Form 8700-23 RCRA Hazardous Waste Part A Permit Application

2013 Hazardous Waste Report, Notification of Regulated Waste Activity, and Part A Hazardous Waste Permit Application and Modification (Revision)

RCRA Hazardous Waste Part A Permit Application FINAL

RCRA Hazardous Waste Part A Permit Application (Private Facilites)

OMB: 2050-0024

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2050-0024 can be found here:

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United States
Environmental Protection
Agency

[INSERT MONTH] 2011

RCRA Hazardous
Waste Part A
Permit Application
Instructions and Form
EPA Form 8700-23
(OMB #2050-0024; Expires xx/xx/xxxx)

Office of Resource Conservation and Recovery (ORCR)
(5303P)
Washington, DC 20460
RCRA Hazardous Waste Part A Permit Application
Instructions and Form
The Resource Conservation and Recovery Act (RCRA) Section 3005 requires EPA to establish permitting requirements
applicable to hazardous waste treatment, storage, or disposal facilities (TSDFs). The owner and operator of a TSDF must obtain
a permit as required under 40 CFR Part 270. Respondents must submit the information required in the RCRA Hazardous Waste
Part A Permit Application (EPA Form 8700-23) for a first permit application or for a revised permit application. Owners and
operators of four types of TSDFs are subject to the requirements: new facilities not yet constructed; newly regulated existing
facilities subject to RCRA permitting requirements for the first time; permitted facilities with newly regulated units; and interim
status facilities. EPA needs information contained in the application to identify the person(s) legally responsible for hazardous
waste activity, to determine which facilities require permits under more than one program, to assess potential for the facility to
pollute nearby ground and surface waters, to identify the timeframe available for EPA to process permit applications, and to
determine the specific wastes a facility is legally allowed to handle for different purposes. EPA must ensure that hazardous
wastes are managed in a way that protects human health and the environment as required by RCRA. This is mandatory reporting
by the respondents.
EPA enters Part A Permit application information submitted by respondents into RCRAInfo, the EPA national database, and
issues permits. EPA uses this information to identify the universe of regulated waste TSDFs and their specific regulated
hazardous waste activities. EPA also uses the information for tracking and planning and for a variety of enforcement and
inspection purposes. Finally, EPA uses this information to ensure that: hazardous wastes are managed properly; TSDFs are
operated and maintained as required; statutory provisions are upheld; and that regulations are adhered to by facility owners and
operators.
Section 3007(b) of RCRA and 40 CFR Part 2, Subpart B, which defines EPA’s general policy on public disclosure of
information, both contain provisions for confidentiality. However, the Agency does not anticipate that businesses will assert a
claim of confidentiality covering all or part of the RCRA Hazardous Waste Part A Permit Application. If such a claim were
asserted, EPA must and will treat the information in accordance with the regulations cited above. EPA also will assure that this
information collection complies with the Privacy Act of 1974 and OMB Circular 108.
Estimated Burden: The public reporting burden for First Part A Permit Applications (new applications) is estimated to be
approximately 26 hours. The public reporting burden for Revised Part A Permit Applications is estimated to be approximately 13
hours. This reporting burden includes time for reviewing instructions, searching existing data sources, gathering the data,
completing the application, and recordkeeping.
To comment on EPA 's need for this information, the accuracy of the provided burden estimates, and any suggested methods for
minimizing respondent burden, including the use of automated collection techniques, EPA has established a public docket for this
ICR under Docket ID Number EPA-HQ-RCRA-2011-0280, which is available for online viewing at www.regulations.gov, or in
person viewing at the RCRA Docket in the EPA Docket Center (EPA/DC), EPA West, Room B102, 1301 Constitution Avenue,
NW, Washington, D.C. The EPA Docket Center Public Reading Room is open from 8:30 a.m. to 4:30 p.m., Monday through
Friday, excluding legal holidays. The telephone number for the Reading Room is (202) 566-1744, and the telephone number for
the RCRA Docket is (202) 566-0270. An electronic version of the public docket is available at www.regulations.gov. This site
can be used to submit or view public comments, access the index listing of the contents of the public docket, and to access those
documents in the public docket that are available electronically. When in the system, select “search,” then key in the Docket ID
Number identified above. Also, you can send comments to the Office of Information and Regulatory Affairs, Office of
Management and Budget, 725 17th Street, NW, Washington, D.C. 20503, Attention: Desk Officer for EPA. Please include the
EPA Docket ID Number EPA-HQ-RCRA-2011-0280 and OMB Control Number 2050-0024 in any correspondence.

