SQG $0.00 $0.00 $2.99 $2.99 $2.99Reverse Distributors Small 7 SQG CESQG $0.00 $0.00 $2.99 $2.99 $2.99Other HealthcareFacilitiesLarge 3,721 LQG LQG $0.00 $0.00 $2.98 $2.98 $2.98Reverse Distributors Large 28 LQG SQG $0.00 $0.00 $0.00 $0.00 $0.00Non-teaching HospitalsLarge 421 LQG LQG $0.00 $0.00 $0.18 $0.18 $0.18Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $0.00 $0.00 $0.00 $0.00 $0.00Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $0.00 $0.00 $0.00 $0.00 $0.00Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $0.00 $0.00 $0.00 $0.00 $0.00D-3EXHIBIT D-2. ANNUAL TRAINING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGenerator Status(under 2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other Healthcare Facilities Small 123,957 CESQG CESQG $0 $0 $0 $0 $0Other Healthcare Facilities Large 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $2,236 $2,236 $2,236Hospitals Small 785 SQG SQG $6,197 $6,197 $6,197 $3,418 $3,418Hospitals Large 1,612SQG SQG $7,211 $7,211 $7,211 $4,432 $4,432Other Healthcare Facilities Small 18,147 SQG SQG $981 $981 $1,022 $1,022 $1,022Other Healthcare Facilities Large 2,763 SQG SQG $1,659 $1,659 $1,728 $1,728 $1,728Reverse Distributors Small 7 SQG CESQG $1,022 $1,022 $2,236 $2,236 $2,236Other Healthcare Facilities Large 3,721 LQG LQG $3,876 $3,876 $4,024 $4,024 $4,024Reverse Distributors Large 28 LQG SQG $4,024 $4,024 $4,024 $4,024 $4,024Non-teaching HospitalsLarge 421 LQG LQG $9,046 $9,046 $9,046 $6,596 $6,596Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $12,648 $12,648 $12,648 $7,632 $7,632Teaching Hospitals, 370 to799 bedsLarge 480 LQG LQG $24,411 $24,411 $24,411 $11,019 $11,019Teaching Hospitals, 800 ormore bedsLarge 82 LQG LQG $43,198 $43,198 $43,198 $16,427 $16,427D-4EXHIBIT D-3. ANNUAL MANIFEST TRAINING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGenerator Status(under 2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other Healthcare Facilities Small 123,957 CESQG CESQG $0 $0 $0 $0 $0Other Healthcare Facilities Large 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $228 $228 $228Hospitals Small 785 SQG SQG $228 $228 $228 $228 $228Hospitals Large 1,612 SQG SQG $228 $228 $228 $228 $228Other Healthcare Facilities Small 18,147 SQG SQG $219 $219 $228 $228 $228Other Healthcare Facilities Large 2,763 SQG SQG $219 $219 $228 $228 $228Reverse Distributors Small 7 SQG CESQG $228 $228 $228 $228 $228Other Healthcare Facilities Large 3,721 LQG LQG $220 $220 $228 $228 $228Reverse Distributors Large 28 LQG SQG $228 $228 $228 $228 $228Non-teaching Hospitals Large 421 LQG LQG $228 $228 $228 $228 $228Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $228 $228 $228 $228 $228Teaching Hospitals, 370 to799 bedsLarge 480 LQG LQG $228 $228 $228 $228 $228Teaching Hospitals, 800 ormore bedsLarge 82 LQG LQG $228 $228 $228 $228 $228D-5EXHIBIT D-4. ANNUAL CONTINGENCY PLAN UPDATING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $950 $0 $0Hospitals Small 785 SQG SQG $0 $0 $0 $0 $0Hospitals Large 1,612 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 18,147 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 2,763 SQG SQG $0 $0 $0 $0 $0Reverse Distributors Small 7 SQG CESQG $0 $0 $950 $0 $0Other HealthcareFacilitiesLarge 3,721 LQG LQG $915 $915 $950 $915 $915Reverse Distributors Large 28 LQG SQG $950 $950 $950 $0 $0Non-teaching Hospitals Large 421 LQG LQG $950 $950 $950 $950 $950Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $950 $950 $950 $950 $950Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $950 $950 $950 $950 $950Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $950 $950 $950 $950 $950D-6EXHIBIT D-5. ANNUAL CONTAINER MANAGEMENT COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $86 $86 $86 $86 $86Hospitals Large 1,719 CESQG CESQG $86 $86 $86 $86 $86Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $86 $86 $86 $86 $86Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $86 $86 $86 $86 $86Reverse Distributors Small 21 CESQG CESQG $74 $74 $297 $297 $297Hospitals Small 785 SQG SQG $491 $342 $502 $428 $417Hospitals Large 1,612 SQG SQG $491 $342 $502 $428 $417Other HealthcareFacilitiesSmall 18,147 SQG SQG $331 $331 $491 $417 $405Other HealthcareFacilitiesLarge 2,763 SQG SQG $331 $331 $491 $417 $405Reverse Distributors Small 7 SQG CESQG $594 $594 $594 $594 $594Other HealthcareFacilitiesLarge 3,721 LQG LQG $1,324 $1,005 $1,644 $1,421 $1,398Reverse Distributors Large 28 LQG SQG $8,906 $8,906 $8,906 $8,906 $8,906Non-teaching Hospitals Large 421 LQG LQG $673 $662 $982 $833 $822Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $1,324 $1,313 $1,655 $1,433 $1,398Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $3,345 $3,002 $4,018 $3,944 $3,864Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $5,696 $5,331 $7,020 $6,946 $6,810D-7EXHIBIT D-6. ANNUAL LABELING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG$0.00 $0.00 $0.00 $0.00 $0.00Hospitals Large 1,719 CESQG CESQG $0.00 $0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Reverse Distributors Small 21 CESQG CESQG $0.00 $0.00 $24.48 $8.57 $8.57Hospitals Small 785 SQG SQG $24.48 $4.90 $24.48 $19.59 $19.59Hospitals Large 1,612 SQGSQG $24.48 $4.90 $24.48 $19.59 $19.59Other HealthcareFacilitiesSmall 18,147 SQG SQG $0.00 $0.00 $24.48 $22.79 $22.79Other HealthcareFacilitiesLarge 2,763 SQG SQG $0.00 $0.00 $24.48 $22.79 $22.79Reverse Distributors Small 7 SQG CESQG $24.48 $24.48 $24.48 $8.57 $8.57Other HealthcareFacilitiesLarge 3,721 