United States
Environmental Protection Agency



### FINAL Draft March 2 9 , 2016



# 2015 2017
Hazardous Waste Report

Instructions and Form

EPA Form 8700

- 1 3 A/B

(OMB #2050

- 0024; Expires ?? / ?? / ??? )

### Office of Resource Conservation and Recovery (ORCR) (5303P) Washington, DC 20460

2015 2017 Hazardous Waste Report
Instructions and Form

This is an ongoing information collection from hazardous waste generators and hazardous waste treatment, storage, or disposal
facilities. This collection is done on a two

- year cycle as required by Sections 3002 and 3004 of the Resource Conservation and Re covery Act (RCRA). The information is collected via a mechanism known as the Hazardous Waste Report for the required reporting year [EPA

Form 8700

- 13 A/B] (also known as the “ Biennial Report ” ). Both RCRA Sections 3002 and 3004 require the U.S. Environmen tal Protection Agency ( EPA ) to establish standards for recordkeeping and reporting of hazardous waste. Section 3002 applies to hazardous waste generators and Section 3004 applies to hazardous waste treatment, storage, and disposal facilities. The impleme nting regulations are found at 40 CFR 262.40(b) and (d); 262.41(a)(1)

- (5), (a)(8), and (b); 264

. 75(a)

- (e) and (j); 265.75(a)

- (e) and (j); and 270.30(1)(9). This is mandatory reporting by the respondents.

The respondents’ submissions (reports) describe eac h generated hazardous waste, the activity by which they generated the wastes, and the waste quantity; the reports also list the management method by which each waste is treated, recycled, or disposed

, and the quantity managed. There are a number of uses o f Biennial Report data. The EPA uses Biennial Report data for planning and developing regulations, compliance monitoring, and enforcement. Also, Biennial Report data allow the Agency to determine whether its regulations are having the desired effect on t he generation and management of hazardous waste. For example, Biennial Report data provide information on whether waste management has shifted from one method of disposal to another. Some State uses of Biennial Report data include support of planning, fe e assessment, compliance monitoring, and enforcement.

Some businesses consider some of their hazardous waste information to be Confidential Business Information (CBI). A business may, if it desires, protect its Biennial Report information from public disc losure by asserting a claim of confidentiality covering all or part of its information. When a claim is made, the EPA will treat the information in accordance with the confidentiality regulations in 40 CFR Part 2, Subpart B. The EPA also ensures that the information collection procedures comply with the Privacy Act of 1974 and OMB
Circular 108.

Estimated Burden : The reporting burden for the 2015 2017 Hazardous Waste Report is estimated to average 14 hours for a facility to gather data, complete and review the forms, and su bmit the Hazardous Waste Report. The recordkeeping burden is estimated to average 5 hours for a facility to read the instructions, and file and store the Hazardous Waste Report submissio n for three years

.

To comment on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggested method s for minimizing respondent burden, including the use of automated collection techniques, the EPA has establishe d a public docket for the Information Collection Request (ICR) under Docket ID Number EPA

- HQ

- OLEM

– 201 6

– 0 182 , which is available for public viewing at the RCRA Docket in the EPA Docket Center (EPA/DC), EPA West, Room 3334, 1301 Constitution Ave., NW, Washin gton , D.C. The EPA Docket Center Public Reading Room is open from 8:30 a.m. to 4:30 p.m., Monday through Friday, excluding legal holidays. The telephone number for the Reading Room is (202) 566

- 1744 and the telephone number for the RCRA Docket is (202) 566

- 0 270. An electronic version of the public docket is available through EPA Dockets (EDOCKET) at http://www.epa.gov/dockets/regulations.htm

. Use EDOCKET to submit or view public comments, acces s the index listing of the contents of the public docket, and to access those documents in the public docket that are available electronically. Once in the system, select “search,” then key in the docket ID number identified above. Also, you can send com ments to the Office of Information and Regulatory Affairs, Office of Management and Budget,

725 17 th Street, NW, Washington, D.C. 20503, Attention: Desk Office for EPA. Please include the EPA Docket ID Number EPA

- HQ

OLEM

– 2016

– 0182 and OMB Control Number 2 050

- 0024 in any correspondence.1 

## TABLE OF CONTENTS

Table of Contents

................................ ................................ ................................ ................................ ................... 1

Introduction

................................ ................................ ................................ ................................ ............................... 5
What’s New

................................ ................................ ................................ ................................ ............................... 6

Who Must File the 2017 Hazardous Waste Report

................................ ................................ ................................ . 8

Who Is Required to File the Hazardous Waste Report

................................ ................................ .............................. 8

SITES THAT SHOULD NOT FILE THE HAZARDOUS WASTE REPORT

................................ ................................ ............ 9

State

- specific Requirements

................................ ................................ ................................ ................................ ...... 9

Instructions for Filing the 2017 Hazardous Waste Report

................................ ................................ .................... 10

Introduction

................................ ................................ ................................ ................................ ............................. 10 Authority

................................ ................................ ................................ ................................ ................................ .. 10 Overview of the 2017 Hazardous Waste Report

................................ ................................ ................................ ..... 10 When and Where to Send Your Completed Report

................................ ................................ ................................ 11 Which Forms to Submit and What to Report

................................ ................................ ................................ .......... 11 Filling Out the Forms

................................ ................................ ................................ ................................ ............... 13

Contacts for Assistance

................................ ................................ ................................ ................................ ........ 13

Copies of Hazardous Waste Report Instructions and Forms

................................ ................................ ............... 13

Documents Helpful in Filling Out the Forms

................................ ................................ ................................ ........ 13

Code Lists

................................ ................................ ................................ ................................ ............................. 13

Alphanumeric Field s

................................ ................................ ................................ ................................ ............ 14

Right Justification of Quantities

................................ ................................ ................................ ........................... 14

Comments Section of Forms

................................ ................................ ................................ ................................ 14

Page Numbering of Forms

................................ ................................ ................................ ................................ ... 15

Photocopies of form

................................ ................................ ................................ ................................ ............ 15

Electron ic Reporting

................................ ................................ ................................ ................................ ............ 15

Confidential Business Information (CBI)

................................ ................................ ................................ .............. 15

Instructions for Filling Out the RCRA Subtitle C Site Identification Form (Site ID Form)

................................ ....... 17

Who Must Submit this Form

................................ ................................ ................................ ................................ ... 17

Pu rpose of this Form

................................ ................................ ................................ ................................ ............... 17
How to Fill Out this Form

................................ ................................ ................................ ................................ ......... 17

Item

- By

- Item Instructions

................................ ................................ ................................ ................................ ........ 18

Item 1

– Reason for Submittal

................................ ................................ ................................ ............................. 18

Item 2

– Site EPA Id Number

................................ ................................ ................................ ............................... 202 Item 3 and 4

– Site Name and Location

................................ ................................ ................................ ............... 20

Item 5

– Site Land Type

................................ ................................ ................................ ................................ ....... 21

Item 6

– North American Industry Classification System (NAICS) Code(s)

................................ .......................... 21

Item 7

– Site Mailing Address

................................ ................................ ................................ .............................. 22

Item 8

– Site Contact Person

................................ ................................ ................................ ............................... 22

Item 9

– Legal Owner and Operator of the Site

................................ ................................ ................................ ... 22

Item 10

– Type of Regulated Waste Activity

................................ ................................ ................................ ........ 24

Item 11

– Description of Hazardous Wastes

................................ ................................ ................................ ....... 32

Item 12

– Notification of Hazardous Secondary Material (HSM) Activity

................................ ........................... 33

Item 13

– Comments

................................ ................................ ................................ ................................ ........... 33

Item 14

– Certification

................................ ................................ ................................ ................................ ......... 34

Addendum to the Site Identification Form: Notification of Hazardous Secondary Material Activity

................... 35

You Must Fill Out this Section if:

................................ ................................ ................................ ............................. 35

Item 1

– Indicate Reason for Notification (include dates where requested)

................................ ....................... 36

Item 2

– Description of Excluded Hazardous Sec ondary Material (HSM) Activity

................................ ............... 37

Item 3

– Facility has Financial Assurance Pursuant to 40 CFR 261.4(a)(24)(vi)

................................ ................... 40

Instructions for Filling Out the Waste Generation and Management Form (GM Form)

................................ ....... 41

Who Must Submit this Form

................................ ................................ ................................ ................................ ... 41

Pu rpose of this Form

................................ ................................ ................................ ................................ ............... 41
How to Fill Out this Form

................................ ................................ ................................ ................................ ......... 41

Wastes to be Reported

................................ ................................ ................................ ................................ ............ 42 Wastes not to be Reported

................................ ................................ ................................ ................................ ..... 43

HO W TO REPORT SIMIMILAR WASTEREPORTING SIMILAR HAZARDOUS WASTE ON THE GM FORM

.................... 45

Item

- By

- Item Instructions

................................ ................................ ................................ ................................ ........ 45

Section 1

– Waste Characteristics

................................ ................................ ................................ ........................ 45

Item A

– Waste Description

................................ ................................ ................................ ................................ . 45

It em B

– EPA Hazardous Waste Code(s)

................................ ................................ ................................ .............. 46

Item C

– State Hazardous Waste Code(s)

................................ ................................ ................................ ............ 46

Item D

– Source Code and Management Method Code for Source Code G25

................................ .................... 46

Item E

– Form Code

................................ ................................ ................................ ................................ ............. 473 Item F

– Q uantity Generated in 2017 / UOM and Density

................................ ................................ .................. 47

Item G

– Waste Minimization Code

................................ ................................ ................................ ..................... 48

Section 2

– On

- site Generation and Management of Hazardous Waste During 2017

................................ ........ 49

Was any of this wAste that was generated at this facility treated, disposed, and/or recycled on

- site?

............ 49

On

- Site Management Method Code

................................ ................................ ................................ ................... 49

Quantity Treated, Disposed, or Recycled On

- site in 2017

................................ ................................ ................... 51

Section 3

– Off

- site Shipment of Hazardous Waste

................................ ................................ ............................. 51

Item A

– Was any of this Waste Shipped Off

- site in 2017 for Treatment, Disposal, or Recycling?

..................... 51

Item B

– EPA ID Number of Facility to which Waste was Shipped

................................ ................................ ...... 51

Item C

– Off

- site Management Method Code Shipped To

................................ ................................ .................. 52

Item D

– Total Quantity Shipped in 2017

................................ ................................ ................................ ............ 52

Comments

................................ ................................ ................................ ................................ ............................ 52

Instructions for Filling Out the WAste RECEIVED FROM Off

- site Form (WR Form)

................................ ............... 53

Who Must Submit this Form

................................ ................................ ................................ ................................ ... 53

Pu rpose of this Form

................................ ................................ ................................ ................................ ............... 53
How to Fill Out this Form

................................ ................................ ................................ ................................ ......... 53

Item

- By

- Item Instructions

................................ ................................ ................................ ................................ ........ 54

Item A

– Waste Description

................................ ................................ ................................ ................................ . 54

It em B

– EPA Hazardous Waste Code(s)

................................ ................................ ................................ .............. 54

Item C

– State Hazardous Waste Code(s)

................................ ................................ ................................ ............ 55

Item D

– Off

- site Handler EPA Identification Number

................................ ................................ ......................... 55

Item E

– Quantity Received in 2017

................................ ................................ ................................ ..................... 55

Item F

– UOM and Density

................................ ................................ ................................ ................................ ... 56

Item G

– Form Code

................................ ................................ ................................ ................................ ............. 56

Item H

– Management Method Code

................................ ................................ ................................ .................. 57

Comments

................................ ................................ ................................ ................................ ............................ 57

OTHER REFERENCE INFORMATION

................................ ................................ ................................ ...................... 58

AND

................................ ................................ ................................ ................................ ................................ ..... 58

CODE LISTS

................................ ................................ ................................ ................................ ........................... 584 Excluded Wastes

................................ ................................ ................................ ................................ .................. 59

Definitions

................................ ................................ ................................ ................................ ........................... 61

Special Instruct ions

................................ ................................ ................................ ................................ .............. 71

EPA Hazardous Waste Codes

................................ ................................ ................................ ............................... 75

Ha zardous Secondary Material (HSM) Facility Codes

................................ ................................ ........................... 76

Hazardous Secondary Material (HSM) Land

- Based Unit Codes

................................ ................................ ............ 79

Source Codes

................................ ................................ ................................ ................................ ....................... 80

Form C odes

................................ ................................ ................................ ................................ .......................... 82

Management Method Codes

................................ ................................ ................................ ............................... 84

Waste Minimization Codes

................................ ................................ ................................ ................................ .. 85

INST RUCTIONS FOR FILLING OUT THE OI FORM

– OFF

- SITE IDENTIFICATION

................................ ..................... 100

Who Must Submit this Form

................................ ................................ ................................ ................................ . 100 Purpose of this Form

................................ ................................ ................................ ................................ ............. 100

How to Fill Out this Form

................................ ................................ ................................ ................................ ....... 100

Item

- By

- Item Instructions

................................ ................................ ................................ ................................ ...... 100

Item A

– EPA ID No. of Off

- site Installation or Transporter

................................ ................................ ............... 101

Item B

– Name of Off

- Site Installation or Transporter

................................ ................................ ...................... 101

Item C

– Handler Type

................................ ................................ ................................ ................................ ....... 101

Item D

– Address of Off

- site Installation

................................ ................................ ................................ ........... 1015 

## The 2015 2017 Hazardous Waste Report

INTRODUCTION

The U.S. Environmental Protection Agency’s (EPA ’s ) mission to protect human health and the environment includes the responsibility to effectively manage, with the States, the nation’s hazardous waste. As part
of this task, the EPA and the States collect and maintain information about the generation, management, and final disposition of the nation’s hazardous waste regulated by the Resource Conservation and Recovery Act (RCRA).

The EPA prepared this booklet for hazardous waste generators and for facilities that treat, store, or dispose hazardous waste to report their hazardous waste activities for calendar year 2015 2017 . The
information collected will:

• Provide the EPA and the St ates with an understanding of hazardous waste generation and management in the U.S

.

• Help the EPA measure the quality of the environment, such as monitoring industry compliance with the regulations and evaluating waste minimization efforts taken by indust ry.

• Be summarized and communicated to the public, primarily through publication of the 2015 2017 National Biennial RCRA Hazardous Waste Report.

The data you provide will be entered into a computer database by the State or the EPA Regional Office to which y ou return your Hazardous Waste Report. After review, to ensure the quality of the data, the EPA will create a national database for this information. Your efforts in carefully filling out all the report forms are appreciated.

IMPORTANT

Before completing the 2015 2017 Hazardous Waste Report forms, please carefully read the

instructions in this booklet.

IF YOU NEED ASSISTANCE

To obtain assistance in filling out the 2015 2017 Hazardous Waste Report forms, please contact your
State Office. Some States’ report ing requirements differ from the Federal requirements. The list of State and EPA Regional Office addresses, contact names, telephone numbers, and e

- mail addresses

is located at: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.The 2015 2017 Hazardous Waste Report (continued)

6 

### WHAT’S NEW

Below is a list of changes to the 2015 2017 Hazardous Waste Report Instructions and Forms.

UPDATED TO REFLECT 2 015 DEFINITION OF SO LID WASTE FINAL RULE

On January 13, 2015, EPA published the Definition of Solid Waste (DSW) final rule (80 FR 1694), which revised the regulations related to certain exclusions from solid and hazardous waste regulation. Changes have been made to the Site ID form, particularly to the Addendum to the Site ID Form, to reflect this final
rule.

OTHER CHANGES

1) Changes were made to the list of Excluded Wastes, and Hazardous Secondary Material (HSM) Facility Codes; 2) New fields added to Site ID: Owner: Added telephone number, extension , and notes field and Operator: Added address, telephone number, extension, and notes field;

HSM Addendum: removed Financial Assurance question.

CLARIFICATION FOR IM PORT AND EXPORT SHIP MENTS; USE FOREIGN S ITE IDENTIFICATION

NUMBER CODES O THER CHANGES

CLAR IFIED THE DEFINITION OF LARGE QUANTITY GE NERATOR (LQG) CLARIFICATION FOR

IMPORT AND EXPORT SHIPMENTS; USE FOREIGN SITE INDETIF ICATION IDENTIFICATION

NUMBER CODES

Beginning with the 2017 Hazardous Waste R eport, EPA is implementing site

- specific unique Foreign Site
Identification Numbers for use in reporting foreign handlers on GM

, and WR , and OI Forms

. This is occurring so that a more complete picture of waste generation and management is available nationwide
in the BR database

. See Special Instructi on for “Waste Received from Foreign Countries”.

There is a federal requirement under 40 CFR §§ 264.75 and 265.75 for TSDFs and/or the 40 CFR § 262.41
for importers complying with generator requirements (or equivalent authorized state requirements).

Although current RCRA regulations do not specifically define the term “large quantity generator” (LQG), they do define the terms “conditionally exempt small quantity generator” (CESQG) and “small quantity generator “(SQG). Thus, a LQG is a generator that is not a CESQG or SQG. For purposes of clarity, the definition of LQG has been revised to describe all those situations where a generator would be a LQG

.

CLARIFIED THE DEFINI TION OF SMALL QUANTI TY GENERATOR (SQG)

A SQG is defined at 40 CFR 260.10 as a s ite that generates less than 1,000 kilograms ( kg; 2,200 pounds [ lbs ] ) of hazardous waste in a calendar month. However, there are other situations where a generator could generate small amounts of acute hazardous waste listed in sections 261.31 or 261.33(e); and anyThe 2015 2017 Hazardous Waste Report (continued)

7 

### residues or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous w astes listed in sections 261.31 or 261.33(e) and still maintain its regulatory status as a SQG. Therefore, for purposes of clarity, the definition of SQG has been revised to describe all those situations where a generator would continue to be a SQG . The EPA plans to make the appropriate conforming change to the outdated definition of SQG at 40 CFR 260.10 in the future.

CLARIFIED THE DEFINI TION OF CONDITIONALL Y EXEMPT SMALL QUANT ITY GENERATOR (CESQG)

A C ESQG is defined at 40 CFR 261.5 (a) as a site that generates less than or equal to 100 kg (220 lbs) o f
hazardous waste in a calendar month . However, as found in 40 CFR 261.5(e), a generator also may generate small amounts of acute hazardous waste listed in sections 261.31 or 261.33(e); and any residues or contaminated soil, waste, or other debris resulting from the clean up of a spill, into or on any land or water, of any acute hazardous wastes listed in sections 261.31, or 261. 33(e) and still maintain its regulatory status as a CESQG. Therefore, for purposes of clarity, the definition of CESQG has been revised
to describ e all those situations where a generator would continue to be a CESQG.Who Must File the 2015 2017 Hazardous Waste Report (continued)

8 

## WHO MUST FILE THE 2015 2017 HAZARDOUS WASTE REPO RT

W HO I S REQUIRED TO FILE THE HAZARDOUS WASTE R E PORT

You are required by Federal statute (mandatory reporting) to complete and file the 2015 2017 Hazardous Waste Report (also known as the “Biennial Report”) or your State’s equivalent hazardous waste report if

you:

• Met the definition (see box below) of a RCRA Large Quantity Generator (LQG) during 2015 2017 ;

or

• Treated, stored, or disposed of RCRA hazardous wastes on

- site during 2015 2017

. If you are required to report, see “ WHICH FO RMS TO SUBMIT AND WHAT TO REPORT ” to determine which forms you must submit.

DEFINITION OF A RCRA LARGE QUANTITY GENERATOR FOR PURPOSES OF REPORTING

WHO MUST REPORT FOR CALENDAR YEAR 2015 2017

You are a RCRA LQG for 2015 2017 if you, by site

, generate any of the following amounts in a calendar
month : ( i ) G reater than or equal to 1

, 000 kilograms ( kg; 2

, 200 pounds [ lbs ] ) of hazardous waste ; or ( ii ) G reater than 1 k g (2.2 lbs ) of any acute hazardous wastes listed in sections 261.31 or 261.33(e) ; or ( iii ) G reater than 100 k g (220 lbs ) of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes listed in

sections 261.31 or 261.33(e)

.

Note: Although current RCRA regulations do not specifically define the term “ large quantity generator ” (LQG), they do define the terms “ conditionally exempt small quantity generator ” (CESQG) and “ small quantity generator “ (SQG). Thus, a LQG is a generator that is not a CESQG or SQG. F or purposes of clarity,

we describe above the situations when a site would be a LQG.

Also, you may be a CESQG or SQG (d efined below) and generate excess amounts of either acute hazardous waste or residue or contaminated soil containing acute haz ardous wastes such that you become a LQG for
the calendar month. In this case, you also would need to complete a Hazardous Waste Report.

Note: You will report your current Hazardous Waste Generator status as of the date of submitting your

2015 2017 Hazardous W aste Report on the Site ID Form in Item 10.A.1

– Generator of Hazardous Waste. Your current status may be different from the status during the report year that requires you to file the Hazardous Waste Report.

Note: Hazardous waste imported f rom a foreign a site located in a foreign country in 2015 2017 must be counted in determining your generator status if your site is the U.S. Importer. This waste must be reported
on the Waste Generation and Management Form (GM Form) and/ or the Waste Receive d F rom Off

- site Form (WR Form) in your 2015 2017 Hazardous Waste Report.Who Must File the 2015 2017 Hazardous Waste Report (continued)

9 

### Note: Some States, as a matter of S tate law, require other categories of generators to report as well

. See
the discussion under “ STATE

- SPECIFIC REQUIREMENTS

. ”

SITES THAT SHOULD NO T FILE THE HAZARDOUS WASTE REPORT

Do not file the 2015 2017 Hazardous Waste Report if, during 2015 2017 , your site was not a RCRA LQG (your site did not meet any of the LQG criteria) and your site did not treat, store, or dispose of RCRA
hazardous wastes on

- site in waste management units subject to a RCRA operating permit. Exception: File the report if your State has more stringent reporting requirements. See “ STATE

- SPECIFIC
REQUIREMENTS ” below.

If you are not required to report, you should notify us if your hazardous waste generator status has changed; please fill out the RCRA Subtitle C Site Identification Form (Site ID Form) and submit it to your
State Office. See the “ ITEM

- BY

- ITEM INSTRUCTIONS ” for information on filling out the Site ID Form. Place an “X” in the box for Subsequent Notification in Item 1

– Reason for Submittal.

Unless requi red by your State, you are not required to submit the 201 5 7 Hazardous Waste Report if, during 201 5 7 , all of your hazardous waste was exported directly out of the U.S. to a foreign country site located in a foreign country

. Facilities that export hazardous waste must file a separate Annual Report under 40 CFR 262.56. (This Annual Report will be in addition to the biennial Hazardous Waste Report, if your State requires you to submit a Hazardous Waste Report.)

STATE

- SPECIFIC REQUIREMEN TS

States may impose reporting requirements above and beyond the Federal requirements. If your State does so, it will attach information to (or delete information from) this booklet. Alternatively, some
States use a modified version of this report or the ir own instructions and forms to fulfill their reporting
requirements. Please contact your State office about State

- specific requirements. See the contacts list

at: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

10 

## INSTRUCTIONS FOR FIL ING THE 2015 2017 HAZARDOUS WASTE REPO RT

INTRODUCTION

The instructions and forms for the 2015 2017 Hazardous Waste Report are prepared by the U.S. Environmental Protection Agency (EPA) for generators and for treatment, storage, and disposal facilities (TSDFs) to report their hazardous waste activities for 2015 2017 . Additionally, facilities may use this Hazardous Waste Report to notify their regulatory authority that they are managing hazardous secondary
material under 40 CFR 261.2(a)(2)(ii) 260.30(a) , 40 CFR 261.4(a)(23), (24), or ( 25 ) (27) (these facilities

w ould notify using the RCRA Subtitle C Site Identification Form and Addendum to the Site Identification Form).

AUTHORITY

The authority for the 2015 2017 Hazardous Waste Report is contained in Sections 3002 and 3004 of the Resource Conservation and Recovery Act of 1976 (RCRA), as amended by the Hazardous and Solid Waste Amendments of 1984 (HSWA). Section 3002 requires hazardous waste generators to report to the EPA or the authorized States, at least every two years, the quantities, nature, and disposition of generated hazardous waste. Under the authority of Section 3004, the EPA requires reporting by TSDFs for the wastes they receive.

OVERVIEW OF THE 2015 2017 HAZARDOUS WASTE REPO RT

To determine if you are required to file the Hazardous Waste Report, read “ WHO MUST FILE THE

2015 2017 HAZARDOUS WASTE REPORT

. ”

“ WHICH FORMS TO SUBMIT AND WHAT TO REPORT ” describes circumstances and situations under which each of the forms should be completed.

“ FILLING OUT THE FORMS ” provides general guidelines for filling out the Hazardous Waste Report forms. This includes where to find the telephone number for the State Contacts, which you can call with questions about comp leting the Hazardous Waste Report.

Detailed instructions for filling out each of the forms are provided. Other reference information and code lists are provided, including: a list of excluded wastes; definitions of key terms; special instructions that

ex plains how to report certain types of wastes (e.g., lab packs, PCBs); a list of hazardous waste codes, hazardous secondary material facility codes, hazardous secondary material land

- based unit codes, source codes, form codes, management method codes, and w aste minimization codes.Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

11 

### WHEN AND WHERE TO SE ND YOUR COMPLETED RE PORT

The 2015 2017 Hazardous Waste Report is due to your State or EPA Regional Office by March 1, 201 6

2018 or the next business day if March 1 falls on a weekend . Return your completed Hazardous Waste Report to the address listed for your State or Regional contact. See the additional information sent to
you with this booklet. An updated listing of State and EPA Regional mailing addresses, contact names,
telepho ne numbers, and e

- mail addresses is maintained at: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.

WHICH FORMS TO SUBMI T AND WHAT TO REPORT

The 2015 2017 Hazardous Waste Report contains the following four forms:

SITE ID FORM

A site required to file the 2015 2017 Hazardous Waste Report MUST submit the RCRA Subtitle C Site Identification Form (Site ID Form) as a component of the Report.

You will report that you are submitting the Site ID F orm as part of the 2015 2017 Hazardous Waste Report

in Item 1

– Reason for Submittal. Mark “As a component of the Hazardous Waste Report (If marked, see
sub

- bullet below)” and mark the sub

- bulle t, if the status is applicable to you during the 2015 2017 reporting year.