Table of Contents

PURPOSE OF THE RCRA HAZARDOUS WASTE PART A PERMIT............................... 1
Where to Get Help ...................................................................................................................... 1
Existing Facilities........................................................................................................................ 2
New Facilities ............................................................................................................................. 3
First Part A Submission .............................................................................................................. 3
Revised Part A Submission ......................................................................................................... 4
DETERMINING IF YOU MUST FILE ..................................................................................... 5
Who Must File a RCRA Hazardous Waste Permit Application? ............................................... 5
How Do I Know if I Handle a Regulated Hazardous Waste?..................................................... 5
Off-Site Facilities .................................................................................................................... 5
On-Site Facilities .................................................................................................................... 5
HOW TO FILE A RCRA HAZARDOUS WASTE PERMIT APPLICATION ..................... 7
How Many Permit Applications Should I File? .......................................................................... 7
Can I Request that this Information be Kept Confidential? ........................................................ 7
Where Should I Send My Completed Permit Application? ........................................................ 8
When Should I File My Permit Application? ............................................................................. 8
When Should My Permit Application be Revised? .................................................................... 9
Facilities Operating Under Interim Status .............................................................................. 9
Facilities Operating Under a RCRA Hazardous Waste Permit .............................................. 9
INSTRUCTIONS FOR FILLING OUT THE RCRA SUBTITLE C SITE
IDENTIFICATION (SITE ID) FORM ..................................................................................... 11
Who Must Submit This Form ................................................................................................... 11
Purpose Of This Form ................................................................Error! Bookmark not defined.
How To Fill Out This Form .......................................................Error! Bookmark not defined.
Item-By-Item Instructions ..........................................................Error! Bookmark not defined.
Item 1 – Reason for Submittal ...............................................Error! Bookmark not defined.
Item 2 – Site EPA ID Number ...............................................Error! Bookmark not defined.
Item 3 and 4 – Site Name and Location .................................Error! Bookmark not defined.
Item 5 – Site Land Type.........................................................Error! Bookmark not defined.
Item 6 – North American Industry Classification System (NAICS) Code(s) ................ Error!
Bookmark not defined.
Item 7 – Site Mailing Address ...............................................Error! Bookmark not defined.
Item 8 – Site Contact Person ..................................................Error! Bookmark not defined.
Item 9 – Legal Owner and Operator of the Site .....................Error! Bookmark not defined.
Item 10 – Type of Regulated Waste Activity ........................Error! Bookmark not defined.
Item 11 – Description of Hazardous Wastes..........................Error! Bookmark not defined.
Item 12 – Notification of Hazardous Secondary Material (HSM) Activity Error! Bookmark
not defined.
Item 13 – Comments ..............................................................Error! Bookmark not defined.