LQG LQG $70.76 $14.15 $73.45 $68.36 $68.36Reverse Distributors Large 28 LQG SQG $73.45 $73.45 $73.45 $8.57 $8.57Non-teaching Hospitals Large 421LQG LQG $73.45 $14.69 $73.45 $58.76 $58.76Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $73.45 $14.69 $73.45 $58.76 $58.76Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $73.45 $14.69 $73.45 $58.76 $58.76Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $73.45 $14.69 $73.45 $58.76 $58.76D-8EXHIBIT D-7. ANNUAL INSPECTION COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $2,551 $2,551 $2,551Hospitals Small 785 SQG SQG $2,546 $2,546 $2,546 $2,546 $2,546Hospitals Large 1,612SQG SQG $5,093 $5,093 $5,093 $5,093 $5,093Other HealthcareFacilitiesSmall 18,147 SQG SQG $2,445 $2,445 $2,546 $2,445 $2,445Other HealthcareFacilitiesLarge 2,763 SQG SQG $4,890 $4,890 $5,093 $4,890 $4,890Reverse Distributors Small 7 SQG CESQG $2,546 $2,546 $2,551 $2,551 $2,551Other HealthcareFacilitiesLarge 3,721 LQG LQG $4,906 $4,906 $5,093 $4,906 $4,906Reverse Distributors Large 28 LQG SQG $5,093 $5,093 $5,097 $5,097 $5,097Non-teaching HospitalsLarge 421 LQG LQG $5,093 $5,093 $5,093 $5,093 $5,093Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $5,093 $5,093 $5,093 $5,093 $5,093Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $5,093 $5,093 $5,093 $5,093 $5,093Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $5,093 $5,093 $5,093 $5,093 $5,093D-9EXHIBIT D-8. ANNUAL SECURITY (WAREHOUSING) COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $60 $0 $0Hospitals Small 785 SQG SQG $0 $0 $0 $0 $0Hospitals Large 1,612 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 18,147 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 2,763 SQG SQG $0 $0 $0 $0 $0Reverse Distributors Small 7 SQG CESQG $0 $0 $60 $0 $0Other HealthcareFacilitiesLarge 3,721 LQG LQG $0 $0 $0 $0 $0Reverse Distributors Large 28 LQG SQG $0 $0 $163 $0 $0Non-teaching Hospitals Large 421 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $0 $0 $0 $0 $0D-10EXHIBIT D-9. ANNUAL CLOSURE COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $843 $0 $0Hospitals Small 785 SQG SQG $0 $0 $47 $0 $0Hospitals Large 1,612 SQG SQG $0 $0 $47 $0 $0Other HealthcareFacilitiesSmall 18,147 SQG SQG $0 $0 $47 $0 $0Other HealthcareFacilitiesLarge 2,763 SQG SQG $0 $0 $47 $0 $0Reverse Distributors Small 7 SQG CESQG $0 $0 $843 $0 $0Other HealthcareFacilitiesLarge 3,721 LQG LQG $827 $827 $859 $1,009 $1,009Reverse Distributors Large 28 LQG SQG $1,252 $1,252 $1,252 $2,668 $2,668Non-teaching Hospitals Large 421 LQG LQG $828 $828 $828 $938 $938Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $859 $859 $859 $1,048 $1,048Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $969 $969 $969 $1,520 $1,520Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $1,111 $1,111 $1,111 $2,086 $2,086D-11EXHIBIT D-10. ANNUAL RCRA STORAGE PERMIT COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $12,100 $0 $0Hospitals Small 785 SQG SQG $0 $0 $0 $0 $0Hospitals Large 1,612 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 18,147 SQG SQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 2,763 SQG SQG $0 $0 $0 $0 $0Reverse Distributors Small 7 SQG CESQG $0 $0 $12,100 $0 $0Other HealthcareFacilitiesLarge 3,721 LQG LQG $0 $0 $0 $0 $0Reverse Distributors Large 28 LQG SQG $0 $0 $12,100 $0 $0Non-teaching Hospitals Large 421 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $0 $0 $0 $0 $0Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $0 $0 $0 $0 $0D-12EXHIBIT D-11. ANNUAL SORTING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $24 $12 $37 $37 $24Hospitals Large 1,719 CESQG CESQG $24 $12 $37 $37 $24Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $24 $12 $24 $24 $24Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $24 $12 $24 $24 $24Reverse Distributors Small 21 CESQG CESQG $0 $0 $0 $0 $0Hospitals Small 785 SQG SQG $649 $282 $759 $759 $759Hospitals Large 1,612 SQG SQG $649 $282 $759 $759 $759Other HealthcareFacilitiesSmall 18,147 SQG SQG $465 $49 $588 $588 $588Other HealthcareFacilitiesLarge 2,763 SQG SQG $465 $49 $588 $588 $588Reverse Distributors Small 7 SQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 3,721 LQG LQG $1,775 $539 $2,130 $2,130 $2,130Reverse Distributors Large 28 LQG SQG $0 $0 $0 $0 $0Non-teaching Hospitals Large 421 LQG LQG $1,224 $514 $1,420 $1,420 $1,420Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $2,204 $930 $2,583 $2,583 $2,583Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $6,146 $2,583 $7,186 $7,186 $7,186Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $10,798 $4,542 $12,610 $12,610 $12,610D-13EXHIBIT D-12. ANNUALIZED BIENNIAL REPORTING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under 2and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $0 $0 $0 $0 $0Hospitals Large 1,719 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0 $0 $0 $0 $0Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0 $0 $0 $0 $0Reverse Distributors Small 21 CESQG CESQG $0 $0 $138 $0 $0Hospitals Small 785 SQG SQG $0 $0 $138 $0 $0Hospitals Large 1,612 SQG SQG $38 $35 $38 $34 $34Other HealthcareFacilitiesSmall 18,147 SQG SQG $38 $35 $38 $34 $34Other HealthcareFacilitiesLarge 2,763 SQG SQG $34 $31 $35 $31 $31Reverse Distributors Small 7 SQG CESQG $34 $31 $35 $31 $31Other HealthcareFacilitiesLarge 3,721 LQG LQG $24 $19 $170 $0 $0Reverse Distributors Large 28 LQG SQG $170 $136 $170 $0 $0Non-teaching Hospitals Large 421 LQG LQG $245 $220 $254 $214 $214Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $761 $279 $761 $17 $17Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $328 $277 $328 $265 $265Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $328 $277 $328 $265 $265D-14EXHIBIT D-13. ANNUAL RECORDKEEPING COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG$0.00 $0.00 $0.00 $0.00 $0.00Hospitals Large 1,719 CESQG CESQG $0.00 $0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Reverse Distributors Small 21 CESQGCESQG $0.00 $0.00 $5.30 $5.30 $5.30Hospitals Small 785 SQG SQG $5.30 $5.30 $5.30 $0.00 $0.00Hospitals Large 1,612SQG SQG $5.30 $5.30 $5.30 $0.00 $0.00Other HealthcareFacilitiesSmall 18,147 SQG SQG $5.09 $5.09 $5.30 $0.00 $0.00Other HealthcareFacilitiesLarge 2,763 SQG SQG $5.09 $5.09 $5.30 $0.00 $0.00Reverse Distributors Small 7 SQG CESQG $5.30 $5.30 $5.30 $5.30 $5.30Other HealthcareFacilitiesLarge 3,721 LQG LQG $5.11 $5.11 $5.30 $0.00 $0.00Reverse Distributors Large 28 LQG SQG $5.30 $5.30 $5.30 $5.30 $5.30Non-teaching HospitalsLarge 421 LQG LQG $5.30 $5.30 $5.30 $0.00 $0.00Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $5.30 $5.30 $5.30 $0.00 $0.00Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $5.30 $5.30 $5.30 $0.00 $0.00Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $5.30 $5.30 $5.30 $0.00 $0.00D-15EXHIBIT D-14. ANNUAL MANIFEST COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus (under2 and 3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2)ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG$0.00 $0.00 $0.00 $0.00 $0.00Hospitals Large 1,719 CESQG CESQG $0.00 $0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $0.00$0.00 $0.00 $0.00 $0.00Reverse Distributors Small 21 CESQG CESQG $0.00 $0.00 $46.81 $34.28 $34.28Hospitals Small 785 SQG SQG $25.06 $25.06 $59.34 $45.83 $45.83Hospitals Large 1,612 SQGSQG $25.06 $25.06 $59.34 $45.83 $45.83Other HealthcareFacilitiesSmall 18,147 SQG SQG $25.06 $25.06 $59.34 $45.83 $45.83Other HealthcareFacilitiesLarge 2,763 SQG SQG $25.06 $25.06 $59.34 $45.83 $45.83Reverse Distributors Small 7 SQG CESQG $25.06 $25.06 $59.34 $34.28 $34.28Other HealthcareFacilitiesLarge 3,721 LQG LQG $84.28 $84.28 $118.56 $52.51 $52.51Reverse Distributors Large 28 LQG SQG $84.28 $84.28 $118.56 $57.38 $57.38Non-teaching Hospitals Large 421LQG LQG $84.28 $84.28 $118.56 $52.51 $52.51Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $84.28 $84.28 $118.56 $52.51 $52.51Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $84.28 $84.28 $118.56 $88.97 $88.97Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $84.28 $84.28 $118.56 $107.20 $107.20D-16EXHIBIT D-15. ANNUAL TRANSPORTATION COSTS PER MODEL FACILITY, BY SCENARIO (7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus(under 2 and3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $227 $203 $227 $227 $227Hospitals Large 1,719 CESQG CESQG $227 $203 $227 $227 $227Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $251 $226 $251 $251 $251Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $251 $226 $251 $251 $251Reverse Distributors Small 21 CESQG CESQG $316 $316 $316 $316 $316Hospitals Small 785 SQG SQG $316 $316 $316 $316 $316Hospitals Large 1,612 SQG SQG $927 $886 $967 $935 $935Other HealthcareFacilitiesSmall 18,147 SQG SQG $927 $886 $967 $935 $935Other HealthcareFacilitiesLarge 2,763 SQG SQG $820 $789 $922 $890 $890Reverse Distributors Small 7 SQG CESQG $820 $789 $922 $890 $890Other HealthcareFacilitiesLarge 3,721 LQG LQG $1,930 $1,930 $1,969 $1,899 $1,899Reverse Distributors Large 28 LQG SQG $1,930 $1,930 $1,969 $1,899 $1,899Non-teaching HospitalsLarge 421 LQG LQG $2,552 $2,453 $2,716 $2,591 $2,591Teaching Hospitals, lessthan 370 bedsLarge 570 LQG LQG $31,320 $31,320 $31,359 $31,221 $31,221Teaching Hospitals, 370to 799 bedsLarge 480 LQG LQG $1,558 $1,590 $1,723 $1,597 $1,597Teaching Hospitals, 800or more bedsLarge 82 LQG LQG $2,661 $2,571 $2,825 $2,700 $2,700D-17EXHIBIT D-16. ANNUAL DISPOSAL COSTS PER MODEL FACILITY, BY SCENARIO(7 PERCENT DISCOUNT RATE, 2011$)Facility TypeEstablishmentSizeEstablishmentsBaselineGeneratorStatusRegulatoryGeneratorStatus(under 2 and3)Baseline:FullcomplianceBaseline:Partialcompliance1) MoreStringentOption2) ProposedOption3) LessStringentOptionHospitals Small 836 CESQG CESQG $612 $549 $624 $624 $612Hospitals Large 1,719 CESQG CESQG $612 $549 $624 $624 $612Other HealthcareFacilitiesSmall 123,957 CESQG CESQG $630 $572 $640 $640 $630Other HealthcareFacilitiesLarge 18,874 CESQG CESQG $630 $572 $640 $640 $630Reverse Distributors Small 21 CESQG CESQG $723 $723 $723 $723 $723Hospitals Small 785 SQG SQG $10,072 $8,523 $10,531 $10,525 $10,525Hospitals Large 1,612 SQG SQG$10,072 $8,523 $10,531 $10,525 $10,525Other HealthcareFacilitiesSmall 18,147 SQG SQG $10,018 $8,265 $10,548 $10,531 $10,531Other HealthcareFacilitiesLarge 2,763 SQG SQG $10,018 $8,265 $10,548 $10,531 $10,531Reverse Distributors Small 7 SQG CESQG $10,544 $10,544 $10,544 $10,529 $10,529Other HealthcareFacilitiesLarge 3,721 LQG LQG $36,689 $31,561 $38,238 $38,201 $38,201Reverse Distributors Large 28 LQG SQG $191,679 $191,679 $191,679 $191,659 $191,659Non-teaching Hospitals Large 421 LQG LQG $18,953 $16,060 $19,842 $19,817 $19,817Teaching Hospitals,less than 370 bedsLarge 570 LQG LQG $34,407 $29,136 $36,007 $35,963 $35,963Teaching Hospitals,370 to 799 bedsLarge 480 LQG LQG $95,841 $81,180 $100,299 $100,286 $100,286Teaching Hospitals,800 or more bedsLarge 82 LQG LQG $168,341 $142,590 $176,183 $176,154 $176,154E-1 

