Environmental Compliance Certification Program
Self-Certification Checklist Package
For
Auto Salvage Yard Facilities
May 2007
Rhode Island Department of Environmental Management
Office of Technical and Customer Assistance
235 Promenade Street
Providence, RI 02908
(401) 222‑6822
Table of Contents
1.0 What is Compliance Certification? …………………………………………………………….. 2
1.1 Submission Timeline …………………………………………………………………………………………. 3
1.2 Do I have to certify? ……………………………………………………………………………………. 3
2.0 How Do I Fill Out the Compliance Certification Forms? ………………………. 4
2.1 How do I submit a Compliance Certification? …………………………………………. 5
2.2 What is not covered by the Compliance Certification? ……………………….. 5
2.3 What Does Participation in the Self‑Certification Program
Entitle Your Facility To? ………………………………………………………………………………. 5
3.0 Step‑by‑step instructions for filling out the Compliance Certification 6 Checklist
2007 Facility Non‑Applicability Statement …………………………………………..…….…… 9
2007 Compliance Certification Checklist …………………………………………………………… 11
2007 Return‑to‑Compliance Plan Form ………………………………………………………………. 39
2007 Return-to-Compliance Completion Form ……………………………………………………. 45
Note: This booklet is a public document and is not copyrighted. It may be reproduced for educational purposes, but may not be sold for profit.
DISCLAIMER: The Rhode Island Department of Environmental Management does not
warrant or assume any legal liability or responsibility for the accuracy,
completeness, usefulness, or application of any information, apparatus,
product, or process disclosed in this document.
2007 Compliance Certification Instructions
1.0 What is Compliance Certification?
In order to improve environmental protection at less cost to both government and business, auto salvage yard facilities can now self‑certify to the Rhode Island Department of Environmental Management Office of Technical & Customer Assistance (RIDEM) that they are complying with the environmental regulatory requirements that apply to their business. This new, common sense approach to regulation holds great promise for making it easier for the auto salvage yard industry to meet ‑ and surpass ‑ Rhode Island's environmental regulations. This package contains the materials needed to complete and submit the self‑certification checklist. The accompanying workbook provides the information needed to help you understand and comply with state and federal regulations. The entire program package has two parts:
1. Environmental Compliance Certification Workbook for Auto Salvage Yard Facilities: The workbook explains the environmental protection standards and regulatory requirements that apply to your facility, and how to make sure you are complying with them. The workbook is designed to be used in conjunction with the accompanying self‑certification checklist and can also be used as a reference for your facility. The workbook also provides information regarding best management practices and pollution prevention techniques that can help your facility minimize human health risks and environmental impacts while saving money.
2. Self‑Certification Checklist and Accompanying Forms Booklet (This Booklet): The checklist requires facility information (facility name, address, owner, etc.), and contains a series of compliance questions, which generally require "Yes" or "No” answers about whether or not your facility is following the applicable environmental regulatory requirements. The checklist ends with a certification statement which must be signed by the facility owner. The checklist begins on Page 11 of this booklet. Also, two additional forms are provided as follows:
2007 Non‑Applicability Statement: This statement is to be submitted only if you are not required to self‑certify. See Section 1.1 of the Certification Workbook to determine if you are eligible to file a Non‑Applicability Statement (You may file this statement only if there is no active auto salvage yard operations at your facility address, or if the facility property has been sold.) If either of these situations are true, then complete this form and submit it to RIDEM. It can be found on Page 9 of this booklet.
Return-to-Compliance Plan: Complete the Return-to-Compliance (RTC) Plan if your facility is not in compliance with a particular checklist item at the time of certification. The facility must detail its plans to address the particular items to bring them back into conformance with environmental regulations within a specified period of time. This form can be found on Page 39 of this booklet.
Return-to-Compliance Plan Completion: Complete the Return-to-Compliance Plan Completion Form when checklist items that required that an RTC Plan be submitted have been corrected, for each item.
1.1 Submission Timeline
Workbooks and checklists were mailed in May of 2007. Compliance Certification Checklists must be returned and postmarked by September 15, 2007. Return-to- Compliance Forms must also be submitted with the compliance certification checklist on or before September 15, 2007. Facilities that submit Return-to-Compliance Forms will receive an additional 60‑day grace period in which to bring their operations into compliance. Certification will take place every three years. Checklists are expected to be sent again in May of 2010.
