OMB Control No. 20XX
-XXXX Approval expires XX/XX/XX 

## DRAFT Sample Data Tracking Form for 

### Collection of Information on Anaerobic Digestion Facilities Processing Wasted Food to Support EPA’s Sustainable Food Management Programs
Section I. Facility and C ontact Information

_____________________________________________________________________________________ 1. Project/Facility Name : 2. Type of **Stand -** 

**Alone Facility** 

**1** : a. **Multi -** **Source Digester**  b. **Industry Dedicated Digester**  c. O ther – please specify
. 3. Street address of facility : 4. C ity, County, State: 5. Contact information for facility operational data : a. Name b. P hone number c. Email d. Mailing address 6. Facility o peratin g status: a. Planning stage ; b. I n permitting process; c. Under construction ; d. Operational ; e. Temporary shut
- down; f. Ceased o peration ; g. Other – please specify.

1 Terms in bold
- italics are defined in the glossary.Section II. Feedstock and Capacity Information:

_____________________________________________________________________________________ 7. In Table 1 below, please i dentify the types of **Food -** **Based Materials** ( **feedstocks** ) that are processed in your digester. Check all that apply. **Table 1: Food**  **- Based Feedstocks** 

8. Please provide the total amount of **Food -** **Based Materials** processed at this facility . The preferred units are total tons or total gallons (please specify). a. D uring calendar year 2014 = _______________________ b. D uring calendar year 2015 = _______________________ c. D uring calendar year 2016 = _______________________ 9. In Table 2 below, please i dentify the types of **N on**  **- Food** **- Based Materials**  that are processed in your digester. Check all that apply. **Table 2**  **: Non**  **- Food**  **- Based Feedstocks**  **Non -**  **Food -**  **Based Feedstocks Feedstock Type:**  **Accepted (Y/N?):**  **Generated**

**Onsite/Offsite? Source of Feedstock**  **Volume processed in 2015 (in tons or**  **gallons –**  **pls specify)** Mixed yard waste Crop residues Manures Wastewater solids (sludge) Litters De - icing fluid **Feedstock Type: Accepted**  **(Y/N?): Generated** 

**Onsite/Offsite? Source of Feedstock**  **: Volume processed in**  **2015 ( in tons or**  **gallons –**  **pls specify)** Fruit/vegetative wastes F ood processing industry waste B everage processing industry waste Food service waste, pre & post - consumer Retail food waste Source
- separated commercial, institutional or residential organic wastes Fats, oils and greases (FOG) Rendering wastes Other (please specify):L ab (or Pharma ) wastes

Paper mill wastes Crude glycerine Other (please specify): 10. Please provide the total amount of **N on**  **- Food** **- Based**  **Materials** processed at this facility . The preferred units are total tons or total gallons (please specify). a. D uring calendar year 2014 = _______________________ b. D uring calendar year 2015 = _______________________ c. D uring calendar year 2016 =

_______________________ 11. Please describe any **feedstock** pre - processing and the reason for pre
- processing 12. Please describe your de
- packaging process, if applicable. 13. Please identify the tipping fee charged for offsite **feedstocks** including units (e.g., $/ton or $/gal).
Section III. Design Specifications :

_____________________________________________________________________________________ 14. Please answer the following questions about your digester: a. What is your t emperature range ? i. Unheated ii. Ambient iii. Thermophillic iv. Mesophillic) b. Is your digester Wet or Dry ? c. Is your digester Batch or Continuous Flow ? d. Is your digester Single or Multi
- stage ? e. How would you describe you r digester? i. Contin uous Stirred Tank Reactor ii. High Rate Bioreactor iii. Plug Flow iv. Complete mix v. C overed Lagoon vi. Induced Blanker Reactor vii. Hydraulic Self
- stir Reactors viii. Hybrid ix. Fixed Film x. Unknown xi. OtherSection IV. Product End
- Uses

_____________________________________________________________________________________ **BIOGAS** 15. Please provide the average biogas production volume at your facility in Standard Cubic Foot ( SCF ) /minute, SCF/hour or SCF/year: a. D uring calendar year 2014 = _______________________ b. D uring calendar year 2015 = _______________________ c. During calendar year 2016 =