## APPENDIX E. REGRESSION BASED APPROACH FOR ESTIMATING HAZARDOUS
WASTE GENERATION FOR LQG HOSPITALS

As described in Chapter 2, this RIA estimates waste quantities for a series of LQG model hospitals defined in terms of their teaching status and the num ber of beds at each hospital. The specification of these model hospitals was based in part on the Ameri can Hospital Directory data presented in Chapter 2, which included information on hospital revenues, dischar ges, patient days, beds, and teaching status. The statistical analysis presented in Chapter 2 showed that each of these variables has a statistically significant correlation with hospital hazardous waste generation (b ased on generation data in EPA’s 2009 Biennial Report database). Based on these correlations, we c onsidered using a regression-based framework to estimate hazardous waste generation for LQG hospitals, using each of the hospital characteristics that are correlated with hazardous waste generation as an expl anatory variable. More specifically, we assessed the feasibility of using a multivariate model to capture how the different variables outlined above interact and collectively explain variation in hazardous wast e generation. All of the explanatory variables, however, are highly correlated with one another. This presents a significant challenge in multivariate regression analysis. Specifically, a regression model with a high degree of correlation among the explanatory variables—a phenomenon known as multicollin earity—may not give reliable estimates of the individual parameters or about wh ich predictors are “more significant” with respect to others. 1 

## Furthermore, multicollinearity can cau se coefficient estimates to be hi ghly sensitive to small changes in the model or the data. Recognizing these limitations, Exhibit E-1 reports the results of a multivariate regression model with the following explanatory variabl es: number of beds, revenue, and teaching status. Each of these explanatory variables has a positiv e impact on hazardous waste generation and the regression yields a fairly robust go odness-of-fit or “R-squared” value.

1 

### The multivariate model with multicollinearity would still provide unbiased estimates of waste generation.E-2 EXHIBIT E-1. REGRESSION RESULTS FOR HOSPITAL HAZARDOUS WASTE GENERATION 1

EXPLANATORY VARIABLE COEFFICIENT STANDARD ERROR 2



### Number of Beds 0.00032* 0.00019

Natural Log of Revenue 3 

### 0.24817*** 0.06168

Teaching Status 0.20519** 0.08826

Constant -3.68544*** 1.19527 Observations (Number of Hospitals) R-squared 154 0.44
Notes: *** Significant at the 99% level, ** Significant at the 95% level, * Significant at the 90% level


### 1. The dependent variable is transformed in order to achieve an approximate normal distribution and diminish the differences in outliers in the da ta. We use the fourth root of total hazardous pharmaceutical waste generation. This is the first n th root that does not re ject the null hypothesis that the sample came from a normally distribu ted population using the Shapiro-Wilk test. The transformation of the data makes it more challe nging to interpret the magnitude of the resultant coefficients, but improves th e reliability and overall fit of the regression model. 2. Standard errors represent a measure of uncertainty associated with the precision of the regression coefficients. Standard errors can be used to construct confidence in tervals for the coefficients, which may vary depending on the level of significance de sired. For example, a 95% confidence interval for the natural log of revenue is calculated as approximately 0.24817±1.96×0.06168 or [0.12629,0.37004].


### 3. We use the natural log of revenue in order to ac hieve an approximate normal distribution and diminish the differences in outliers in the data.



## The R-squared value for the regression implies that th e hospital characteristics in Exhibit E-1 explain a non-trivial proportion, but not all, of the variation in hazardous waste generation. While this approach to estimating total hazardous waste generation was promisi ng, the results are considerably weaker for the generation of hazardous waste pharmaceuticals. This may be due to a significant number of hospitals generating zero or very low quantities of hazardous waste pharmaceuticals. Nearly a third of hospitals in the BR database report no hazardous pharmaceutical waste. In the regression, the R-squared value drops considerably when we use hazardous waste pharmac euticals generation as the dependent variable.
Considering the limitations of the regression-based approach, we instead use the series of “model hospitals” presented in Chapter 2 as the basis fo r estimating the generation of hazardous waste (pharmaceutical and total) among LQG hospitals.F-1 

## APPENDIX F. OCCURRENCE OF APIs IN FINISHED DRINKING WATER

Exhibit F-1is reproduced from Daughton (2010), Table I. See notes for full citation.

EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCEAlimentaryTract&Metabolism A01AB21 Chlortetracycline 57-62-5 ND (DL=5-150) (2)

A02BA02 Ranitidine 66357-35-5 ND (DL=0.01) (3)

A07AB03 Sulfaguanidine 57-67-0 ND (DL=5-75) (2)CardiovascularSystem: C03 Diuretics; C04 Peripheral Vasodilators; C07 BetaBlocking Agents; C08 Calcium Channel Blockers; C10Lipid ModifyingAgents C03AA03 Hydrochlorothiazide 58-93-5 0.8-117 [2.8] (RO DWTP) (4) 2.6-330 [7.1] (NF DWTP) (4)
C03CA01 Furosemide 54-31-9 ND (DL=4.30) (3)
C04AD03 Pentoxifylline 6493-05-6 ND (DL=5-60) (2) ND (DL=1) (5)
C07AA05 Propranolol 525-66-6 ND (DL=1.9; 3 tap water samples) (6)