Questions and/or Comments can be directed to:
RI DEM - Office of Technical and Customer Assistance
Auto Salvage Yard Facilities Certification Program
235 Promenade Street
Providence, RI 02908‑5767
(401) 222‑6822, Ext. 4412
1.2 Do I have to certify?
Participation in the program is voluntary. However, any auto salvage yard licensed and operating in the State of Rhode Island should strongly consider participating in this Self‑Certification Program to take advantage of the benefits detailed in Section 1.2 of the workbook. All facilities that are licensed by the Rhode Island Department of Business Regulation (RIDBR) as an auto salvage yard, or Auto Wrecking and Salvage Yard as defined by RIDBR, are eligible to participate in the Self‑Certification Program. [Note: facilities engaged in the business of operating an auto wrecking and salvage yard must be licensed by RIDBR]
All auto salvage yard facilities operating in the State of Rhode Island must comply with the standards outlined in the “Certification Workbook”, whether or not they self-certify. To participate in the program, please complete and return the certification checklist as instructed.
If your facility does not meet the description of an actively operating auto salvage yard, or if this package has been sent to you in error, please complete and sign the 2007 Non‑Applicability Statement found on Page 9 of this booklet, and return to RIDEM. If you have any questions regarding the status of your facility, please call us at 222‑6822, Ext 4412.
2.0 How Do I Fill Out the Compliance Certification Forms?
1. Read the accompanying Certification Workbook to understand your environmental regulatory responsibilities.
2. Make a copy of the Compliance Certification Checklist to use as a working
draft. It is found on Page 11 through Page 38 of this document.
3. Read the checklist and identify all the questions that apply to your facility. You
may not have to answer all of the questions on the form. The form itself will
direct you to skip certain questions. Do not answer questions that you are
directed to skip. Additional step‑by‑step instructions for the Compliance Certification Checklist are included in Section 3.0 of this package.
4. Walk through your facility with the checklist copy and identify all the questions
where you are already in compliance, and those where you will need to make
changes to come into compliance. This step should be done well in advance of
September 15, 2007.
5. If your facility will be out of compliance after September 15, 2007, be sure to submit a Return-to-Compliance Plan for each checklist item that you are not in compliance with.
6. Review your Compliance Certification Checklist for completeness. Once complete, copy your answers from the draft, make a copy of the completed certification checklist for your files, and mail the original signed copy to RIDEM.
When checklist items that required a Return-to-Compliance Plan to be submitted have been corrected, submit a Return-to-Compliance Completion Plan Form to RIDEM for each item when it has been completed. Do not submit this form with the Compliance Certification Checklist.
2.1 How do I submit a Compliance Certification?
If you intend to participate in the program, you are required to complete the Compliance Certification Checklist (Pages 11-38) with any applicable Return-to-Compliance Plans, and mail to RIDEM on or before September 15, 2007. Mail the completed certification checklist forms to:
RI Department of Environmental Management
Office of Technical and Customer Assistance
Auto Salvage Yard Facilities Certification Program
235 Promenade Street
Providence, RI 02908‑5767
2.2 What is not covered by the Compliance Certification?
This Environmental Compliance Certification is intended to review many environmental regulatory requirements. There may be other Federal or Local requirements or permits that apply to your facility, such as permits, building codes, fire codes, etc. that are not covered in this program. You must still comply with these requirements.
What Does Participation in the Self‑Certification Program Entitle Your Facility To?
Compliance with environmental regulations is a requirement for all auto salvage yard facilities. Participation in the Self‑Certification Program is voluntary, but entitles your facility to the following incentives:
reduced inspection priority by RIDEM
receiving a Certificate of Participation from RIDEM
being placed on a public list of certified auto salvage yard facilities on RIDEM’s website
- the ability to correct environmental violations without gravity‑based
penalties, provided that you comply with the RI Compliance Incentive Act
provides a comprehensive evaluation of your facility's compliance status,
making you better prepared for a random inspection
free technical assistance from RIDEM's Office of Technical and
Customer Assistance and the URI Center for Pollution Prevention &
Environmental Health.
Note: Participation in the Self‑Certification Program does not guarantee that your shop will not be subject to a random inspection, or an inspection prompted by an employee or a complaint. Both state and federal environmental agencies have the authority to perform such inspections. These inspections can result in enforcement actions against your facility. Participation in this program will identify deficiencies and prepare your facility in the event of an inspection. However, keep copies of your checklists to assist you in demonstrating compliance with applicable state and federal regulations.