Item 14 – Certification ...........................................................Error! Bookmark not defined.
ADDENDUM TO THE SITE IDENTIFICATION FORM: NOTIFICATION OF
HAZARDOUS SECONDARY MATERIAL ACTIVITY ........Error! Bookmark not defined.
You Must Fill Out This Section If .............................................Error! Bookmark not defined.
Item 1 – Indicate Reason for Notification..............................Error! Bookmark not defined.
Item 2 – Description of Hazardous Secondary Material (HSM) Activity .. Error! Bookmark
not defined.
Item 3 – Facility has Financial Assurance Pursuant to 40 CFR 261 Subpart H ............ Error!
Bookmark not defined.
INSTRUCTIONS FOR FILLING OUT THE HAZARDOUS WASTE PERMIT
INFORMATION FORM............................................................................................................ 32
General Instructions .................................................................................................................. 32
Item-By-Item Instructions ......................................................................................................... 33
Item 1 – Facility Permit Contact ........................................................................................... 33
Item 2 – Facility Permit Contact Address ............................................................................. 33
Item 3 – Operator Mailing Address and Telephone Number ............................................... 33
Item 4 – Facility Existence Date ........................................................................................... 33
Item 5 – Other Environmental Permits ................................................................................. 33
Item 6 – Nature of Business .................................................................................................. 34
Item 7 – Process Codes and Design Capacities .................................................................... 34
Item 8 – Other Processes....................................................................................................... 34
Item 9 – Description of Hazardous Wastes........................................................................... 34
Item 10 – Map ....................................................................................................................... 35
Item 11 – Facility Drawing ................................................................................................... 36
Item 12 – Photographs .......................................................................................................... 36
Item 13 – Comments ............................................................................................................. 36
OTHER REFERENCE INFORMATION AND CODE LISTS ............................................. 37
Excluded Wastes ....................................................................................................................... 38
Definitions................................................................................................................................. 39
EPA Hazardous Waste Codes ................................................................................................... 48
HSM Facility Codes .................................................................................................................. 49
HSM Land-Based Unit Codes .................................................................................................. 50

PURPOSE OF THE RCRA HAZARDOUS WASTE PART A PERMIT
APPLICATION
The Resource Conservation and Recovery Act (RCRA) requires anyone who owns or operates a facility
where hazardous waste is treated, stored, or disposed to have a RCRA hazardous waste permit issued by
the U.S. Environmental Protection Agency (EPA). This booklet is designed to help you determine if you
are subject to RCRA hazardous waste permitting requirements. The instructions contained in this booklet
will assist you in starting the permitting process by completing and submitting a RCRA Hazardous Waste
Part A Permit Application [EPA Form 8700-23] (Part A Permit Application) or in modifying your
hazardous waste permit by submitting a revised application.
There are two parts to a RCRA hazardous waste permit application – Part A and Part B. Part A of the
RCRA hazardous waste permit application consists of EPA Form 8700-23 (includes both the RCRA
Subtitle C Site Identification Form and the Hazardous Waste Permit Information Form), along with maps,
drawings, and photographs, as required by 40 CFR 270.13. Part B of the RCRA hazardous waste permit
application contains detailed, site-specific information. There is no form for the Part B Permit
Application; rather, the Part B Permit Application must be submitted in narrative form and contain the
information described in applicable sections of 40 CFR 270.14 through 270.27.

NOTE

•

Although this booklet contains information and instructions for completing a
RCRA Hazardous Waste Part A Permit Application, it should not be considered a
substitute for the regulations in Title 40 of the Code of Federal Regulations (40
CFR). Rather, this booklet serves as a supplement to the regulations and provides
additional information not contained in 40 CFR. As an owner or operator of a
hazardous waste treatment, storage, or disposal facility, you are responsible for
learning and complying with all the requirements that apply to you and the
operations at your facility.

•

In addition, remember that this booklet and the regulations in 40 CFR address only
the Federal hazardous waste program. Many States may have hazardous waste
permitting requirements that differ from the Federal requirements; those States
may use EPA Form 8700-23 for the RCRA Part A submission or they may use a
similar State form that requires information not requested in the EPA form. Again,
it is your responsibility to make sure that you have completed and submitted all
forms required under the Federal or your State program.

Where to Get Help
We realize that the regulations are complex. Although we are not providing reprints of the 40 CFR
regulations in this booklet, copies of the Federal regulations are available from EPA (see below). The list
of State and EPA Regional Office addresses, contact names, telephone numbers, and e-mail addresses
located at: http://www.epa.gov/osw/inforesources/data/form8700/contact.pdf.