C07AB02 Metoprolol 37350-58-6 up to 13.5 [2.6] (RO/NF DWTP) (4)

14-26 [20] (2 of 44 samples; 22 DWTPs over 2 years) (7)

C07AB03 Atenolol 29122-68-7 1.2 [18] (8 of 18 samples) 0.84 [0.47] (8 of 15 samples) (8)

[2.8] max=26 (11 of 20 DWTPs) (9) ND (RL=0.25) (10) ND (DL=0.05) (3)
C08CA05 Nifedipine 21829-25-4 ND (DL=15.5; 3 tap water samples) (6)

C08CA05
metabolite Dehydronifedipine (metabolite) 67035-22-7 2-6 (2 of 12 samples) (11) 4 (12)
C08DB01 Diltiazem 42399-41-7 ND (DL=13.0; 3 tap water samples) (6)

C09AA02 Enalapril 75847-73-3 ND (RL=0.25) (10)
C10AA01 Simvastatin 79902-63-9 ND (RL=1.0) (10)
C10AA01
metabolite Simvastatin hydroxy
acid 12009-77-6 (Na salt) ND (RL=0.25) (10)

C10AA05 Atorvastatin 134523-03-8 ND (RL=0.25) (10) ND (MRL=0.25) (18 samples) <MRL (15 samples) (8)

C10AA05
metabolite o -Hydroxy atorvastatin 214217-86-6 ND (MRL=0.50) (18 samples) <MRL (18 samples) (8)

C10AA05
metabolite p -Hydroxy atorvastatin 214217-88-6 (Ca-salt, acid form) ND (RL=0.50) (10) ND (MRL=0.50) (18 samples) <MRL (18 samples) (8)

C10AB01 Clofibrate 637-07-0 ND (DL=55) (13)
C10AB01
metabolite Clofibric acid 882-09-7 up to 170 (12 of 14 DWTPs) (14) 3.2-5.3 (1 of 3 DWTPs) (DL=1.50) (3)

up to 70 (16 of 30 samples) (DL=1) (15)F-2 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

up to 70 (16 of 25 samples) (DL=1) (16)

270 (14) 32 (17) 0.9-1.1 (2 of 4 samples) (18) >50, <100 (2 of 22 samples) (19) 13-136 [59] (3 of 44 samples; 22 DWTPs over 2 years) (7)

10-165 (64 of 64 tap water samples from Berlin) (1)

ND (DL=130) (13) ND (DL=3-90) (2) C10AB02 Bezafibrate 41859-67-0 27 (1 of 25 samples) (DL=25) (16) up to 14 (20) [0.7] max=1.9 (21) 13-20 [17] (2 of 44 samples; 22 DWTPs over 2 years) (7)

ND (DL=0.05) (3) ND (DL=3-90) (2) C10AB04 Gemfibrozil 25812-30-0 ND (RL=0.25) (10) 1.3-6.5 (5) 70 (1 of 10 DWTPs) (DL=3-90) (2) 2.4 (22) 2.1 [0.48] (7 of 18 samples) 1.2 [0.43] (4 of 15 samples) (8)

0.6-10.6 (5 of 5 DWTPs) (23) up to 3.0 (20) [0.4] max=0.8 (21) [1.0] max=2.0 (6 of 20 DWTPs) (9) >2.4, LOD (mean 3 tap water samples) (6)

ND (LOD=0.1; 6 tap water samples) (24)

C10AB05 Fenofibrate 49562-28-9 14-21 [18] (2 of 44 samples; 22 DWTPs over 2 years) (7)

C10AB05
metabolite Fenofibric acid 42017-89-0 42 (1 of 30 samples) (DL=5) (15)Dermatologicals: D01 Antifungals; D06Antibiotics &Chemotherapeutics; D08Antiseptics & Disinfectives D01AE12
S01BC08 Salicylic acid (also transformation product) 69-72-7 10-122 [39] (13 of 44 samples; 22 DWTPs over 2 years) (7)

4.2 (mean 3 tap water samples) (6)

D06AX02 (multiple) Chloramphenicol 56-75-7 12-13 [13] (2 of 44 samples; 22 DWTPs over 2 years) (7)

D08AE04 Triclosan 3380-34-5 734 (1 of 15 samples) (DL=125) (13) 43 (1 of 20 locales) (5) 1.2 (1 of 18 samples) <MRL (15 samples) (8) [1.1] max=1.2 (2 of 20 DWTPs) (9) ND (DL=1) (25) ND (RL=1.0) (10)F-3 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

ND (DL=2.4; 3 tap water samples) (6)

D08 (possible assignment) Triclocarban (Trichlorocarbanilide) 101-20-2 ND (DL= 10; samples from 12 DWTPs) (26)Genito Urinary System & Sex Hormones: G03 Sex Hormones &Modulators of the Genital System G03AC01 Norethisterone (Norethindrone) 68-22-4 ND (DL=10) (27)

G03BA03 Testosterone 58-22-0 ND (DL=1) (5) ND (MRL=0.50) (18 samples) <MRL (15 samples) (8)
G03CA01 17 α -Ethynylestradiol 57-63-6 0.15-0.50 (28) ND (DL=5) (27) ND (DL=1) (5) ND (MRL=1.0) (18 samples) <MRL (15 samples) (8) <90 (below LOQ; 12 tap water samples
over several months) (29)

ND (DL=4.8; 3 tap water samples) (6)

G03CA03 17 α -Estradiol 57-91-0 0.3 (28)
G03CA03 17 β -Estradiol 50-28-2 0.20-2.1 (28) >100 (below LOQ; 1 of 12 tap water samples over several months) (29)

ND (DL=1) (5) ND (MRL=0.50) (18 samples) <MRL (15 samples) (8) G03CA07 Estrone 53-16-7 1.1-2.3 (5)

0.2-0.6 (28)

1.7 (mean 3 tap water samples) (6)

1 (1 of 5 DWTPs; but not in raw water) (30)

ND (MRL=0.20) (18 samples) <MRL (15 samples) (8)

<70 (below LOQ; 2 of 12 tap water samples over several months) (29)

G03CA07
metabolite Estrone-3-sulfate 481-97-0 0.22 (post ozonation, but ND after GAC) (31)