You will fill out the Site ID F orm by reporting all information current as of the date of submitting your

2015 2017 Hazardous Waste Report. This includes reporting your current Hazardous Waste Generator status in Item 10.A.1 (Generator of Hazardous Waste), which may have changed since 2015 2017

.

• Facilities that will begin managing, are managing, or will stop managing hazardous secondary
material under 40 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24), or (25) (27)

, must submit the
Addendum to the Site Identification Form as a component of the Hazardous Waste Report pursuant to 40 CFR 260.42. You are required to re

- notify by March 1 of each even

- numbered year pursuant to 40 CFR 260.42. These regulations exclude certain hazardous secondary material(s) being reclaimed from the RCRA Subtitle C definition of solid waste provided certain requirements
and conditions are met. Note: If your facility was granted a solid waste variance un der 40 CFR 260.30 prior to July 13, 2015, your management of hazardous secondary materials under 40 CFR 260.30 is grandfathered under the previous regulations and you are not required to notify

GM FORM

A site required to file the 2015 2017 Hazardous Waste Report must submit Waste Generation and Management Form(s) (GM Form(s)) for all hazardous waste that was used to determine the site’s generator status. Hazardous waste must be reported if it was:Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

12 

### • Generated and accumulated on

- site and subs equently managed on

- site or shipped off

- site in

2015 2017 ; or

• Generated and accumulated on

- site in 2015 2017 but not managed on

- site or shipped off

- site until
after 2015 2017 ; or

• Generated and accumulated on

- site prior to 2015 2017 but either managed on

- sit e or shipped off

site in 2015 2017 ; or

• Imported from a site located in a foreign a site located in a foreign country in 2015 2017

.
Examples of RCRA hazardous wastes to be report ed include those that were:

• Generated on

- site from a production process, service activity, or routine cleanup;

• Generated from equipment decommissioning, spill cleanup, or remedial cleanup activity;

• Shipped off

- site, including hazardous waste that was received from off

- site (reported on the
Waste Received From Off

- site Form [W R Form]) and subsequently shipped off

- site without being treated or recycled on

- site;

• Removed from on

- site storage for treating, recycling, or disposing on

- site or shipped off

- site

, including any waste shipped off

- site to a site located in a foreign coun try ;

• Derived from the management of non

- hazardous waste; or

• Derived from the on

- site treatment (including reclamation), disposal, or recycling of previously existing hazardous waste (as a residual).

Unless required by your State, you are not required to submit GM Form for any hazardous waste shipped directly to a foreign country site located in a foreign country . Facilities that export hazardous waste must file a separate Annual Report under 40 CFR 262.56. (This Annual Report will be in addition to the Hazardous Waste Report, if your State requires you to submit a Hazardous Waste Report.)

WR FORM

A site required to file the 2015 2017 Hazardous Waste Report must submit Waste Received From Off

- site Form(s) (WR Form(s)) if, during 2015 2017 , it received RCRA hazardous waste from off

- site and managed
the waste on

- site (including subsequent transfer off

- site).

OI FORM

A site must complete Off

- site Identification Form(s) (OI Form(s)) only if the site’s State requires it

. Instructions for OI Forms are on the bac k of the form. For a list of State contacts go to: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

13 

### .

FILLING OUT THE FORM S

CONTACTS FOR ASSISTA NCE

To obtain assistance in filling out the 2015 2017 Hazardous Waste Report forms, please contact your State or EPA Regional Office. States’ reporting requirements or forms may differ from the Federal
requirements. The list of contact addresses, contact names, telephone numbers, and e

- mail addresses

is lo cated at: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.

COPIES OF HAZARDOUS WASTE REPORT INSTRUC TIONS AND FORMS

If your State uses the EPA’s version of the instructions and forms, you can download the booklet from: http://www.epa.gov/epawaste/inforesources/data/biennialreport/index.htm

, otherwise, the State

2017 Hazardous Waste Report Instructions and Forms can be obtained by contacting your State.

DOCUMENTS HELPFUL IN FILLING OUT THE FORM S

To prepare the 2015 2017 Hazardous Waste Report, you should consult your records on quantities and types of hazardous waste that your site generated, managed, shipped, or received in 2015 2017 . Some records that may be helpful are:

• Hazardous waste manifest forms;

• Hazardous Waste Report forms submitted in previous years;

• Records of quantities of hazardous waste generated or accumulated on

- site;

• Results of laboratory analyses of your waste;

• Contracts or agreements with off

- site facilities managing your wastes; and

• Copies of permits for on

- site waste management systems.

CODE LISTS

LIST

The LIST symbol denotes references to relevant code lists. Please use only the codes included in the instructions or in the lists of codes provided.Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

14 

### SKIP INSTRUCTIONS

The symbol denotes dir ections to skip to the next appropriate section or item to be completed, given certain responses to some questions.

EXPLANATIONS

The NOTE symbol denotes explanatory text of definitions of terms used in the instructions.

ALPHANUMERIC FIELDS

Valid characters for alphanumeric fields are limited to:

`~!@#$%^&*()_

- +={}[]| \ :;’”,.?/1234567890ABCDEFGHIJKLMNOPQRSTUVWXYZ

Invalid characters for alphanumeric fields include:

<>

If the “<” or “>” symbols are used to indicate less than or greater than, it is recommended that these symbols be replaced with “LT” or “GT

. ”

RIGHT JUSTIFICATION OF QUANTITIES

Right justify all quantities report ed on the forms. For example, enter a quantity of 12,000 tons on the
form as:

1 2 0 0 0

. 0

Enter a quantity of 29,599 .5 tons as:

2 9 5 9 9

. 5

COMMENTS SECTION OF FORMS

Use the Comments section at the bottom of the forms to clarify or continue any entry. For each comment, reference the section number and item letter of the entry that is being continued. For example, if a hazardous waste generated on

- site has seven EPA hazardous waste codes, enter the first six in Section 1Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

15 

### - Item B of the GM Form. Enter the seventh waste code in the Comments section and cross

- reference

Section 1

- Item B. For example, you w ould write: “Sec. 1, Item B, continued: D007.”

PAGE NUMBERING OF FO RMS

When you have filled out all the appropriate forms in your Hazardous Waste Report submission, number the pages (each piece of paper is a page) consecutively throughout your submission

. Do not number each set of forms separately, but rather number each page sequentially. The individual page number and the total number of pages in your submission should appear at the bottom of each page (e.g., Page 1 of 7, Page 2 of 7).

If it is necess ary to continue information from one form onto another page, make additional copies of the form and number the additional pages with the same page number as the first page, followed by a letter (e.g., page 27, page 27a;, page 28, page 28a, 28b). When cont inuing information on a supplemental page, enter only the information that is being continued.

PHOTOCOPIES OF FORM

A single copy of each form is included in this booklet. Photocopy as many forms as you need to complete your Hazardous Waste Report. Make copies after you have written your site name and EPA Identification Number in the top left

- hand corner of the form, b ut before you begin filling out the form.

After you have finished filling out the forms, photocopy the entire Hazardous Waste Report and keep a copy for a period of at least three years from the due date of the report as required by 40 CFR 262.40(b).

ELEC TRONIC REPORTING

The EPA encourages electronic reporting of Hazardous Waste Reports. To obtain instructions on how to file electronically, contact your State or EPA Regional Office.

CONFIDENTIAL BUSINES S INFORMATION (CBI)

You may not withhold information from the Administrator of the EPA because it is confidential. However, when the Administrator is requested to consider information confidential, it must be treated according to the EPA regulations contained in 40 CFR Part 2, Subpart B. These regulations provide that a business may, if it desires, assert a claim of business confidentiality covering all or part of the information furnished to the EPA. 40 CFR 2.203(b) explains how to assert a claim.

The EPA will treat information covered by such a claim in accordance with the procedures set forth in

40 CFR Part 2, Subpart B. If someone requests release of information covered by a claim of confidentiality,Instructions for Filing the 2015 2017 Hazardous Waste Report (continued)

16 

### or if the EPA otherwise decides to make a determination as to whether such information is entitled to confidential treatment, the EPA will notify the business. The EPA will not disclose information as to when a claim of confidentiality has been made except to the extent of and in accordance with 40 CFR Part 2, Subpart B. However, if the business does not claim confidentiality when it furnishes the information, the EPA may make the information available to the public without notice to the business.

Add a “ Contact your State ” sentence here to tell them that if the state is authorized to conduct the BR program, they should check with them if they wish to assert a Confidential Business Information claim on their report.

IF YOU NEED ASSISTANCE

To obtain assistance in filling out the 2015 2017 Hazardous Waste Report forms, please contact your State or EPA Regional Office. States’ reporting requirements or forms may differ from the Federal
requirements. The list of State and EPA Regional Office a ddresses, contact names, telephone
numbers, and e

- mail addresses is located at : https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.p df

.

This booklet and other related information can be found at: http://www.epa.gov/epawaste/inforesources/data/biennialreport/index.htm

.Site ID Form (continued)

17 

## INSTRUCTIONS FOR FIL LING OUT THE

RCRA SUBTITLE C SITE IDENTIFICATION FORM (SITE ID FORM)

WHO MUST SUBMIT THIS FORM

All sites required to submit any of the following mus t submit the RCRA Subtitle C Site Identification Form (Site ID Form):

• Initial Notification of Regulated Waste Activity;

• Subsequent Notification of Regulated Waste Activity;

• First RCRA Hazardous Waste Part A Permit Application;

• Revised RCRA Hazardous Waste Part A Permit Application;

• Hazardous Waste Report;

• Notification for eligible academic entities opting into or withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262 Subpart K (if in an eligible State); and

• Notification for facili ties managing hazardous secondary material pursuant to 40 CFR 260.42 (if in an eligible State).

Some States have requirements in addition to, or that are different from the Federal requirements. To obtain the appropriate forms or ask questions, refer to a list of contacts at: https://www.epa.gov/sites/production/files/2016

- 03/documents/contact02172016.pdf

.

The list will tell you whether the Federal form or a State form is used, who to contact, and where to mail the completed form.

PURPOSE OF THIS FORM

The Site ID Form provides site

- specific information about your facility and is used to obtain an EPA Identification Number under the RCRA Program. The Site ID Form also provides updated information for items that have changed at your site and verifies the information for those items that remain unchanged.

HOW TO FILL OUT THIS FORM

Complete the following Site ID Form items, as applicable to your facility:

• Item 1

- your reason for submitting the form

• Item 2

- your site’s EPA Identification Number

• Item 3

- the name of your site

• Item 4

- the physical location of your site

• Item 5

- the land type of your site

• Item 6

- the North American Industry Classifi cation System (NAICS) code(s) for your site

• Item 7

- the mailing address for your site

• Item 8

- name, title, address, e

- mail, telephone number, extension , and fax of a contact personSite ID Form (continued)

18 

### at your site

• Item 9

- name, address of the legal owner(s), address, e

- mail, telephone number, extension, and fax number of the operator(s) of your site

• Item 10

- your site’s regulated waste activities (enter all that apply)

• Item 11

- the description of hazardous waste

• Item 12

- your site’s hazardous secondary material activity, if you manage any

• Item 13

- additional comments on Items 1

– 12

• Item 14

- certification that the information you provided throughout the form is truthful, accurate, and complete

• Addendum to the Site Identification Form

– notification of hazardous secondary material activity

Type or print, in black ink, all items except the Signature box in Item 14. In Item 14, provide the required ink signatures. Signatures must be original. Stamped or photocopied signatures are not acceptable. Ent er your site’s EPA Identification Number in the top left

- hand corner on all pages of the form; for an Initial Notification for this site, leave the EPA identification Number blank. Use

Item 13

– Comments to clarify or provide additional information for an y entry. When entering information in the comments section, enter the item number and box letter to which the comment refers. If you must use additional sheets for comments, enter your site’s EPA Identification Number in the top left

- hand corner of each sheet.

ITEM

- BY

- ITEM INSTRUCTIONS

ITEM 1

– REASON FOR SUBMITTAL

Place an “X” in the appropriate box(es) to indicate whether this form is your Initial Notification (i.e., this is your first time submitting site identification information / to obtain an EPA Identification Number for this location); a Subsequent Notification (to update your site identification information); a component of a First or a Revised Hazardous Waste Part A Permit Application; or a component of the Hazardous Waste Report.

TO PROVIDE A N INITIAL NOTIFICATI ON (FIRST TIME SUBMI TTING SITE IDENTIFIC ATION INFORMATION / TO OBT AIN AN EPA IDENTIFIC ATION NUMBER FOR THI S LOCATION)

• If your waste activity is regulated under Subtitle C of the Resource Conservation and Recovery Act (RCRA) and the rule s promulgated pursuant to the Act (specifically 40 CFR Parts 260

- 299), you

must submit this form to notify the appropriate State or EPA Regional Office of your regulated
waste activities and obtain an EPA Identification Number.

• If you are an eligible acad emic entity opting into 40 CFR Part 262, Subpart K for managing laboratory hazardous wastes AND you have never before submitted site identification information, you must submit this form to notify the appropriate State or EPA Regional Office of your activi ties. Note: You must check with your State to determine if you are eligible to manage laboratory hazardous waste pursuant to 40 CFR Part 262, Subpart K in order for you to notify.Site ID Form (continued)

19 

### • If you will begin managing hazardous secondary material under 40 CFR 261 .2(a)(2)(ii) 260.30

, 40 CFR 261.4(a)(23), (24), or (25) (27) AND you have never before submitted site identification information, you must submit this form, pursuant to 40 CFR 260.42, to notify the appropriate State or EPA Regional Office of your activitie s. Note: You must check with your State to determine if you are eligible to manage hazardous secondary material under these exclusions in order for you to notify.

TO PROVIDE A SUBSEQU ENT NOTIFICATION (TO UPDATE SITE IDENTIFI CATION

INFORMATION FOR THIS L OCATION)

• You must use this form to submit a subsequent notification if your site already has an EPA Identification Number and you wish to change information (e.g., generator status, new site contact person, new owner, new mailing address, new regulated was te activity, etc.).

• If you have previously submitted site identification information and are an eligible academic entity opting into or withdrawing from 40 CFR Part 262, Subpart K for managing laboratory hazardous wastes, you must use this form. Note: Y ou must check with your State to determine if you are eligible to manage laboratory hazardous waste pursuant to 40 CFR Part 262, Subpart K in order for you to notify.

• If you have previously submitted site identification information and are notifying (or re

- notifying) that you will begin managing, are managing, or have stopped managing hazardous secondary
material under 40 CFR 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24), or (25) (27) , you must submit this form, pursuant to 40 CFR 260.42, to notify the appropriate State or Regional Office of your activities. Note: You must check with your State to determine if you are eligible to manage hazardous secondary material under these exclusions in order for you to notify.

AS A COMPONENT OF A FIRST RCRA HAZARDOUS WASTE PART A PERMIT APPLICATION

If your site is planning to treat, store, or dispose of hazardous waste on

- site in a unit that is not exempt from obtaining a haza rdous waste permit, you must submit this form as part of the Part A Permit Application. Also, if the activity at this site (treatment, storage, or disposal) became newly regulated under RCRA Subtitle C and the rules promulgated pursuant to the Act (specif ically 40 CFR Parts 260

- 299), you must submit this form as part of the Part A Permit Application.

AS A COMPONENT OF A REVISED RCRA HAZARDO US WASTE PART A PERM IT APPLICATION

If you must submit a Revised Part A Permit Application to reflect changes that have occurred at your site, you must submit this form as part of your Revised Part A Permit Application. Examples of site changes requiring a Revised Part A Permit Application include managing new wastes not identified in the first
submission of the form or c hanges to existing waste treatment processes. When submitting a Revised Part A Permit Application, please include the Amendment Number in the appropriate space.Site ID Form (continued)

20 

### AS A COMPONENT OF TH E HAZARDOUS WASTE RE PORT (IF MARKED, SEE SUB

- BULLET BELOW)

If you are req uired to submit a Hazardous Waste Report indicating the amount of hazardous waste you generate, treat, recycle, dispose, ship off

- site, or receive from off

- site, you must fill out this form. A Site ID Form submitted with a Hazardous Waste Report is equiva lent to a Subsequent Notification.

SITE WAS A TSD FACIL ITY AND/OR GENERATOR OF ≥ 1,000 KG OF HAZ ARDOUS
WASTE, > 1 KG OF ACU TE HAZARDOUS WASTE, OR > 100 KG OF ACUTE HAZARDOUS

WASTE SPILL CLEANUP IN ONE OR MORE MONTH S OF THE REPORT YEAR ( OR STATE

EQUIVALENT LQG REGULATIONS)

The purpose of this check box is to distinguish between sites that meet the criteria and are required to file a report versus those who file voluntarily or by State

- only requirement but were not a treatment, storage, and disposal facility (TSDF) or a Large Quantity Generator (LQG) during the report year. Sites required to file the report should place an “X” in this box, while non

LQG/TSD sites should not. For more information about who must file a report, refer to “WHO

MUST FILE THE 201 5 7 HAZARDOUS WASTE REPORT” section of the 201 5 7 Hazardous Waste Report Instructions and Form booklet.

ITEM 2

– SITE EPA ID NUMBER

Provide your EPA Identification Number in Item 2 for this site . The first two characters of the EPA
Identification Number must be a valid State postal code. Be sure to include your EPA Identification number at the top of all pages of the form (as well as on any attachments to the Site ID Form).

NOTE If this is your Initial Notification for this site, leave the EPA Identification Number blank and proceed to Item 3.

ITEM 3 AND 4

– SITE NAME AND LOCATI ON

Provide the legal name of your site and a complete location address. Please note that the address you give for Item 4, Site Location, must be a physical address, n ot a post office box or route number. Only foreign hazardous waste transporters, with their headquarters located outside the U.S., may provide a Site Location Country outside of the U.S.

NOTE A new EPA Identification Number is required if you change the location of your site.Site ID Form (continued)

21 

### ITEM 5

– SITE LAND TYPE

Place an “X’ in the box that best describes the land type of your site. Select only one type: Private, County, District, Federal, Tribal (see below), Municipal, State, or Other. If you r site’s Land Type could be described as Municipal and another Land Type, such as County, District, or Tribal, do not place an “X” in Municipal. Instead, choose the other appropriate Land Type. (For example, if your site’s Land Type is both Municipal
and County, you would place an “X” in the box for County.) You may explain this in Item 13

– Comments.

Tribal

- A member of The l L and which your site is on land belongs to one of the tribes/entities on the list of Federally recognized American Indian tribes and Alaskan Native entities located at: http://www.epa.gov/tribal/whereyoulive/tribes

- a

- z.htm

.

ITE M 6

– NORTH AMERICAN INDUS TRY CLASSIFICATION S YSTEM (NAICS) CODE(S )

Box A must be completed. Completing Boxes B

- D is recommended, if applicable.

BOX A

Provide the North American Industry Classification System (NAICS) code that best describes your site’s primary business production process for your products or services. Referencing the latest version of NAICS codes, use the 6

- digit code (most specific de scription) if available for your business; if not, use the

5

- digit code; do not enter any four (4) or less digit codes.

BOXES B

– D

List other NAICS codes that describe the other business production processes for your site. Referencing
the latest version of NAICS codes, use the 6

- digit code (most specific description) if available for your business; if not, use the 5

- digit code; do not enter any four (4) or less digit codes.

Check with your accounting or business staff to determine your NAICS code(s); the NAICS code is used in tax reporting and other business reports. You can obtain additional information about NAICS codes at http://www.census.gov/eos/www/naics

.

NOTE Changes will be made to the NAICS codes in 2017 . All sites should confirm their NAICS codes
in the new 2017 NAICS code table prior to completing Item 6

– NAICS Codes. You can obtain
additional information about the 2017 NAICS codes at http://www.census.gov/eos/www/naics

.Site ID Form (continued)

22 

### ITEM 7

– SITE MAILING ADDRESS

Please enter the Site Mailing Address. If the Mailing Address and the Location of Site (Item 4) are the same, you can enter “Same as Item 4” in the box for Item 7.

ITEM 8

– SITE CONTACT PERSON

Enter the name, title, business address, telephone number, extension, fax number, and e

- mail address of the individual who should be contacted regarding the information submitted in the Site ID Form. A Subsequent Notification is recommended when the Site Contact Person changes. Do not enter other contact persons here; if there are other persons, who may be contacted about this submission, list them
and their other contact information in Item 13

– Comments. If the person completing the Haza rdous Waste Report this form is not the primary site RCRA hazardous waste contact, enter the primary site RCRA hazardous waste contact here and add the contact information for the person completing the Hazardous Waste Report form in Item 13

– Comments.

NO TE This is NOT the Facility Permit Contact information. The Facility Permit Contact information should be entered on the RCRA Hazardous Waste Part A Permit Application.

ITEM 9

– LEGAL OWNER AND OPER ATOR OF THE SITE

This section should be used to indicate all owners and operators of this site.

A. NAME OF SITE’S LEGAL OWNER

Provide the name of your site’s legal owner(s). This includes owner(s) of the building(s) and land. Please
review these definitions:

Owner

– The pe rson who owns a RCRA site or part of a RCRA site. Note: This includes the owner(s) of the building(s) and/or land. This may be an individual, company, or business name. See Person

.

Person

– An individual, trust, firm, joint stock company, Federal Agenc y, corporation (including a government corporation), partnership, association, State, municipality, commission, political subdivision of a State, or any interstate body.

DATE BECAME AN OWNER

Indicate the date on which the above entity became the owner of y our site. Enter dates as in this example: For April 22, 2015, enter 04/22/2015. This is a required field and a date must be reported.Site ID Form (continued)

23 

### OWNER TYPE

Place an “X’ in the box that best describes the owner type for your site. Select only one type: Private, County, District, Federal, Tribal (see below), Municipal, State, or Other. If your site’s Owner Type could be described as Municipal and another Owner Type, such as County, District, or Tribal, do not place an “X” in Municipal. Instead, choose the other appropriate Owner Type. (For example, if your site’s Owner Type is both Municipal and County, you would place an “X” in the box for Coun ty.) You may explain this

in Item 13

– Comments.

Tribal

- A member of one of the tribes/entities on the list of Federally recognized American Indian tribes

and Alaskan Native entities located at: http://www.epa.gov/tribal/whereyoulive/tribes

- a

- z.htm

.

LEGAL OWNER ADDRESS

Enter the address, e

- mail

, telephone number, extension, and fax number of the legal owner. If the address and the Location of Site (Item 4) are the same, you can enter “Same as Item 4 ” in the box for Item 9 A

.
Use the Comments section in Item 13 to list any additional owners, their names, the dates they became owners, owner type, mailing address, and which owner(s), if any, are no longer owners since your last
submissi on of this form. If necessary, attach a separate sheet of paper. Remember to enter your site’s EPA Identification Number in the top left

- hand corner of each sheet.

B. NAME OF SITE’S OPERA TOR

Provide the name of your site’s operator. Please review these de finitions:

Operator

– The person responsible for the overall operation of a RCRA site. Note: This is the legal entity which controls the RCRA site operation rather than the plant or site manager. This is usually a company or business name, but may be an individual. See Person

.

Person

– An individual, trust, firm, joint stock company, Federal Agency, corporation (including a government corporation), partnership, association, State, municipality, commission, political subdivision of a State, or any inters tate body.

DATE BECAME AN OPERA TOR

Indicate the date on which the above entity became the operator of your site. Enter dates as in this example: For April 22, 2015, enter 04/22/2015. This is a required field and a date must be reported.

OPERATOR TYPE

Place an “X’ in the box that best describes the operator type for your site. Select only one type: Private, County, District, Federal, Tribal (see below), Municipal, State, or Other. If your site’s Operator Type could be described as Municipal and anoth er Operator Type, such as County, District, or Tribal, do not place an “X” in Municipal. Instead, choose the other appropriate Operator Type. (For example, if your site’s Operator Type is both Municipal and County, you would place an “X” in the box for C ounty.) You may explain this in Item 13

– Comments.Site ID Form (continued)

24 

### Tribal

- A member of one of the tribes/entities on the list of Federally recognized American Indian tribes

and Alaskan Native entities located at: http://www.epa.gov/tribal/whereyoulive/tribes

- a

- z.htm

.
Use the Comments section in Item 13 to list any additional operators, their names, the dates they became operators, operator type, mailing address, and which operator(s), if any, are no longer operators since your last submission of this form. If necessary, attach a separate sheet of paper. Remember to enter your site’s EPA Identification Number in the top left

- hand corner of each sheet.

OPERATOR ADDRESS

Enter the address, e

- mail

, tele phone number, extension, and fax number of the operator. If the address and the Location of Site (Item 4) are the same, you can enter “Same as Item 4 ” in the box for Item 9 B

.
Use the Comments section in Item 13 to list any additional operators, their na mes, the dates they became operators, operator type, mailing address, and which operator(s), if any, are no longer operators since your last submission of this form. If necessary, attach a separate sheet of paper. Remember to enter your
site’s EPA Identi fication Number in the top left

- hand corner of each sheet.

NOTE A subsequent notification is recommended when the owner or operator of a site changes.
Because an EPA Identification Number is site

- specific, the new owner will keep the existing

EPA Identification Number for that location. If your business moves to another location, the owner or operator must notify the State or EPA Regional Office of this change. Since your business has changed locations, a new EPA Identification Number will be ass igned.

ITEM 10

– TYPE OF REGULATED WA STE ACTIVITY

Mark box “Yes” or box “No” as appropriate for all current activities (as of the date submitting the form) at this site; complete any additional boxes as instructed. Current activities mean activities th at are in effect when the form is submitted or those that the site plans to begin after EPA Identification Number assignment. The information you provide in Item 10 will be considered current as of the date you certify the form. If the site is no longer a generator as of the date you certify the form, you should mark the “No” (not a generator) box for Generator of Hazardous Waste.

NOTE You must report your current regulated waste activities as of the date of submitting the

Site ID Form

.

C. HAZARDOUS WASTE ACTIVITIES (CO MPLETE ALL PARTS 1 T HROUGH 10)Site ID Form (continued)

25 

### NOTE Listed below are the Federal generator status definitions. If, however, the State where your site is located has definitions different from the Federal definitions, you must use the State
definitions.