Step‑by‑step instructions for filling out the Compliance
Certification Checklist & Associated Forms (Pages 11 through 38)
REMINDER: MAKE COPIES OF THIS FORM BEFORE YOU BEGIN
3.1 Facility Information
In this section, list the name and address of your business, the RI Department of Business Regulation (RIDBR) License Number, the individual that RIDEM should contact if there are questions about your Certification, your Federal Employer Identification number (FEIN) from your state and federal income tax forms, and other facility information as requested.
3.2 Non‑Applicability Statement
If your facility does not meet the description of an auto salvage yard actively operated by you, or if this package has been sent to you in error, please complete, sign and return to RIDEM the 2007 Non‑Applicability Statement found on Page 9 of this booklet. If you have any questions regarding the status of your facility, please call us at 222‑6822, Ext 4412.
3.3 Compliance Certification Checklist
These questions provide RIDEM with some background information about your facility and information about whether or not your facility is following the environmental protection standards and requirements that apply to it. The workbook contains the information you will need to determine how to answer the questions. The checklist tells you where in the workbook you can find information about the environmental requirements referred to in each question.
RIDEM strongly advises you to consult the Certification Workbook before answering any questions. Most of the questions are "Yes" or "No" questions about compliance with particular standards or management practices. If you are not in compliance with the regulatory requirements (identified with “Submit RTC” on the “No” box checklist) on the date you certify, you must complete a Return-to-Compliance Plan (RTC) described below, and submit it with the Compliance Certification Checklist.
Please note that it is your responsibility to keep your facility in compliance with environmental protection requirements at all times. You may be subject to enforcement action if you do not comply with the standards. There are some questions that ask whether you have been doing a routine activity for the past year, such as properly maintaining your equipment. Be sure to comply with the requirements throughout the year. The Certification Statement includes a pledge that you have systems in place to keep your business in compliance with environmental protection standards over the next three years.
3.4 Certification Statement
The Certification Statement is a preprinted statement which says that the person signing the form:
has reviewed it,
believes the information being submitted is true,
will make sure that management systems are in place that will keep the facility in compliance with environmental protection requirements throughout the next three years, and
understands that information provided to RIDEM is true, accurate, and complete, to the best of that person’s knowledge.
The statement may only be signed by the facility owner or certain other types of senior managers. The types of managers that are allowed to sign the statement are listed below the space for the signature. The person who signs the form must also print or type his or her name and title on the appropriate lines, date the form, and check the space next to the type of manager he or she is. Note that you must hold one of the titles listed on the form to sign it.
3.5 Return-to-Compliance Plan (RTC)
If your facility is unable to comply with a standard at the time you certify, fill out this form. The form asks for the standard you are violating, what you plan on doing to comply, and when you will be in compliance with the requirement. Note that submittal of a “RTC” gives only an additional sixty (60) days to come into compliance. A separate form is required each time your answer to a checklist question indicates that a Return-to-Compliance Form is required. Three copies of a Return-to-Compliance Plan Form can be found beginning on Page 39 of this booklet. If you need more forms, make the necessary number of copies, or call RIDEM at (401) 222‑6822, Ext. 4412 for additional copies. Attach all Return-to-Compliance Plan Forms to your completed Compliance Certification Checklist, and mail to RIDEM.
3.6 Return-to-Compliance Plan Completion
If your facility submits Return-to-Compliance (RTC) Plan Forms with your completed Compliance Certification Checklist, you must submit a Return-to-Compliance Plan Completion Form for each RTC that is submitted.
This form is not submitted with your Compliance Certification Checklist, but is completed and submitted to RIDEM, for each RTC, when the compliance issue has been corrected, and it states what corrective action that you have taken.
Three copies of a Return-to-Compliance Plan Completion Form can be found beginning on Page 45 of this booklet. If you need more forms, make the necessary number of copies, or call RIDEM at (401) 222‑6822, Ext. 4412 for additional copies.