G03DA04 Progesterone 57-83-0 1.1 (2 of 20 locales) (5)

0.57 (1 of 18 samples) <MRL (15 samples) (8)F-4 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

G03 Estrogens: Estradiol (E2) Estriol (E3) Estrone (E1) Estradiol-17-glucuronide

Estrone-3-sulfate

Estradiol-17-acetate Ethynylestradiol (EE2) Diethylstilbestrol (DES) ND (< LOQs):

<0.59

<1.02

<0.18

<1.02

<0.02

<0.23

<0.83

<0.21 (31)Antiinfectives for Systemic Use: J01 Antibacterials J01AA02 Doxycycline 564-25-0 ND (DL=50-150) (2)

J01AA06 Oxytetracycline 79-57-2 ND (DL=50-150) (2)
J01AA07 (multiple) Tetracycline 60-54-8 ND (DL=50-150) (2)

J01DD04 Ceftriaxone 73384-59-5 ND (DL=1.80) (3) J01EA01 Trimethoprim 738-70-5 1.3 (1 of 20 locales) (5) ND (RL=0.25) (10) ND (DL=5-60) (2) ND (MRL=0.25) (18 samples) <MRL (15 samples) (8)
J01EB02 (multiple) Sulfamethizole 144-82-1 9 (1 of 8 bottled waters) (32) ND (DL=5-75) (2)
J01EB03 Sulfamethazine (Sulfadimidine) 57-68-1 ND (DL=5-75) (2)

J01EB04 Sulfapyridine 144-83-2 ND (DL=5-75) (2)
J01EB05
S01AB02 Sulfisoxazole (Sulfafurazole) 127-69-5 ND (DL=5-75) (2)

J01EB07
D06BA02 Sulfathiazole 72-14-0 ND (DL=5-75) (2)

J01EB Sulfabenzamide 127-71-9 ND (DL=5-75) (2) J01EC01 Sulfamethoxazole 723-46-6 3.0-3.4 (2 of 3 DWTPs) (33) 13-80 (2 of 8 bottled waters) (32) 2 (after carbon sorption) (34) 14 (17) 20 (1 of 20 locales) (5) 3.0 [0.39] (4 of 18 samples) 0.32 (1 of 15 samples) (8)

0.3-0.5 (2 of 4 samples) (18) 2.0-5.0 (1 of 5 DWTPs) (23) [0.39] max=3.0 (3 of 20 DWTPs) (9)

<25 (2 of 22 samples) (19) 19-25 [22] (4 of 44 samples; 22 DWTPs over 2 years) (7)

ND (RL=0.25) (10) ND (DL=5-75) (2) ND (DL=10) (11)
J01EC02 Sulfadiazine 68-35-9 ND (DL=5-75) (2)
J01EC03 Sulfamoxole 729-99-7 ND (DL=5-75) (2)F-5 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

J01ED01 Sulfadimethoxine 122-11-2 11 (1 of 8 bottled waters) (32) 7.0 (1 of 5 DWTPs) (23) ND (DL=5-75) (2) ND (DL=10) (11)
J01ED04 Sulfameter (Sulfametoxydiazine) 651-06-9 ND (DL=5-75) (2)

J01ED05 Sulfamethoxy

pyridazine 80-35-3 ND (DL=5-75) (2)

J01ED07
D06BA06 Sulfamerazine 127-79-7 ND (DL=5-75) (2)

J01FA01 (multiple) Erythromycin 114-07-8 1.3 (5) 4.9 (1 of 3 DWTPs) (33) ND (DL=10) (11) ND (DL=0.03) (3)
J01FA01
metabolite Erythromycin-H20 114-07-8? ND (DL=10) (11)

J01FA02 Spiramycin 8025-81-8 ND (DL=0.75) (3)
J01FA05 Oleandomycin 3922-90-5 ND (DL=0.02) (3) J01FA06 Roxithromycin 80214-83-1 1.4 (1 of 3 DWTPs) (33) ND (DL=10-150) (2)
J01FF02 Lincomycin 154-21-2 ND (DL=0.02) (3) ND (DL=10) (11) J01MA01 Ofloxacin 82419-36-1 0.7-1.6 (2 of 4 samples) (18) ND (DL=20-100) (2)
J01MA06 Norfloxacin 70458-96-7 ND (DL=20-100) (2)
J01MB04 Pipemidic acid 51940-44-4 ND (DL=20-100) (2) J01MB05 Oxolinic acid 14698-29-4 2.9-4 (2 of 3 DWTPs) (33) ND (DL=20-100) (2) J01MB07 Flumequine 42835-25-6 1.2-2.5 (3 of 3 DWTPs) (33)
J01 Novobiocin 303-81-1 ND (DL=10-150) (2) J01 (misc) Sulfonamides (misc) c :
p -Toluenesulfonamide

o -Toluenesulfonamide
Benzenesulfonamide 70-55-3
88-19-7
98-10-2 up to (95-percentile): 240
160
60 (35)

Antibiotics Absence of 18 of 24 in three DWTPs (with all LODs 3 ng/L or lower, except for minocycline [LOD=6ng/L]). (33)

Survey of 28 antibiotics in Australia showed frequent occurrence in all waters (up to 64 μg/L in sewage influent) but absence of all 28 in drinking waters from 20 different sites (with LODs for 21 of the analytes being 20 ng/L or lower). (36)L01AntineoplasticAgents L01AA01 Cyclophosphamide 50-18-0 ND (DL=0.02) (3)

ND (DL=5-60) (2)F-6 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCEMusculo-skeletal System: M01 Antiinflammatory & Antirheumatic Products M01AB01 Indometacin (Indomethacin) 53-86-1 ND (DL=3-90) (2)

M01AB05 (multiple) Diclofenac 15307-86-5 up to 6 (8 of 30 samples) (DL=1) (15)

up to 6 (8 of 25 samples) (DL=1) (16)

up to 2.5 (6 tap

water samples) (24)

14-18 [16] (2 of 44 samples; 22 DWTPs over 2 years) (7)

ND (RL=0.25) (10) ND (MRL=0.25) (18 samples) ND (MRL=0.25) (15 samples) (8)

ND (DL=1) (5) ND (DL=3-90) (2) ND (DL=1.2; 3 tap water samples) (6)