Purpose of the RCRA Hazardous Waste Part A Permit Application
(continued)
In addition to those contacts, there are several other sources available to help with your questions and
provide information on EPA regulations:
•

RCRA Frequently Asked Questions. This allows users to find answers to commonly asked
questions that cover a wide range of RCRA issues and topics. Find at: http://www.custhelp.com/
cgi-bin/waste.cfg/php/enduser/entry.php.

•

RCRA Online. The RCRA Online database is designed to enable users to locate documents,
including publications and other outreach materials that cover a wide range of RCRA issues and
topics. Find at: http://www.epa.gov/rcraonline.

•

RCRA Regulations. The Federal regulations can be found at:
/nara/cfr/cfr-table-search.html.

•

Compliance Assistance Centers. The Environmental Protection Agency (EPA) has sponsored
partnerships with industry, academic institutions, environmental groups, and other agencies to
launch sector-specific Compliance Assistance Centers (Centers). Each Center addresses real
world issues in understandable language for you to understand Federal environmental
requirements and how to save money through pollution prevention techniques. Visit the
Compliance Assistance Centers at: http://www.assistancecenters.net.

•

EPA National Compliance Assistance Clearinghouse. The Clearinghouse is a comprehensive
source of compliance assistance information and resources. Use links to Federal, State, local, and
other compliance assistance providers to find the tools you need. Visit the Clearinghouse at:
http://www.epa.gov/clearinghouse.

•

EPA Small Business Ombudsman Office – 1-800-368-5888.

•

Your Trade Association

http://www.access.gpo.gov

Existing Facilities
Existing hazardous waste management facilities are those hazardous waste treatment, storage, or disposal
facilities which were in operation or for which construction had commenced on or before November 19,
1980, or which were in existence on the effective date of the statutory or regulatory amendments that
render the facility subject to the requirement to obtain a RCRA permit. RCRA establishes a procedure for
obtaining interim status that allows these existing facilities to continue operating until a final hazardous
waste permit is issued.
You must submit a RCRA Hazardous Waste Part A Permit Application completing all forms included in
this booklet. If you do not file a Notification of RCRA Subtitle C Activity and complete the Part A
Permit Application by the deadlines specified in page 8 of these instructions, you will be required by law
to halt your operations until a RCRA hazardous waste permit is issued.
Facility owners or operators with interim status are treated as having been issued a permit until EPA
reviews the RCRA Part B Permit Application and issues a RCRA hazardous waste permit. You may
submit your Part B Permit Application voluntarily; however, you are not required to submit it until it is
requested by EPA. You will then have up to six months to submit the Part B Permit Application.

Purpose of the RCRA Hazardous Waste Part A Permit Application
(continued)

New Facilities
New hazardous waste management facilities are those hazardous waste treatment, storage, or disposal
facilities which were not in operation or for which construction had not commenced on or before
November 19, 1980. Owners or operators of new hazardous waste management facilities must submit
both Parts A and B of the RCRA hazardous waste permit application at least 180 days before physical
construction of the facility is expected to commence. In addition, these owners or operators are not
allowed to begin physical construction of the new facility or to treat, store, or dispose of hazardous wastes
until receiving a RCRA hazardous waste permit. As such, new facilities do not receive interim status. In
addition, new facilities are those facilities that are newly subject to the requirement to obtain a RCRA
hazardous waste permit (e.g., through EPA’s promulgation of a new hazardous waste listing). An
application for a permit may be submitted any time after promulgation of those standards in 40 CFR
subjecting the facility to hazardous waste permitting requirements.
Most State governments are authorized by EPA to administer hazardous waste management programs in
lieu of the Federal RCRA program. You should contact your State hazardous waste management agency
to determine any additional State requirements. You will need to comply with the specific permit
application requirements of that State.
The following instructions provide specific information for completing and submitting a RCRA
Hazardous Waste Part A Permit Application using the forms included in this booklet. The instructions
also provide general information for completing a RCRA Part B Permit Application. If, after reading the
instructions, you have any questions regarding the RCRA hazardous waste permit application process,
contact your State Representative who can answer your questions and help you understand the Federal
and State requirements that apply to you. A list of State contacts is available at: http://www.epa.gov/osw
/inforesources/data/form8700/contact.pdf.
.

