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BKSFLD FIRE PREVEMTIOM
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES"~':'i: :.?: :,I .:!...~
.1715 Chester Ave., Bakersfield, CA
...:.* .. i:.:k'' .
APPLICATION TO P~RFORM
FUEL MONITORING CERTIFICATION
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AP .FROVED BY
FACILITY NAME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301
INSPECTION DATE 12/
Section 4: Hazardous Waste Generator Program
[] Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) flet.~ ~"~ ~'CC--,~
Authorized for waste treatment and/? storage
Reported release, fire, or explosion within 15 days of occurrence
Established or maintains a con't]h'g~cy-plaii and training
Hazardous waste accumulation time frames
Containers in good condition and not leaking
Containers are compatible with the hazardous waste
Containers are kepi closed when not in use
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line
Secondary containment provided
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste
Proper management of lead acid batteries including labels
Proper management of used oil filters
Transports hazardous waste with completed manifest
Sends manifest copies to DTSC
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years
Determines if waste is restricted from land disposal
C=Compliance V=Violation
Inspector: ~/~ I P/~"~ ~"'~~~~.~~
Office of Environmental Services (661) 326-3979 B'~ts~S~ R~pon Pa~ty
White - Env. Svcs. Pink - Business Copy
STATI:~OF CALI?ORNIA-ENVIRONMENTAL PROTECTION AGENCY
DEP.~,R"~I'MENT OF TOXIC ES CONTROL
CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
PETE WILSON, Governor
FACILITY NAME: lq~rte ,/ o(ou'[l~ ~. es~ /-/oa~,).[, [ EPA ID NUMBER:
PHYSICAL ADDRESS' (/o~ v/d9 d'/b¢r fo'aa9 ag3v~. ~rr~/)/a~ , c~F/. ~33
FACILITY CONTACT-NAME: ~,: [cl~ ~e~re'~, PHONIC: ;"~d &~.4
SIC CODE(S)' ~0~< ' INSPECTION~DATE: O"a~. 2~, /1~=o- Local
NOTIFIED UNIT COUNT:
CORRECT UNIT COUNT:
PBR ~ CA ~ CESW / CESQT ~ TOTAL {.
PBR~ CA~ CESW ) CESQT~ TOTAL }
This checklist and inspection report identify violations'of state law regarding onsite treaters of hazardous waste,
operating under an onsite permitting tier. This inspection verifies the information provided on form DTSC 1772. It also
covers generator requirements, ' although a seParate checklist may be used for those requirements. A checkmark indicates
violation of the law, which are explained in more detail on the attached note sheets. The governing laws are the Health and
Safety Code CHSC) and Title 22 of the California Code of Regulations (22 CCR).
Generator Standards:
Each inspection agency may use their own generator inspection checklist or protocols, which are summarized below, A full
evaluation of each item or document is not conducted during the Verification Inspection, unless serious deficiencies are suspected.
NO
1.
4.
Contingency plan has been prepared (adequately minimize releases, has alarm/communication
system, lists emergency equipment and phone numbers for emergency coordinators).
Written training documents and records prepared for employees handling hazardous waste.
Meet container management standards (storage time limits, closed, labelled, compatibility,
inspected weekly, in good condition, with ignitables/reactives 50 feet from property line).
Meet tank management standards (either secondary containment or integrity assessments, plus
storage time limits, labelled, compatibility, inspected daily, in good condition, with
ignitables/reactives 50 feet from property line).
All wastes are properly identified.
Treatment Items-Facility Wide:
(Facility must submit a revised Form 1772 to correct errors or omissions.)
6. ~ All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new
units with unit sheets or correct tier on the unit sheet.)
7. ¢¢,. All generator identification information on Form DTSC 1772 is correct.
8. &,, The submitted plot plan/map adequately shows the location of all regulated units.
9. ~f~ There are records documenting compliance with sewer agency pretreatment standards and
industrial waste discharge requirements, where applicable.