1. GENERATOR OF HAZARDO US WASTE (AT YOUR SI TE):

If you generate a hazardous waste that is listed in 40 CFR 261.31 through 261.33 or identified by one or more hazardous waste characteristic(s) contained in 40 CFR 261.21 through 261.24, place an “X” in the appropriate box for the quantity of hazardous waste that is generated per calendar month. The regulations for hazardous waste generators are found in 40 CFR 261.5 for conditionally e xempt small quantity generators (CESQGs) and in 40 CFR Part 262 for both small quantity generators (SQGs) and large quantity generators (LQGs). Consult these regulations and your State for deta ils about how the regulations apply to your situation. Below is a brief description of the three types of hazardous waste
generators.

If “Yes”, place an “X” in only one of the following

– a, b, or c.

a. LQG: Large Quantity Generator For purposes of providing information in this form, the site is a n LQG if the site generates any of the following amounts in a calendar month : (i) Greater than or equal to 1,000 kilograms (kg; 2,200 pounds [lbs]) of non

- acute RCRA hazardous
waste; or (ii) Greater than 1 kg (2.2 lbs) of any RCRA acute hazardous waste listed in sections 261.31 or 261.33(e) ; or (iii) Greater than 100 kg (220 lbs) of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes listed in sections 261.31 or 261.33(e).

NOTE As discussed earlier, a RCRA LQG is a site that is neither a CESQG nor a SQG. For purposes of clarity, we describe above the situations when a site would be a n LQG.

If, in addition to being a n LQG, you recycle hazardous wastes at your site, mark both this box
and Item 10.A.4 10.A.7

.

Hazardous secondary material managed under 40 CFR 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24), or (25) (27) DOES NOT count towards your generator status. However,

you must check with your State to determine if you are eligible to manage hazardous secondary material under these exclusions.Site ID Form (continued)

26 

### b. SQG: Small Quantity Generator
This site is a SQG if the site meets all of the following criteria: (i) Generates, in any calendar month, more than 100 kg (220 lbs) but less than 1,000 kg (2,200 lbs) of RCRA hazardous waste; and (ii) Does not generate, in any calendar month, more than 1 kg (2.2 lbs.) of acute hazardous waste
listed in sections 261.31 or 261.33(e) ; and (iii) Does not generate more than 100 kg (220 lbs) of material from the cleanup of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazar dous wastes listed in sections 261.31 or 261.33(e).

NOTE The definition of a n SQG found at 40 CFR 260.10 is outdated. The EPA plans to make the appropriate conforming change in the future. Moreover, here in this document, for purposes of clarity, we include those situations where a n SQG also may have generated amounts of acute hazardous wastes and still maintain its regulatory status as a n SQG.

c. CESQG: Conditionally Exempt Small Quantity Generator
This site is a CESQG if the site generates less than or equal to the following amounts in a calendar
month: (i) 100 kg (220 lbs) of hazardous waste; and (ii) 1 kg (2.2 lbs) of acute hazardous wastes listed in sections 261.31, or 261.33(e); and (iii) 100 k g (220 lbs) of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes listed in sections 261.31, or 261.33(e).

NOTE A CESQG is defined at 40 CFR 261.5(a) as a site that generates less than or equal to 100 kg (220 lbs) of hazardous waste. However, the regulations at 40 CFR 261.5(e) discuss situations where a CESQG could be subject to full regulation. For purposes of cl arity, we describe all those situations where a site continues to be a CESQG.

If you generate acute hazardous wastes listed in 40 CFR 261.31, 261.32, or 261.33(e), please refer to 40 CFR 261.5(e) to determine the circumstances under which you must notify the

EPA.

If you marked “Yes” above ”Y” for item 10.A.1 Generator of Hazardous Waste , indicate your other
generator activities size in 10.A.1a , 10.A.1b, or through item 10.A.1 c . Mark “Yes” or “No” ”Y” or “N” for
the other hazardous waste activities listed below in item 10.A.2 through item 10.A.10 that may occur at
this site. Complete all parts 2

- 10.Site ID Form (continued)

27 

### 2. SHORT

- TERM GENERATORS

Mark “Yes” if the site is currently generating hazardous waste only as the result of a one

- time, non

recurring, temporary event that is not related to normal production processes. In other words, short

term generators produce hazardous waste from a partic ular activity for a limited time and then cease conducting that activity. Short

- term generators would not be considered episodic generators because episodic generators have the potential to generate on a regular basis (for example, a facility that fluctua tes from SQG to LQG in one month is not a short

- term generator). Examples of short

- term generators include: (1) one

- time highway bridge waste generation; (2) underground storage tank removals; (3) generation of
off

- spec or out

- of

- date chemicals at a site that normally doesn’t generate hazardous waste; (4) remediation or spill clean

- up at sites with no previous RCRA EPA Identification Number; and (5) site or production process decommissions by a new operator. If you mark “Yes”, you must provide an explana tion of your short

- term generation event in Item 13

– Comments.

3. U.S. IMPORTER OF HAZ ARDOUS WASTE

Mark “Yes” if you import hazardous waste from a foreign country a site located in a foreign country into the U.S. Refer to 40 CFR 262.10(e) and 40 CFR 262.60 (a ) for additional information.

4. MIXED WASTE GENERATO R

Mark “Yes” if you are a generator of mixed waste (waste that is both hazardous and radioactive). RCRA defines “mixed waste” as waste that contains both hazardous waste and source, special nuclear, or by

product material subject to the Atomic Energy Act (AEA), RCRA Section 1004(41), 42 U.S.C. 6903 (63 FR 17414; April 9, 1998). See the “ DEFINITIONS ” section.

5. TRANSPORTER OF HAZAR DOUS WASTE

a. Transporter You transport hazardous waste within the U.S. The Federal regulations for hazardous waste transporters are found in 40 CFR Part 263

.

b. Transfer Facility (at your site)
You are a hazardous waste transfer facility, at your site, if you hold manifested hazardous waste(s) at your site for a period of ten (10) days or less while the waste is in transit. The Federal regulations for
hazardous waste transfer facilities are found in 40 CFR 263.12

.

6. TREATER, STORER, OR DISPOSER OF HAZARDOU S WASTE (AT YOUR SIT E)

If you treat, store, or dispose of hazardous waste, mark “Yes.” A RCRA Hazardous Waste Part B Permit is required for this activity. Co ntact the appropriate office for your State for more information. The Federal regulations for owners and operators of permitted treatment, storage, and disposal facilities (TSDFs) are
found in 40 CFR Parts 264, 265, 266, and 270

.
Mark “No” if any of the following conditions are true for your facility:

• This facility does not receive hazardous waste from other generators and ships all waste off

- site for management within the regulatory timeframe.Site ID Form (continued)

28 

### • This facility is only involved with on

- going post

- closure activities, corrective actions under the Hazardous and Solid Waste Amendments of 1984 (HSWA), or a consent order under a non

traditional permit or without a RCRA permit being required.

• Receives wast e from off

- site but does not store greater than 10 days before re

- shipping (i.e., transfer facility).

NOTE If your site is a destination facility for universal wastes in addition to being a TSDF for other RCRA hazardous wastes, mark “Yes” for both this box and Item 10.B.2.

7. RECYCLER OF HAZARDOU S WASTE (AT YOUR SIT E)

If you recycle regulated hazardous wastes (r ecyclable materials) at your site, mark “Yes”. The Federal regulations for owners and operators of sites that recycle hazardous waste are found in 40 CFR 261.6

. You also may be subject to othe r Federal and State regulations; in some cases a permit is required.

NOTE If your site, in addition to being a recycling site for hazardous waste, is a treater, storer, or disposer treats, stores, or disposes of hazardous waste, mark “Yes” for both this box and Item 10.A.6. If your site is a destination facility for universal wastes in addition to being a recycling site for other RCRA hazardous wastes, mark “Yes” for both this box and Item 10.B.2.

8. EXEMPT BOI LER AND/OR INDUSTRIA L FURNACE (AT YOUR S ITE)

If “Yes”, place an “X” in all that apply.

a. Small Quantity On

- Site Burner Exemption You burn small quantities of hazardous waste in an on

- site boiler or industrial furnace in accordance
with the conditions in 40 CFR 266.108 , place an “X” in the box to indicate that you qualify for the Small Quantity On

- Site Burner Exemption.

b. Smelting, Melting, and Refining Furnace Exemption You process hazardous wast es in a smelting, melting, or refining furnace solely for metals recovery,
as described in 40 CFR 266.100(d) , or to recover economically significant amounts of precious metals,
as described in 40 CFR 266.100(g) , or if you process hazardous wastes in a lead recovery furnace to recover lead, as described in 40 CFR 266.100(h)

, place an “X’ in the box to indicate that you qualify for the Smelting, Melting, and Refining Furnace Exemption.

9. UNDERGROUND INJECTIO N CONTROL (AT YOUR S ITE)

If you generate, treat, store, or dispose of hazardous waste and place the waste or its residuals i nto an underground injection well (e.g., a Class I well) located at your site, mark “Yes.” The Federal regulations for owners and operators of underground injection wells are found in 40 CFR Pa rt 148

.Site ID Form (continued)

29 

### 10. RECEIVES HAZARDOUS W ASTE FROM OFF

- SITE (AT YOUR SITE)

If you received hazardous waste from another site, whether this waste was received as a commercial transaction or waste received from a restricted group of off

- site generators, mark “Yes.”

In ad dition to the above, mark “Yes” or “No” for the other regulated waste activities listed below that may occur at this site. Complete Items B, C, and D as appropriate.

D. UNIVERSAL WASTE ACTI VITIES (AT YOUR SITE )

Refer to your State

- specific requirements and definitions for universal waste. Also, refer to 40 CFR 261.9
and 40 CFR Part 273 for the Federal regulations covering universal was te. Complete parts 1 and 2.

11. LARGE QUANTITY HANDL ER OF UNIVERSAL WAST E (LQHUW)

You are an LQHUW if you accumulate a total of 5,000 kg or more total of universal wastes (batteries, pesticides, mercury

- containing equipment, or lamps

– calculated collectively ) at any time. This designation is retained through the end of the calendar year in which the 5,000 kg limit is met or exceeded. If “Yes,” place an “X” in the appropriate box(es) to indicate the type(s) of universal wastes managed at your site. If your State has other additional universal wastes, indicate what they are by placing an “X” in the corresponding box(es) (10.B.1.e, f, or g).

12. DESTINATION FACILITY FOR UNIVERSAL WASTE

Mark “Yes” if you treat, dispose, or recycle universal wastes on

- site. A hazar dous waste permit is required if you treat or dispose of universal wastes; a permit may be required if you recycle universal wastes.

NOTE If your site, in addition to being a destination facility for universal wastes, is also a TSDF for RCRA hazardous wastes, mark “Yes” for both this box and Item 10.A.6. In addition, if your site recycles RCRA hazardous wastes, mark “Yes” for both this box and Item 10.A.7.

E. USED OIL ACTIVITIES

Mark the appropriate box(es) to indicate which used oil management activities are taking place at this site. The Federal regulations for used oil management are found in 40 CFR Part 279

. Complete all parts 1 through 4.

13. USED OIL TRANSPORTER

If “Yes,” place an “X” in all that apply.

a. Transporter You transport used oil within the U.S. The Federal regulations for used oil transporters are found in

40 CFR 279.40

- 47.Site ID Form (continued)

30 

### b. Transfer Facility (at your site) You own or operate a used oil transfer facility. The Federal regulations for used oil transfer facilities
are found in 40 CFR 279.40

- 47.

14. USED OIL PROCESSOR A ND/OR RE

- REFINER (AT YOUR SIT E)

If “Yes,” place an “ X” in all that apply.

a. Processor You process used oil. The Federal regulations for processors of used oil are found in 40 CFR 279.50

- 59.

b. Re

- refiner You refine used oil. The Federal regulations for re

- refiner s of used oil are found in 40 CFR 279.50

- 59.

15. OF F

- SPECIFICATION USED O IL BURNER (AT YOUR S ITE)

You burn off

- specification used oil fuel. Mark “Yes” to indicate this used oil management activity.

16. USED OIL FUEL MARKET ER (AT YOUR SITE)

If “Yes,” place an “X” in all that apply.

a. Marketer Who Directs Shipme nt of Off

- Specification Used Oil to Off

- Specification Used Oil Burners You are a marketer who directs shipment of off

- specification used oil to off

- specification used oil burners. The Federal regulations for off

- specification used oil used oil fuel market ers are found in 40

CFR 279.70

- 75.

b. Marketer Who First Claims the Used Oil Meets the Specification You are the first to claim that used oil meets the used oil specification s established in 40 CFR 279.11.

NOTE If either of these boxes is marked, you must also notify (or have previously notified) as a used oil transporter (10.C.1), used oil processor/re

- refiner (10.C.2), or off

- specification used oil fuel burner (10.C.3), unless you are a used oil generator. (Used oil generators are not required to notify .)

F. ELIGIBLE ACADEMIC EN TITIES WITH LABORATO RIES

– NOTIFICATION FOR OPT ING INTO

OR WITHDRAWING FROM MANAGING LABORATORY HAZARDOUS WASTES PUR SUANT
TO 40 CFR PART 262, SUBPART K

Note: Fill out Box D ONLY if you are at least one of the following: a college or university; a teaching hospital that is owned by or has a formal written affiliation agreement with a college or university; or a

non

- profit research institute that is owned by or has a formal written affiliation agreement with a
college or university; AND you have checked with your State to determine if 40 CFR Part 262, Subpart K
is effective in your State and for any State

- specific requirements. See EPA’s website for moreSite ID Form (continued)

31 

### information about these regulations : http://www.epa.gov/wastes/hazard/generation/labwaste/implementation.htm http://www2.epa.gov/hwgenerators/regulations

- hazardous

- waste

- generated

- academic

- laboratories

.
Subpart K is an optional alternative set of requir ements for eligible academic entities with laboratories. Certain generators (i.e., eligible academic entities defined under (1) below) are eligible to operate under Subpart K for management of their hazardous wastes in laboratories in lieu of 40 CFR 262.3 4(c) (or 40 CFR 261.5 for CESQGs). Eligible academic entities with laboratories that generate hazardous waste that elect to opt into Subpart K, are currently operating under Subpart K, or subsequently withdraw from Subpart K must complete this section to meet the notification requirements of this Subpart. Refer to 40 CFR 262.203
and 40 CFR 262.204

.

NOTE Eligible academic entities with laboratories must complete a separate Site ID Form for each site (i.e., EPA Identification Number) that is managing hazardous waste under Subpart K. All laboratories with the same EPA Identification Number will be regulated under this Subpart.
If el igible academic entities with laboratories withdraw from Subpart K, all laboratories with the same EPA Identification Number associated with the withdrawal from Subpart K will be regulated under 40 CFR 262.34(c) requirements (or 40 CFR 261.5 for CESQGs).

17. OPTING INTO OR CURRE NTLY OPERATING UNDER 40 CFR PART 262, SUB PART K FOR THE

MANAGEMENT OF HAZARD OUS WASTES IN LABORA TORIES

Mark “Yes” for this box if you are an eligible academic entity and you elect to opt into or are currently operating under 40 CFR Pa rt 262, Subpart K for the hazardous wastes generated in your laboratories. If you mark “Yes” for this box, you must place an “X” in at least one of the following to indicate your type of eligible academic entity. Place an “X” in all that apply:

a. College o r University You are an eligible college or university if you are a private or public, post

- secondary, degree

- granting, academic institution, that is accredited by an accrediting agency listed annually by the U.S. Department of Education.

b. Teaching Hospita l that is owned by or has a formal written affiliation agreement with a college or university You are an eligible teaching hospital if you are a hospital that trains students to become physicians, nurses, or other health personnel and is either: (1) owned by a college or university, or (2) has a master affiliation agreement and program letter of agreement, as defined by the Accreditation Council for Graduate Medical Education, with an accredited medical program or medical school.

c. Non

- profit Institute that is owned by or has a formal written affiliation agreement with a college or universitySite ID Form (continued)

32 

### You are an eligible non

- profit institute if you are an organization that conducts research as its primary
function and files as a non

- profit organization under the tax code of 26 U.S.C. 501(c)(3) and is either: (1) owned by a college or university, or (2) has a formal written affiliation agreement with a college or university that establishes a relati onship between institutions for the purposes of research and/or education and is signed by authorized representatives from each institution. A relationship on a project

- by

- project or grant

- by

- grant basis is not considered a formal written affiliation agre ement.

18. WITHDRAWING FROM 40 CFR PART 262, SUBPAR T K FOR THE MANAGEME NT OF

HAZARDOUS WASTES IN LABORATORIES

Mark “Yes” for this box if you have previously elected to opt into 40 CFR Part 262, Subpart K and are now withdrawing from participation in this opti onal set of alternative requirements for hazardous waste generation in laboratories. Withdrawing generators will automatically revert to regulation under 40 CFR 262.34(c) requirements (or 40 CFR 261.5 for CESQGs). If marking “Yes” for this box, please in clude

comments in Item 13

– Comments that explain your reasons for withdrawing from Subpart K.

ITEM 11

– DESCRIPTION OF HAZAR DOUS WASTES

Complete this item if you marked “Yes” for any activity 1 (a

- c), 6, 7, or 8 in Item 10.A

. You will need to
refer to 40 CFR Part 261 to complete this item. Part 261 identifies those solid wastes which the EPA defines as hazardous and regulates under RCRA. If you need help completing this section, please conta ct your State Office.

G. WASTE CODES FOR FEDE RALLY REGULATED HAZA RDOUS WASTES

Please list the waste codes of the Federal hazardous wastes (described in 40 CFR Part 261) handled at your site. List them in the order they are presented in the regulations using the appropriate 4

- digit code(s) (e.g., D001, D003, F007, U112).

NOTE If you handle more hazardous wastes than will fit under Item 11.A, please continue under

Item 13

– Comments or on an extra sheet. Remember to include your EPA Identification Number on the top of each page. If you handle a large number of codes, you may copy the list in this booklet and mark the ones that you handle. Attach any additional sheets to the Site ID Form. Remember to include your EPA Identification Number on the top of each page.

H. WASTE CODES FOR STAT E

- REGULATED (I.E., NON

- FEDERAL) HAZARDOUS W AS TES

If you manage State

- regulated hazardous wastes that have a State waste code, enter the appropriate code(s) in the box(es) provided. Please list the waste codes of the State

- regulated hazardous wastes handled at your site in the order they are presente d in the regulations. (Go to Table of Contents )Site ID Form (continued)

33 

### NOTE If you handle more hazardous wastes than will fit under Item 11.B, please continue under

Item 13

– Comments or on an extra sheet. Remember to include your EPA Identification Number on the top of each page.

ITEM 12

– NOTIFICATION OF HAZA RDOUS SECONDARY MATE RIAL (HSM) ACTIVITY

A. Mark “Yes” if you are notifying under 40 CFR 260.42 that you will begin managing, are still managing, or will stop managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24), or (25) (27) . Mark “No” if you are not notifying under 40 CFR 260.42. Note: You must check with your State to determine if you are eligible to manage hazardous secondary material under these regulations.

NOTE If you mark “Yes, ” you must fill out the Addendum to the Site ID Form: Notification of Hazardous Secondary Material Activity. See instructions for this Addendum after Item 14.

B. Mark “Yes ” if you are submitting a legitimate recycling notification under 40 CFR 260.43(a )(4)(iii). Recycling of hazardous secondary materials for the purpose of the exclusions or exemptions from hazardous waste regulations must be legitimate. You must notify EPA if the product of your recycling process has levels of hazardous constituents tha t are not comparable to a legitimate product or intermediate, but the recycling is still legitimate. The recycling can be shown to be legitimate based on lack of exposure from toxics in the product, lack of the bioavailability of the toxics in the product, or other relevant considerations which show that the recycled product does not contain levels of hazardous constituents that pose a significant human health or environmental risk. Documentation of legitimacy must be maintained onsite for three years. If you’d like to submit additional information regarding your recycling, use the Comments Box in Item 13.

Mark “No” if you are not notifying under this provision. Notification is not required if the product of the recycling process is comparable to a legitim ate product or intermediate per 40 CFR 260.43(a)(4)(i) or (ii).

ITEM 13

– COMMENTS

Use this section as needed to provide additional information for Items 1 through 12. Include the item number and box letter (if any) for each comment you make. You may at tach additional sheets if needed. Remember to include your EPA Identification Number on the top of each page.Site ID Form (continued)

34 

### ITEM 14

– CERTIFICATION

This certification must be signed and dated by the owner(s), operator(s), responsible official(s), or authorized repres entative(s) of the site. See 40 CFR 270.11 for more information on signatories in general.
See also 40 CFR 270.10(b) for additional Hazardous Waste Part A Permit Application signatory specifics. An “authorized representative” is a person responsible for the overall operation of the site (i.e., a plant manager or superintendent, or a person of equal responsibility).

N OTE All Site ID Form submissions must include this certification to be complete.35 

## ADDENDUM TO THE SITE IDENTIFICATION FORM :

NOTIFICATION OF HAZA RDOUS SECONDARY MATE RIAL ACTIVITY

YOU MUST FILL OUT TH IS SECTION IF:

• You are located in a State that allows you to manage excluded hazardous secondary material
under 40 CFR 261.2(a)(2)(ii) 260.30 , 261.4(a)(23), (24), or (25) (27) . See http://www.epa.gov/epawaste/hazard/dsw/statespf.htm for a list of eligible States; AND

• You will begin managing, are still managing, or will stop managing excluded hazardous secondary material under 40 CFR 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24) , or (25) (27) and must notify the appropriate State or Regional Office of your activities, pursuant to 40 CFR 260.42. These regulations exclude certain hazardous secondary material being reclaimed from the RCRA Subtitle C definition of solid waste provid ed certain requirements and conditions are met. See EPA’s website for more information about these regulations: http://www.epa.gov/osw/hazard/dsw/rulemaking.htm

.
Complete all parts 1

– 3 1 and 2

.

NOTE You must be managing excluded hazardous secondary material in compliance with

40 CFR 261.2(a)(2)(ii) 260.30 , 261.4(a)(23), (24), and/or (25) (27) (or State equivalent). Do not include any information regarding your hazardous wastes in this section. See 73 FR

64668 or http://www.epa.gov/epawaste/hazard/dsw/impresource.htm for more
information on these exclusions.

You must submit a completed Site ID Form, including this Addendum, prior to operating under the exclusion(s) and by March 1 of each even

- numbered year thereafter to your regulatory authority using the Site ID Form as pursuant to 40 CFR 260.42. Persons who must satisfy this notification requirement can submit th is information at the same time as their Hazardous Waste Report (which is also due by March 1 of each even

- numbered year).

If you stop managing hazardous secondary material in accordance with the exclusion(s) and do not expect to manage any amount of hazardous secondary material under the exclusion(s) for at least one year, you must also submit a completed Site ID Form, including this Addendum, within thirty (30) days pursuant to 40 CFR 260.42.

Remember to include your EPA Identification Number on the top of each page.36 

### ITEM 1

– INDICATE REASON FOR NOTIFICATION (INCLUD E DATES WHERE REQUES TED)

Place an “X” in the box for the reason that applies to you:

FACILITY WILL BEGIN MANAGING EXCLUDED HAZARDOUS S ECONDARY MATERIAL AS OF (MM/DD/YYYY)

Place an “X” in this box if you are notifying that you will begin managing hazardous secondary material under the exclusion(s).

• Facilities must notify prior to operating under the exclusion(s).

• If placing an “X” in this box, list the date (mm/dd/yyyy) when you will begin managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii) 260.30 , 40 CFR 261.4(a)(23), (24), or (25) (27)

. Note: If the facility had previously notified that it will stop managing hazardous secondary material in the past but will now begin anew, list the next planned start date.

FACILITY IS STILL MANAGING EXCLUDED HAZARDOUS S ECONDARY MATERIAL/RE

NOTIFYING AS REQUIRE D BY MARCH 1 OF EACH EVEN

- NUMBERED YEAR

Place an “X” in t his box if you are re

- notifying that you are still managing hazardous secondary material under the exclusion(s). Note: You must have previously notified that you began managing hazardous secondary material in order to check this box.

• Facilities must re

- n otify by March 1 st 

### of each even

- numbered year.

• If placing an “X” in this box, you do not have to list a date.

FACILITY HAS STOPPED MANAGING EXCLUDED HA ZARDOUS SECONDARY MA TERIAL AS OF (MM/DD/YYYY) AND IS NOTIFYING AS REQUIRE D

Place an “X” in this box, if you are notifying that you have stopped managing hazardous secondary material under the exclusion(s) and do not expect to manage any amount of hazardous secondary material for at least one year (pursuant to 40 CFR 260.42(b)). List the date when you stoppe d managing hazardous secondary material. Enter the date in “mm/dd/yyyy” format.

• Facilities must notify within 30 days of when they stopped managing hazardous secondary material. You are considered to have stopped managing hazardous secondary material if: (1) you stop managing hazardous secondary material completely (e.g., you cease operations); (2) you choose to manage the hazardous secondary material as hazardous waste; (3) you undergo closure and request release from financial assurance per 40 CFR 261. 143(h) or 40 CFR 264.143 ; or (4) you temporarily suspend management of hazardous secondary material for at least one year.

• Only place an “X” in this box if you have stopped managing all hazardous secondary material under the exclusion(s). For example, i f your facility only stopped managing one hazardous secondary material, but continued to manage another hazardous secondary material, you would leave this box blank since your facility continues to manage some amount of hazardous secondary material.37 

### • If yo u submit a notification that you have stopped managing hazardous secondary material, you
do not need to re

- notify (unless you choose to manage hazardous secondary material again, in which case you would have to submit a notification prior to managing). Af ter submitting a stop notification, you can leave the Addendum blank for subsequent submissions, including any subsequent Hazardous Waste Report submissions.

ITEM 2

– DESCRIPTION OF EXCLU DED HAZARDOUS SECOND ARY MATERIAL (HSM) A CTIVITY

In the table provided on the Addendum to the Site Identification Form, list your appropriate facility code, each waste code for the hazardous secondary material you manage, the estimated and actual quantities in short tons for each hazardous secondary mate rial, and the appropriate land

- based code for how you manage the hazardous secondary material. Do not include any information regarding your hazardous
wastes in this section. See examples below on how to answer this question.

a. Facility Code Using the faci lity codes, found in the “ HAZARDOUS SECONDARY MATERIAL (HSM) FACILITY CODES ” section of this booklet, enter the appropriate 2

- digit code(s) that correctly describes your facility. If more than one code appl ies to your facility, enter each 2

- digit code on a separate row. Each hazardous secondary material should be reported by facility code.

b. Waste Code(s) for HSM Use the box provided to enter the appropriate 4

- digit hazardous waste code(s) that would apply t o your hazardous secondary material if you managed it as hazardous waste (i.e., the waste code(s) that would apply if you did not manage your material in accordance with 40 CFR 261.2(a)(2)(ii) 260.30

, 40 CFR 261.4(a)(23), (24), or (25) (27) ).