First Part A Submission
Both new and existing facilities that treat, store, or dispose of regulated hazardous waste are required to
submit a RCRA Hazardous Waste Part A Permit Application in accordance with the deadlines set forth in
page 8 of these instructions. Owners or operators of facilities that have not previously submitted a Part A
Permit Application will need to submit a permit application for the first time. Examples of facilities
making their first Part A submission are new facilities or existing facilities that become newly subject to
the requirement to have a RCRA hazardous waste permit. You should mark the box in Item 1 of the
RCRA Subtitle C Site Identification Form (Site ID Form) to indicate as a component of a first RCRA
Hazardous Waste Part A Permit Application. This booklet contains information and item-by-item
instructions for completing both the Site ID Form and the Hazardous Waste Permit Information Form.

Purpose of the RCRA Hazardous Waste Part A Permit Application
(continued)

Revised Part A Submission
There are several conditions under which a facility that has previously submitted a RCRA Hazardous
Waste Part A Permit Application must revise that first submission to reflect changes that have occurred at
the facility. Both facilities operating under interim status and facilities operating under a RCRA
hazardous waste permit may find it necessary to revise their Part A Permit Application. You should mark
the box in Item 1 of the RCRA Subtitle C Site Identification Form (Site ID Form) to indicate as a
component of a revised RCRA Hazardous Waste Part A Permit Application.
If the owner or operator of this facility has changed since the facility last submitted the Part A Permit
Application, be sure to submit a Revised Part A Application. The conditions requiring submission of a
Revised Part A Permit Application are summarized in the “How to File a RCRA Hazardous Waste Permit
Application” section of this booklet. There is also item-by-item instructions for completing both the Site
ID Form and the Hazardous Waste Permit Information Form contained in this booklet.

DETERMINING IF YOU MUST FILE
Who Must File a RCRA Hazardous Waste Permit Application?
The Resource Conservation and Recovery Act of 1976 (RCRA), as amended, requires each person
owning or operating a facility for the treatment, storage, or disposal of regulated hazardous waste to have
a RCRA hazardous waste permit. This includes individuals, trusts, firms, joint stock companies, Federal
agencies, corporations (including government corporations), partnerships, associations, States,
municipalities, commissions, interstate bodies, other political subdivisions of a State, or Indian tribes (or
an authorized Indian tribe organization). If you treat, store, or dispose of regulated hazardous waste
without obtaining a permit, you may be subject to a civil or criminal penalty.
Both new and existing facilities that treat, store, or dispose of regulated hazardous waste are required to
submit a RCRA Hazardous Waste Part A Permit Application as described in 40 CFR Part 270. Four
types of facilities are required to submit the Part A Permit Application; new facilities not yet constructed;
newly regulated existing facilities subject to RCRA permitting requirements for the first time; permitted
facilities with newly regulated units; and interim status facilities.
In an instance where the State may have a newly regulated unit, a Part A Permit Application is required.
Adding new units for treating, storing, and disposing of waste creates a change to the facility (be it an
existing facility or interim status facility) which would require a revised Part A Permit Application, as
does a major permit modification.
Contact your State if you have questions about the applicability of the Part A form to your facility. A list
of Part A contacts can be found at: http://www.epa.gov/osw/inforesources/data/form8700/contact.pdf.