10.~)q Generator has prepared/maintained source reduction documents requirements (SB 14/SB
1726). For many wastes, a checklist or plan is required only if annual hazardous waste volume
is over 5,000 kilograms (approx 11,000 pounds or 1,350 gallons). HSC 25244.15, 25244.19-.21
For CA or PBR notifiers:
1141//7 The generator has an annual waste minimization certification. (PBR submit with renewals.)
Onsite Checklist (A)
Page 1 of / August 2, 1994
STATE,,OF CALI~ORNIA-F. NVIRONMENTAL PROTE,,~'i.~ION AGENCY
DEPARTMENT OF TOXIC SUBST;a[~ICE$ CONTROL
CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
UNIT SHEET
PETE WILSON, Governor
Complete one unit sheet for each unit either listed in the notificatiOn or identified during the' inspection.
Unit Number: ~a / Unit Name: /r/7,~/~ ~r ~ ~.
Notified Tier: ces ~ Correct Tier: c'~-~
Notified Device Count:
Correct Device Count:
Tanks ~- Containers
Tanks C:gr Containers
For each Unit:
NO
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22
23.
All hazardous wastes treated are generated onsite.
The unit notification is accurate as to the number of tank(s) and/or container(s).
The estimated notification monthly treatment volume is appropriate for the indicated tier.
The waste identification/evaluation is appropriate for the tier indicated.
The wastestream(s) given on the notification form are appropriate for the tier.
The treatment process(es) given on the notification form are appropriate for the tier.
The residuals management information on the form is correct and documented for the unit.
The indicated basis for not needing a federal permit on the notification form is correct.
There are written operating instructions and a record of the dates, volumes, residual
management, and types of wastes treated in the unit.
There is a written inspection schedule (containers-weekly and tanks-daily).
There is a written inspection log maintained of the inspections conducted.
If the unit has been closed, the generator has notified DTSC and the local agency of the
closure.
For each CA or PBR unit:
24.W;/ The generator has secondary containment for treatment in containers.
For each PBR unit:
25. ~ There is a waste analysis plan
26./~//J There are waste analysis records.
27. There is a closure plan for the unit.
Unit Comments/Observations: (If this is a unit that was not included on }he notification form, the violation is operating
without a permit-HSC 25201 (a). Also note if the activity is currently ineligible for onsite authorization.)
Onsite Checklist (B) Page ._f__ of / August 2, 1994
STATE.OF CALIF~ORNIA-ENVIRONMENTAL PROTEf=~ON AGENCY
DEPA S CONTROL
CI-[ECKLIST AND INITIAL VERI~CATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
SIGNATURE SHEET
PETE WILSON, Governor
Onsite Recycling: Only answer jf this facility recycles more than 100 kilograms/month of hazardous waste onsite.
NO
... 28.t9p The appropriate local agency has been notified. HSC 25143.10
29'~.
Activities claimed under the onsite recycling exemption are appropriate. HSC 25143.2 et sec.
Releases:
YES-
30.
31.
If there has been a release, provide the following information: number of releases, date(s), type(s) and quantity of
materials/waste, and the cause(s). Use unit sheet or attach additional pages.
Within the last three years, were there any unauthorized or accidental releases to the
environment of hazardous waste or hazardous waste constituents from onsite treatment units?
Within the last three years, were there any unauthorized or accidental releases
to the environment of hazardous waste' or hazardous waste constituents from any location at
this facility?
For purposes of a Tiered Permitting inspection, an unauthorized and/or accidental
release to the environment does not include spills contained within containment systems.
This report may identify conditions observed this date that are alleged to be violations of one or
more sections at the California Health and Safety Code (HSC) or the California Code of Regulations,
Title 22 (22 CCR) relating to the management of hazardous waste. The violations may be described in
more detail on the attached note sheets. If any violations are noted, the facility is required to the submit
a signed Certification of Return to Compliance within 60 days, unless otherwise specified. (A
certification form is provided.) If any corrections are needed to the initial notification, the facility will
submit a revised notification within 30 days to the Department of Toxic Substances Control with a copy
to the local enforcement agency.