_______________________ 16. Please identify what the biogas produced at this facility is used for, check all that apply
. a. Power engines to produce: i. Mechanical power; ii. Heat; and/or iii. Electricity b. Fuel boilers and furnaces to: i. H eat digesters ; and /or ii. H eat other sp aces c. Compressed to vehicle fuels d. Sold to the grid (electricity) e. Renewable natural gas (processed for pipeline injection ) f. Other 17. Are you able to utilize all of the biogas produced ? Y es/N o 18. If you can’t utilize all the gas, do you flare the excess? Yes/No 19. What type of engine(s), turbine(s) , boilers, gas purification or fuel cell(s) do you employ? 20. Does the size of you r gas utilization system limit your energy production 21. Is the biogas produced at this facility used onsite or sold? **DIGESTATE:** 22. Is further processing of digestate occurring ? Yes/No 23. If yes, please specify what kind of processing is occurring and for what reason
. a. Dewateringb. Nutrient recovery i. to meet NPDES permit requirements ii. to recover Nitrogen iii. to recover Phosphorous iv. to recover Pota ssium v. for other use c. Drying d. Composting e. Other 24. P lease identify how the liquid digestate is used or managed , check all that apply. a. Fertilizer/land application b. Re - circulated through digester c. Discharge to W astewater Treatment Plant d. Other 25. P lease identify how the solid digestate is used or managed, check all that apply. a. Direct l and application/agricultural use b. Animal bedding i. As is ii. Further processed c. Further processed into a soil amendment, then (check all that apply). i. Land applied ii. B agged and sold or sold in bulk iii. O ther d. Made into other products (please specify the products ) e. Other 26. Is any amount of your digestate disposed of in a landfill or incinerated ? Yes/No a. If yes , how much digestate was disposed of in a landfill in 2015 ? Units = tons or gallons (please specify). b. If yes, how much digestate was incinerated in 2015? Units = tons or gallons (please specify). Section V. Identi fication of other Anaerobic Digestion Facilities Processing Wasted Food

__________________________________________ ___________________________________________ 27. Please review the names and locations of facilities in the list provided. If you are aware of any anaerobic digestion facilities that are processing **F ood**  **- B** **ased M** **aterials** that are not identified in this list, please provide the following information: a. Project/Facility Name b. Type of Facility: i. **Stand -**  **Alone Facility** : 1. **Multi -** **Source Digester**2. **Industry Dedicated Digester**  ii. Anaerobic digester at a wastewater treatment plant that **co -** **digests** organic **feedstocks** other than wastewater solids/sludges iii. On
-farm anaerobic digester that **co -** **digests** organic **feedstocks** other than livestock manures iv. Other– please specify. c. Street address of facility d. City, County, and State e. Contact information for facility operational data i. Name ii. Phone number iii. Email iv. Mailing address
The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania A ve., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
**GLOSSARY** 1. **Co -** **digestion -**  Co
- digestion happens when more than one type of organic material is digested at the same time. Digesters are often built for a single purpose. For example, a farmer may build an anaerobic digester to handle cow manure. If the farmer also takes food waste from a local grocery store and puts the food waste in the digester along with the cow manure, it is called co
digestion. 2. **Feedstocks –**  Feedstocks are organic waste streams that can be processed in an anaerobic digester . Common feedstocks include man ure; sewage slud ge; wasted food; yard waste; fats, oils, and greases (FOG); a nd industrial organic residuals . 3. **Food -** **B ased**  **M aterials**  **-** Organic wastes suitable for digestion that are food
- based i ncluding but are not limited to : food scraps that have been separated and collected by municipalities from residential sources ; food scraps that have been separated and collected from institutions or venues (prisons, hospitals, stadiums , etc.); food scraps from food preparation at restau rants, cafeterias, and other food services; plate scrapings from restaurants, cafeterias, and other food services; fats, oi ls and greases ; unused food collected from retail stores (bakery items, bruised fruit, items passed shelf life, etc.) and food a nd be verage processing industry wastes . 4. **Industry Dedicated Digester -**  Is a type of Stand
-Alone Facility that is typically developed in a certain location for a food
- processing plant . These digesters are built to process a specific waste stream or streams from a specific industry location (e.g., brewery waste from a beer company,yogurt by
- products from a yogurt company, etc.)

5. **Multi -** **Source Digester**  – Is a type of Stand
-Alone Facility that could manage source
- s eparated organic waste streams f rom one or more municipality, institution (e.g., a prison, a university or a hospital) , or other source . 6. **Non -**  **Food -**  **B ased Materials**  – Organic wastes suitable for digestion that are not food
- based including but not limited to: mixed yard waste, crop residues, manures, w astewater solids (sludge) , litters, de
- icing fluid, lab (or pharma) wastes, paper mill wastes and crude glycerine. 7. **Stand -** 

**Alone Facility** – A Stand
-Alone Facility may take other feedstocks but it is designed to process the organic fraction of municipal solid waste (MSW). Although feedstocks can include yard waste, manures and wastewater solids, the primary feedstock is food
- based materials. This type of facility could be for
- profit organics recycling, community
- based or built by a municipality to acc ommodate MSW.