Program documents are also found on the Auto Salvage Yard Facilities Certification Program webpage at
http://www.dem.ri.gov/programs/benviron/assist/asy/index.htm
Rhode Island Department of Environmental Management
A
uto
Salvage Yard Facilities Certification
Program
2007 Facility Non‑Applicability Statement
N
ote:
Participation in the program is voluntary. However, any actively
operated auto salvage yard facility should consider participating in
the Self‑Certification Program to take advantage of the
incentives detailed in Section 2.3. All facilities that are
licensed by the RI Department of Business Regulation as an “Auto
Wrecking and Salvage Yard” are eligible to participate in the
Self‑Certification Program. [Note: facilities engaged in the
business of operating an auto wrecking and salvage yard must
be licensed by the RI Department of Business Regulation.] If your
facility does not meet the description of an auto salvage facility
actively operated by you, or if this package has been sent to you in
error, please complete, sign and return the 2007
Non‑Applicability Statement to
RIDEM.
If you have any questions regarding the status of your facility,
please call us at 222‑6822, Ext. 4412.
F
acility
Information:
Facility Name: _____________________________________________________________ _
Facility Street Address: _____________________ Phone #: ______ ___________________
___________________________________ ____ Fax #: _______________ _____ ______
City/Town: _______________________________ Federal Employer ID # (FEIN):
Zip Code: ________________________________ ______________________________
Contact Person: __________ _________________ Owner/Corporation: __ ______ _____
This facility is not participating in the Auto Salvage Yard Facilities Certification Program for the following reason(s):
No actively operated auto salvage yard operations occur at this address.
The facility/property has been sold.
Please
submit this form by September 15, 2007
Returning this statement does not relieve you of your responsibility to comply with environmental requirements.
Signature: _______________________________________ Date: ____________________
Return
this form to: RI DEM/Office of Technical & Customer
Assistance
Auto
Salvage Yard Facilities Certification Program
235
Promenade Street
Providence,
RI 02908‑5767
This page intentionally left blank.
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Compliance Certification Checklist
F
acility
Name:
Address: Street
City/Town
County
State Zip Code
Mailing Address (if different) _____________________________
_____________________________
RI Department of Business Regulation License #: ______________
Contact Person:
Owner Name:
Phone #: Fax #:
E-mail:
Total Site Acreage: acres
Total Size of Vehicle Storage Area: acres
Approximate Total # Vehicles Currently Stored On-Site:
Approximate Total # Vehicles Received Per Year:
Approximate Total # Vehicles Removed Per Year:
Total # Employees:
Federal Employer ID Number (FEIN): ___________________________
Days and Hours of Operation:
Total Yrs. in Operation (former and current owners):
Prior Use of Facility Location (if different): ______________________
Building Size: __________ ft. X __________ ft.
Paved Parking Area: __________ ft. X __________ ft.
Are you certified with any other program or organization (regulatory/industry)? If so, please explain:
_____________________________________________________
Which of the following are in service at your facility? (please check all that apply)
Public Water Supply On-site Drinking Water Well
Public Sewer System Septic System/Leachfield
Floor Drain to holding tank UIC Authorized Discharge
Floor drain to other location (please specify) ____________________________
Which of the following best describes your facility operations? (please check all that apply)
Dismantler/Recycler Towing Yard Auto Dealer
Auto Repair/Service Auto Body or Rebuilder
Shredder/Processor Other (please specify: __________________)
Which of the following describes vehicle crushing at your facility? (please check all that apply)
This facility does NOT crush vehicles Vehicles are taken to another site to be crushed
Vehicles are crushed at this facility The crusher sits on a concrete/asphalt pad
Vehicles are crushed on site The crusher is covered or indoors
using our own dedicated crusher
The crusher sits on the bare ground
Which of the following licenses and permits do you hold? (please check all that apply)
Auto Wrecking & Salvage Yard License from the RI Department of Business
Regulation
Salvage Rebuilder License from the RI Department of Business Regulation
Auto Dealers License from the RI Department of Administration
Other than motor vehicles, does your facility receive any other type of solid waste, such as appliances, other scrap metal, or demolition debris?
No Yes (please specify type(s)) _________________________
Which of the following parts/components are removed from the vehicles and separately managed? (check all that apply)
Air Bag Assemblies Anti-Freeze
Batteries Brake Fluid
Catalytic Converters CFC’s (Chlorofluorocarbons)/Freon
Fuel Tanks Lead Parts
Mercury Switches Oil Filters
Tires Used Oil (check all that apply):
Windshield Washer Fluid Transmission Fluid Crankcase Oil
Drive Train/Engine Power Steering Fluid
Other:_________________________________________________________
This page intentionally left blank.
2007 Compliance Certification Checklist
Checklists for Specific Areas
This page intentionally left blank.