Inspector(s):
Lead Inspector:
Signature:
Print
Title: fi,. 2~ rg)~,.~
Agency:~<?/.
Phone Number:
Other Inspector:
Signature:
Print Name:
Title:
Agency:
Phone Number:
Facility Representative:
Your signattF', e'}acknowledges receipt of this
Title:
report and does not imply agreement with the findings.
Print Name:
Onsite Checklist (C) Page / of [ August 2, 1994
STATE'~.~.F CALIFORNIA-ENVIRONMENTAL PROTION AGENCY
DEPARTMENT OF TOXIC SUBSTANCES CONTROL
CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR
Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers
NOTE SHEET
PETE WILSON, Governor
This sheet includes inspecto( observations and expands upon the violations identified on the checklist (by number). In some
cases, it indicates how the facility should correct the violations. It also includes the names of any others participating in this inspection.
Onsite 'Checklist (D) Page / of/ August 2, 1994
zz~ co~E ~ ~ I
FILE TYPE
OTHER
STATE'OF CALIFORNIA--ENVIRONMENTAL PROTEC; ~ .GENCY
DEPARTMENT OF TOXIC SUBSTANCES CONTROL
400 P Street, 4th Floor
P.O. Box 806
Sacramento, CA 95812-0806
(916) 323-5871
PETE WILSON. Governo,
09/23/93
EPA ID: CAD983660127
MERCY HEALTHCARE BAKERSFIELD
VICKIE BERRY
P.O. BOX 1499
BAKERSFIELD, CA 93302
For facility lomted at:
MERCY SOUTHWEST HOSPITAL
400 OLD RIVER ROAD
BAKERSFIELD, CA 93311
Authorization Date: 09123193
Dear Conditionally Authorized and/or Conditionally Exempt Facility:
ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR
CONDITIONAL EXEMPTION
The Department of Toxic Substances Control (DTSC) has received your facility specific notification (form
DTSC 1772) and forms for Conditional Authorization and/or Conditional Exemption for Specified Waste, streams (form
DTSC 1772B and/or 1772C). Your notifications are administratively complete, but have not been reviewed for technical
adequacy. A technical review of your notifications will be conducted when an inspection is performed. At any time,
you may be inspected and will be subject to penalty if violations of laws or regulations are found.
The Department acknowledges receipt of your completed notification for the treatment unit(s) listed on the last
page of this letter. These units operating under Conditional Authorization or Conditional Exemption are authorized by
California law without additional Department action, pursuant to Health and Safety Code sections 25200.3 and 25201.5.
Your authorization to operate continues until you notify DTSC that you have stopped treating waste and have fully
closed the unit(s). You will be charged annual fees calculated on a calendar year basis for each year you operate and
have not notified DTSC that the units have been closed.
You must notify the DTSC 60 days before first treating hazardous wastes in any new unit. You must also
notify the DTSC whenever any of the information you provided in these notifications changes. To revise information,
mail a cover letter to the above address explaining the changes, attach only the pages of your notification package that
have changed, and re-sigu and date at the signature space on page 3 of form 1772.
Your status to operate under Conditional Authorization and/or Conditional Exemption is contingent upon the
accuracy of information submitted by you in the notifications mentioned above, and your compliance with all applicable
requirements in the Health and Safety Code. Any misrepresentation or any failure to fully disclose all relevant facts
shall render your authorization to operate null and void.
You are also required to properly close any treatment unit. Additional guidance on closure will be issued and
distributed to all authorized onsite facilities later this year.
Page 2 EPA ID: CAD983660127
If you have any questions regarding this letter, or have questions on operating requirements for your facility,
please contact the nearest DTSC regional office, or this office at the letterhead address or phone number.