How Do I Know if I Handle a Regulated Hazardous Waste?
Off-Site Facilities
Owners or operators of off-site facilities that treat, store, or dispose of solid wastes, as defined by 40 CFR
261.2, are encouraged to obtain information on the solid wastes they receive from generators. If the
generators will not supply this information, you are still responsible for determining if the solid wastes
you handle are also hazardous wastes that are regulated by RCRA. To do so, you should follow the
procedures for on-site facilities that are described below.
On-Site Facilities
Generators who treat, store, or dispose, on-site, their own solid wastes (as defined by 40 CFR 261.2),
should employ the following procedures in determining if their solid wastes are hazardous wastes that are
regulated by RCRA. This determination is made as follows:
•

First, you need to determine if the solid waste handled is excluded from regulation under RCRA.
The list of exclusions can be found in the regulation entitled “Identification and Listing of
Hazardous Waste,” 40 CFR 261.4. If the solid wastes handled are excluded, a RCRA hazardous
waste permit is not needed to treat, store, or dispose of these solid wastes. If the solid waste
handled is not excluded by Section 261.4, you need to determine if the solid waste handled is a

Determining if You Must File
(continued)
hazardous waste that is regulated under RCRA. As described below, EPA regulates a solid waste
as a hazardous waste by specifically listing it as a hazardous waste or by assigning it a generic
hazardous waste code because it possesses any of the four hazardous waste characteristics.
•

If the solid waste handled is not excluded by Section 261.4, you need to determine if it is a
hazardous waste that is listed in 40 CFR Part 261, Subpart D, “Lists of Hazardous Wastes”. If
you own or operate a facility where listed hazardous waste is treated, stored, or disposed, you are
subject to regulation and must file a RCRA hazardous waste permit application, unless the
hazardous waste has been exempted as described below.

•

If the solid waste handled is not listed in 40 CFR Part 261, Subpart D, the solid waste may still be
a hazardous waste if it possesses certain characteristics or contains certain contaminants. These
characteristics and contaminants are described in 40 CFR Part 261, Subpart C, “Characteristics of
Hazardous Waste”. A determination that a solid waste possesses these characteristics or
contaminants may be made based on either:
1.

your knowledge of the hazard characteristic of the solid waste in light of the
materials or processes used; or

the results of testing the solid waste according to the methods in 40 CFR Part
261, Subpart C.

If you own or operate a facility where characteristic hazardous waste is treated, stored, or
disposed, you are subject to regulation and must file a RCRA Hazardous Waste Permit
Application, unless the hazardous waste has been exempted as described below.
•

If the hazardous waste that you handle has been exempted under 40 CFR 261.5 or 261.6(a)(3),
you are not subject to regulation and do not need to file a RCRA Hazardous Waste Permit
Application.

In addition, certain other persons who handle hazardous waste are not required to obtain a RCRA
hazardous waste permit. They are:
•

Generators who accumulate their own hazardous waste on-site for less then 90 days as provided
in 40 CFR 262.34;

•

Farmers who dispose of hazardous waste pesticides from their own use as provided in 40 CFR
262.70; and

•

Owners and operators of totally enclosed treatment facilities as defined in 40 CFR 260.10.

HOW TO FILE A RCRA HAZARDOUS WASTE PERMIT
APPLICATION
As noted above, there are two parts to the RCRA Hazardous Waste Permit Application – Part A and Part
B. As required by 40 CFR 270.13, the Part A Permit Application defines the processes to be used for
treatment, storage, and disposal of hazardous wastes; the design capacity of such processes; and the
specific hazardous wastes to be handled at a facility. The RCRA Hazardous Waste Part A Permit
Application is submitted by completing the two forms included in this booklet: the RCRA Subtitle C Site
Identification Form and the Hazardous Waste Permit Information Form.
The Part A Permit Application serves as a vehicle through which an owner or operator may submit
facility-specific information to the regulatory authority and keep this information current. As specified by
40 CFR 270.14 through 270.27, the Part B Permit Application requires detailed site-specific information
such as geologic, hydrologic, and engineering data. The Part B Permit Application is submitted in
narrative form.

How Many Permit Applications Should I File?
You need submit only one RCRA Hazardous Waste Permit Application (Part A and Part B) per facility,
provided that you describe all of the activities at that facility. If you conduct hazardous waste activity(ies)
at more than one facility, you must submit a separate RCRA Hazardous Waste Permit Application (Part A
and Part B) for each facility location. You must also have an EPA Identification Number for each of the
facilities.