A. Air Pollution Control – Page 14 in Certification Workbook |
Yes No |
|
|
___________________________________________ |
|
|
|
|
|
|
|
If so, do you apply chemicals or liquids, other than water, to control the dust? Please note any used: ___________________________________________ |
|
|
|
|
|
Please refer to Section 3.A in the Workbook for additional information. |
B. Freon/Refrigerant Recovery - Page 16 in CertificationWorkbook |
Yes No |
|
|
|
- Submit RTC |
|
- Submit RTC |
|
- Submit RTC |
|
|
|
- Submit RTC |
Please refer to Section 3.B in the Workbook for additional information, or contact US EPA New England staff: Abdi Mohamoud (617) 918-1858 or Roy Crystal (617) 918-1745 |
Workbook |
Yes No |
|
|
|
|
|
|
|
|
If so, from which agency? ______________________ |
-Submit RTC N/A (no discharge) |
|
- Submit RTC |
|
|
|
|
Please refer to Section 3.C in the Workbook for additional information. |
D. Lead Acid Batteries – Page 19 in Certification Workbook |
Yes No |
|
|
|
|
|
|
____________________________________________ |
|
____________________________________________ |
|
|
|
|
_____ |
Please refer to Section 3.D in the Workbook for additional information. |
E. Fuel/Gasoline – Page 21 in Certification Workbook |
Yes No |
_____________________________________________ |
|
If “Yes”, what kind of surface?____________________ Do you empty fuel tanks over the ground surface? |
|
|
|
|
|
|
|
Outdoor, above ground tanks -------------------------- Outdoor, underground storage tanks ----------------- Outdoor drums ----------------------------------------- Outdoor, other containers ---------------------------- Indoor, above ground tanks --------------------------- Indoor, underground storage tanks ------------------- Indoor drums ------------------------------------------- Indoor, other containers ------------------------------ If Underground Storage Tanks are used, are they registered with RIDEM? |
-Submit RTC N/A (no UST’s) |
|
|
E. Fuel/Gasoline, continued |
Yes No |
|
|
|
|
_____________________________________________ |
|
|
|
Please refer to Section 3.E in the Workbook for additional information. |
Workbook |
Yes No |
|
- Submit RTC |
|
|
|
-Submit RTC |
_____________________________________________ |
|
_____________________________________________ |
|
|
-Submit RTC |
|
|
|
_____ |
Please refer to Section 3.F in the Workbook for additional information. |
G. Waste Tires – Page 26 in Certification Workbook |
Yes No |
|
|
|
|
|
|
|
Both |
_____________________________________________ |
|
_____________________________________________ |
|
If “No”, skip to Section H. If “Yes”, are you licensed to operate a vehicle tire storage and recycling facility? |
-Submit RTC
|
|
-Submit RTC |
If so, are the tire piles lower than 20 feet in height? |
- Submit RTC |
|
-Submit RTC
|
G. Waste Tires, continued |
Yes No |
|
-Submit RTC
|
|
-Submit RTC
|
_____________________________________________ _____________________________________________ |
-Submit RTC
|
|
-Submit RTC
|
If “Yes”, do you store tire chips (8 inches in size and less) in piles that do not exceed 200 feet in length, 150 feet in width and 20 feet in height? |
-Submit RTC |
Please refer to Section 3.G in the Workbook for additional information. |
H. Used Oil – Page 29 in Certification Workbook |
Yes No |
|
- Submit RTC |
|
- Submit RTC |
|
|
|
- Submit RTC |
Outdoor, above ground tanks -------------------------- Outdoor, underground storage tanks ----------------- Outdoor drums ----------------------------------------- Outdoor, other containers:___________________ Indoor, above ground tanks --------------------------- Indoor, underground storage tanks ------------------- Indoor drums ------------------------------------------- Indoor, other containers:____________________ Underground Storage Tanks (if used, they must be registered with RIDEM) |
Yes No
|
____________________________________________ |
|
H. Used Oil, continued |
Yes No |
|
-Submit RTC |
If “Yes”, is the burner capacity less than 500,000 BTU’s? If “Yes”, skip to ix. If the burner capacity is greater than 500,000 BTU’s, have you complied with the regulatory requirements outlined in RIDEM Hazardous Waste Rule 15.03(B) or (D), as appropriate for the burner capacity? |
-Submit RTC |
____________________________________________ ____________________________________________ |
|
How much used (waste) oil do you ship off-site annually? |
_____ Gallons _____ Gallons |
Please refer to Section 3.H in the Workbook for additional information. |
I. Wastewater Discharge – Page 32 in CertificationWorkbook |
Yes No |
_______________________________________ |
|
|
|
|
|
____________________________________ |
-Submit RTC |
I. Wastewater Discharge, continued |
Yes No |
If “Yes”, does your facility have a RIDEM permit to discharge waste water in this manner? |
-Submit RTC |
If “Yes” does your facility have a municipal permit to discharge waste water in this manner?
