Nevada Administrative Code › Chapter 459 - Hazardous Materials › REGULATION OF HIGHLY HAZARDOUS SUBSTANCES AND EXPLOSIVES › General Requirements › Section 459.95344 - Reports of regulatory agencies

Current through June 11,
				  2024
A governmental entity or agency of the State
				  that is required by subsection 1 of
				  NRS
				  459.382 to submit a report to the Division
				  shall do so, upon request, within 10 working days after a determination is made
				  or an action is taken related to hazards involving highly hazardous substances
				  or explosives at a facility. The report must be submitted on the following
				  form:
NEVADA DIVISION OF ENVIRONMENTAL PROTECTION
CHEMICAL ACCIDENT PREVENTION PROGRAM
GOVERNMENTAL AGENCY
				  REPORTING FORM
A facility which produces, uses, stores or handles
				  a highly hazardous substance or manufactures an explosive for sale in a process
				  subject to NAC
				  459.95323 is subject to the
				  provisions of NRS
				  459.380 to
				  459.3874, inclusive. Pursuant to
				  NRS
				  459.382, governmental entities or agencies of
				  the State are required to complete the following information whenever a
				  determination is made or an action is taken related to hazards involving highly
				  hazardous substances or explosives at a facility. Please complete this form and
				  return it to the Nevada Division of Environmental Protection, 901 South Stewart
				  Street, Suite 4001, Carson City, Nevada 89701.
1. Facility Name
				  .........................................................................................................................
2. Facility Location
				  ....................................................................................................................
...............................................................................................................
...............................................................................................................
3. Highly Hazardous Substances or Explosives
				  Present at the Facility
Substance Estimated Quantity (lbs.)
......................................................................
				  ...............................
......................................................................
				  ...............................
......................................................................
				  ...............................
4. Describe any specific hazards related to
				  highly hazardous substances or explosives which were noticed by regulatory or
				  inspection staff at the facility
				  .............................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
5. Describe any action your agency has taken
				  at this facility related to highly hazardous substances or explosives. Include
				  orders, notices, penalties,
				  etc......................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
6. List statutes, regulations, standards or
				  codes related to or controlling actions taken by your agency
				  ...........................................................................................................................
...............................................................................................................
...............................................................................................................
7. Agency contact:
				  ......................................................... Phone:
				  ...................................
8. Authorized signature:
				  ................................................ Date:
				  ......................................
Attach additional sheets if
				  required.
Added to NAC by Div. of
				  Environmental Protec., eff. 7-10-92; A by R137-04, 2-15-2005; A by
				  R103-22A,
				  eff. 12/7/2022
NRS
				  459.3818,
				  459.382