NOTE If yo u list more codes or manage more hazardous secondary material than will fit in the table under Item 2, please continue under Item 13

– Comments, or on an extra sheet. Remember to include your EPA Identification Number on the top of each page.

c. Estimate Short Tons of Excluded HSM to be Managed Annually In the box provided, enter your estimated tonnage (using short tons) of hazardous secondary material you expect to manage annually. Convert all physical quantities (e.g., gallons, cubic yards, kilograms,

m etric tons, etc.) to short tons (1 short ton = 2,000 pounds) and round to the nearest ton (no decimals). Note: Your estimated tonnage should be for the entire amount of hazardous secondary
material to be reclaimed NOT just the quantity of constituent or product reclaimed.38 

### d. Actual Short Tons of Excluded HSM Managed During the Most Recent Odd

- Numbered Year Report the tonnage (using short tons) of each hazardous secondary material you actually managed during the most recent odd

- numbered year. For example, if you are submitting this notification on February 20, 2016, enter the amount you actually managed during 2015 (i.e., the tonnage you managed from January 1, 2015 to December 31, 2015). Convert all physical quantities (e.g., gallons, cubic yards, kilogra ms, metric tons, etc.) to short tons (1 short ton = 2,000 pounds) and round to the nearest ton (no decimals). Note: Your actual tonnage should be for the entire amount of hazardous secondary material that was sent for reclamation NOT just the quantity of constituent or product reclaimed. If this is your initial notification, enter “0.”

e. Land

- based Unit Code Using the land

- based unit codes, found in the “ HAZARDOUS SECONDARY MATERIAL ( HSM) LAND

BASED UNIT CODES ” section of this booklet, enter in the 2

- digit code that best describes the land

based unit you use or will use to manage the hazardous secondary material. If you do not use any
land

- based units, enter “NA.” If you use the code “OT” (Other), please describe your land

- based unit

in Item 13

– Comments. If more than one land

- based unit code applies to a hazardous secondary material, list it separately using another row.

EXAMPLES FOR REPORTI NG HAZARDOUS SECONDA RY MATERIAL ACTIVITY

EXAMPLE 1

A pharmaceutical manufacturer generates spent solvents that are characteristic for ignitability (D001). The manufacturer plans to manage spent solvents under 40 CFR 261.2(a)(2)(ii) 40 CFR 261.4(a)(23) and 261.4(a)(24) by sending some amount to a reclaimer within its own company and the rest off

- site to a
reclamation recycling facility within the U.S. The manufacturer will not manage any spent solvents in a
land

- based unit. Following the regulations, the manufacturer submits an initial notificati on prior to managing its spent solvents under the exclusions. The facility would report its hazardous secondary material activity as follows:

a. Facility code (answer

using codes listed in
the Code List section of the instructions) b. Waste Code(s) for hazardous secondary material (HSM) c. Estimated short tons
of HSM to be managed annually d. Actual short tons of
HSM that was managed during the
most recent odd

numbered year e. Land

- based unit code (answer using codes
listed in the Code List
section of the

instr uctions)

02 D001 15 0 NA

06 D001 40 0 NA



### EXAMPLE 2

A steel manufacturer generates electric arc furnace dust and spent pickle liquor from one of its steel operations. The manufacturer sends electric arc furnace dust (K061) off

- site to a reclamation recycling facility within the U.S. and reclaims spent pickle liquor (K062) on

- site. Neither hazardous secondary material is managed in a land

- based unit. The steel manufacturer has managed both hazardous secondary
material under 40 CFR 261.2(a) (2) ( ii ) 40 CFR 261.4(a)(23) and 261.4(a)(24) for a number of years and it is

now time to re

- notify. The facility would report its hazardous secondary material activity as follows:39 a. Facility code (answer

using codes listed in
the Code List section of the instructions) b. Waste Code(s) for hazardous secondary material (HSM) c. Estimated short tons
of HSM to be managed annually d. Actual short tons of
HSM that was managed during the
most recent odd

numbered year e. Land

- based unit code (answer using codes
listed in the Code List
section of the instructions)

01 K062 60 52 NA

06 K061 20,000 22,468 NA



### EXAMPLE 3

A reclamation A RCRA

- permitted recycling facility has been receiving and reclaiming spent solvents under 40 CFR 261.2(a) (2) ( ii ) 40 CFR 261.4(a)(23) and 261.4(a)(24) for a number of years. The facility receives and reclaims spent solvents from multiple hazardous secondary material generators, so me of which are within the same company. No spent solvents are managed in a land

- based unit. It is now time to re

notify. The facility would report its hazardous secondary material activity as follows:

a. Facility code (answer

using codes listed in
the Code List section of the instructions) b. Waste Code(s) for hazardous secondary material (HSM) c. Estimated short tons
of HSM to be managed annually d. Actual short tons of
HSM that was managed during the
most recent odd

numbered year e. Land

- based unit code (answer using codes
listed in the Code List
section of the instructions)

03 D001; F002; F003; F005 6,000 7,533 NA

03 D001; D035; F002; F003 1,500 918 NA

07 D001; F002; F003; F005 3,000 3,509 NA

07 D001; D038; F002; F003 1,000 523 NA



### EXAMPLE 4

A smelting operation generates furnace bricks that are characteristic for chromium (D007) and sends them
off

- site for reclamation recycling . Before shipping the bricks off

- site, the facility manages some of the
bricks in a containme nt building and the rest in a pile on the land. The facility has been managing the bricks under 40 CFR 261.4(a)(24) for a number of years and must now re

- notify. The facility would report its activity as follows:

a. Facility code (answer

using codes listed in
the Code List section of the instructions) b. Waste Code(s) for hazardous secondary material (HSM) c. Estimated short tons
of HSM to be managed annually d. Actual short tons of
HSM that was managed during the
most recent odd

numbered year e. Land

- based unit code (answer using codes
listed in the Code List
section of the instructions)

06 D007 200 235 NA

06 D007 115 126 PL



### EXAMPLE 5

An A RCRA

- permitted intermediate facility has been managing wastewater treatment sludges from electroplating operations (F006) for the past seven years but, due to company consolidation, it will soon shut down. In accordance with 40 CFR 260.42, the facility notifies that it will stop managing hazardous secondary material. The facility would report its activity as follows:

a. Facility code (answer

using codes listed in
the Code List section of the instructions) b. Waste Code(s) for hazardous secondary material (HSM) c. Estimated short tons
of HSM to be managed annually d. Actual short tons of
HSM that was managed during the
most recent odd

numbered year e. Land

- based unit code (answer using codes
listed in the Code List
section of the instructions)

08 F005 0 5,034 NA40 

### ITEM 3

– FACILITY HAS FINANCI AL ASSURANCE PURSUAN T TO 40 CFR 261.4(A) (24)(VI)

Financial assurance is required for reclaimers (07, 11) and intermediate (08) facilities managing hazardous secondary material under 40 CFR 261.4(a)(24) and (25). See EPA’s website for m ore information about these regulations: http://www.epa.gov/epawaste/hazard/dsw/impresource.htm

.

• Mark “Yes,” if you have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi) AND you use at least one facility code that is 07, 08, or 11 in Item 2.a above. For example, the facilities in Examples 3 and 5 above are required to have financial assurance because the facility codes are 07 and 08, respectively.

• Mark “No,” if you do NOT have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi). Note: Reclaimers (07, 11) and intermediate (08) facilities must have financial assurance in order to manage hazardous secondary material under 40 CFR 261.4(a)(24) and (25). Answering “No” to
this question may mean you are in violation of these regulations if you report facility codes 07, 08, or 11. For example, the facilities in Examples 1, 2, and 4 above are not required to have financial assurance because these facilities did not report facilit y codes of 07, 08, or 11.41 

## INSTRUCTIONS FOR FIL LING OUT THE

WASTE GENERATION AND MANAGEMENT FORM (GM FORM)

WHO MUST SUBMIT THIS FORM

A site required to file the 2015 2017 Hazardous Waste Report must submit a GM Form if the site generated RCRA hazardous waste that, in 2015 2017 , was accumulated on

- site; managed on

- site in a treatment, storage, or disposal unit; and/or shipped off

- site for management, consistent with the crit eria below. (See

“ WASTES TO BE REPORTED
, ” below, for specific instructions on generated RCRA hazardous wastes that should be reported on the GM Form. See “ WASTES NOT TO BE REPORTED
, ” belo w, for any exclusions or exemptions from the GM Form reporting requirements under the 2015 2017 Hazardous Waste Report.)

PURPOSE OF THIS FORM

The GM Form is for reporting on

- site hazardous waste generation and management in 2015 2017 . The
GM Form is divide d into three sections that document : ( 1) the source, characteristics, and quantity of hazardous waste generated; ( 2) the quantity of hazardous waste managed on

- site along with the management method used; and ( 3) the quantity of hazardous waste shipped off

- site for treatment, disposal, or recycling along with the off

- site management method used.

HOW TO FILL OUT THIS FORM

Make and submit a photocopy of the GM Form for each generated RCRA hazardous waste that should be reported, consistent with the criter ia discussed below. Prior to photocopying, place the pre

- printed site identification label in the top left

- hand corner of the form or, if you did not receive pre

- printed labels, enter the site name and EPA Identification Number in this space.

Use the Co mments section at the end of the form to clarify any entry (e.g., “Other” responses) or to continue any entry. When entering information in the Comments section, cross

- reference the section
number and item letter to which the comment refers.

NOTE Please review your previous cycle’s GM source, form, and management method codes to see if they are still applicable. If applicable, use those same codes for consistency.

Refer to the “ SPECIAL INSTRUCTIONS ” section of this booklet for reporting lab packs, asbestos, PCBs, waste oils, groundwater contaminated by hazardous waste, RCRA

radioactive mixed wastes, and laboratory clean

- out wastes.GM Form (continued)

42 

### WASTES TO BE R E PORTED

In general, each generated RCRA hazardous waste that is used to determine the site’s generator status should be reported on the GM Form. (See “ WASTES NOT TO BE REPORTED
, ” below, for any exclusions or exemptions from the G M Form reporting requirements under the 2015 2017 Hazardous Waste Report. See also the reference document “ Biennial Reporting: Reportable and Non

- Reportable Wastes ”

at : http://www.epa.gov/epawaste/inforesources/data/biennialreport/index.htm

.
A GM Form must be submitted for each generated RCRA hazardous waste. Hazardous waste must be

rep orted if it was:

• Generated and accumulated on

- site and subsequently managed on

- site or shipped off

- site in

2015 2017 ; or

• Generated and accumulated on

- site in 2015 2017 but not managed on

- site or shipped off

- site until
after 2015 2017 ; or

• Generated and accu mulated on

- site prior to 2015 2017 but either managed on

- site or shipped off

site in 2015 2017 ; or

• Imported from a foreign a site located in a foreign country in 2015 2017

. Refer to 40 CFR 262.10(e) and 40 CFR 262.60(a) for additional information.

Examples of RCRA hazardous wastes to be reported include those that were:

• Generated on

- site from a production process, service activity, or routine cleanup.

• Generated from equipment decommissioning, spill cleanup, or remedial cleanup activity.

• Removed from on

- si te storage for treating, recycling, or disposing on

- site or shipped off

- site

.

• Derived from the management of non

- hazardous waste.

• Derived from the on

- site treatment (including reclamation), disposal, or recycling of previously existing hazardous waste ( as a residual).

• Shipped off

- site, including hazardous waste that was received from off

- site (reported on the
Waste Received From Off

- site Form [WR Form]) and subsequently shipped off

- site without being treated or recycled on

- site.

• Radioactive wastes mixed with RCRA hazardous wastes should also be reported; be sure to mark
“Yes” on the Site ID Form in Item 10.A. 4. See the “ DEFINITIONS ” and “ SPECIAL INSTRUCTIONS ”
sections of this booklet for information on this waste.

• Hazardous wastes regulated only by your State should be reported if required by your State.GM Form (continued)

43 

### WASTES NOT TO BE REP ORTED

RCRA hazardous wastes exported directly to a foreign a site located in a foreign country should not be reported on the GM Form (unless required by your State). Facilities that export hazardous waste must file a separate Annual Report under 40 CFR 262.56 and 40 CFR 262.87(a) . (This Annual Report will be in
addition to the Haza rdous Waste Report, if your State requires you to submit a Hazardous Waste Report.)

In addition, m M aterials and wastes identified at 40 CFR 261.2(a)(2)(ii) and 261.4(a) and (b)

, 261.5(c) and

266.70 should not be reported on the GM Form. Section 261.4(a) and (b) identify materials and solid wastes that do not qualify as solid or hazardous wastes, respectively. Section 261.5(c) identifies hazardous wastes that should not be included in a site’s generator status determinat ion, even if these hazardous wastes were generated at the site. Section 266.70 identifies recyclable materials utilized for precious metal recovery.

Following are the materials and wastes addressed under 40 CFR 261.4(a) and (b)

, 261.5(c) , and 266.70

, whic h should not be reported on the GM Form:

• Materials which are excluded from being a solid waste, e.g., any mixture of domestic sewage and other wastes that passes through a sewer system to a publicly owned treatment works (unless they are stored or treated in regulated units prior to being discharged). (40 CFR 261.4(a))

• Solid wastes that are excluded from being hazardous waste, e.g., petroleum

- contaminated media and debris that fail the test for toxicity characteristic (waste codes D018 through D043 only) and are subject to the corrective action regulations under 40 CFR Part 280. (40 CFR 261.4(b))

• Waste exempt from regulation because the waste has not exited the raw material storage or production unit yet, as specified in 261.4(c). (40 CFR 261.5(c)(1))

• Hazardous waste that has been collected as a sample(s) for the purpose of determining its characteristic or composition, as specified in 261.4(d). (40 CFR 261.5(c)(1))

• Sample(s) undergoing treatability studies, as specified in 261.4(e). (40 CFR 261.5(c )(1))

• Sample(s) undergoing treatability studies at the laboratory or testing facility, as specified in 261.4(f). (40 CFR 261.5(c ) (1))

• Hazardous waste that is a specified recyclable material such as ethyl alcohol or scrap metal, as specified in 261.6(a)( 3). (40 CFR 261.5(c)(1))

• A residue of hazardous waste in an empty container or in an inner liner removed from an empty container, as specified in 261.7(a)(1). (40 CFR 261.5(c)(1))GM Form (continued)

44 

### • PCB wastes regulated under the Toxic Substance Control Act, as specified in 40 CFR 261.8, unless mixed with a hazardous waste. (40 CFR 261.5(c)(1))

• Wastes managed immediately upon generation only in on

- site elementary neutralization units, wastewater treatment units, or totally enclosed treatment facilities as defined in 40 CFR 260.10. (40 CFR 261.5(c)(2)) Any hazardous waste residues generated from these units, however, must be reported on the GM Form. (For additional information, see the reference document “Biennial Report: Reportable and Non

- Reportable Wastes” at http://www.epa.gov/epawaste/inforesources/data/biennialreport/index.htm .)

• Wastes recycled, without prior storage, only in an on

- site process subject to regulation under

40 CFR 261.6(c)(2). (40 CFR 261.5(c)(3)) Any hazardous waste residues generated from these units, however, must be reported on the GM Form.

• Used oil that is recycled and is also a hazardous waste solely because it exhibits a hazardous waste characteristic and is managed under 40 CFR Part 279. (40 CFR 261.5(c)(4))

• Spent lead

- acid b atteries managed under the requirements of 40 CFR Part 266, Subpart G, which includes persons who reclaim spent lead

- acid batteries that are recyclable materials; persons who generate, transport, or collect spent batteries; persons who regenerate spent bat teries; or persons who store them (other than spent batteries that are to be regenerated). (40 CFR 261.5(c)(5)) Any hazardous wastes generated during battery reclamation, however, must be reported on the GM Form. ( But a TSDF that receives spent lead acid batteries (SLAB) needs to report according to 40 CFR 264.75 or 265.75.)

• Universal wastes managed under 40 CFR 261.9 and 40 CFR Part 273. (40 CFR 261.5(c)(6)) Any hazardous waste residues generated from these units, however, must be reported on the GM

F orm. (But a TSDF that receives spent lead acid batteries (SLAB) needs to report according to 40 CFR 264.75 or 265.75.)

• Recyclable materials that are reclaimed to recover economically significant amounts of gold, silver, platinum, palladium, iridium, osmiu m, rhodium, ruthenium, or any combination of these. (40 CFR 266.70)

• Unless required by your State, hazardous waste that were, during 2017, exported directly out of
the U.S. to a foreign country site located in a foreign country . Facilities that export h azardous waste must file a separate Annual Report under 40 CFR 262.56. (This Annual Report will be in addition to the Hazardous Waste Report, if your State requires you to submit a Hazardous Waste Report.)GM Form (continued)

45 

### HOW TO REPORT SIMIMI LAR WASTEREPORTING SIMILAR HAZARDOUS WA STE ON THE

GM FORM

Generally, a GM form should be completed for each generated RCRA hazardous waste. A separate GM form should be completed whenever a combination of wastes would require more than one Source Code or Form Code. Contact y our state about combining similar hazardous wastes on the GM form.

ow to Report Similar Wastes on the GM Form

H ow to Report Similar Wastes on the GM Form

Generally, a GM Form should be completed for each generated RCRA hazardous waste. Contact your State about combining and reporting similar hazardous wastes on the GM Form.



### ITEM

- BY

- ITEM INSTRUCTIONS

SECTION 1

– WASTE CHARACTERISTIC S

Section 1 requests information on each RCRA hazardous waste that, in 2015 2017 , was generated and
accumulated on

- site; managed on

- site; and/or shipped off

- site.

All items in this section are mandatory. Note: Either Item B and/or Item C must be provided fo r each

waste stream.

ITEM A

– WASTE DESCRIPTION

Provide a short narrative description of the waste, such as:

• General type;

• Source;

• Type of hazard; and

• Generic chemical name or primary hazardous constituents.

EXAMPLE

“Ignitable spent solvent from degreasing operation in tool production; mixture of mineral spirits and
kerosene.”

In the example, note that the general type (spent solvent), source (degreasing operation in tool production), type of hazard (ignitability), and generic chemical names (mine ral spirits and kerosene) have
all been cited.GM Form (continued)

46 

### ITEM B

– EPA HAZARDOUS WASTE CODE(S)

Enter the four

- character EPA hazardous waste code(s) that appl y ies to the waste reported in Section 1

- Item A. EPA hazardous waste codes are provided in the “ OTHER REFERENCE INFORMATION AND CODE

LISTS ” section of this booklet. If you need room for additional codes, list the codes in the Comments
section and cross

- reference Section 1

- Item B. If fewer than six EPA hazardous waste co des are applicable, leave the remaining spaces blank. If the waste is regulated only by your State, leave Item B blank and report the State hazardous waste codes in Item C.

LIST For a list of EPA Hazardous Waste Codes, see the “ OTHER REFERENCE INFORMATION AND

CODE LISTS ” section of this booklet.

ITEM C

– STATE HAZARDOUS WAST E CODE(S)

Enter the State hazardous waste code(s) that applies to the waste reported in Section 1

- Item A, if:

• Your State regulates hazardous wastes not regulated as RCRA hazardous waste and requires these wastes to be reported in the 2015 2017 Hazardous Waste Report; or

• Your State uses a hazardous waste code system other than the EPA hazardous waste codes that applies to the waste describe in Section 1

- Item A.

Otherwise, leave Section 1

- Item C blank. If you need space for additional State hazardous waste codes,
list the codes in the Comments section and cross

- referen ce Section 1

- Item C.

ITEM D

– SOURCE CODE AND MANA GEMENT METHOD CODE F OR SOURCE CODE G25

Enter the Source Code that best describes how the hazardous waste reported in Section 1

- Item A originated. If the hazardous waste was mixed with other non

- hazard ous materials, report the Source Code for only the hazardous waste portion.

If your site is a U.S. Importer, provide the appropriate Source Code for hazardous waste imported from a foreign a site located in a foreign country. Also, mark “Yes” on the Site I D Form, Item 10.A.3

– United States Importer of Hazardous Waste. Review the “ SPECIAL INSTRUCTIONS ” and Foreign Site Identification
Number Codes List section s of this booklet for information on reporting wastes received from foreign

countries

.

LIST For a list of Source and Management Method Codes, see the ” the “ OTHER REFERENCE

INFORMATION AND CODE LISTS ” section of this booklet.GM Form (continued)

47 

### NOTE • If reporting Source Code G25 ( Treatment, disposal, or recycling of hazardous

wastes ), you also need to provide the Management Method Code. Source Code G25 indicates that this waste was generated from a n on

- site hazardous waste management system described on a separate GM Form or WR Form. Enter the same Management Method Code that is listed on the matching GM Form

– Section 2, or on the matching WR Form

– Item H, linking this waste with the on

- site process that
created it. Do not report H141 in Section 1

– Item D.

• If reporting Source Code G61 (Hazardous waste received from off

- site for storage/bulking and transfer off

- site for treatment or disposal), the generation amount must be zero (0) in Section 1

– Item F.

NOTE • Source Code G17 (Subpart K laboratory waste clean

- out) is for facilities that have opted into the Subpart K Academic Laboratory Waste Rule to report the amount of laboratory waste shipped or managed during clean

- out. The generation amount must be zero (0)

in Section 1

– Item F for this source code. See the “ SPECIAL INSTRUCTIONS ” section of
this booklet for additional information.

ITEM E

– FORM CODE

Review the Form Codes and enter the code that best corresponds to the physical form or chemical composition of the hazardous waste reported in Section 1

– Item A.

LIST For a list of Form Codes, see the “ OTHER REFERENCE INFORMATION AND CODE LISTS ”
section of this booklet.

ITEM F

– QUANTITY GENERATED I N 2015 2017 / UOM AND DENSITY

Enter the total quantity of the hazardous waste described in Section 1

– Item A that was generated during

2015 2017 . Right justify the quantity entry.GM Form (continued)

48 

### Enter the Unit of Measure (UOM) code for the quantity you reported in Section 1

– Item F. Report the quantity in one of the units of measure listed below. If you select a volumetric measure (gallons, liters, or cubic yards), you also must report the dens ity of the waste.

Code Unit of Measure Weight and Volume Conversions

1 kilogram (kg) = 2.2046 pounds (lb s ) 1 short ton = 2,000 lb s 1 metric ton = 1,000 kg
1 metric ton = 1.1023 short tons

1 cubic meter (m) = 1.3079 cubic yards 1 cubic yard (yd) = 27 cubic feet (ft) 1 liter (l) = 0.2642 gallons (gal) 1 Pounds

2 Short tons (2,000 pounds)

3 Kilograms

4 Metric tons (1,000 kilograms)

5 Gallons

6 Liters

7 Cubic yards



### Skip to Section 1

– Item G if you selected code 1, 2, 3, or 4. Continue to Density if you selected code 5, 6, or 7.

Report the density only if you entered code 5, 6, or 7 for the unit of measure. Provide the density in either pounds per gal (lbs/gal) or specific gravity (sg) and place an “X” in the appropriate box to indicate which
measure was used.

ITEM G

– WASTE MINIMIZATION C ODE

40 CFR 262.41(a)(6), 264.75(h), and 265.75(h) requires that data be collected for waste minimization activities. Enter the code that best corresponds to waste minimization, recycling, o r pollution prevention efforts implemented to reduce the volume and toxicity of the hazardous waste reported in Section 1, Item A. This waste minimization activity must have occurred during this reporting cycle . If minimization was not attempted (to the point of implementing a change) for this waste, you must enter an “X” (no waste minimization efforts were implemented for this waste) for this item.

LIST For a list of Waste Minimization Codes and the definition of waste minimization , see the

“ OTHER REFERENCE INFORMATION AND CODE LISTS ” section of this booklet.GM Form (continued)

49 

### SECTION 2

– ON

- SITE GENERATION AND MANAGEMENT OF HAZARD OUS WASTE DURING

2015 2017

Answering “Yes” or “No” to this question i s mandatory . If you answer “Yes

, ” for each on

- site RCRA

regulated management system, you must report the management method and quantity treated, disposed, or recycled on

- site during 2015 2017

.

WAS ANY OF THIS W A STE THAT WAS GENERAT ED AT THIS FACILITY TREATED, DISPOSED, AND/OR RECYCLED ON

- SITE?

Mark “Yes” or “No” to this question to indicate if the site did any of the following to the waste reported

in Section 1

– Item A: treat on

- site; dispose on

- site; recycle on

- site. If you marked “Yes,” complete the
blocks for On

- site Proc ess Systems below. If you marked “No,” skip to Section 3.

EXAMPLE 1

Facility A generates spent solvents that it recycles on

- site in a distillation column. This facility would mark
“Yes” in Section 2 and would fill out the on

- site process system box accordingly.

EXAMPLE 2

Facility B receives spent solvents from off

- site and blends the solvents into fuel. The facility then sends
the fuels off

- site to be burned for energy recovery. Facility B would report on its GM Form the new waste generated in Sect ion 1

– Item D as Source Code G25 ( Treatment, disposal, or recycling of hazardous wastes) ) with the management method code of H061 (Fuel Blending). Facility B would mark “No” in Section 2 because it did not manage any of the newly generated fuels on

- site . This facility would report
the off

- site shipment in Section 3 and would report the Management Method Code H050 (Energy Recovery).

ON

- SITE MANAGEMENT METH OD CODE

Classify the process system (see definition) with a Management Method Code that best ident ifies the last substantive purpose/operation performed at your site. Space is provided to report up to two different (non

- sequential) Management Methods. If you did not use a second on

- site process system to manage the waste, leave the Management Method Code under On

- site Process System 2 blank. Do not report
H141 in Section 2.