|
-Submit RTC |
If “Yes” does your facility have a RIDEM permit to discharge waste water in this manner? |
-Submit RTC |
|
|
Please refer to Section 3.I in the Workbook for additional information. |
J. Stormwater Management – Page 34 in CertificationWorkbook |
Yes No |
|
|
|
-Submit RTC |
|
|
J. Stormwater, continued |
Yes No |
If so, which one:_________________________ If “Yes”, do you have a permit from RIDEM? |
-Submit RTC |
If so, which one:_________________________ If “Yes”, do you have a permit from RIDEM? |
-Submit RTC |
|
|
If ‘Yes”, RIPDES Permit No.____________________ |
-Submit RTC |
|
|
|
|
|
|
J. Stormwater, continued |
Yes No |
|
|
|
|
|
|
|
|
|
|
If ”Yes”, for what purpose: _________________________________ |
|
|
|
|
-Submit RTC |
Please refer to Section 3.J in the Workbook for additional information. |
K. Hazardous Waste – Page 39 in Certification Workbook |
Yes No |
|
|
|
-Submit RTC |
EPA hazardous waste identification number? List below: ____________________________________________ |
-Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
__________________________________________________ |
|
annually? |
_____ Gal/lbs. |
K. Hazardous Waste, continued |
Yes No |
- Satellite accumulation area - 90-day storage area |
|
|
-Submit RTC
-Submit RTC |
|
-Submit RTC -Submit RTC -Submit RTC -Submit RTC -Submit RTC -Submit RTC -Submit RTC |
K. Hazardous Waste, continued |
Yes No |
|
-Submit RTC |
|
-Submit RTC -Submit RTC -Submit RTC -Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
|
-Submit RTC |
K. Hazardous Waste, continued |
|
Please refer to Section 3.K in the Workbook for additional information.
L. Other Fluid Management – Page 53 in CertificationWorkbook |
Yes No |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
-Submit RTC |
|
|
|
|
Outdoor, above ground tanks -------------------------- Outdoor, underground storage tanks ----------------- Indoor, above ground tanks --------------------------- Indoor, underground storage tanks ------------------- |
|
Please refer to Section 3.L in the Workbook for additional information. |
Certification
Statement
Note: Complete all required Return-to-Compliance Plans (RTC) before signing
this statement!
I ________________________________________, hereby certify to the following:
I) That I have personally examined and am familiar with the information contained in this submittal, including any and all documents accompanying this certification statement;
II) That, based on my inquiry of those individuals responsible for obtaining the information, the information contained in this submittal is, to the best of my knowledge, true, accurate and complete:
III) That systems to maintain compliance are in place at the facility and will be maintained for the next three (3) years even if processes or operating procedures are changed over the course of this time; and
IV) That I am fully authorized to make this attestation on behalf of this facility.
I certify that the information that I have provided in this form is true, accurate and complete, to the best of my knowledge.
Signature:____________________________ Date:___________________
Printed Name:_________________________ Title:___________________
Owner
Source of Signatory Authority:
______________________________________(other, Please indicate)
If a Corporation: President Secretary Treasurer
Vice President (If authorized by corporate vote.)
Representative of the above (If authorized by corporate vote
and if responsible for overall operation of the facility.)
If a Partnership: General Partner
If a Sole Proprietorship: Proprietor
Return
this form to: RI DEM/Office of Technical & Customer Assistance
Auto
Salvage Yard Facilities Certification Program
235
Promenade Street
Providence,
RI 02908‑5767
Return
the completed checklist by September 15, 2007
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance Form for EACH compliance
question that requires one. Attach to Certification Checklist and
return with entire package.
Only submit a Return‑to‑Compliance Plan for violations that you were unable to correct BEFORE certifying.
