Connecticut Administrative Code › Title 22a - Environmental Protection › 209 - Solid Waste Management › Appendix I

Current through July 10, 2024
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This appendix describes each section (box) of the biomedical
				waste tracking form and provides mandatory instructions for completing each of
				these sections. The generator shall complete Boxes 1-15, the transporter shall
				complete Boxes 16-21, and the operator of the solid waste facility shall
				complete Boxes 22-23. The transporter may assist the generator in completing
				any of the boxes, but the generator is responsible for ensuring the accuracy of
				information entered on the form and must sign Box 15 after Boxes 1-14 are
				completed.
Box 1. Generator's Name and Mailing Address.
Enter
				the name and mailing address of the generator. The mailing address shall be the
				address to which the solid waste facility will return the signed copy of the
				tracking form, and should be for the location where the generator's tracking
				forms will be handled for purposes of recordkeeping and exception reporting
				(e.g., the company's billing office, corporate headquarters, or the actual site
				of generation).
While the address entered here need not identify the particular
				site of generation, the generator shall maintain his records so that individual
				waste shipments (identified by a unique tracking form number assigned by the
				generator, discussed next) can be associated with the actual sites of
				generation.
Box 2. Tracking Form Number.
This is the unique
				number that the generator shall assign to each shipment of biomedical waste. It
				will ensure that each individual shipment can be identified and independently
				tracked from the site of generation. (The number may be the date of shipment or
				some other notation that the generator wishes to utilize.)
Box 3. Generator Telephone Number.
Enter the
				telephone number of a contact person for the generator who can provide
				additional information about the shipment in the event of an emergency or in
				the event that the transporter or solid waste facility requires it for other
				reasons (e.g., to inform the generator that an alternative waste disposal
				facility must be used).
Box 4. State Generator Permit or ID Number.
This
				box is not applicable under current state law and should be left blank.
Box 5. Transporter's Name, Mailing Address and U.S.
				Environmental Protection Agency ("EPA") Medical Waste Identification
				Number.
Indicate in this space the name and address of the transporter
				who will be the first transporter of the biomedical waste which is the subject
				of the tracking form. The address shall be the business mailing address of the
				transporter. The transporter shall fill in his EPA Medical Waste Identification
				Number for the State in which the waste was generated. If a number has not yet
				been assigned, the transporter shall leave this box blank. The EPA Medical
				Waste Identification Number is assigned by EPA when the transporter notifies
				EPA.
Box 6. Transporter Telephone Number.
Enter the
				telephone number of the transporter that the generator or solid waste facility
				operator may call to obtain information regarding a biomedical waste
				shipment.
Box 7. State Transporter Permit or ID Number.
Enter the biomedical waste transporter permit number issued to transporter
				pursuant to subsection (g) of this section.
Box 8. Solid Waste Facility Name and Address.
Enter the name and site address of the solid waste facility to which the
				biomedical waste is to be delivered. The site address is necessary to inform
				the transporter where the waste must be delivered. (If the generator does not
				have this information, the transporter may complete this section, but only
				before the generator signs the form. Transfer stations and other temporary
				storage facilities used by transporters for storage of waste during transport
				shall not be listed here as the solid waste facility.)
Box 9. Solid Waste Facility Telephone Number.
Enter the solid waste facility's telephone number which a generator or
				transporter may call to obtain information regarding a biomedical waste
				shipment.
Box 10. State Solid Waste Facility Permit or ID
				Number.
Enter the solid waste facility permit number assigned by
				Department of Environmental Protection pursuant to Section
				22a-208a
				of the General Statutes. If the solid waste facility is located outside
				Connecticut, enter the facility permit or other identification number assigned
				by the State in which the facility is located.
Box 11. U.S. Environmental Protection Agency Waste
				Description.
In Box 11 (A), indicate untreated biomedical waste. In Box
				11 (B), indicate decontaminated biomedical waste. In Box 11 (C), indicate
				chemotherapy waste. The generator shall determine and indicate the type(s) of
				his waste before completing Boxes 12 and 13.
Box 12. Total Number of Containers.
Enter the
				total number of containers (e.g., bags, boxes, pails, drums, etc.) for each
				applicable waste type in the corresponding space.
Box 13. Total Weight or Volume.
Enter the total
				weight of the waste, by applicable waste type, in the corresponding space. If
				the waste is oversized and is not packaged in a standard container, a
				volumetric measure may be used; however, the unit of measure shall be noted in
				that space as well.