LIST For a list of Management Method Codes, see the “ OTHER REFERENCE INFORMATION AND

CODE LISTS ” section of this booklet.GM Form (continued)

50 

### The space provided for the second on

- site process system should be used only in the special case of management of the same waste on

- site by more than one process system during 2015 2017 . Use the
second on

- site process system only when:

• A waste is managed in one process system for a part of a year and in another process system for the rest of the year; or

• A waste is managed by two different process systems at the same time (i.e., management of the waste is split between parallel process systems).

EXAM PLE OF NON

- SEQUENTIAL (PARALLEL ) PROCESSES

A firm generated 100 tons of F002 solvent waste in 2015 2017 . 80 tons were recycled for reuse in a batch distillation process system, generating 5 tons of still bottoms. The remaining 20 tons were burned in an

in dustrial boiler. Under On

- site Process System 1, the site enters the Management Method Code H020 (Distillation) and a quantity of 80 tons. Under On

- site Process System 2, the site enters the Management Method Code H050 (Energy Recovery) and a quantity of 20 tons. The 5 tons of still bottoms should be reported on a separate GM Form.

If more than two on

- site process systems meet one of the above conditions, you need not complete the entire form again. Simply attach a second copy of the GM Form with the EP A I dentification number and Site Name. Leave all the other fields blank, except Section 2 for on

- site process systems. Note in the Comments section of each page: “Section 2, On

- site Process System Type continued on supplemental page.” (Refer to instruct ions on “ PAGE NUMBERING OF FORMS ” for information on supplemental pages.)

The space provided for the second on

- site process system should not be used to report the following:

• The on

- site management of the treatment res idual generated from management of the waste by the first management method (on

- site management of treatment residuals should be reported on a separate GM Form); or

• To report treatment in a series of process units (see definition in the “ OTHER REFERENCE

INFORMATION AND CODE LISTS ” section of this booklet ). Report only process systems, not process units.

EXAMPLE OF SEQUENTIA L PROCESSES

A firm generated 100 tons of D002 and D007 plating waste in 2015 2017 . 100 ton s were neutralized,
stored on

- site, and then chemically batch

- treated to remove the D007 (Chromium). 90 tons of wastewater and 10 tons of D007 and F006 sludge were shipped off

- site for eventual disposal. Under On

site Process System 1, the site enters th e last substantive on

- site Management Method Code H070 (Chemical Treatment) and a quantity of 100 tons. The site reports the residual 10 tons of sludge on a separate GM Form with Section 1

– Item D Management Method Code H070 (Chemical Treatment). (If
th ere was no storage and the wastewater had been allowed to go into the POTW or NPDES, this page would not be reported, only the D007 and F006 sludge

– with a source code of G23.)GM Form (continued)

51 

### QUANTITY TREATED, DI SPOSED, OR RECYCLED ON

- SITE IN 2015 2017

Enter the quantit y of hazardous waste described in Section 1 that was treated, disposed, or recycled by the reported on

- site process management method during 2015 2017

. Enter the quantity in the same unit of measure reported in Section 1

– Item F (Quantity Generated in 2015 2017 ).

SECTION 3

– OFF

- SITE SHIPMENT OF HAZ ARDOUS WASTE

This section requests information on the off

- site shipment of hazardous waste. Answering “Yes” or “No” to this question is mandatory . If you answer “Yes

, ” all items in this section are mand atory

. Do report shipments of previously generated hazardous wastes stored until 2015 2017

. Do report waste shipped via transfer facility. Do not report shipments of de

- characterized wastes.

Space is provided to report shipments of the waste to three dif ferent off

- site facilities. If the waste you reported in Section 1 was shipped to more than three of f

- site facilities during 2015 2017 , you need not complete the entire form again. Simply attach a second copy of the GM Form, leaving blank all entries except Section 3

– Items B, C, and D. Note in the Comments section of each page: “Section 3

- Item B continued on supplemental page.” ( Refer to instructions on “ PAGE NUMBERING OF FORMS ” for
information on supplemental pages.)

ITEM A

– WAS ANY OF THIS WAST E SHIPPED OFF

- SITE IN 2015 2017 FOR TREATMENT,
DISPOSAL, OR RECYCLI NG?

Mark “Yes” or “No” to indic ate if any of the waste described in Section 1 was shipped off

- site for treatment, disposal, or recycling during 2015 2017

.

This GM Form is complete if you marked “No” in Item A.

Continue to Section 3

– Item B if you marked “Yes” in Item A.

ITEM B

– EPA ID NUMBER OF FAC ILITY TO WHICH WASTE WAS SHIPPED

The 12

- digit EPA Identification Number of the facility to which the waste was shipped. Do not create a GM Form for hazardous waste shipped directly to a foreign a site located in a foreign country from this site (unless required by your State). You must complete an Annual Report as required under 40 CFR

262.56 and 40 CFR 262.87(a) , no later than March 1 of each year. Facilities that export hazardous waste
should list in Item B a can use the Foreign Site Identification Number Codes listed in the Codes Description

s ection for Item B . If a site located in a foreign country to which hazardous waste is shipped is not on the list, enter “FC” followed by the name of the country as the EPA Identification n N umber. Please also seeGM Form (continued)

52 

### the “SPECIAL INSTRUCTIONS” section. For wastes shipped to foreign countries, if the facility does not have
an identification number listed in the “SPECIAL INSTRUCTIONS”, enter “FC” followed by the name of the country for the EPA Ident ification Number.

ITEM C

– OFF

- SITE MANAGEMENT METH OD CODE SHIPPED TO

Review the Management Method Codes in the “ OTHER REFERENCE INFORMATION AND CODE LISTS ” section of this booklet. Enter the Management Method Code that best describes the way in which the waste was managed at the initial receiving facility reported in Section 3

– Item B.

LIST For a list of Management Method Codes, see the “ OTHER REFERENCE INFORMATION AND

CODE LISTS ” section of this booklet.

ITEM D

– TOTAL QUANTITY SHIPPED IN 2015 2017

Enter the total quantity of the waste shipped to the off

- site facility during 2015 2017

. Report the quantity in the same unit of measure entered in Section 1

– Item F. Shipment quantities should equal the total quantity recorded on Uniform Hazardous Waste Manifests for this site during 2015 2017 , unless there were rejections or other complicat ions. The quantity shipped may not necessarily equal the quantity generated (e.g., because some waste is still on

- site at the end of the year or waste was removed from storage from a previous year’s generation).

COMMENTS

Use this section as needed to exp lain anything contained in the form including any waste minimization efforts. The comments may help make determinations of data validity if questions arise during the review of the report. If there are special circumstances surrounding the waste describe d on the form, please note this here, especially if you are filing the report due to a one

- time event.53 

## INSTRUCTIONS FOR FIL LING OUT THE

WASTE RECEIVED FROM OFF

- SITE FORM (WR FORM)

WHO MUST SUBMIT THIS FORM

A site required to file the 2015 2017 Hazardous Waste Report must submit this form if, during 2015 2017

, it received RCRA hazardous waste from off

- site.

PURPOSE OF THIS FORM

The WR Form identifies hazardous wastes that were received from other hazardous waste sites and the method(s) used to manage them. The WR Form is divided into three identical parts (i.e., waste blocks), labeled Waste 1, Waste 2, and Waste 3, that collect information on the quantities and characteristics of
each hazardous waste received from an off

- site source during 2015 2017 and managed on

- site.

HOW TO FILL OUT THIS FORM

You may report waste received from more than one off

- site handler on the same page of the form. A separate waste block must be filled out for each hazardous waste received from each off

- site handler.
Hazardous waste from the same off

- site handler may be aggregated as long as a single form code describes the physical form or chemical comp osition, and all of the waste is managed in a single process system (i.e., same management method code).

If your site received more than three RCRA hazardous wastes from off

- site handlers during 2015 2017

, photocopy and fill out additional copies of this fo rm. Prior to photocopying, place the pre

- printed site identification label in the top left

- hand corner of the form or, if you did not receive pre

- printed labels, enter the site name and EPA Identification Number in the space provided.

Use the Comments sec tion at the end of the form to clarify any entry (e.g., “Other” responses) or to continue any entry. When entering information in the Comments section, cross

- reference the waste block
and item letter to which the comment refers.WR Form (continued)

54 

### ITEM

- BY

- ITEM INSTRUCTIONS

All items in this section are mandatory for each waste reported. Note: Either Item B and/or Item C must be provided for each reported waste.

ITEM A

– WASTE DESCRIPTION

Provide a short narrative description of the waste, such as:

• General type;

• Source;

• Type of hazard; and

• Generic chemical name or primary hazardous constituents.

EXAMPLE

“Ignitable spent solvent from degreasing operation in tool production; mixture of mineral spirits and
kerosene.”

In the example, note that the ge neral type (spent solvent), source (degreasing operation in tool production), type of hazard (ignitability), and generic chemical names (mineral spirits and kerosene) have
all been cited.

ITEM B

– EPA HAZARDOUS WASTE CODE(S)

Enter the four

- character EPA h azardous waste code(s) that applies to the waste reported in Item A. EPA hazardous waste codes are provided in the “ OTHER REFERENCE INFORMATION AND CODE LISTS ” section of this booklet. If you need room for additional codes, l ist the codes in the Comments section and cross

reference the applicable waste block number (e.g., Waste 1) and Ite m B. If fewer than four EPA hazardous waste codes are applicable, leave the remaining spaces blank. If the waste is regulated only by your State, leave Item B blank and report the State hazardous waste codes in Item C.

LIST For a list of EPA Hazardous Waste Codes, see the “ OTHER REFERENCE INFORMATION AND

CODE LISTS ” section of this booklet.WR Form (continued)

55 

### ITEM C

– STATE HAZARDOUS WAST E CODE(S)

Enter the State hazardous waste code(s) that applies to the waste reported in Item A, if:

• Your State regulates hazardous wastes not regulated as RCRA hazardous waste and requires these wastes to be reported in the 2015 2017 Hazardous Waste Report; or

• Your State uses a hazardous waste code system other than the EPA hazardous waste codes that applies to the waste describe in Item A.

Otherwise, leave I tem C blank. If you need space for additional State hazardous waste codes, list the
codes in the Comments section and cross

- reference the applicable waste block number (e.g., Waste 1)
and Item C.

ITEM D

– OFF

- SITE HANDLER EPA IDE NTIFICATION NUMBER

E nter the 12

- digit EPA Identification Number of the off

- site handler from which the waste was received. If the site does not have an EPA Identification Number, it may be a conditionally exempt small quantity generator ( CESQG ) or a site located in a foreign country. Refer to the “ SPECIAL INSTRUCTIONS ” and the Foreign Site Identification Number Codes List section s of this booklet for instructions on how to complete
Item D for these off

- site handlers.

If the waste reported under Waste 2 is received from the same off

- site handler as the waste reported under Waste 1, put “Same as above” to indicate that the EPA Identification Number is the same as the one reported in Waste 1; if Waste 3 is received from the same off

- s ite handler as Waste 2, put “Same as above” to indicate that the EPA Identification Number is the same as the one reported under Waste 2.

NOTE Refer to the “ SPECIAL INSTRUCTIONS ” section of this booklet for information on reporting wastes received from CESQGs and wastes received from sites located in foreign countries.

ITEM E

– QUANTITY RECEIVED IN 2015 2017

Report the total quantity of hazardous waste reported in Item A that was received from the off

- site handler reported in Item D during 2015 2017 . If more than one shipment of this waste was received from
the same off

- site handler, add the quantities and rep ort only the sum.WR Form (continued)

56 

### ITEM F

– UOM AND DENSITY

Enter the Unit of Measure (UOM) code for the quantity you reported in Item E . Report the quantity in
one of the units of measure listed below. If you select a volumetric measure (gallons, liters, or cubic yards), you must also report the density of the waste.

Code Unit of Measure Weight and Volume Conversions

1 kilogram (kg) = 2.2046 pounds (lb s ) 1 short ton = 2,000 lb 1 metric ton = 1,000 kg
1 metric ton = 1.1023 short tons

1 cubic meter (m) = 1.3079 cubic yards 1 cubic yard (yd) = 27 cubic feet (ft) 1 liter (l) = 0.2642 gallons (gal) 1 Pounds

2 Short tons (2,000 pounds)

3 Kilograms

4 Metric tons (1,000 kilograms)

5 Gallons

6 Liters

7 Cubic yards



### Skip to Item G if you selected code 1, 2, 3, or 4. Continue to Density if you selected code 5, 6, or 7.

Report the density only if you entered code 5, 6, or 7 for the unit of measure. Provide the density in either pounds per gal (lbs/gal) or specific gravity (sg) and place an “X” in the appropriate box to indicate which
measure was used.

ITEM G

– FORM CODE

Review the Form Codes and enter the code that best corresponds to the physical form or chemical composition of the hazardous waste reported in Item A.

LIST For a list of Form Codes, see the “ OTHER REFERENCE INFORMATION AND CODE LISTS ”
section of this booklet.WR Form (continued)

57 

### ITEM H

– MANAGEMENT METHOD CO DE

Enter the code that describes the type of process system (see definition) in which the waste was managed.

LIST For a list of Management Method Codes, see the “ OTHER REFERENCE INFORMATION AND

CODE LISTS ” section of this booklet.

COMMENTS

Use this section as needed to explain anything contained in the form. The comments may help make determinations of data validity if questions arise during the review of the report. If there are special circumstances surrounding the waste described on the form, please note this here.

# 2015 2017 Hazardous Waste Report

OTHER REFERENCE INFO RMATION

AND

CODE LISTS59 

## EXCLUDED WASTES

This section presents a partial list of excluded materials and wastes. This list includes materials excluded from the definition of solid waste in 40 CFR 261.4(a) and solid wastes excluded from the definition of hazardous waste in

40 CFR 261.4(b). In addition, it also includes specific solid waste samples that are excluded from the definition of hazardous waste in 40 CFR 261.4(d)

- (f). Finally, this list includes specific hazardous wastes, as described in 40 CFR 261.4(c), that are exempted from certain RCRA Subtitle C regulations.

Agricultural Waste Fertilizer §261.4(b)(2)

Analytical Samples

– A Sample Of Solid Waste Or A Sample Of Water, Solid, Or Air, Which Is Collected For The Sole Purpose Of Testing To Determine Its Characteristics Or Composition §261.4(d)

Arsenic Treated Wood and Wood
Products §261.4(b)(9)

Carbon Dioxide Stream Injected For Geologic Sequestration. Carbon
Dioxide Stream s That Are Captured And Transported For Purposes Of Injection Into An Underground Injection Wells, Including The Requirements in 40 CFR Parts 144 And 146 Of The Underground Injection Control Program Of The Safe Drinking

Water Act §261.4(h )

Cement Kiln Dust §261.4(b)(8)

Coking By

- products §261.4(a)(10 )

Comparable/Syn gas Fuels §261.4(a)(16)

Domestic Sewage §261.4(a)(1)

Dredged Material That Is Subject To The Requirements Of A Permit That
Has Been Issued Under 404 Of The
Federal Water Pollution Control Act (33 U.S.C. 1344) Or Section 103 Of The Marine Protection, Research, And Sanctuaries Act of 1972 (33 U.S.C. 1413) §261.4(g) Drilling Flu id §261.4(b)(5)

Excluded Scrap Metal Being Recycled §261.4(a)(13)

Exported Wastes
§262.56

Fossil Fuel Emission Control Waste §261.4(b)(4)

Hazardous Secondary Material Being
Remanufactured §261.4(a)(27)

Hazardous Secondary Material s Generated And Legitimately
Reclaimed Under The Control Of The

Generator §26 1.4(a)(23 )

Hazardous Secondary Material
Generated and Reclaimed Under the
Control of the Gener ator 40 CFR §261.2(a)(2)(ii)

40 CFR §261.4(a)(23)

Hazardous Secondary Material
That Is Generated And Then
Transferred To A Verified Reclamation Facility For The Hazardous Secondary
Material Purpose Of Reclamation
§26 1.4(a)(24 )

Hazardous Secondary Material
Transferred Off

- site for Reclamation to A Verified Recycler

40 CFR §261.4(a)(25)

40 CFR §261.4(a)(24)

Hazar dous Secondary Material Used to Make Zinc Fertilizers, Provided That
The Following Conditions Specified Are
Satisfied §261.4(a)(20) Household Waste §261.4(b)(1)(i)

- (ii)

HTMR Condenser Residue §261.4(a)(11)

In situ Mining Materials §261.4(a)(5)

Irrigation Return Flows §261.4(a)(3)

Kraft Mill Steam Stripper Condensates §261.4(a)(15)

Leachate Or G as Condensate Collected
From Landfills Where Certain Solid Wastes Have Been Disposed §261.4(b ) (15)

Mining and Mineral Process Wastes §261.4(b)(7)

Mining Overburden §261.4(b)(3)

Non

- terne plated used oil filters that
are not mixed with wastes listed in subpart D of this part if these oil filters have been gravity hot

- drained using one of the following methods:

- §261.4(b)(13)

Nuclear Material §261.4(a)(4)

Oil Filters §261.4(b)(13)

Petrochemical Recovered Oil §261.4(a)(18)

Petroleum

- contaminated Media and
Debris §261.4(b)(10)

Petroleum Refining §261.4(a)(12)60 Pulping Liquor §261.4(a)(6)

Refrigerants §261.4(b)(12)

Secondary Material Returned to Original Process §261.4(a)(8)

Secondary Material from Mineral Processing §261.4(a)(17)

Shredded Circuit Boards Being Recycled §261.4(a)(14)

Solid Waste That Would Otherwise
Meet The Definition Of Low

- level Mixed Wastes (LLMW) Pursuant to
§266.210 §261.4(b)(17)

Solvent

- Contaminated Wipes , Except For Wipes That Are Hazardous Waste
Due To The Presence Of Trichloroethylene, That Are Sen t F or Disposal Are Not Hazardous Waste
From The Point Of Generation §261.4(b)(18) Solvent

- Contaminated Wipes Sent for Cleaning or Disposal §261.4(a)(26)

Spent Caustics from Petroleum Refining §261.4(a)(19)

Spent Wood Preserving Solutions and

Wastewaters §261.4(a)(9)

Sulfuric Acid §261.4(a)(7)

Treatability Study Samples §261.4(e)

Treatability Studies at Laboratories and Testing Facilities §261.4(f)

Trivalent Chromium Waste §261.4(b)(6)

Used Cathode Ray Tubes (CRTs) §261.4(a)(22)

Used Chlorofluorocarbon Refrigerants From Totally Enclosed Heat Transfer Equipment §261.4(b)(1 2) Used Oil Distillation Bottoms §261.4(b)(14)

Used Oil Re

- refining Distillation
Bottoms That Are Used As Feedstock To Manufacture Asphalt Products §261.4(b)(14)

Wastes Generated in Storage Tanks, Transport Vehicles, Pipelines, or Manufacturing Process Units §261.4(c)

Wastewater Point Source Discharge §261.4(a)(2)

Zinc Fertilizers Made From Hazardous Wastes, Or Hazardous Secondary
Material That Are Excluded Under Paragraph (a)(20) Of This Section §261.4(a)(21)61 

## DEFINITIONS

This section contains definitions of terms helpful for completing the form. For terms defined in the Code of Federal Regulations (CFR), the appropriate citation is provided.

A CCUMULATION



### – A site that does not hold RCRA Interim Status or a RCRA permit may accumulate hazardous waste for a short period of time before shipping it off

- site. The waste must be accumulated in either tanks or containers; it may not be accumulated in surface impo undments.

Generators of more than 1,000 kilograms ( kg; 2,200 pounds [ lbs ] ) of hazardous waste per month may accumulate their waste for up to 90 days before shipping it off

- site. Generators of 100 kg (220 lbs) to 1,000 kg (2,200 lbs) of hazardous waste per month may accumulate their waste for up to 180 days before shipping it off

- site. If the nearest treatment, storage, disposal, or recycling facility to which they can send their waste is more than 200 miles away, they may accumulate their waste for 270 da ys.
See 40 CFR 262.34.

A CT OR 

### RCRA

– The Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act of 1976, as amended by the Hazardous and Solid Waste Amendments of 1984, 42 U.S.C. Section 6901
et seq

.

A CUTE 

### H AZARDOUS 

### W ASTE



### – An y hazardous waste with an EPA hazardous waste code beginning with the letter “P” (40 CFR 261.33(e)) or any of the following “F” codes: F020, F021, F022, F023, F026, and F027 (40 CFR 261.31). These wastes are subject to stringent quantity standards for ac cumulation and generation (40 CFR 261.5(e)).

A UTHORIZED 

### R EPRESENTATIVE



### – The person responsible for the overall operation of the site or an operational unit (i.e., part of a site), e.g., superintendent or plant manager, or person of equivalent responsibili ty.

A UTHORIZED 

### S TATE



### – A State that has obtained authorization from the EPA to direct its own RCRA program.

B OILER



### – An enclosed device using controlled flame combustion and having the following characteristics:

• The unit has physical provisions for recover ing and exporting energy in the form of steam, heated fluids, or hea t ed gases;

• The unit’s combustion chamber and primary energy recovery section(s) are of integral design (i.e., they are physically formed into one manufactured or assembled unit);

• The unit continuously maintains an energy recovery efficiency of at least 60 percent, calculated in terms of the recovered energy compared with the thermal value of the fuel;

• The unit exports and utilizes at least 75 percent of the recovered energy, calculated on an annual basis (excluding recovered heat used internally in the same unit, for example, to preheat fuel or combustion air or drive fans or feedwater pumps); or

• The un it is one which the Regional Administrator has determined, on a case

- by

- case basis, to be a boiler, after considering the standards in 40 CFR 260.32.

B Y



### - PRODUCT 

### M ATERIAL



### – A by

- product material is : (1) any radioactive material (except special nuclear material) yielded in or made radioactive by exposure to the radiation incident to the process of producing or utilizing special nuclear material; and (2) the ta ilings or wastes produced by theDefinitions (continued)

62 

### extractio n or concentration of uranium or thorium from any ore processed primarily for its source material content (defined in the Atomic Energy Act of 1954).

C ODE OF 

### F EDERAL 

### R EGULATIONS 

### (CFR)

– Codification of the general and permanent rules published in the Federal Register by the Executive departments and agencies of the Federal Government. The Code is divided into 50 titles which represent broad areas subject to Federal regulation. Each t itle is divided into chapters that usually bear the name of the issuing agency. Each chapter is further subdivided into parts covering specific regulatory areas. The CFR title applicable for the Haza r dous Waste Report is “40,” as in “40 CFR 262.34.”

C ON DITIONALLY 

### E XEMPT 

### S MALL 

### Q UANTITY 

### G ENERATOR 

### (CESQG) OF 

### H AZARDOUS 

### W ASTE 

### is a generator who generates less than or equal to the following amounts in a calendar month: ( i ) 100 kilograms ( kg; 220 pounds [ lbs ] ) of hazardous waste; and ( ii ) 1 k g (2.2 lbs) of acute hazardous wastes listed in sections 261.31, or 261.33(e); and ( iii ) 100 k g (220 lbs) of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes listed in sections 261.31, or 261.33(e)

.

C ONFIDENTIAL 

### B USINESS 

### I NFORMATION 

### (CBI)

– Information a facility does not wish to make available to the general public for competitive business reasons. Confidential Business Information (CBI) may be
claim ed for certain information in your submittal. A claim may be made in accordance with 40 CFR Part 2, Subpart B.

D ELISTED 

### W ASTE



### – Site

- specific wastes excluded from regulation under 40 CFR 260.20 and 260.22. A waste at a particular generating site may be excluded by petitioning the EPA Administrator for a regulatory amendment. These wastes are listed in Appendix IX of 40 CFR Part 261.

D ISPOSAL



### – The discharge, deposit, injection, dumping, spilling, leaking, or placing of any solid waste or
hazardous wast e into or on any land or water so that such solid waste or hazardous waste or any constituent thereof may enter the environment or be emitted into the air or discharged into any waters, including groundwaters.

E LIGIBLE 

### A CADEMIC 

### E NTITY



### – A college or unive rsity, or a non

- profit research institute that is owned by or has a formal written affiliation with a college or university, or a teaching hospital that is owned by or has a formal written affiliation with a college or university pursuant to 40 CFR Part 26 2

, Subpart K (See 40 CFR 262.200).

E NVIRONMENTAL 

### P ROTECTION 

### A GENCY 

### (EPA)

– The EPA, also called U.S. EPA, means the U.S. Environmental Protection Agency. Some State environmental authorities may be called the EPA also, as in “Illinois
EPA.”

EPA I DENTIFICATION 

### (ID) N UMBER



### – The number assigned by the EPA to each hazardous waste generator, hazardous waste transporter, and treatment, storage, or disposal facility; U.S. importer of hazardous waste; mixed waste (hazardous and radioactive) generator; r ecycler of hazardous waste; exempt boiler and/or industrial furnace burning or processing hazardous waste; large quantity handler of or destination facility for universal wastes; disposer of hazardous waste with an underground injection permit; used oil tr ansporter, used oil processor/re

- refiner, off

- specification used oil fuel burner, usedDefinitions (continued)

63 

### oil fuel marketer; eligible academic entity managing laboratory hazardous waste under Subpart K; or site undergoing corrective action. Additionally, facilities that mus t notify using the Site ID Form and
Addendum to the Site Identification Form that they are managing hazardous secondary material will also be assigned an EPA I dentification N umber.

E XCLUDED 

### W ASTES



### – Wastes excluded from the definition of solid or hazardou s waste under 40 CFR 261.3 and 261.4. For a partial listing, see the “ EXCLUDED WASTES ” section of this booklet.

GM F ORM



### – Waste Generation and Management Form.

H AZARDOUS 

### W ASTE



### – A hazardous waste as defined in 40 CFR 261.3.

H AZARDOUS 

### S ECONDARY 

### M ATERIAL 

### (HSM)

– A secondary material (e.g., spent material, by

- product, or sludge) that, when discarded, would be identified as hazardous waste under 40 CFR Part 261. Facilities managi ng hazardous secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25) must complete the Addendum to the Site Identification Form: Notification for Managing Hazardous Secondary Material. You must check with your State to determi ne if you are eligible to manage hazardous secondary material under these exclusions (see also http://www.epa.gov/epawaste/hazard/dsw/statespf.htm ).