M01AE01 Ibuprofen 15687-27-1 510-1,350 [930] (2 of 15 samples) (MDL=280) (13)

18-23 (37) up to 8.5 (38) up to 3 (3 of 30 samples) (DL=1) (15)

up to 3 (3 of 25 samples) (DL=1) (16)

2.7 (22) 1-32 (5) up to 39 (20) up to 112 (25) 2.2-3.0 (39) up to 0.6 (6 tap water samples) (24)

28 (1 of 44 samples; 22 DWTPs over 2 years) (7)

3.4 (mean 3 tap water samples) (6)

ND (DL=0.50) (3) ND (DL=3-90) (2)
M01AE01
metabolite Ibuprofen methyl ester 81576-55-8 4,950 (1 of 15 samples) (MDL=110) (13)

M01AE02
M02AA12 Naproxen 22204-53-1 up to 7.5 (38) 8 (5) 3.0 (1 of 5 DWTPs) (23) up to 1 (25) up to 0.2 (6 tap water samples) (24)

ND (DL=0.4) (40) ND (RL=0.50) (10) ND (MRL=0.50) (18 samples) <MRL (15 samples) (8)F-7 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

ND (DL=2.1; 3 tap water samples) (6)

M01AE03 Ketoprofen 22071-15-4 up to 3.0 (6 tap

water samples) (24)

ND (DL=3-90) (2) ND (DL=8) (38)
M01AE04 Fenoprofen 31879-05-7 ND (DL=3-90) (2) M01AG01 Mefenamic acid 61-68-7 up to 19.8 [0.9] (RO DWTP) (4) up to 19.9 [1.9] (NF DWTP) (4)Nervous System: N02 Analgesics; N03 Antiepileptics;N05 Psycholeptics; N06 Psychoanaleptics; N07 Other Nervous System Drugs N02BA01
A01AD05 Acetylsalicylic acid 50-78-2 >50 (17) >50, <100 (2 of 22 samples) (19) N02BB01 Phenazone (Antipyrine) 60-80-0 50 (1 of 12 samples) (DL=10) (15) 400 (41) 250 (42) 11-29 [21] (8 of 44 samples; 22 DWTPs over 2 years) (7)

N02BB04 Propyphenazone (Isopropyl-antipyrine ) 479-92-5 120 (41) 80 (42) N02BE01 Acetaminophen (Paracetamol) 103-90-2 0.3-3 (2 of 12 samples) (11) 1.1-1.3 [3 of 10 brands of bottled water] (43)

up to 210.1 (6 tap

water samples) (24)

33 (1 of 44 samples; 22 DWTPs over 2 years) (7)

N03AA03 Primidone (2- Deoxypheno

­ barbital) 125-33-7 up to 16 (44) 0.7-1.3 (4 of 4 samples) (45) N03AB02 Dilantin (Phenytoin) 57-41-0 1.1-1.2 (22) [1.3] (10) 1.6-13 (5) 19 [6.2] (10 of 18 samples) 16 [3.6] (10 of 15 samples) (8)

[9.4] max=32 (15 of 20 DWTPs) (9)

1-2 (3 of 4 samples) (45) N03AF01 Carbamazepine 298-46-4 0.3-2.0 (46) 258 max (12) 5.3-7.5 (37) 6.5-24 (3 of 10 DWTPs) (2) up to 20 ng/L (44) 2 (after ozonation) (34) 1.1-5.7 (5) [29] max=140 (12 of 12 samples) (11)

23 (17) 18 [6.0] (8 of 18 samples) 10 [6.8] (6 of 15 samples) (8)

0.8-135 (2 of 4 samples) (18) 2.0-7.0 (3 of 5 DWTPs) (23) 2.9-721 (20)F-8 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

[5.0] max=9.1 (21) up to 1.8 [1.2] (RO DWTP) (4) 0.5-5.7 [1.0] (NF DWTP) (4) [5.4] max=18 (12 of 20 DWTPs) (9)

up to 43.2 (6 tap

water samples) (24)

10-25 [17] (4 of 44 samples; 22 DWTPs over 2 years) (7)

>0.7, LOD (3 tap water samples) (6)

ND (RL=0.50) (10) 30 (1 of 12 samples) (DL=10) (15) <25 (1 of 22 samples) (19)
N03AF01
metabolite 10,11-Dihydroxy

­ 10,11- dihydro

­ carbamazepine 125-28-0 up to 13 (44)

N05AX08 Risperidone 106266-06-2 ND (MRL=2.5) (18 samples) 2.9 (1 of 15 samples) (8)

ND (RL=0.25) (10) N05BA01 Diazepam 439-14-5 0.33 [0.33] (1 of 18 samples) <MRL (15 samples) (8) 19.3-23.5 (1 of 3 DWTPs) (DL=0.02) (3)

ND (RL=0.25) (10) ND (DL=1) (5) ND (LOD=0.4; 6 tap water samples) (24)

N05BA16 Nordazepam 1088-11-5 ND (LOD=0.4; 6 tap water samples) (24)

N05BC01 Meprobamate (also a metabolite of the prodrug carisoprodol) 57-53-4 1.6-13 (5) [5.9] (10) 6.5-8 (22) 42 [5.7] (14 of 18 samples) 40 [5.2] (11 of 15 samples) (8)

[9.2] max=43 (17 of 20 DWTPs) (9)

6.3-9.4 (4 of 4 samples) (45)
N06AA02 Imipramine 50-49-7 ND (LOD=0.7; 6 tap water samples) (24)

N06AA09 Amitriptyline 50-48-6 up to 1.4 (6 tap

water samples) (24)

N06AA12 Doxepin 1668-19-5 ND (LOD=0.7; 6 tap water samples) (24)

N06AB03 Fluoxetine 54910-89-3 0.82 [0.71] (2 of 18 samples) 0.64 (1 of 15 samples) (8)

1.0 (1 of 5 DWTPs) (23) 10 (1 of 44 samples; 22 DWTPs over 2 years) (7)

ND (DL=1) (5) ND (DL=14) (11) ND (DL=5-60) (2)F-9 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

ND (RL=0.50) (10)
N06AB03
metabolite Norfluoxetine 56161-73-0 ND (RL=0.50) (10) ND (DL=5-60) (2) ND (MRL=0.50) (18 samples) 0.77 (1 of 15 samples) (8)