Box 14. Special Handling Instructions and Additional
				Information.
Generators may use this space to indicate special
				transportation, treatment, storage, or disposal information or bill of lading
				information, including alternative treatment and/or disposal facility
				information, if necessary. Generators may also include in this box a written
				request for the solid waste facility to certify disposal of the waste through
				signature and dating within this box. (Note: The signature in the solid waste
				facility Certification Box (Box 22) is only to be used to acknowledge receipt
				of the waste at the time of delivery to the facility.)
For out-of-State shipments, generators shall enter in this
				space the point of departure (city and State) for those wastes destined for
				facilities outside of Connecticut. This space may also be used if there is need
				to identify a third transporter.
This space should also be used to provide special instructions
				or additional information regarding oversized biomedical waste that cannot be
				easily packaged in plastic bags or standard containers. In these instances,
				enter a description of the waste, including whether the waste is untreated or
				decontaminated, the number of pieces, and the approximate total weight.
Box 15. Generator's Certification.
This statement,
				when signed by the generator, certifies that (i) all information required to be
				provided by that generator is accurate (including any information provided by
				the transporter in Boxes 1-14), (ii) all wastes indicated on the tracking form
				are properly prepared for transport, and (iii) all applicable State and Federal
				requirements have been met. The generator shall enter his name into this
				statement and read it, sign it by hand, and date it. The individual signing the
				statement must be authorized in writing to make the required declarations by
				the generator.
Box 16. Transporter 1 Certification of Receipt.
The first transporter shall acknowledge acceptance of a biomedical waste
				shipment from the generator by signing the form in this box and recording the
				date of acceptance. Before doing so, a transporter shall indicate in Box 23 of
				the tracking form any circumstances of the type described in subparagraph (h)
				(20) (A) of this section. In those instances when a transporter initiates a
				tracking form, he shall complete Boxes 1-15 and if he is also the first
				transporter as identified in Box 5 (Transporter's Name and Mailing Address), he
				shall acknowledge receipt as transporter 1.
Box 17. Transporter 2 Name, Address, and U.S.
				Environmental Protection Agency Medical Waste Identification Number.
In
				the event the waste shipment is to be transported by a second transporter, such
				second transporter shall enter in this box his name and business mailing
				address and his U.S. Environmental Protection Agency Medical Waste
				Identification Number if it is available.
Box 18. Transporter 2 Telephone Number.
Enter the
				second transporter's telephone number to be used when checking or investigating
				the status of a shipment.
Box 19. Transporter 2 State Transporter Permit or ID
				Number.
In this box, a second transporter shall enter his biomedical
				waste transporter permit number assigned under subsection (g) of this section,
				or, if such second transporter is an out-of-state transporter, he shall enter
				any permit or other identification number assigned to him by such other
				state.
Box 20. Transporter 2 or Intermediate Handler
				Certification of Receipt.
A second transporter shall acknowledge
				acceptance of the waste shipment by entering his name and the date of
				acceptance and signing the form. Before doing so, he shall indicate in Box 23
				of the tracking form any circumstances of the type described in subparagraph
				(h) (20) (A) of this section.
Box 21. New Tracking Form Number.
If a biomedical
				waste transporter consolidates multiple biomedical shipments on a new tracking
				form, a new tracking form number shall be recorded in this box on the original
				generator's form.
Box 22. Solid Waste Facility.
The operator of a
				solid waste facility shall acknowledge acceptance of biomedical waste by
				printing or typing his name and date of acceptance and signing in this box.
				Before doing so, he shall complete Box 23, as applicable, or, if there is
				nothing to record in Box 23, he shall place a check next to the statement
				"received in accordance with items 11, 12 and thirteen."
If biomedical waste is delivered to a solid waste facility
				other than that indicated in Box 8, the operator of the solid waste facility
				that accepted the waste shall complete Box 22 in the manner described in the
				foregoing paragraph and shall type or print his address, telephone number, and
				permit number assigned pursuant to Section
				22a-208a
				of the General Statutes.
Box 23. Discrepancy Box.
In Box 23 the operator of
				the solid waste facility shall indicate any circumstances of the type described
				in subparagraph (h) (20) (A) of this section. (Note: In some instances, due to
				the consolidation provisions of subdivisions (h) (18) and (19) of this section,
				transporters may also need to complete this box.)