H AZARDOUS 

### W ASTE 

### G ENERATOR



### – Any person , by site, whose act or process produces hazardous waste
identified or listed in 40 CFR Part 261.

H AZARDOUS 

### W ASTE 

### N UMBER OR 

### C ODE 

### , EPA

– The number (or code) assigned by the EPA to each hazardous waste listed in 40 CFR Part 261, Subpart D and to each chara cteristic identified in 40 CFR Part 261, Subpart C. The codes consist of one letter (D, F, P, U, or K) and three numbers . For a list of EPA
hazardous waste codes

, see the “ EPA HAZARDOUS WASTE CODES ” section of this booklet.

H AZARDOUS 

### W ASTE 

### N UMBER OR 

### C ODE 

### , S TATE



### – The number (or code) assigned by the State to each hazardous waste listed in the State regulations. Obtain a list of the States waste codes from your State.

H AZARDOUS 

### W ASTE 

### S TORAGE



### – The holding of hazard ous waste for a temporary period, at the end of which the hazardous waste is treated, disposed of, or stored elsewhere.

H AZARDOUS 

### W ASTE 

### T RANSFER 

### F ACILITY



### – Refer to “Transfer Facility” definition.

H AZARDOUS 

### W ASTE 

### T RANSPORTER



### – Refer to “Transporter” definition.

H AZARDOUS 

### W ASTE 

### T REATMENT



### – Any method, technique, or process, including neutralization, designed to change the physical, chemical, or biological character or composition of any hazardous waste so as to neutralize such hazardous waste, or so a s to recover energy or material resources from the hazardous waste, or so as to render such hazardous waste nonhazardous, or less hazardous; safer to transport, store, or dispose of; or amenable for recovery, amenable for storage, or reduced in volume. Su ch term includes any activity or processing designed to change the physical form or composition of
hazardous waste so as to render it nonhazardous.Definitions (continued)

64 

### I NCINERATION



### – Burning of certain types of solid, liquid, or gaseous materials; or a treatment technol ogy involving destruction of waste by controlled burning at high temperatures (e.g., burning sludge to remove the water and reduce the remaining residues to a safe, non

- burnable ash that can be disposed safely on land, in some waters, or in underground loc ations).

I NDUSTRIAL 

### F URNACE



### – Any of the following enclosed devi c es that are integral components of manufacturing processes and that use thermal treatment to accomplish recovery of materials or energy: cement kilns; lime kilns; aggregate kilns; phosphate kilns; coke ovens; blast furnaces; smelting, melting, and refining furnaces; titanium dioxide chloride process oxidation reactors; methane reforming furnaces; pulping liquor recovery furnaces; combustion devices used in the recovery of sulfur values from spent sulfuric acid; halogen acid furnaces, as defined under industrial furnace in 40 CFR 260.10; and such other devices as the Administrator may add to this list.

I NTERIM 

### (P ERMIT 

### ) S TATUS



### – Period during which the owner/operator of an existing TSD facilit y is treated as having been issued a RCRA permit even though he/she has not yet received a final determination. An existing facility should have automatically qualified for interim status if the owner/operator filed both timely “notification” and the firs t part (Part A) of the RCRA permit application. Interim status continues until a final determination is made to issue or deny the permit. Owner/operator of new facilities cannot by definition qualify for interim status; rather, they need a RCRA permit pr ior to beginning construction of a hazardous waste management facility.

L ARGE 

### Q UANTITY 

### G ENERATOR 

### (LQG) OF 

### H AZARDOUS 

### W ASTE



### – is a generator who generates any of the following amounts in a calendar month : ( i ) G reater than or equal to 1

, 000 kilograms ( kg; 2

, 200 pounds [ lbs ] ) or more of hazardous waste ;

or ( ii ) G reater than 1 k g (2.2 lbs ) of any acute hazardous wastes listed in §§ 261.31 or 261.33 (e) ; or ( iii ) G reater than 100 k g (220 lbs ) of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes
listed in sections 261.31 or 261.33(e)

.

L ARGE 

### Q UANTITY 

### H ANDLER OF 

### U NIVERSAL 

### W ASTE 

### (LQHUW)

– A universal waste handler (as defined in 40 CFR 273.9) who accumulates 5,000 k ilograms (kg) or more total of universal wastes (batteries, pesticides,

mercury

- containing equipment, or lamps

– calculated collectively) at any time. This designation is

ret ained through the end of the calendar year in which the 5,000 kg limit is met or exceeded.

M ANAGEMENT 

### , OR 

### H AZARDOUS 

### W ASTE 

### M ANAGEMENT



### – Systematic control of the collection, source separation, storage, transportation, processing, treatment, recovery, or di sposal of hazardous waste (40 CFR 260.10).

M ANIFEST 

### , U NIFORM 

### H AZARDOUS 

### W ASTE



### – The shipment document EPA Form 8700

- 22 and, if necessary,

Form 8700

- 22A, originated and signed by a generator in accordance with the instructions included in
the A ppendix to 40 CFR Part 262. The “cradle

- to

- grave” paperwork must accompany a shipment of hazardous waste as it moves from the generator to the transporter and eventually to the hazardous waste management facility.Definitions (continued)

65 

### M IXED 

### W ASTE



### – Waste that contains both hazardous and source, special nuclear, or by

- product material subject to the Atomic Energy Act (AEA), RCRA section 1004(41), 42 U.S.C. 6903 (63 FR 17414; April 9, 1998).

M UNICIPALITY



### – A city, village, town, borough, county, pa rish, district, association, Indian tribe or authorized Indian tribal organization, designated and approved management agency under Section 208 of the Clean Water Act, or any other public body created by or under State law and having jurisdiction over disp osal of sewage, industrial wastes, or other wastes.

O FF



### - SITE 

### F ACILITY



### – A hazardous waste treatment, storage, disposal, or recycling area located at a place away from the generating site.

OI F ORM



### – Off

- site Identification Form.

O FF



### - S PECIFICATION 

### U SED 

### O I L 

### B URNER



### – A site where used oil not meeting the specification requirements in 40 CFR 279.11 (off

- specification used oil) is burned for energy recovery in devices identified in Section 279.61(a).

O FF



### - S PECIFICATION 

### U SED 

### O IL 

### F UEL



### – Used oil fuel that does n ot meet the specification provided under 40 CFR

279.11.

O N



### - SITE 

### F ACILITY



### – A hazardous waste treatment, storage, disposal, or recycling area located on the generating site.

O N



### - S PECIFICATION 

### U SED 

### O IL 

### F UEL



### – Used oil fuel that meets the specification provided under 40 CFR 279.11.

O PERATOR



### – The person responsible for the overall operation of a RCRA site. Note: This is the legal entity which controls the RCRA site operation rather than the plant or site m anager. This is usually a company or business name, not an individual. See Person

.

O WNER



### – The person who owns a RCRA site or part of a RCRA site. Note: This includes the owner(s) of the building(s) and/or land. This may be an individual, company, or business name. See Person

.

P ERSON



### – An individual, trust, firm, joint stock company, Federal Agency, corporation (including a government corporation), partnership, association, State, municipality, commission, political subdivision of a State, or any in terstate body.

P ROCESS 

### S YSTEM



### – For purposes of the Hazardous Waste Report, a process system refers to one or more units used together to treat, recover, or dispose of a hazardous waste. The process system begins at
the unit where the hazardous waste first enters and consists of all other treatment, recovery, or disposal units downstream from the point of entry. Note that storage is not considered a process
system , except for storage at a bulking and re

- shipping facility (H141)

.

Classify each process system with a Management M ethod code that best identifies the last substantive purpose/operation it performs. For example, a process system to remove dissolved metals from wastewater prior to shipping the sludge off

- site typically includes equalization, pH adjustment, chemical pre cipitation, flocculation, clarification/settling, and dewatering of the sludgeDefinitions (continued)

66 

### removed from the bottom of the clarifier. The chemical precipitation process best identifies the last purpose of this treatment system

– to remove metals from the wastewater. If this wastewater treatment system is RCRA

- regulated, it would be reported as H07 0 (Chemical Treatment ). If the sludge will be disposed at the reporting site in a landfill, the code will be H132 (Landfill) and will need to be reported on a separate GM Fo rm because it is a residual from a treatment process. However, this process is exempt if the treated water flows to a POTW or a NPDES outfall with no RCRA

- regulated storage or treatment units in the system, and should not be reported. A listing of Manage ment Method codes may be found in the “ MANAGEMENT METHOD CODES ” section of this booklet.

P ROCESS 

### U NIT



### – For purposes of the Hazardous Waste Report, a process unit refers to a single type of treatment (e.g., tank, distillation column, surface impoundment) in which hazardous waste is treated, disposed, or recycled.

R ESOURCE 

### C ONSERVATION AND 

### R ECOVERY 

### A CT 

### (RCRA)

– The Solid Waste Disposal Act as amended by the Resource Conservation and Recovery Act (RCRA) (40 CFR 270 .2). It is the Federal statute that regulates the generation, treatment, storage, disposal, recycling, and/or transportation of solid and hazardous

waste.

RCRA I NTERIM 

### (P ERMIT 

### ) S TATUS



### – Refer to “Interim (Permit) Status” definition.

RCRA P ERMIT



### – A complete RCRA permit is comprised of an operating permit for hazardous waste treatment, storage, and disposal, and a corrective action permit addressing releases from solid waste management unit (SWMUs). To apply for a permit, a site must file a two

- part application (Part A and Part B). A facility is not considered to have a complete RCRA permit until both parts have been issued.

RCRA S UBTITLE 

### C S ITE 

### (RCRA S ITE OR 

### S ITE 

### )

– The physical plant or location at which one or more of the following regulated waste activities occurs: the generation, transportation, treatment, storage, or disposal of hazardous wastes; recycling of hazardous wastes; U.S. importer of hazardous waste; mixed waste (hazardous and radioactive) generator; exempt boiler and/or industr ial furnace burning or processing hazardous waste; large quantity handler of or destination facility for universal wastes; disposing hazardous waste with an underground injection permit; the transportation (and temporary storage during transportation), pro cessing/re

- refining, burning, or marketing of used oil; eligible academic entity managing laboratory hazardous waste under Subpart K; facility managing hazardous secondary material being reclaimed that must comply with certain requirements and conditions; or undergoing corrective action.

A site may consist of several treatment, storage, or disposal operational units. For entities that only transport regulated wastes, the term site refers to the headquarters of that entity’s operations.

R ECYCLING



### – Use, reuse, or reclamation of a material (40 CFR 261.1(c)(7)). “Reclamation” is the processing or regeneration of a material to recover a usable product (e.g., recovery of lead values from spent batteries, regeneration of spent solvents) (40 CFR 261.1(c)( 4)). A material is “used or reused” if it is either: (1) employed as an ingredient (including use as an intermediate) in an industrial process to make a product (e.g., distillation bottoms from one process used as feedstock in another process) (40

CFR 26 1.1(c)(5)). However, a material will not satisfy this condition i f distinct components of the material are recovered as separate end products (as when metals are recovered from metal

-Definitions (continued)

67 

### containing secondary material); or (2) a commercial product (e.g., spent pickle liquor used as phosphorous precipitant and sludge conditioner in wastewater treatment).

R ESIDUAL



### – A hazardous waste derived from the treatment, disposal, or recycling of a previously existing hazardous waste (e.g., the sludge remaining after initial wastewater treatment).

S HORT



### - TERM 

### G ENERATOR



### – A generator whose generator status is the result of a one

- time, non

- recurring, temporary event that is not related to normal production processes. In other words, short

- term generators produce hazardous waste from a particular activity for a limited time and then cease conducting that activity. Short

- term g enerators would not be considered episodic generators because episodic generators have the potential to generate on a regular basis. Examples of short

- term generators include: one

- time highway bridge waste generation, underground storage tank removals,

g eneration of off

- spec or out

- of

- date chemicals at a site that normally does n o t generate hazardous waste, remediate or spill clean

- up sites with no previous RCRA EPA Identification Number , and site or production process decommissions by a new operator.

S LUDGE



### – Any solid, semi

- solid, or liquid waste generated from a municipal, commercial, or industrial wastewater treatment plan, water supply treatment plant, or air pollution control facility exclusive of the treated effluent from a wastewater treatment p lant (40 CFR 260.10).

S MALL 

### Q UANTITY 

### G ENERATOR 

### (SQG) OF 

### H AZARDOUS 

### W ASTE



### – is a generator if the site meets all of the following

criteria: (i) Generates, in any calendar month, more than 100 kilograms ( kg; 220 pounds [ lbs ] ) but less than 1,000 kg (2,200 lbs) o f RCRA hazardous waste; and (ii) Does not generate, in any calendar month, more than 1 kg (2.2 lbs) of acute hazardous waste
listed in sections 261.31 or 261.33(e) ; and (iii) Does not generate more than 100 kg (220 lbs) of material from the cleanup of any residue or contaminated soil, waste, or other debris resulting from the cleanup of a spill, into or on any land or water, of any acute hazardous wastes listed in sections 261.31 or 261.33(e).

S MALL 

### Q UANTITY 

### O N



### - SITE 

### B URNER 

### E XEMPTION



### – The persons who burn small quantity of hazardous waste in

an on

- site boiler or industrial furnace, in accordance with 40 CFR 266.108, are conditionally exempt from regulation for that activity.

S MELTING 

### , M ELTING 

### , AND 

### R EFINING 

### F URNACE 

### E XEMPTION



### – Under 40 CFR 266.100(c), owners or operators of smelting, melting, and refining furnaces that process hazardous wastes solely for metals recovery are conditionally exempt from regulation, except for 40 CFR 266.101 and 266.112, provided they comply
with limited r equirements set forth in Section 266.100(c). Similarly, 40 CFR 266.100(f) provides that owners or operators of smelting, melting, and refining furnaces that process hazardous wastes for the recovery of precious metals are conditionally exempt from regulat ion, except for 40 CFR 266.112, provided they comply with limited requirements specified in Section 266.100(f).

S OLID 

### W ASTE



### – Any garbage, refuse, or sludge, or other materials not excluded under 40 CFR 261.4(a). Exclusions include, for example, dom estic sewage and any mixture of other wastes that pass through a sewer system to a publicly owned treatment works (POTWs); industrial wastewater discharges that are point source discharges subject to regulation under the Clean Water Act; irrigation return flows; nuclear materials defined by the Atomic Energy Act; and in situ mining materials (see the “ EXCLUDEDDefinitions (continued)

68 

### WASTES ” section of this booklet). Wastewaters being collected, stored, or treated before discharge and sludges ge nerated by wastewater treatment are not excluded. The EPA defines hazardous waste
as a subset of solid waste.

S OURCE 

### M ATERIAL



### – As defined by the Atomic Energy Act of 1954: (1) Uranium, thorium, or any other material determined by the Nuclear Regulatory Commission pursuant to the provisions of Section 2091 of this title to be source material; or (2) ores containing one or more of the foregoing materials in such concentration as the Commission may by regulation determine from time to time.

S PECIAL 

### N UCLEAR 

### M ATERIAL



### – As defined by the Atomic Energy Act of 1954: (1) plutonium, uranium enriched in the isotope 233 or in the isotope 235, and any other material which the Nuclear Regulatory Commission, pursuant to the provisions of Section 2071 of this title, determines to be special nuclear material, but does not include source material; or (2) any material artificially enriched by an y of the foregoing, but does not include source material.

S UBPART 

### K

– An alternative set of generator requirements for managing laboratory hazardous waste at eligible academic entities. Generators that are eligible academic entities with laboratories may elect to opt into 40 CFR 262 Subpart K and manage their laboratory hazardous waste under Subpart K in lieu of 40 CFR 262.34(c) (or 40 CFR 261.5 for CESQGs). In order for eligible academic entities (see definition) to opt into Subpart K or subsequently wi thdraw from Subpart K, they must use the Site ID Form to notify the appropriate State or EPA Regional Office. Refer to 40 CFR 262.203 and 262.204.

Note: You must check with your State to determine if you are eligible to manage laboratory hazardous

waste pursuant to 40 CFR Part 262 Subpart K and for any S tate

- specific requirements.

S UPERFUND



### – The program operated under the legislative authority of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and the Superfund Amendments and Reauthorization Act (SARA) that funds and carries out the solid waste emergency r esponse and long

term remedial activities of the EPA.

S URFACE 

### I MPOUNDMENT



### – A natural topographic depression, man

- made excavation, or diked area formed primarily from earthen materials (though it may be lined with man

- made materials) that is designed

to a ccumulate liquid wastes or wastes containing free liquids, and that is not an injection well (40 CFR 260.10).

T OLLING



### – Tolling arrangements describe a particular type of recycling contract between two companies. Specifically, the “tolling” company certi fies that it has a contract with a manufacturer to produce a product, and that manufacturing process generates a residual material that can be recycled by the tolling company. If the tolling company certifies that the contract specifies that the tolling c ompany owns and has responsibility for the recyclable material once it is generated, and the material is returned to the tolling company for reclamation, and subsequently recycled, the material is excluded from regulation (under 40 CFR 261.2(a)(2)(ii) or 4 0 CFR 261.4(a)(23)), provided certain requirements

are met.

T RANSFER 

### F ACILITY



### – Any transportation

- related facility including loading docks, parking areas, storage areas, and other similar areas where shipments of hazardous waste are held for 10 days or less during the normal course of transportation ( 40 CFR 260.10 40 CFR 261.4(a)(23) and 40 CFR 263.12).Definitions (continued)

69 

### T RANSPORTER



### – A person engaged in the off

- site transportation of hazardous waste by air, rail, highway, or

water.

U NDERGROUND 

### I NJECTION 

### C ONTROL



### – The subsurface emplacement of fluids through a bored, drilled or driven well; or through a dug well, where the depth of the dug well is greater than the largest surface dimension. Underground injection wells are regulated under both the Safe Drinking Wate r Act and the Resource Conservation and Recovery Act (see 40 CFR Part 148).

U NIT



### – Refer to “Process Unit ” definition.

U NITED 

### S TATES 

### I MPORTER



### – Any person who imports hazardous waste from a foreign a site located in a foreign country into the U.S . This does not include hazardous waste shipped from a foreign Department of Defense site, Maquiladora, U.S. territory or protectorate.

U NIVERSAL 

### W ASTE



### – Any of the following hazardous wastes that are managed under the universal waste requirements of 40 CFR Part 273: batteries, pesticides, mercury

- containing equipment, and lamps. Some States may have State

- specific universal wastes defined as well.

U SED 

### O IL



### – Any oil that has been refined from crude oil, or any synthetic oil, that has been used, and as a result of such use, is contaminated by physical or chemical impurities.

U SED 

### O IL 

### F UEL 

### M ARKETER



### – Any person who conducts either of the following activities: (i) Directs a shipment of off

- specification used oil from their site to an off

- specification used o il burner; or (ii) First claims that used oil that is to be burned for energy recovery meets the used oil fuel specifications set forth in 40 CFR 279.11.

U SED 

### O IL 

### M ANAGEMENT 

### A CTIVITIES



### – For the purposes of the Site ID Form, includes used oil transportation;

u sed oil processing and re

- refining; burning off

- specification used oil fuel; and used oil fuel marketing.

U SED 

### O IL 

### P ROCESSING



### – Chemical or physical operations designed to produce from used oil, or to make used oil more amenable for production of, fuel oi ls, lubricants, or other used oil

- derived products. Processing includes, but is not limited to: blending used oil with virgin petroleum products, blending used oils to meet the fuel specification, filtration, simple distillation, chemical or physical sep aration,
and re

- refining.

U SED 

### O IL 

### P ROCESSOR



### – A site that processes on

- specification or off

- specification used oil.

U SED 

### O IL 

### R E



### - R EFINER



### – A site that produces lubricating oils and greases, industrial fuel, asphalt extender, gasoline, and other products from on

- specification or off

- specification used oil.

U SED 

### O IL 

### T RANSFER 

### F ACILITY



### – Any transportation

- related facility, including loading docks, parking areas, storage areas, and other areas where shipments of used oil are held for more than 24 hours during the normal course of transportation and not longer than 35 days. Transfer fac ilities that store used oil for more than 35 days are subject to regulation under 40 CFR Part 279, Subpart F.Definitions (continued)

70 

### U SED 

### O IL 

### T RANSPORTER



### – Any person who transports used oil, any person who collects used oil from more than one generator and transports the colle cted oil, and owners and operators of used oil transfer facilities. Used oil transporters may consolidate or aggregate loads of used oil for purposes of transportation but, with the following exception, may not process used oil. Used oil transporters may conduct incidental processing operations that occur in the normal course of used oil transportation (e.g., settling and water separation), but that are not designed to produce (or make more amenable for production of) used oil

- derived products or used oil fuel.

W ASTE 

### M INIMIZATION



### – The reduction, to the extent feasible, of hazardous waste that is generated or subsequently treated, stored, or disposed. It includes any source reduction or recycling activity undertaken by a generator that results in: (1) t he reduction of total volume or quantity of hazardous waste; (2) the reduction of toxicity of hazardous waste; or (3) both, as long as the reduction is consistent with the goal of minimizing present and future threats to human health and the

environment.

W ASTE 

### O IL



### – Any oil that has been refined from crude oil, or any synthetic oil, that has been used, and as a result of such use, is contaminated by physical or chemical impurities and is managed as a hazardous

waste.

WR F ORM



### – Waste Received F rom Off

- site Form.71 

## SPECIAL INSTRUCTIONS

These instructions explain how to complete the 2015 2017 Hazardous Waste Report for wastes and sites with unique regulatory or reporting requirements.

A SBESTOS 

### , PCB S 

### , W ASTE 

### O ILS



### – In most cases, do not report asbestos, PCBs, and waste oils. However, you

must report them if any of the following conditions exist:

(1) If your State specifically requires that these wastes be reported;

(2) If a listed RCRA hazardous waste (i.e., EPA haza rdous waste code that begins with “F

, ” “K

, ” “P

, ” or “U”) is mixed with asbestos, PCBs, or waste oil, in which case the entire mixture is a hazardous

waste; or

(3) If the waste possesses one or more of the characteristics that result in assigning EPA hazardous waste code beginning with “D

. ” (This does not apply to used oil that is recycled as explained below.)

Do not report “used oil that is recycled and is also a hazardous waste solely because it exhibits a hazardous characteristic (criterion 3 above ). Used oil that is recycled includes any used oil which is reused, following its original use, for any purpose (including the purpose for which the oil was originally used). Such term includes, but is not limited to, oil which is re

- refined, reclaimed, burned for energy recovery, or reprocessed.” (40 CFR 261.6(a)(4))

G ROUNDWATER 

### C ONTAMINATED BY 

### H AZARDOUS 

### W ASTE



### – Groundwater contaminated by RCRA hazardous

waste is not considered a solid waste and is, therefore, not classified as a hazardous waste. Howev er, because hazardous waste is “contained in” the groundwater, it must be treated “as if” it were a RCRA hazardous waste if it is removed for treatment, storage, or disposal. 1 

### When reporting groundwater contaminated by hazardous waste in the 2015 2017 Hazardous Waste Report, observe the following

conventions:

(1) Enter “0” in the GM Form, Section 1

– Item F (Quantity). Explain in the Comments section that it is groundwater, not a hazardous waste that was generated on

- site.

(2) Report quantities managed on

- site (GM Form, Section 2, On

- site Process Systems 1 and 2); quantities shipped off

- site for management (GM Form, Section 3); and quantities received from
off

- site and managed on

- site (WR Form, Item E).

1 To determine if the contaminated media must be reported at all (generated OR treated): If the contamination is due to a char acteristic waste, then it is the generator’s responsibility to determine if the contaminated groundwater is a hazardous waste. Onc e the characteristics are eliminated, the media is no longer considered to “contain” hazardous waste. If a facility has first removed groundwater and is claiming that the groundwater is contaminated with a listed hazardous waste or “contains” listed hazar dous waste, EPA Regions or Authorized States should
make a site

- specific determination of whether the media is a RCRA Waste. Please see: “Management of Remediation Waste Under RCRA,”

EPA530

- F

- 98

- 026, October 14, 1998. RCRA Online Document No. 14291. Av ailable online at: http://yosemite.epa.gov/osw/rcra.nsf/0c994248c239947e85256d09007115f/d9e61a0505db4b6885256817006e32b8!Open Document

.72 

### L AB 

### P ACKS



### – The following rules apply to the reporting of lab pack wastes in the 2015 2017 Hazardous Waste Report:

(1) You may aggregate lab pack wastes if they have the same Form Code. However, you must report them as separate wastes under the following conditions:

• If they contain RCRA acute hazardous wastes (i.e., EPA hazardous waste codes F020, F021, F022, F023, F026, F027, and all “P” waste codes). Report separately from lab packs containing other RCRA hazardous wastes (all other EPA hazardous waste codes).

• If they are managed differently from each other. For example, report lab packs shipped to landfills separately from those incinerated.

(2) Enter a Form Code indicating lab packs (i.e., W001 or W004) on the GM Form, in Section 1

– Item
E or on the WR Form in It em G. These Form Codes are to be used with any lab pack, whether the wastes are gaseous, liquid, solid, or sludge.

(3) It is not necessary to report every EPA hazardous waste code included in a batch of lab packs. Record one, or a few predominant, EPA haza rdous waste codes in Section 1

– Item B of the GM Form, or Item B of the WR Form. If there are many EPA hazardous waste codes associated with the batch of lab packs, enter “LABP” in the first four

- character field in Section 1

– Item B of the GM Form, or I tem B of the WR Form; then enter “NA” in the remaining spaces for the EPA
hazardous waste codes.

(4) When reporting quantities for lab packs:

• Include the weight of the containers if they are disposed (e.g., landfilled) or treated (e.g., incinerated) with the waste.

• Exclude the weight of the containers if the waste is removed from the containers before treatment or disposal.

RCRA

- R ADIOACTIVE 

### M IXED 

### W AS TES



### – By themselves, source material, special nuclear material, or by

- product materials (see the “ DEFINITIONS ” section of this booklet ), as defined by the Atomic Energy Act of 1954 and amended by 42 U.S.C. 2011 et. Seq., are not classified as hazardous wastes under RCRA. However, if these materials are mixed with a RCRA hazardous waste, the material is controlled under RCRA regulation, as well as under the Atomic Energy Act (DOE, NRC, and EPA) regulations, and is to be reported in the 2015 2017 Hazardous Waste Report.