Enclosure
Sincerely,
Michael S. Homer, Chief
Ousite Hazardous Waste Treatment Unit
Permit Stream]inlng Branch
Hazardous Waste Management Program
SUSAN LANEY
DTSC REGION 1
SURVEILLANCE & ENFORCEMENT BR.
10151 CROYDON WAY, SUITE 3
SACRAMENTO, CA 95827
STEVE MCCALLEY
KERN COUNTY
ENVIRON. HEALTH SERVICES DEPT
2700 M STREET, SUITE 300
BAKERSFIELD, CA 93301
Page 3
ENCLOSURE 1
U~sit. v amhoriz~ to operate m this iomtion:
UNDER CONDITIONAL AUTHORIZATION:
EPA ID:
CAD983660127
UNDER CONDITIONAL EXEMPTION:
1
..~'*..St~a~of CalEemla- CalEornl, Ea*~oameaUd Pro__~cdo-
.~ 026861 0 2 0
Del~-~e~ o Toxic ~es Com,rol
?age I of 3_
ONSITE HAZARDOUS WASTE TREATMENT NOTIFICATION FORM
FACILITY SPECIFIC NOTIFICATION
For Usc by HaTurdous Waste Generators Performing Treatment []
Under Conditional Exemption and Conditional Authorization, []
and by Permit By Rule Facilities
Initial
Revised
Please refer to the attached Instructions before completing this form. You may notify for more than one permitting tier by using thi~
notification form, DTSC 1 772. You must attach a separate unit specific notification forrn for each unit at this location. There are
di~erent unit specific notification forms for each of the four categories and an additional notification forrn for transportable treatment
units (TTTJ's). You only have to submit forrns for the tier(s) that cover your unit(s). Discard or recycle the other unused forms.
Number each page of your completed notification package and indicate the total number of pages at the top of each page at the
'Page ~ of__'. Put your EPA ID Number on each page. Please provide all of the information requesteat,, all fields must be
completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any
attachments.
The notification will not be considered complete without payment of the appropriate fee for each tier under which you are operating.
(Please note that the fee is per TIER not per UNIT. For example, if you operate 5 units but they are all Conditionally Authorized,
you only owe $1,140, NOT5 tirnes $1,140. lf you operate any Permit by Rule units and any units under Conditional Authorization
you owe $2,280.) Checks should be made payable to the Department of Toxic Substances Control and be stapled to the top of this
form. Please write your EPA lD Number on the check. Fill in the check number in the box above.
I. NOTIFICATION CATEGORIES
'Indicate the number of units you operate.in each tier. This will also be the number of unit specific notification forms you must attach.
Conditionally Exeatpt Small Quantity Treatment operationa may not operate unitt under any other tier.
Number of units and attached unit specific notifications
A. Conditionally Exempt-Small Quaatity Treatment
(Form DTSC 1772A)