N07BC02 Methadone 76-99-3 0.1-2.6 (47)
N07BC02
metabolite EDDP (methadone metabolite) [2-Ethylidene-1,5

­ dimethyl-3,3

­ diphenylpyrrolidine] 30223-73-5 1.7-4.7 (47)Veterinary: QJ01Antibacterials for SystemicUse; QP51 Antiprotozoals QJ01EQ08 Sulfaphenazole 526-08-9 ND (DL=5-75) (2) QJ01EQ12 Sulfachlorpyridazine 80-32-0 ND (DL=5-75) (2) QJ01FA90 Tylosin 1401-69-0 0.6-1.7 (1 of 3 DWTPs) (DL=0.25) (3)

4.2 (1 of 3 DWTPs) (33) QJ01FA91 Tilmicosin 108050-54-0 ND (DL=0.75) (3) QP51AG03 Sulfaquinoxaline 59-40-5 ND (DL=5-75) (2) QP51AH03 Monensin 17090-79-8 0.1-2.8 (3 of 5 DWTPs) (23)RespiratorySystem:R03ObstructiveAirwayDiseases R03AC02 Albuterol (Salbutamol) 18559-94-9 ND (DL=0.02) (3)

ND (6 tap water samples) (24)

R03AC03 Terbutaline 23031-25-6 ND (6 tap water samples) (24)
R03AC14
R03AC13 Clenbuterol ND (LOD=0.6; 6 tap water samples) (24)SensoryOrgans: S01Ophthalmologicals S01AB04 Sulfacetamine (Sulfacetamide) 144-80-9 ND (DL=5-75) (33) (2)Various: V08 Contrast Media V08AA01 Diatrizoate (Diatrizoic acid; Amidotrizoic acid) 117-96-4 85 max [21] (5 of 10 samples) (DL=10) (15)

32 (34) 60 (48) 18-100 (3 of 3 DWTPs) (30) 129-149 (49)
V08AA04 Iotalamic acid (Iothalamic acid) 2276-90-6 10 (48) ND (DL=4) (34) V08AA05 Ioxitalamic acid 28179-44-4 12 (34) ND (4 of 4 DWTPs) (DL=25) (30)
V08AB02 Iohexol 66108-95-0 57 (1 of 44 samples; 22 DWTPs over 2 years) (7)

38-40 (49)
Iohexol
transformation product 83 (50)

V08AB04 Iopamidol 60166-93-0
62883-00-5 244 (50) up to 79 (4 of 10 samples) (15)F-10 EXHIBIT F-1. COMPILATION OF PUBLISHED POSI TIVE OCCURRENCE DATA FOR APIs IN FINISHED DRINKING WATER (AND SELECT DATA ON NEGATIVE OCCURRENCE – INDICATED BY SHADED CELLS)

ATC NAME a ATC CODE a API (SYNONYM) CAS RN FINISHED DRINKING WATER,

NG/L [MEDIAN] b DISTRIBUTION WATER (NG/L) REFERENCE

(DL=10) 60 (34) 70 (48) 180 (1 of 4 DWTPs) (DL=25) (30) 72-98 (49) Iopamidol
transformation product 57 (50)

V08AB05 Iopromide 73334-07-3 up to 177 (37) 86 (1 of 10 samples) (DL=10) (15) 1.1-31 (5) 4.6 (22) 40 (48) 33-36 [35] (2 of 44 samples; 22 DWTPs over 2 years) (7)

29 (1 of 4 DWTPs) (DL=10) (30) 69-77 (49) ND (DL=4) (34)
V08AB10 Iomeprol 78649-41-9 11 (34) 81-92 (49) 12 (1 of 4 DWTPs) (DL=10) (30) Iomeprol
transformation product 18 and 289 (50)Schedule I & II ControlledSubstances illicit (also: N01BC01) (multiple) Cocaine 50-36-2 ND (after ozonation & GAC) (LOD <80 pg/L) (51)

illicit (also: N01BC01) (metabolite) Benzoylecgonine (primary metabolite of cocaine) 519-09-5 [45] with max of 130 (22 of 24 samples (51)

illicit MDMA (ecstasy: 3,4

­ methylenedioxy

methamphetamine) 69610-10-2 2-10 (after ozonation & GAC) ND (after post-chlorination) (51)

Notes:

a. ATC/DDD Index (Anatomical Therapeutic Chemical) cl assification system: 

### http://www.whocc.no/atcddd/ ; AT vet Index: 

### http://www.whocc.no/atcvet/database/index.php

. b. DL: detection limit; GAC: granular activated carbon; LOD: limi t of quantitation; max: maximum va lue in range; NF: nanofiltratio n; ND: not detected (less than DL or RL); (M)RL: (metho d) reporting limit; RO: reverse osmosis.

c. Richter et al. (67) provide an overview of the work done in Germany since the 1990s on a series of sulfonamides [p

­ toluenesulfonamide (pTSA), o-toluenesulfonamide (o-TSA), and benz enesulfonamide (BSA)], which ha ve had a steady presence in certain areas such as Be rlin, which rely on ground waters recharged by rivers; their concentrations in ground waters reach up into the low μg/L range. The sources of these sulfonamides in the environment are not solely from antimicrobia ls (e.g., p-TSA is the primary de gradation product of the disin fectant chloramine-T), as they also have a wide variety of other non- pharmaceutical uses. Richter et al. (67) provide some of the only data on finished drinking water for p-TSA, o-TSA, and BSA, which are detected at ng/L concentrations (95th percentile) up to 240, 160, and 60, r espectively.

Source: Daughton CG "Pharmaceutical Ingredients in Drinking Wate r: Overview of Occurrence and Si gnificance of Human Exposure," In: Contaminants of Emerging Concern in the En vironment: Ecological and Hu man Health Considerations, Ro lf Halden (Ed.), ACS Symposi um Series 1048, American Chemical Society: Washington, D.C., Chapter 2, p 9-68, 2 November 2010; DOI: 10.1021/bk-2010-1048.ch002; pre-pub lication
version: http://www.epa.gov/esd/bios/d aughton/ACS-SS1048-2010.pdf

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