S UBPART 

### K L ABORATORY 

### W ASTE 

### C LEAN



### - OUT



### – A Subpart K laboratory clean

- out conducted in accordance with 40 CFR 262.213(a) , is defined as: once per 12 months per laboratory, a laboratory will have 30 days to
conduct a clean

- out and will not have to count the hazardous waste that consists of unused commercial chemical products (either listed or characteristic) generated during those 30 days towards the eligible academic entity’s generator status for the purposes of on

- site accumulation. See 40 CFR 262.213(a)(1

- 4) for other Subpart K laboratory clean

- out requirements.

The waste generated from this clean

- out should be reported on the GM Form with a source code of
“G17

– Subpart K Laboratory Waste Clean

- out” with a generation amount of zero (0) (Section 1

– Item73 

### F). The amount shipped off

- site or managed on

- site will be reported in Sections 2 or 3 of the GM Form as appropriate.

Laboratory waste that is generated during routine operations (e.g., spent solvents or spent acids/bases) should be reported separately from Subpart K laboratory clean

- out wastes. Routinely generated laboratory waste should be reported with source code(s ) other than G17.

W ASTES 

### R ECEIVED FROM 

### C ONDITIONALLY 

### E XEMPT 

### S MALL 

### Q UANTITY 

### G ENERATORS 

### (CESQG S 

### )

– Waste management facilities sometimes receive hazardous waste from large numbers of CESQGs or other sites that do not
have RCRA EPA Identification Numbers. To minimize the response burden for filling out the WR Form for these wastes, you may aggregate the wastes across generating sites, in accordance with these guidelines:

(1) All the wastes must have the same EPA hazardous waste code (Item B), State hazardous wast e code (Item C), Form code (Item G), and Management Method code (Item H).

(2) Wastes received from different States must be reported separately. For the off

- site handler EPA Identification Number (Item D), the entry should include the two

- letter postal code of the originating State, followed by the letters “CESQG”.

For example, wastes received from several CESQGs in the State of Alaska (AK) that share a common EPA hazardous waste code, State hazardous waste code, Form code, and Management Method code
could b e aggregated in a single waste block of the WR Form (e.g., Waste 1). In Item D, the off

- site handler EPA ID number is entered as “AKCESQG

. ” Note: This method of completing Item D can also be used for CESQG waste that is not aggregated.

W ASTES 

### R ECEIVED FROM 

### F OREIGN 

### C OUNTRIES



### – Reporting on the GM Form

– If your site was the generator of record and was the U.S. Importer for hazardous waste received from a foreign a site located in a foreign country (other than a foreign Department of Defense site, Maquilad ora, U.S. territory or protectorate), complete a GM Form. Enter the appropriate code in Section 1

– Item D (Source Code) from the list of codes G63 through G75 (Hazardous waste received from [name of foreign country]). Include the Import Notification and other foreign generator information in the Comments. Also, mark “Yes” on the Site ID Form, Item 10.A.3

– United States Importer of Hazardous Waste. Report on the OI Form the name and address of all foreign generators if this form is required by your Sta te.

Report on the WR Form

– If your site received hazardous waste directly from a generator in at a foreign a site located in a foreign country (other than a foreign Department of Defense site, Maquiladora, U.S. territory or protectorate), complete a WR Fo rm for the waste treated, recovered, or disposed at your site . This waste was not shipped to your site by a U.S. Importer. Only the first TSD site receiving foreign hazardous waste should report the waste in WR. If this waste is then shipped to another domestic site it is not counted as imported waste on the WR by the second site. Report the code “FC” followed by the name of the foreign country in Item D

– Off

- site Handler EPA

ID nu mber if the site located in a foreign country is not found in the Foreign Site Identification Number

List Codes list ed in the Codes Description section . Include the Import Notification and other foreign generator information in the Comments. Report on the OI Form the name and address of all foreign generators if this form is required by your State.74 

### There is a federal requirement under 40 CFR §§ 264.75 and 265.75 for TSDFs and/or the 40 CFR § 262.41
for importers complying with generator requirements (or equivalent authorized state requirements

As the owner or operator of the TSDF receiving hazardous waste import shipments, you must report
such hazardous waste import shipments using the “waste received from off

- site ( WR )” F f orm, as appropriate. If your fac ility was acting as the importer of record, you assumed generator requirements
for those import shipments and must also report the import shipments as generated hazardous wastes
from a foreign source using the “waste generation and management ( GM )” F f

orm . An EPA

- acceptable alternative for you to meet your generator biennial reporting requirement for those import shipments
would be for you to add a statement to the comment field of your WR form for those import shipments
noting that your TSDF was the impor ter of record for the listed import shipment(s). Please check with
your authorized State Agency on how best to meet your generator biennial reporting requirements.

If your facility was not acting as the importer, EPA strongly encourages you to remind the importer to comply with the biennial reporting requirements in 40 CFR § 262.41 (or equivalent authorized state requirements). All parties possibly acting as the importer could be held jointly and severally liable for
compliance with the generator requirem ents of Part 262 2



### .

W ASTES 

### S HIPPED TO 

### F OREIGN 

### C OUNTRIES



### – Reporting on the GM Form

– Report all wastes sent off

- site to sites located in foreign countries. If the foreign site has an EPA Identification (ID) Number, fill out the GM Form as you would for a domestic site. If the site does not have an EPA ID number, refer to “Foreign
Site Identification Number List Codes list ed lat er in this document. Enter the remaining information for that facility as you would for a domestic facility.

2 Memo from John Skinner, Director of EPA’s Office of Solid Waste to Harry Seraydarian, Director, Toxics and Waste Management Division, EPA Region IX, June 25, 1985, available online at http://yosemite.epa.gov/osw/rcra.nsf/0c994248c239947e85256d0 90071175f/E27643CD81ABBDCA8525670F006B D187/$file/11085.pdf

.75 

## EPA HAZARDOUS WASTE CODES

A list of all the hazardous waste codes is shown below. See the regulations for details.

CHARACTERISTICS OF HAZARDOUS WASTE (SEE 40 CFR 261.24)

– DXXX

HAZARDOUS WASTE FROM NON

- SPECIFIC SOURCES (SEE 40 CFR 261.31)

– FXXX

HAZARDOUS WASTE FROM SPECIFIC SOURCES (SEE 40 CFR 261.32)

- KXXX DISCARDED COMMERCIAL CHEMICAL PRODUCTS, OFF

SPECIFICATION SPECIES, CONTAINER RESIDU ES , AND SPILL

RESIDUES THEREOF

– ACUTE HAZARDOUS WASTE (SEE 40 CFR 261.33)

– PXXX

DISCARDED COMMERCIAL CHEMICAL PRODUCTS, OFF

SPECIFICATION SPECIES, CONTAINER RESIDUES, AND SPILL

RESIDUES THEREOF

– TOXIC WASTES (SEE 40 CFR 261.33)

– UXXX

D001

D002

D003

D004

D005

D006

D007

D008

D009

D010

D011

D012

D013

D014

D015

D016

D017

D018

D019

D020

D021

D022

D023

D024

D025

D026

D027

D028

D029

D030

D031

D032

D033

D034

D035

D036

D037

D038

D039

D040

D041

D042

D043 F001

F002

F003

F004

F005

F006

F007

F008

F009

F010

F011

F012

F019

F020

F021

F022

F023

F024

F025

F026

F027

F028

F032

F034

F035

F037

F038

F039 K001

K002

K003

K004

K005

K006

K007

K008

K009

K010

K011

K013

K014

K015

K016

K017

K018

K019

K020

K021

K022

K023

K024

K025

K026

K027

K028

K029

K030

K031

K032

K033

K034

K035

K036

K037

K038

K039

K040

K041

K042

K043

K044

K045

K046 K047

K048

K049

K050

K051

K052

K060

K061

K062

K069

K071

K073

K083

K084

K085

K086

K087

K088

K093

K094

K095

K096

K097

K098

K099

K100

K100

K101

K102

K103

K104

K105

K106

K107

K108

K109

K110

K111

K112

K113

K114

K115

K116

K117

K118 K123

K124

K125

K126

K131

K132

K136

K141

K142

K143

K144

K145

K147

K148

K149

K150

K151

K156

K157

K158

K159

K161

K169

K170

K171

K172

K174

K175

K176

K177

K178

K181 P001

P002

P003

P004

P005

P006

P007

P008

P009

P010

P011

P012

P013

P014

P015

P016

P017

P018

P020

P021

P022

P023

P024

P026

P027

P028

P029

P030

P031

P033

P034

P036

P037

P038

P039

P040

P041

P042

P043

P044

P045

P046

P047

P048

P049 P050

P051

P054

P056

P057

P058

P059

P060

P062

P063

P064

P065

P066

P067

P068

P069

P070

P071

P072

P073

P074

P075

P076

P077

P078

P081

P082

P084

P085

P087

P088

P089

P092

P093

P094

P095

P096

P097

P098

P099

P101

P102

P103

P104

P105 P106

P108

P109

P110

P111

P112

P113

P114

P115

P116

P118

P119

P120

P121

P122

P123

P127

P128

P185

P188

P189

P190

P191

P192

P194

P196

P197

P198

P199

P201

P202

P203

P204

P205 U001

U002

U003

U004

U005

U006

U007

U008

U009

U010

U011

U012

U014

U015

U016

U017

U018

U019

U020

U021

U022

U023

U024

U025

U026

U027

U028

U029

U030

U031

U032

U033

U034

U035

U036

U037

U038

U039

U041

U042

U043

U044

U045

U046

U047 U048

U049

U050

U051

U052

U053

U055

U056

U057

U058

U059

U060

U061

U062

U063

U064

U066

U067

U068

U069

U070

U071

U072

U073

U074

U075

U076

U077

U078

U079

U080

U081

U082

U083

U084

U085

U086

U087

U088

U089

U090

U091

U092

U093

U094 U095

U096

U097

U098

U099

U101

U102

U103

U105

U106

U107

U108

U109

U110

U111

U112

U113

U114

U115

U116

U117

U118

U119

U120

U121

U122

U123

U124

U125

U126

U127

U128

U129

U130

U131

U132

U133

U134

U135

U136

U137

U138

U140

U141

U142 U143

U144

U145

U146

U147

U148

U149

U150

U151

U152

U153

U154

U155

U156

U157

U158

U159

U160

U161

U162

U163

U164

U165

U166

U167

U168

U169

U170

U171

U172

U173

U174

U176

U177

U178

U179

U180

U181

U182

U183

U184

U185

U186

U187

U188 U189

U190

U191

U192

U193

U194

U196

U197

U200

U201

U202

U203

U204

U205

U206

U207

U208

U209

U210

U211

U213

U214

U215

U216

U217

U218

U219

U220

U221

U222

U223

U225

U226

U227

U228

U234

U235

U236

U237

U238

U239

U240

U243

U244

U246 U247

U248

U249

U271

U278

U279

U280

U328

U353

U359

U364

U367

U372

U373

U387

U389

U394

U395

U404

U409

U410

U41176 

## HAZARDOUS SECONDARY MATERIAL ( HSM ) FACILITY CODES

Facility codes describe the specific regulation a facility uses to manage its hazardous secondary material (HSM) and the type of activity the facility performs under the regulation (e.g., generator, reclaimer). Review the groups and pick the appropriate c ode. If more than one facility code applies to you, enter each code on a separate row under Item 2 of the Addendum to the Site Identification Form.

Under Control of the Generator Exclusion (40 CFR 261.2(a)(2)(ii) or 261.4(a)(23)) Under Generator Exclusion (40 CFR 261.4(a)(23))

Code Facility Code Description

01 HSM Generator reclaiming HSM “on

- site”: This code applies if you generate and reclaim hazardous secondary material at your generating facility. See also paragraph (1) in the Federal definition of “Hazardous secondary material generated and reclaimed under the control of the generator” in 40 CFR Part 260.10.

02 HSM Generator transferring HSM to reclaimer within the “same company”: This code applies if you generate hazardous secondary material and send the material for reclamation to a different facility that is either controlled by you or controlled by the same person that controls your generating facility. See also paragraph (2) in the Federal definition of “Hazardous secondary material generate d and reclaimed under the control of the generator” in 40 CFR Part

260.10.

03 Reclaimer receiving HSM from HSM generator within the “same company”: This code applies if you receive and reclaim hazardous secondary material from a different facility that either controls you or is controlled by the same person that controls you. See also paragraph (2) in the Federal definition of “Hazardous secondary material generated and reclaimed under the control of the generator” in 40 CFR Part 260.10.

04 Tolling Contractor reclaiming HSM pursuant to a tolling contract: This code applies if you are a tolling contractor that reclaims hazardous secondary material pursuant to a written contract with a toll manufacturer. See also paragraph (3) in the Federal definition of “Hazardous secondary material generated and reclaimed under the control of the generator”

in 40 CFR Part 260.10.

05 Toll Manufacturer managing HS M pursuant to a tolling contract: This code applies if you generate and send hazardous secondary material for reclamation to a tolling contractor pursuant to a written contract. See also paragraph (3) in the Federal definition of “Hazardous secondary mat erial generated and reclaimed under the control of the generator” in 40

CFR Part 260.10.

Transfer

- based Exclusion (40 CFR 261.4(a)(24)) Verified Recycler Exclusion (40 CFR 261.4(a)(24))

Code Facility Code Description

06 HSM Generator transferring HSM off

- site to a domestic reclamation permitted or verified facility: This code applies if you generate and send hazardous secondary material for reclamation to an off

- site domestic reclamation permitted or
verified facility.

07 Permitted Reclaimer receiving HSM from off

- site: This code applies if you have a RCRA Part B permit, or operate under interim status standards, and reclaim hazardous secondary material received from an off

- site domestic hazardous secondary material gener ator or other domestic facility. (If you do not have a RCRA Part B permit and are not operating under interim status standards and instead, have obtained a variance to receive hazardous secondary material under this exclusion, use code 17 below.)

08 Permi tted Intermediate facility: This code applies if you have a RCRA Part B permit, or operate under interim status standards, and receive hazardous secondary material from an off

- site domestic hazardous secondary material generator
or another domestic facility and you store it for more than ten days. This code does not apply if you generate or reclaim the hazardous secondary material. (If you do not have a RCRA Part B permit and are not operating under interim status standards and instead, have obtaine d a variance to receive hazardous secondary material under this exclusion, use code 18 below.)77 Imports/Exports (40 CFR 261.4(a)(24) or (25))

Code Facility Code Description

09 HSM Generator exporting HSM off

- site to a foreign reclamation facility: This code applies if you generate and export hazardous secondary material for reclamation to a foreign reclamation facility.

10 HSM Generator importing HSM from a foreign entity to send to another domestic reclamation facility: This code applies if you import hazardous secondary material from a foreign entity and send the material for reclamation to a domestic reclamation facility. HSM Generator importing HSM from a foreign country to send to recycling : This code applies if you im port hazardous secondary material from a foreign country and send the material for reclamation to a permitted or verified recycling facility.

11 HSM Generator AND Reclaimer of imported HSM: This code applies if you import hazardous secondary material from a foreign entity and reclaim the material at your facility. HSM Generator AND Permitted Reclaimer of imported HSM: This code applies if you import hazardous secondary material from a foreig n entity and reclaim the material at your facility under a RCRA Part B permit or under interim status standards. (If you do not have a RCRA Part B permit and are not operating under interim status standards and, instead, have obtained a variance to receive hazardous secondary material under this exclusion, use code 18 below.)

Imports/Exports (40 CFR 261.4(a)(24) or (25))

Code Facility Code Description

12 HSM Generator transferring HSM off

- site to a remanufacturer: This code applies if you generate and send hazardous secondary material to a remanufacturer in the pharmaceutical, basic organic chemical, plastics and resins, and/or paint and coatings manufacturing sectors.

13 Remanufacturer receiving HSM from off

- site: This code applies if you remanufactur e hazardous secondary material
received from an off

- site domestic hazardous secondary material generator. You must be in the pharmaceutical, basic organic chemical, plastics and resins, and/or paint and coatings manufacturing sectors to use this code.

Non

- waste Determinations and Solid Waste Variances (40 CFR 260.30)

Code Facility Code Description

14 Variance for Materials that are Accumulated Speculatively: This code applies if you operate under an approved variance from EPA or your State for materia ls that are accumulated speculatively without sufficient amounts being recycled (see 40 CFR 260.31(a))

. 15 Variance for Materials that are Reclaimed and then Reused within the Original Production Process: This code applies if you operate under an approved variance from EPA or your State for materials that are reclaimed and then reused as feedstock within the original production process in which the materials were generated (see 40 CFR 260.31(b))

. 16 Variance for Materials that are Partially

- Reclaimed: Thi s code applies if you operate under an approved variance from EPA or your State for materials that have been partially

- reclaimed but must be reclaimed further before recovery is completed if the partial reclamation has produced a commodity

- like material (see 40 CFR 260.31(c))

. 17 Variance for HSM transferred for reclamation and managed at a verified reclamation facility: This code applies if you operate under an approved variance from EPA or your State for hazardous secondary materials that are transferr ed to you for reclamation under 40 CFR 261.4(a)(24) (see 40 CFR 260.31(d)) . (If you have not obtained a variance to receive hazardous secondary material under this exclusion and, instead, have a RCRA Part B permit or operate under interim status standards, use code 07 above.)

18 Variance for HSM transferred and managed at a verified intermediate facility: This code applies if you operate under an approved variance from EPA or your State for hazardous secondary materials that are transferred to you for stor age greater than 10 days under 40 CFR 261.4(a)(24) (see 40 CFR 260.31(d)) . (If you have not obtained a variance to receive hazardous secondary material under this exclusion and, instead, have a RCRA Part B permit or operate under interim
status standards a s an intermediate facility, use code 08 above.)

19 Variance for HSM imported AND managed at a verified reclamation facility: This code applies if you operate under an approved variance from EPA or your State for hazardous secondary materials that are impo rted to you for reclamation at your site under 40 CFR 261.4(a)(24) (see 40 CFR 260.31(d)) . (If you have not obtained a variance to receive hazardous secondary material under this exclusion and, instead, have a RCRA Part B permit or operate under interim st atus standards, use code 07 above.)78 20 Non

- waste determination for HSM reclaimed in a continuous industrial process: This code applies if you operate under an approved non

- waste determination from EPA or your State for hazardous secondary material which i s reclaimed in a continuous industrial process (see 40 CFR 260.34(b))

. 21 Non

- waste determination for HSM that are indistinguishable from a product or intermediate: This code applies if you operate under an approved non

- waste determination from EPA or you r State for hazardous secondary materials which is indistinguishable in all relevant aspects from a product or intermediate (see 40 CFR 260.34(c))

.79 

## HAZARDOUS SECONDARY MATERIAL ( HSM ) LAND

- BASED UNIT C ODES

A 2

- digit code that best describes the land

- based unit you use or will use to manage the hazardous secondary material.

Code Land

- based Unit Code Description

NA Do not use land

- based units to manage hazardous secondary material.

SI Use surface impoundment(s) to manage hazardous secondary material. A surface impoundment is a natural topographic depression, man

- made excavation or diked are a formed primarily of earthen materials (although it may be lined with man

- made materials), which is designed to hold an accumulation of liquid hazardous secondary materials or materials containing free liquids and which is not an injection well.

PL Use pile(s) to manage hazardous secondary material. Pile means any non

- containerized accumulation of solid, non

- flowing hazardous secondary material that is used for storage and is not a containment building.

OT Use other land

- based unit(s) to manage hazardous secondary material.80 

## SOURCE CODES

Source codes describe the type of process or activity (i.e., source) from which a hazardous waste was generated. Review the groups and pick the appropriate code.

Wastes From On

- going Production and Service Processes (waste from general day to day manufacturing, production, or maintenance activities)

Code Source Code Description

G01 Dip, flush or spray rinsing (using solvents to clean or prepare parts or assemblies for further processing

– i.e. painting or assembly)

G02 Stripping and acid or caustic cleaning (using caustics to remove coatings or layers from parts or assemblies)

G03 Plating and ph osphating (electro

- or non

- electroplating or phosphating)

G04 Etching (using caustics or other methods to remove layers or partial layers)

G05 Metal forming and treatment (pickling, heat treating, punching, bending, annealing, grinding, hardening, etc.)

G06 Painting and coating (manufacturing, building, or maintenance)

G07 Product and by

- product processing (direct flow of wastes from chemical manufacturing or processing, etc.)

G08 Removal of spent process liquids or catalysts (bulk removal of wastes fr om chemical manufacturing or processing, etc.)

G09 Other production or service

- related processes from which the waste is a direct outflow or result (specify in comments)

Wastes From Other Intermittent Events or Processes

Code Source Code Description

G11 Discarding off

- specification, out

- of

- date, and/or unused chemicals or products

G12 Lagoon or sediment dragout and leachate collection (large scale operations in open pits, ponds, or lagoons)

G13 Cleaning out process equipment (periodic sludge or resi dual removal from enclosed processes including internal scrubbing or cleaning)

G14 Removal of tank sludge, sediments, or slag (periodic sludge or residual removal from storage tanks including internal scrubbing or cleaning)

G15 Process equipment change

- o ut or discontinuation of equipment use (final materials and residuals removal including cleaning)

G16 Oil changes and filter or battery replacement (automotive, machinery, etc.)

G17 Subpart K laboratory waste clean

- out (facility must have opted into the Subpart K rule to use this source code)

G19 Other one

- time or intermittent processes (specify in comments)

Residuals From Pollution Control and Waste Management Process es
Code Source Code Description

G21 Air pollution control devices ( e.g., baghouse dust ash , etc. from stack scrubbers or precipitators; vapor collection, etc.)

G22 Laboratory analytical wastes ( e.g., used chemicals from laboratory operations)

G23 Wastewater treatment ( e.g., sludge, filter cake, etc., including wastes from treatment before discharge by NPDES or POTW or by UIC disposal)

G24 Solvent or product distillation as part of a production process (including totally enclosed treatment systems). Does not include batch treatment in a separate process.

G25 Treatment, disposal, or recycling of hazardous wastes

– indicate in Item H the management method (enter the related H code) that produced the residuals

G26 Leachate collection (from landfill operations or other land units)

G27 T reatment or recovery of universal wasteSource Codes (continued)

81 Wastes From Spills and Accidental Releases

Code Source Code Description

G31 Accidental contamination of products, materials, or containers (other than G11)

G32 Cleanup of spill residues (infrequent, not routine)

G33 Leak collection and floor sweeping (on

- going, routine)

G39 Other cleanup of current contamination (specify in comments)

Wastes From Remediation of Past Contamination

Code Source Code Description

G41 Closure of hazardous waste management unit under RCRA

G42 Corrective action at a solid waste management unit under RCRA

G43 Remedial action or emergency response under Superfund

G44 Cleanup under State or voluntary program
G45 Cleanup of u nderground storage tank

G49 Other remediation (specify in comments)

Waste s Not Physically Generated On

- site

Code Source Code Description

G61 Hazardous waste received from off

- site for storage/bulking and transfer off

- site for treatment or disposal

For
codes

G63

- G75 Hazardous waste received from a foreign a site located in a foreign country (other than a foreign Department of Defense site, Maquiladora, U.S. territory or protectorate). This site was the generator of record and is the U.S. Importer. Enter the appropriate code from the list below

-

G63 Hazardous waste received from A ntarctica

G64 Hazardous waste received from Aruba

G65 Hazardous waste received from Bahamas

G66 Hazardous waste received from Belgium

G67 Hazardous waste received from Brazil

G68 Hazardous waste received from Canada

G69 Hazardous waste received from Holland

G70 Hazardous waste received from Malaysia

G71 Hazardous waste received from Mexico

G72 Hazardous waste received from New Zealand

G73 Hazardous waste received from Taiwan

G74 Hazardous waste received from Venezuela

G75 Hazardous waste received from other foreign country

– see Comments for country name82 

## FORM CODES

Form codes describe the general physical and chemical characteristics of a hazardous waste. Review the groups and pick the appropriate code.

Mixed Media/Debris/Devices

– Waste that is a mixture of organic and inorganic wastes, liquid and solid wastes, or devices that are not easily categorized

Code Form Code Description

W001 Lab packs from any source not containing acute hazardous waste

W002 Contaminated debris (see definition at 40 CFR 268.2(g) and requirements at 40 CFR 268.45); for example, certain paper, clothing, rags, wood, empty fiber or plastic containers, glass, piping, or other solids

W004 Lab packs from any so urce containing acute hazardous waste

W005 Waste pharmaceuticals managed as hazardous waste

W301 Contaminated soil (usually from spill cleanup, demolition, or remediation); see also W512

W309 Batteries, battery parts, cores, casings (lead

- acid or other types)

W310 Filters, solid adsorbents, ion exchange resins and spent carbon (usually from production, intermittent processes, or remediation)

W320 Electrical devices (lamps, fluorescent lamps, or thermostats usually containing mercury; CRTs containing le ad; etc.)