Fee per Tier
· (notper uniO
$ 100
B. 1 Conditionally Exempt-Specified Wastestream (Form DTSC 1772B) $ 100
C. Conditionally Authorized / %~('qa~i~e:~o~'?:';?,. (Form DTSC 1772C) · $1,140
D. Permit by Rule / ,~/.~.~ ' (F,grm DTSC 1772D) $1,140
· 1 Total Number of Units \ ~.~ ..,~ '~ ~,~7; · Total Fee Attached $ 100.00
II. GENERATOR IDENTIFICATION~/~.
EPA ID NUMBER CA CAD983660127 ~ ....... BOE NUMBER (if available) H__HQ__
NPd~fE (Company or Facility). MERCY HEALTHCARE BAKERSFIELD
(DBA-Doing Busimsa Aa)
MERCY SOUTHWEST HOSPITAL
PHYSICAL LOCATION
400 OLD RIVER ROAD
' I For DTSC Usc Only
crI'Y BAKERSFIELD CA ZIP 9331
COUNTY KERN
CONTACT PERSON
VICKIE BERRY
(Firs~ N&m~) (I. aa Natty)
PHONE NUMBER8(_~_O_5_)632- 5549
DTSC 1772 (1/93) Page t
EPA ID NUMBER CAD9836~ 127
MAILING ADDRESS, IF DIFFERENT:
COMPANY NAME (DBA) MERCY SOUTHWEST
STREET PO BOX 1499
HOSPITAL
Page 2 of 7
CITY
COUNTRY
CONTACT PERSON
BAKERSFIELD
STATE CA
(only ¢orr~lct~ if not USA)
VICKIE
(Fh'~ Name)
BERRY
(Last Name)
ZIp93302
PHONE NUMBER 80~q~ 632 .5549
III.. TYPE OF CoWfPANY: STANDARD INDUSTRLkL CLASSIFICATION (SIC) CODE:
Use either one or two SIC codes (a four digit number} that best describe your company's products, services, or industrial activity.
Example: 7384 ' Photofinishing lab · $6~.. Printed circuit boards
First: 8062~__General_ , L ~medical &:~surg Second: 7384 Photofinishing lab
IV. PRIOR PERbflT STATUS:
YES NO
D. .G
El [] 2.
Check yes or no to each qUeStion:
Did you file a PBR Notice of Intent to Operate' (DTSC Form 8462) in 1992 for this location?
Do you now have or have you ever held a state or federal h-~nrdous waste facility full permit, or interim
status for any of these treatment units?
Do you now have-, or have you ever held a state or federal full permit or interim status for any other'
hazardous waste activities at this location?
Have you ever held a variance issued by the Department of Toxic SubStances Control for the treatment you
ar~ now notifying for at this location?
Has this location ever been inspected by the state or any local agency as a b-~'-rdons waste generator?
PRIOR ENFORCEMF_,NT HISTORY: Not req~redfrom gentrator~ on/y nodfy/ng at cond/t/ona//y es~m/n.
NO
Within the last three years, has this facility been the subject of ~.any convictions, judgments, settlements, or final
orders resulting from an action' by any local, state, or federal environmental, hazardous waste, or public health
enforcement agency? . .
(For the purposes of this form, a notice of violation does not constitute an order and need not be reported unleas
it was not corrected and became a final order.)
If you answered.Yes, check this box and attach a listing of convictions, judgments, settlements, or orders and a copy
of the cover sheet from each document. (Se~ the Instructions for more information)
DTSC 1772 (1/93) Page 2
EPA ID NUMBER " ' Page 3 of 7'
ATTACH31ENTS:
A plot plax~/map detailing tho location(s) of tho covered unit(s) in relation to the facility boundaries.
A unit specific notification form for each unit to be covered at this location.
CERTIFICATIONS: This form must be signed by an authorized corporate o~cer or any other person in the company who
has operational control and performs decision-making functions that govern operation of the facility (per title 22, California
Code of Regulations (CCR) section 66270.11). ~ three copie~ mart have original signatur~.
Waste Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the
degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or
disposal currently available to me which minimize8 the present and futura threat to human health and the environment.
Tiered Permitting Certification I certify that the unit or units described in these documents meet the eligibility and oPerating
requirements of state statutes and regulations for the indicated Permitting tier, including generator and secondax'y containment
requirements. I uaderstapd tha~ if any of the units operate under Permit by Rule or Conditional Authorization, I will also be required
to provide required financiai assurances by January 1, 1994, and conduct a Phase I environmental assessment by January l, 1995.
I certify under penalty of law that this document and ail attachments were prepared under my direction oi' suPervision in accordance
with a system designed to assure that qualified Personnel proPerly gather and evaluate the information submitted. Based on my inquiry
of the Person or persons who manage the system, or those directly responsible for'gathering the information, the information is, to
the best of my knowledge and belief, tree, accurate, and complete.