Completing this form does not relieve the facility of its affirmative responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
F
Please
note that submittal of this RTC
Form
gives your facility an additional
sixty
(60) days to come into compliance.
acility Information:
Facility Name: ________________________
1. What is the Compliance Section & Question # for which you are reporting non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section & Page # in which the requirement is explained, and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action will you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility is expected to be in compliance with this issue? _______________________
This page intentionally left blank
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance Form for EACH compliance
question that requires one. Attach to Certification Checklist and
return with entire package.
Only submit a Return‑to‑Compliance Plan for violations that you were unable to correct BEFORE certifying.
Completing this form does not relieve the facility of its affirmative responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
F
Please
note that submittal of this RTC
Form
gives your facility an additional
sixty
(60) days to come into compliance.
acility Information:
Facility Name: ________________________
1. What is the Compliance Section & Question # for which you are reporting non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section & Page # in which the requirement is explained, and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action will you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility is expected to be in compliance with this issue? _______________________
This page intentionally left blank
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance Form for EACH compliance
question that requires one. Attach to Certification Checklist and
return with entire package.
Only submit a Return‑to‑Compliance Plan for violations that you were unable to correct BEFORE certifying.
Completing this form does not relieve the facility of its affirmative responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
F
Please
note that submittal of this RTC
Form
gives your facility an additional
sixty
(60) days to come into compliance.
acility Information:
Facility Name: ________________________
1. What is the Compliance Section & Question # for which you are reporting non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section & Page # in which the requirement is explained, and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action will you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility is expected to be in compliance with this issue? _______________________
This page intentionally left blank
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Completion Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance
Completion Form
for EACH compliance question for which you submitted a
Return-to-Compliance Plan, when you have completed corrective action
on that compliance question. Return the completed form to:
RI DEM/Office of Technical & Customer Assistance
Auto Salvage Yard Facilities Certification Program
235 Promenade Street
Providence, RI 02908‑5767
Completing this form does not relieve the facility of its responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
Facility Information:
Facility Name: _______________________________
1. What is the Compliance Section and Question # for which you reported non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section and Page # in which the requirement is explained and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action did you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility returned to compliance with this issue? _______________________
Signature: _______________________________ Title: _________________________
Printed Name: ____________________________
This page intentionally left blank
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Completion Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance
Completion Form
for EACH compliance question for which you submitted a
Return-to-Compliance Plan, when you have completed corrective action
on that compliance question. Return the completed form to:
RI DEM/Office of Technical & Customer Assistance
Auto Salvage Yard Facilities Certification Program
235 Promenade Street
Providence, RI 02908‑5767
Completing this form does not relieve the facility of its responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
Facility Information:
Facility Name: _______________________________
1. What is the Compliance Section and Question # for which you reported non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section and Page # in which the requirement is explained and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action did you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility returned to compliance with this issue? _______________________
Signature: _______________________________ Title: _________________________
Printed Name: ____________________________
This page intentionally left blank
R
hode
Island Department of Environmental Management
Auto Salvage Yard Facilities Certification Program
2007 Return‑to‑Compliance Plan Completion Form
B
efore
you complete this form, make as many copies as needed. Complete a
separate Return‑to‑Compliance
Completion Form
for EACH compliance question for which you submitted a
Return-to-Compliance Plan, when you have completed corrective action
on that compliance question. Return the completed form to:
RI DEM/Office of Technical & Customer Assistance
Auto Salvage Yard Facilities Certification Program
235 Promenade Street
Providence, RI 02908‑5767
Completing this form does not relieve the facility of its responsibility to operate in compliance with applicable regulations. Failure to operate in full compliance with the applicable regulations may result in enforcement actions which may include fines or penalties.
Facility Information:
Facility Name: _______________________________
1. What is the Compliance Section and Question # for which you reported non-compliance?
Compliance Question #: ________________________
2. What is the specific violation (reference the Workbook Section and Page # in which the requirement is explained and a description of the requirement)
Workbook Section & Page #: ________________________
Brief Description of Requirement:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. What corrective action did you take to return to compliance?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. Date that facility returned to compliance with this issue? _______________________
Signature: _______________________________ Title: _________________________
Printed Name: ____________________________
File Type | application/msword |
File Title | Certification Checklist Package |
Author | Tom Armstrong |
Last Modified By | Tom Armstrong |
File Modified | 2007-05-31 |
File Created | 2007-03-19 |