W 512 Sediment or lagoon dragout, drilling or other muds (wet or muddy soils); see also W301

W801 Compressed gases of any type

Inorganic Liquids

– Waste that is primarily inorganic and highly fluid (e.g., aqueous), with low suspended inorganic solids and low organic content

Code Form Code Description

W101 Very dilute aqueous waste containing more than 99% water (land disposal restriction defined wastewater that is not exempt under NPDES or POTW discharge)

W103 Spent concentrated acid (5% or more)

W105 Acidic aqueous wastes less than 5% acid (diluted but pH <2)

W107 Aqueous waste containing cyanides (generally caustic)

W110 Caustic aqueous waste without cyanides (pH >12.5)

W113 Other aqueous waste or wastewaters (fluid but not sludge)

W117 Waste liquid mercury (metallic)

W119 Other inorganic liquid (specify in comments)

Organic Liquids

– Waste that is primarily organic and is highly fluid, with low inorganic solids contents and low

- to

moderate water content

Code F orm Code Description

W200 Still bottoms in liquid form (fluid but not sludge)

W202 Concentrated halogenated (e.g., chlorinated) solvent

W203 Concentrated non

- halogenated (e.g., non

- chlorinated) solvent

W204 Concentrated halogenated/non

- halogenated solvent mixture

W205 Oil

- water emulsion or mixture (fluid but not sludge)

W206 Waste oil managed as hazardous waste

W209 Paint, ink, lacquer, or varnish (fluid

– not dried out or sludge)

W210 Reactive or polymerizable organic liquids and adhesives (fluid but not sludge)

W211 Paint thinner or petroleum distillates

W219 Other organic liquid (specify in comments)Form Codes (continued)

83 Inorganic Solids

– Waste that is primarily inorganic and solid, with low organic content and low

- to

- moderate water content; not pumpable

Code Form Code Description

W303 Ash (from any type of burning of hazardous waste)

W304 Slags, drosses, and other solid thermal residues

W307 Metal scale, filings and scrap (including metal drums)

W312 Cyanide or metal cyanide bearing solids, salts or chemicals

W316 Metal salts or chemicals not containing cyanides

W319 Other inorganic solids (specify in comments)

Organic Solids

– Waste that is primarily organic and solid, with low

- to

- moderate inorganic content and water content; not pumpable

Code F orm Code Description

W401 Pesticide solids (used or discarded

– not contaminated soils

– W301)

W403 Solid resins, plastics or polymerized organics

W405 Explosives or reactive organic solids

W406 Dried paint (paint chips, filters, air filters, other)

W409 Other organic solids (specify in comments)

Inorganic Sludges

– Waste that is primarily inorganic, with moderate

- to

- high water content and low organic content; mostly pumpable

Code Form Code Description

W501 Lime and/or metal hydroxide sludges and solids with no cyanides (not contaminated muds

– W512)

W503 Gypsum sludges from wastewater treatment or air pollution control

W504 Other sludges from wastewater treatment or air pollution control

W505 Metal bearing sludges (including plating sludge) not containing cyanides

W506 Cyanide

- bearing sludges (not contaminated soils

– W512)

W519 Other inorganic sludges (not contaminated muds

– W512; specify in comments)

Organic Sludges

– Waste that is primarily organic with low

- to

- moderate inorganic solids content and water content; pumpable

Code Form Code Description

W603 Oily sludge (not contaminated muds

– W512)

W604 Paint or ink sludges, still bottoms in sludge form (not contaminated muds

– W512)

W606 Resins, tars, polymer or tarry sludge (not contaminated muds

– W512)

W609 Other organic sludge (specify in comments)Management Method Codes (continued)

84 

## MANAGEMENT METHOD CO DES

Management method codes describe the type of hazardous waste management system used to treat, recover, or dispose a hazardous waste. Select the final substantive method used. Review the groups and pick the appropriate code.

Reclamation and Recovery

Code Management Method Code Description

H010 Metals recovery including retorting, smelting, chemical, etc.

H020 Solvents recovery (distillation, extraction, etc.)

H039 Other recovery or reclamation for reuse including acid regeneration, organics recovery, etc. (specify in comments)

H050 Energy recovery at this site

– used as fuel (includes on

- site fuel blending before energy recovery; report only this code)

H061 Fuel blending prior to e nergy recovery at another site (waste generated on

- site or received from off

- site)

Destruction or Treatment Prior to Disposal at Another Site

Code Management Method Code Description

H040 Incineration

– thermal destruction other than use as a fuel (includes any preparation prior to burning)

H070 Chemical treatment (reduction/destruction/oxidation/precipitation); do not include immediate treatment in an exempt wastewater treatment unit with discharge to a NPDES

- POTW (unless required by S tate)

H081 Biological treatment; do not include immediate treatment in an exempted wastewater treatment unit with discharge

to a NPDES

- POTW (unless required by S tate)

H100 Physical treatment only (adsorption/absorption/separation/stripping/dewatering); do not incl ude immediate treatment in an exempted wastewater treatment unit with discharge to a NPDES

- POTW (unless required by S tate)

H110 Stabilization prior to land disposal at another site (encapsulation/stabilization/fixation)

H120 Combination of chemical, biological, and/or physical treatment; do not include immediate treatment in an exempted wastewater treatment unit with discharge to a NPDES

- POTW (unless required by S tate)

H121 Neutralization only (no other treatment)

H122 Evapo ration (as the major component of treatment; not reportable as H070, H081, H100 or H120)

H129 Other treatment that does not include onsite disposal (specify in comments)

Disposal

Code Management Method Code Description

H130 Surface Impoundment that will be closed as a landfill (to include prior treatment)

H131 Land treatment or application (to include any prior treatment and/or stabilization)

H132 Landfill or surface impoundment that will be closed as landfill (to include prior treatment and/or stabilization)

H134 Deepwell or underground injection (with or without treatment; this waste was counted as hazardous waste)

H135 Discharge to sewer/POTW or NPDES(with prior storage

– with or without treatment)

Trans fer Off

- site

Code Management Method Code Description

H141 The site receiving this waste stored/bulked and transferred the waste with no treatment or recovery (H010

- H129), fuel blending (H061), or disposal (H131

- H135) at that receiving site. Do not use this code on GM Form in Section 1

– Item
D or in Section 2.85 

## WASTE MINIMIZATION C ODES

The following codes provide a description of existing or new waste minimization efforts undertaken to
reduce the volume and/or toxicity of hazardous waste generated at the facility.

You may use the Comment s section to provide any additional information (including toxicity and quantity reductions to the extent that data are available) that will help the EPA and the S t ates understand your efforts to prevent pollution, minimize waste, or recycle in regards to this waste stream. Additionally, you may explain in the Comments section why your efforts were either successful or unsuccessful or why you did not implement waste minimization efforts for this reporting year.

The facility initiated waste minimization efforts prior to 2015 2017 and continued these efforts during the

2015 2017 reporting year for this hazardous waste

Code Description Examples

A Continued initiatives to reduce quantity and/or toxicity of this waste • Improved production/synthesis processes, e.g., increased efficiency in product usage/product formulation, used less

toxic or non

- hazardous ingredients, modified product composition, or implemente d technology conversion.

• Modified equipment, layout, and/or piping, e.g., longer

auto bath analyzers, wastewater treatment system upgraded.

• Undertook inventory control/waste management processes

or safety/good operating practices, e.g., materials shelf

- lif e control, clearinghouse for materials exchange, better labeling procedures, improved maintenance scheduling/record keeping/procedures, control production schedule to minimize equipment and feedstock changeovers, bulk systems that replace drums, improved

s torage, spill/leak/accident prevention, cleaning/degreasing, etc.

B Continued initiatives to recycle the waste either on

site or off

- site The waste was used, reused, or reclaimed as a result of a change in the product formulation, product’s chemical ingre dients, or equipment; materials management process with a goal of sustainable use of materials, etc.

The facility initiated waste minimization efforts during the 2015 2017 reporting year for this hazardous waste

C Implemented new initiatives to reduce quantity and/or toxicity of this waste See examples above for Code A.

D Implemented new initiatives to recycle the waste
either on

- site or off

- site See examples above for Code B.

The facility examined or attempted waste minimization efforts for this hazardous waste, but determined it was impracticable to implement these efforts; or the facility did not attempt waste minimization efforts for this

waste

N Waste minimization efforts found to be economically or technically impracticable Economic constraints or not economically feasible; technical limitations of manufacturing operations, problems preventing or halting efforts (e.g., concern of declined product quality); not appearing to be feasible due to regulatory issues (e.g., permitting require ments or burdens); lack of available technology, etc.

X No waste minimization efforts were implemented
for this waste The waste was received from off

- site and was not generated at this location; the waste is infrequently generated.86 

## Foreign Facility Site Identification Number Codes List

Report all wastes sent off

- site to facilities sites located in foreign countries. If the foreign site has EPA
assigned Identification (ID) Number listed below , fill out the GM Form as you would for a domestic site

, using this number . If the site does not have an EPA assigned ID number, report the code “FC” for foreign country followed by the name of the country in the space for the EPA ID Number. Enter the remaining

information for that facility site as you would for a do mestic facility. This may not be a comprehensive

list and will be re

- visited and posted as needed.

Bennett Environmental Saint Ambroise FCCA00000115 Centre de Recyclage Intermediare Ontario, Canada FCCA00000069
ChemRec Quebec, Canada FCCA00000068
Chemtech Quebec, Canada FCCA00000081 Clean Harbors, Corunna Ontario, Canada FCCA00000004 Clean Harbors, London Ontario, Canada FCCA00000100
Clean Harbors Mercier Quebec, Canada FCCA00000120 Clean Harbors, Mississauga Ontario, Canada FCCA00000070
Clean Harbors, Thorold Ontario, Canada FCCA00000050
Clean Harbors Thurso Quebec, Canada FCCA00000121
Custom Environmental Svcs Edmonton FCCA00000104 Cyanide Destruct, Barrie Ontario, Canada FCCA00000099 Cyanide Destruction Systems, Markham Ontario, Canada FCCA00000073 Fielding Chemical Ontario, Canada FCCA00000119

Horizon Environmental Inc Quebec, Canada FCCA00000090 Imperial Oil, Sarnia Ontario, Canada FCCA00000058 Newalta Industrial Svcs, Fort Erie Ontario, Canada FCCA00000067

Nova PB Ste Catherine FCCA00000105 Outokumpu Harjavalta Metals OY Harjavalta, Finland FCFI00000005
Pinnacle Waste Services Ontario, Canada FCCA00000082 Samji Metals Ind Co Ltd Ansaan City, Korea FCKR00000125
Stablex Canada Inc. Quebec, Canada FCCA00000045

Thermonics Douchervl, Quebec FCCA00000078 Wha Chang Co Ltd Haman

- gun, Korea FCKR00000124

Xstrata New Brunswick, Canada FCCA00000123
Zinc Nacional SA Monterrey, Mexico FCMX00000126

# DRAFT OMB# 2050

- 0024; Expires 01 / 31 / 2017

SEND COMPLETED FORM TO:
The Appropriate State or Regional Office. 

### United States Environmental Protection Agency RCRA SUBTITLE C SITE IDENTIFICATION FORM

1. Reason for Submittal

MARK ALL BOX(ES) THAT
APPLY Reason for Submittal:

 To provide an Initial Notification (first time submitting site identification information / to obtain an EPA ID number for this location)

 To provide a Subsequent Notification (to update site identification information for this location)

 As a component of a First RCRA Hazardous Waste Part A Permit Appli cation

 As a component of a Revised RCRA Hazardous Waste Part A Permit Application (Amendment # )

 As a component of the Hazardous Waste Report (If marked, see sub

- bullet below)

 Site was a TSD facility and/or generator of >1,000 kg of hazardous waste, >1 kg of acute hazardous waste, or >100 kg of acute hazardous waste spill cleanup in one or more months of the report year (or State equivalent LQG regulations)

2. Site EPA ID Number EPA ID Number

3. Site Name Name:

4. Site Location Information Street Address:

City, Town, or Village: County:

State: Country: Zip Code:

5. Site Land Type Private County District Federal Tribal Municipal State Other

6. NAICS Code(s) for the Site (at least 5

- digit codes) A.

- C

. -

B

. - D.

-

7. Site Mailing Address Street or P.O. Box:

City, Town, or Village:

State: Country: Zip Code:

8. Site Contact Person First Name: MI: Last:

Title:

Street or P.O. Box:

City, Town or Village:

State: Country: Zip Code:

Email:

Phone: Ext : Fax :

EPA Form 8700

- 12, 8700

- 13 A/B, 8700

- 23 Page 1 of9. Legal Owner and Operator of the Site A. Name of Site’s Legal Owner: Date Became Owner:

Owner Type: Private County District Federal Tribal Municipal State Other

Street or P.O. Box:

City, Town, or Village:

State: Country: Zip Code:

Email:

Phone: Ext: Fax:

Notes:

B. Name of Site’s Operator: Date Became Operator: Operator

Type: Private County District Federal Tribal Municipal State Other

Street or P.O. Box:

City, Town, or Village:

State: Country: Zip Code:

Email:

Phone: Ext: Fax:

Notes:

EPA Form 8700

- 12, 8700

- 13 A/B, 8700

- 23 Page 2 ofEPA ID Number OMB#: 2050

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10. Type of Regulated Waste Activity (at your site) Mark “Yes” or “No” for all current activities (as of the date submitting the form); complete any additional boxes as instruct ed.

A. Hazardous Waste Activities; Complete all parts 1

- 10.

Y N 1. Generator of Hazardous Waste If “Yes

, ” mark only one of the following

– a, b, or c. Y N 5. Transporter of Hazardous Waste If “Yes

, ” mark all that apply.

a. LQG: Generates, in any calendar month, 1,000 kg/mo (2,200 lbs/mo.) or more of non

- acute hazardous waste; or Generates, in any calendar month, or accumulates at any time, more than 1 kg/mo (2.2 lbs/mo) of acute hazardous waste; or Generates, in any calendar month, or accumulates at any time, more than 100 kg/mo (220 lbs/mo) of acute hazardous spill cleanup material. a. Transporter

b. Transfer Facility (at your site)

Y N 6. Treater, Storer, or Disposer of Hazardous Waste Note: A hazardous waste Part B permit is required for these activities.

Y N 7. Recycler of Hazardous Waste

b. SQG: 100 to 1,000 kg/mo (220

– 2,200 lbs/mo) of

non

- acute hazardous waste and no more than 1 kg (2.2 lbs) of acute hazardous waste and no more than 100 kg (220 lbs) of any acute hazardous spill cleanup material

. c. CESQG: Less than or equal to 100 kg/mo (220 lbs/mo) of

non

- acute hazardous waste. Y N 8. Exempt Boiler and/or Industrial Furnace If “Yes

, ” mark all that apply.

If “Yes” above, indicate other generator activities in 2

- 10

. a. Small Quantity On

- site Burner Exemption

Y N 2. Short

- Term Generator (generate from a short

- term or one

- time event and not from on

- going processes). If “Yes

, ” provide an explanation in the Comments section. b. Smelting, Melting, and Refining Furnace Exemption

Y N 3. United States Importer of Hazardous Waste Y N 9. Underground Injection Control

Y N 4. Mixed Waste (hazardous and radioactive) Generator Y N 10. Receives Hazardous Waste from Off

- site

B. Universal Waste Activities; Complete all parts 1

- 2. C. Used Oil Activities; Complete all parts 1

- 4.

Y N 1. Large Quantity Handler of Universal Waste (you accumulate 5,000 kg or more) [refer to your State regulations to determine what is regulated]. Indicate types of universal waste managed at your site. If “Yes

, ” mark all that apply.

a. Batteries

b. Pesticides

c. Mercury containing equipment

d. Lamps

e. Other (specify)

f. Other (specify)

g. Other (specify) Y N 1. Used Oil Transporter If “Yes

, ” mark all that apply.

a. Transporter

b. Transfer Facility (at your site)

Y N 2. Used Oil Processor and/or Re

- refiner If “Yes

, ” mark all that apply.

a. Processor

b. Re

- refiner

Y N 3. Off

- Specification Used Oil Burner

Y N 4. Used Oil Fuel Marketer

If “Yes

, ” mark all that apply.

Y N 2. Destination Facility for Universal Waste Note: A hazardous waste permit may be required for this activity. a. Marketer Who Directs Shipment of Off

- Specification Used Oil to Off

- Specification Used Oil Burner b. Marketer Who First Claims the Used Oil Meets the Specifications

EPA Form 8700

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D. Eligible Academic Entities with Laboratories

— Notification for opting into or withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262 Subpart K

 You can ONLY Opt into Subpart K if:

• you are at least one of the following: a college or university; a teaching hospital that is owned by or has a formal affilia tion agreement with a college or university; or a non

- profit research institute that is owned by or has a formal affiliation agreem ent with a college or university; AND

• you have checked with your State to determine if 40 CFR Part 262 Subpart K is effective in your state

Y N 1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories See the item

- by

- item instructions for definitions of types of eligible academic entities. Mark all that apply:

a. College or University

b. Teaching Hospital that is owned by or has a formal written affiliation agreement with a college or university

c. Non

- profit Institute that is owned by or has a formal written affiliation agreement with a college or university

Y N 2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories

11. Description of Hazardous Waste

A. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at your site. List them in the order they are presented in the regulations (e.g., D001, D003, F007, U112). Use an additional page if more spaces are needed.

B. Waste Codes for State

- Regulated (i.e., non

- Federal) Hazardous Wastes. Please list the waste codes of the State

- Regulated hazardous wastes handled at your site. List them in the order they are presented in the regulations. Use an additional page if more spaces are needed.

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12. Notification of Hazardous Secondary Material (HSM) Activity

Y N A. Are you notifying under 40 CFR 260.42 that you will begin managing, are managing, or will stop managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25) 40 CFR 260.30, 40 CFR 261.4(a)(23), (24), or (27) ?

If “Yes

, ” you must fill out the Addendum to the Site Identification Form: Notification for Managing Hazardous Secondary Material

.

Y N B. Are you notifying under 40 CFR 260.43(a)(4)(iii) that the product of your recycling process has levels of hazardous constituents that are not comparable to or unable to be compared to a legitimate product or intermediate but that the recycli ng is still legitimate?

If “Yes,” you may provide comments in Item 13 below. You must also document that your recycling is still legitimate and maintain that documentation on

- site.

13. Comments

14. Certification. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based

o n my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the informat ion, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. For the RCRA Hazardous Waste Part A Permit Application, all owner(s) and operator(s) must sign (see 40 CFR 270.10(b) and 2 70.11).

Signature of legal owner, operator, or an authorized representative Name and Official Title (type or print : first name, middle initial, last name, and title ) Date Signed (mm/dd/yyyy) Email

EPA Form 8700

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## ADDENDUM TO THE SITE IDENTIFICATION FORM:

NOTIFICATION OF HAZARDOUS SECONDARY MATERIAL ACTIVITY

ONLY fill out this form if:

 You are located in a State that allows you to manage excluded hazardous secondary material (HSM) under 40 CFR 260.30 40 CFR 261.2(a)(2)(ii)

, 261.4(a)(23), (24), or (25) (27) (or state equivalent); See http://www.epa.gov/epawaste/hazard/dsw/statespf.htm for a list of eligible states; AND

 You are or will be managing excluded HSM in compliance with 40 CFR 261.2(a)(2)(ii) 40 CFR 260.30 , 261.4(a)(23), (24), or (25) (27) (or state equivalent) or you have stopped managing excluded HSM in compliance with the exclusion(s) and do not expect to
manage any amount of excluded HSM under the exclusion(s) for at least one year. Do not include any information regarding your

hazardous waste activities in this section. 

### Note: If your facility was granted a solid variance under 40 CFR 260.30 prior to July 13, 2015, your management of hazardous secondary materials under 40 CFR 260.30 is grandfathered under the previous regulations and you are not required to notify for the HSM management activity excluded under 40

CFR 260.3 0.

1. Indicate reason for notification. Include dates where requested.

Facility will begin managing excluded HSM as of _____________ (mm/dd/yyyy).

Facility is still managing excluded HSM/re

- notifying as required by March 1 of each even

- numbered year.

Facility has stopped managing excluded HSM as of ____________ (mm/dd/yyyy) and is notifying as required.

2. Description of excluded HSM activity. Please list the appropriate codes and quantities in short tons to describe your ex cluded HSM activity ONLY (do not include any information regarding your hazardous wastes). Use additional pages if more space is needed.

a. Facility code (answer using codes listed in the Code List section of the instructions) b. Waste code(s) for HSM c. Estimated short tons of excluded HSM to be managed annually d. Actual short tons of excluded HSM that was managed during the most recent odd

numbered year e. Land

- based unit code (answer using
codes listed in the Code List section of the instructions)

3. Facility has financial assurance pursuant to 40 CFR 261.4(a)(24)(vi). (Financial assurance is required for reclaimers and intermediate facilities managing excluded HSM under 40 CFR 261.4(a)(24) and (25))

Y N Does this facility have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi)?

EPA Form 8700

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL OR ENTER:

SITE NAME:

EPA ID Number 

### U.S. ENVIRONMENTAL
PROTECTION AGENCY

2015 2017 Hazardous Waste Report

WASTE GENERATION

AND MANAGEMENT GM
FORM

Sec. 1 A. Waste description:

B. EPA hazardous waste code(s) C. State hazardous waste code(s)

D. Source code

G

Management Method code for Source code G25 E. Form code F. Quantity generated in 2015 2017

.

UOM

Density

. lbs/gal sg G. Waste minimization code

Sec. 2 Was any of this waste that was generated at this facility treated, disposed, and/or recycled on site?

 Yes (CONTINUE TO ON

- SITE PROCESS SYSTEM 1)  No (SKIP TO SEC. 3)

ON

- SITE PROCESS SYSTEM 1 ON

- SITE PROCESS SYSTEM 2

On

- site Management Quantity treated, disposed, or Method code recycled on site in 2015 2017

H

. On

- site Management Quantity treated, disposed, or Method code recycled on site in 2015 2017

H

.

Sec. 3 A. Was any of this waste shipped off site in 2015 2017 for treatment, disposal, or recycling?  Yes (CONTINUE TO ITEM B)

 No (FORM IS COMPLETE)

Site 1 B. EPA ID No. of facility to which waste was shipped C. Off

- site Management Method code shipped to D. Total quantity shipped in 2015 2017

Site 2 B. EPA ID No. of facility to which waste was shipped C. Off

- site Management Method code shipped to D. Total quantity shipped in 2015 2017

Site 3 B. EPA ID No. of facility to which waste was shipped C. Off

- site Management Method code shipped to D. Total quantity shipped in 2015 2017

Comments:

Page __ of ___

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL OR ENTER:

SITE NAME:

EPA ID Number 

### U.S. ENVIRONMENTAL
PROTECTION AGENCY

2015 2017 Hazardous Waste Report

WASTE RECEIVED

FROM OFF SITE WR

FORM

Waste 1 A. Description of hazardous waste

B. EPA hazardous waste code(s) C. State hazardous waste code(s) D. Off

- site handler EPA ID number

E. Quantity received in 2015 2017

. F. UOM

Density

. lbs/gal sg G. Form code

W H. Management Method code

H

Waste 2 A. Description of hazardous waste

B. EPA hazardous waste code(s) C. State hazardous waste code(s) D. Off

- site handler EPA ID number

E. Quantity received in 2015 2017

. F. UOM

Density

. lbs/gal sg G. Form code

W H. Management Method code

H

Waste 3 A. Description of hazardous waste

B. EPA hazardous waste code(s) C. State hazardous waste code(s) D. Off

- site handler EPA ID number

E. Quantity received in 2015 2017

. F. UOM

Density

. lbs/gal sg G. Form code

W H. Management Method code

H

Comments:

Page __ of ___

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL OR ENTER:

SITE NAME:

EPA ID Number 

### U.S. ENVIRONMENTAL
PROTECTION AGENCY

2015 2017 Hazardous Waste Report

OFF

- SITE
IDENTIFICATION OI FORM

Site 1 A. EPA ID number of off

- site installation or transporter B. Name of off

- site installation or transporter

C. Handler type (MARK ALL THAT APPLY)

 Generator

 Transporter

 Receiving facility D. Address of off

- site installation

Street City

State Zip

-

Site 2 A. EPA ID number of off

- site installation or transporter B. Name of off

- site installation or transporter

C. Handler type (MARK ALL THAT APPLY)

 Generator

 Transporter

 Receiving facility D. Address of off

- site installation

Street City

State Zip

-

Site 3 A. EPA ID number of off

- site installation or transporter B. Name of off

- site installation or transporter

C. Handler type (MARK ALL THAT APPLY)

 Generator

 Transporter

 Receiving facility D. Address of off

- site installation

Street City

State Zip

-

Site 4 A. EPA ID number of off

- site installation or transporter B. Name of off

- site installation or transporter

C. Handler type (MARK ALL THAT APPLY)

 Generator

 Transporter

 Receiving facility D. Address of off

- site installation

Street City

State Zip

-

Comments:

Page __ of __

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## INSTRUCTIONS FOR FIL LING OUT THE

OI FORM

– OFF

- SITE IDENTIFICATION

WHO MUST SUBMIT THIS FORM

Sites required to file the 2015 2017 Hazardous Waste Report must submit the OI Form if:

• The OI Form is required by your State; AND

• The site received hazardous waste from off

- site or sent hazardous waste off

- site during 2015 2017

.

For a list of State Contacts go to: https://www.epa.gov/sit es/production/files/2016

- 03/documents/contact02172016.pdf

.

PURPOSE OF THIS FORM

The OI Form documents the names and addresses of off

- site installations and transporters.

HOW TO FILL OUT THIS FORM

The OI Form is divided into four identical parts. You m ust fill out one part for each off

- site installation to which you shipped hazardous waste, each off

- site installation from which you received hazardous waste, and each transporter you used to ship hazardous waste during 2015 2017 . If these off

- site install ations and transporters total more than four, you must photocopy and complete additional copies of the form. Prior to photocopying, place the pre

- printed site identification label in the top left

- hand corner of the form or, if you did not receive pre

- prin ted labels, enter the site name and EPA Identification Number in this space.

Use the Comments section at the end of the form to clarify any entry (e.g., “Other” responses) or to continue any entry. When entering information in the Comments section, cross

- reference the site
number and item letter to which the comment refers.

ITEM

- BY

- ITEM INSTRUCTIONS

Complete Items A through D for each off

- site installation to which you shipped hazardous waste and each
off

- site installation from which you received h azardous waste during 2015 2017 . Complete Items A through C for each transporter you used during the year (address in Item D is not required for transporters).OI Form (continued)



### ITEM A

– EPA ID NO. OF OFF

- SITE INSTALLATION OR TRANSPORTER

Enter the 12

- digit EPA Identi fication Number of the off

- site installation to which you shipped hazardous waste or from which you received hazardous waste. Or, enter the EPA Identification Number of the transporter who shipped hazardous waste to or from your site. Each EPA Identifica tion Number should appear only once. If the off

- site installation or transporter did not have an EPA Identification Number during 2015 2017 , leave blank if this item is not applicable or “don’t know” in Item A and note the reason
in the Comments section.

ITEM B

– NAME OF OFF

- SITE INSTALLATION OR TRANSPORTER

Enter the name of the off

- site installation or transporter reported in Item A.

ITEM C

– HANDLER TYPE

Place an “X” in all boxes that apply to the handler type (i.e., generator, transporter, or receivi ng facility)
of the off

- site installation or transporter reported in Item A.

ITEM D

– ADDRESS OF OFF

- SITE INSTALLATION

Enter the address of the off

- site installation reported in Item A. If the EPA Identification Number reported
in Item A refers to a transporter, leave blank if this item is not applicable or “don’t know” in Item D.