I am aware that there are substantial penaitie~s for submitting t[alse information, including the possibility of fines and imprisonment
for knowing violations.
'BERNARD 'J. HERMAN PRESIDENT
Name (Print or Type)
Title
3-25-93
Date Signed
OPERATING REQUIREM2ENTS:
Please note that generators treating hazardous waste onsite are required to comply with a number of operating requirements which
differ depending on the tier(s) under which one operates. These operating requirements are set forth in the statutes and regulations,
some of which are referenced in the Tier-Specific Factsheets.
SUBMISSION PROCEDURES:
You must xubrnit
two copie~ of this completed notification by certified mail, return receipt requested,, to:
Department of Toxic Substances Control
Form 1772
Onsite Hazardous Waste Treatment Unit
400 P Street, 4th Floor (walk £n only)
P.O. Box 806
Sacramento, CA 95812-0806.
You must al, re submit one col~ of the notification and attachments to the local regulatory agency in your jurisdiction as listed in the
instruction materials. You mtaxt also reta#t a copy a.~ part of your operating record.
All three forms must have original signatures, not photocopies.
DTSC 1772 (I/93) Page 3
EPA II) NUMBER CAD98~ 0127 :
' -- Page 4 of 7
UNIT NAME
NUMBER OF TREATblI~N'T DEVICES:
CONDITIONALLY EXEMFr - SPECIFIED WASTESTREAMS
UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Safety Code Section Z5201.$(c))
MAIN DARKROOM UNIT ID NUMBER 1
2
Tank(s) Container(s)
Each unit must be clearly identified and labeled on the plot plan attached to Form 1772. Assign your own unique number to each
unit. The number can be sequential (I, 2, 3) or using any system you choose.
Enter the estimated monthly total volume of hazardous waste treated by this unit. This should be the maximum or highest amount
treated in any month. Indicate in the narrative (Section II) if your operations have seasonal variations.
I. WASTESTREAMS AND TREATMENT PROCESSES:
Estimated Monthly Total Volume Treated: pounds and/or 30 gallons
The following are the eligible wastestreams and treatment processes. Please check all applicable boxes:
[--] 1. Treats resins mixed in accordance with the manufacturer's instructions.
[~! 2.
Fl
Fl
F1
Fl
Treat containers of 110 gallons or less capacity that contained ha?ardous waste by rinsing or physical~ processes,
such as crushing, shredding, grinding, or puncturing.
Drying special wastes, as classified by the department pursuant to title 22, CCR, section 66261.124, by pressing
or by passive or heat-aided evaporation to remove water.
Magnetic separation or screening to remove components from special waste, as classified by the department pursuant
to title 22, CCR, section 66261.124.
.¸
Neutralize acidic or alkaline (base) wastes from the regeneration Of ion exchange media used to demineralize water.
Claris waste cannot contain more than 10 percent acid or base by weight to be eligible for conditional exemption.)
Neutralize acidic or alkaline (base) wastes from the food processing industry.
Recovery of silver from photofinishing. -The volume limit for conditional exemption is 500 gallons per generator
(at the same location) in any calendar month.
Gravity separation of tho following, including the use of flocculants and demulsifiers if
a. The settling of solids from the waste where the resulting aqueous/liquid stream is not buTurdous.
b. The separation of oil/water mixtures and separation sludges, if the average oil recovered per mOnth is Iess
than 25 barrels (42 gatlons l~r barrel).
Neutralizing acidic or alkaline (base) material by a state certified laboratory or a laboratory operated by an
educational institution. (To be eligible for conditional exemption, this waste cannot contain more than 10 percent
acid or ba.~ by weight.)
DTSC 1772B (1/93) Page 9
EPA ID NUMBER
CAD983660127
Page 5__ of 7
CONDITIONAI,LY EXEMY'r - SPECIFIED WASTESTREAMS
UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Safety Code Section Z5201.5(c))
NARRATIVE DESCRIPTIONS: Provide a brief description of the specific waste treated and the treatment proce, vs u~ed.
1. SPECIFIC WASTE TYPES TREATED: spent photograph±¢ sol. ut±on conta±n±ng s±lver
TREATMENT PROCESS(ES)USED: reclaimer uses electro-lytic process with
abatement cartridge thru ion-exchange
D
' RESIDUAL MANAGEMENT: Check Yes or No to each question as it applies to all residuals from 'this treatment unit.
NO
D
El
1. Do you discharge non-hazardous .aqueous waste to a publicly owned treatment works (POTW)/sewer?
If you do, where is the waste sent? Check all that apply.
['~ a. Offsite recycling ......
b. Thermal treatment
~ c. Disposal to' land
Do you discharge non-hazardous aqueous waste'under aa NPDES permit?
Do you have your residual haTnrdous waste hauled offsite by a registered haTnrdous waste hauler?
D d. Further treatment
D
4. Do you dispose of non-h~ardous solid waste residues at an offsite location?
5. Other method of disposal. Specify:
IV. BASIS FOR NOT NEEDING A FEDERAL PERMIT:
In order to demonstrate eligibility for one of the onsite treatment tiers, facilities are required to provide the basis for determining that
a hazardous waste permit is not required under the federal Resource Conservation and Recovery Act (RCRA) and the federal
regulations adopted under RCRA (2~tle 40, Code of Federal Regulations (CFR)).
Choose the reaSon(s} that describe the operation of your onsite treatment units:
I~ I. The b~,~ntous waste being treated is not a hazardous waste under federal law although it is regulated aa a hazardous
waste under California state law.
D. 2. Tho wardz is treated in wastewater treatment units (tank~), as defined in 40 CFR Part 260. I0, and discharged tO a
publicly oWned treatment works (POTW)/sewering agency or under an NPDES permit. '40 CFR 264. l(g)(6) and
40 CFR 270.2.
DTSC 1772B (I/93) Page 10
" , , EPA ID NUMBER CAD983( 1127 Page6of7
CONDITIONALLY EXEMlYr -SPECIFIED WASTESTREAMS
UNIT SPECIFIC NOTIFICATION
(pursuant to Health and Safety Code Section 25201.5(c))
BASIS. FOR NOT NEEDING A FEDERAL PERMIT: (continued)
The waste is treated ia elementary neutralization units, az defined ia 40 CFR Part 260. I0, and discharged to a
POTW/sewe.ring agency or under an NPDES permit. 40 CFR 264. l(g)(6) and 40 CFR 270.2.
4. The waste is treated ia a totally enclosed treatment facility as defined in 40 CFR Part 260.10; 40 CFR.264. l(g)(5).
The company generates no mom than 100 kg (approximately 27 gallons) of ha:,-rdous waste in a calendar month
and is eligible as a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5.
· The waste is treated in aa accumulation' tank or container within 90 days for over I000 kg/month generators and
180 or 270 days for generators of 100 to 1000 kg/month. 40 CFR 262.34, 40 CFR 270. l(c)(2)(i), and the Preamble
to the March 24, 1986 Federal Register.
Recyclable materials are reclaimed to recover economically significant amounts of silver or other precious metals.
40 CFR 261.6(a)(2)(iv), 40 CFR 264. l(g)(~), and 40 CFR 266.70..
Empty container rinsing and/Or treatment. 40 CFR 261.7.
9. Other. Specify:.
V. TRANSPORTABLE TREATMENT UNIT:
YES NO
Check Yes or No.
Please refer to the Instructions for more information.
Is this unit a Transportable Treatment Unit?
If you answered yes, you must also complete and attach Form 1772E to this page.
The Tier-Specific Factsheets contain a summary of the operating requirements for this category.
Please review those requirements carefully before completing or submitting this notification package.
DTSC 1772B (1/93) Page 11
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