NOTE

Only one permit application is required per facility. At some point, you may be required to
submit revised applications to update your first Part A Permit Application submission. At
any given time, the first submission and any subsequent revised submissions represent the
Part A Permit Application for your facility.

Can I Request that this Information be Kept Confidential?
All information submitted in this form will be subject to public disclosure, to the extent provided by the
Freedom of Information Act, 5 U.S.C. Section 552, and EPA’s Business Confidentiality Regulations, 40
CFR Part 2 and 40 CFR 270.12. Claims of confidentiality for the name and address of any permit
applicant or permittee will be denied. Persons filing this form may make claims of confidentiality for
certain information. Such claims must be clearly indicated by submitting an attachment listing the
specific information for which confidential treatment is requested at the time of filing. This attachment
must include a written substantiation of the claim for confidentiality that answers the following questions:
•

Which sections of the Part A Permit Application form contain the information you claim is
entitled to confidential treatment?

•

For how long is confidential treatment desired for the information?

How to File a RCRA Hazardous Waste Permit Application
(continued)
•

What measures have you taken to guard against undesired disclosure of the information to others?

•

To what extent has the information been disclosed to others, and what precautions have been
taken in connection with that disclosure?

•

Has EPA or any other Federal agency made a pertinent confidentiality determination? If so,
include a copy of such determination or reference to it, if available.

•

Will disclosure of the information be likely to result in substantial harmful effects on your
competitive position? If so, what would those harmful effects be and why should they be viewed
as substantial? Explain the causal relationship between disclosure and the harmful effects.

Information covered by a confidentiality claim and the above substantiation will be disclosed by EPA
only to the extent and by means of the procedures set forth in 40 CFR Part 2 and 40 CFR 270.12.
If no claim of confidentiality or no substantiation accompanies the information when it is submitted, EPA
may make the information available to the public without further notice to the submitter.

Where Should I Send My Completed Permit Application?
You should submit the RCRA Hazardous Waste Permit Application to your State or EPA Regional
contact. A list of State Contacts can be found at: http://www.epa.gov/osw/inforesources/data/form8700/
contact.pdf.
Many States use the form included at the end of this booklet; some also require additional information.
Other States require that you complete and submit a State-specific form. The Contact list indicates which
form to use. Even if you use the included form, you should check with your State to determine if you
need to submit additional information. Also, contact your State if you have any questions about your
submission.

When Should I File My Permit Application?
As required by 40 CFR 270.10, the deadlines for filing RCRA Hazardous Waste Permit Applications are:
•

Existing Facilities: Under 40 CFR 270.10(e), existing facilities must submit a Part A Permit
Application no later than six months following the publication of regulations that subject the
facility to the requirement to have a RCRA hazardous waste permit.

•

New Facilities: Under 40 CFR 270.10(f), new facilities must submit both Part A and Part B
Permit Applications at least 180 days before commencing physical construction of the facility. A
permit must be received before construction begins.

How to File a RCRA Hazardous Waste Permit Application
(continued)

When Should My Permit Application be Revised?
Facilities Operating Under Interim Status
In accordance with 40 CFR 270.72(a), the owner or operator of a facility operating under interim status
must submit a Revised Part A Permit Application at the following times:
•

Prior to treating, storing, or disposing of new hazardous wastes not previously identified in the
facility’s Part A permit. Similarly, when EPA (or a State with an authorized RCRA program)
promulgates a rule listing or identifying new hazardous wastes, facilities managing these wastes
must revise their Part A Permit Application to reflect this activity.

•

Prior to increasing the design capacity of the processes used at the facility. The EPA Regional
Administrator (or the State Director, for an authorized State) must approve changes in capacity
before they take effect at the facility.

•

Prior to changing existing processes or adding new processes for treating, storing, and disposing
of hazardous wastes at the facility. Changes in treatment, storage, and disposal practices must be
approved by the Regional Administrator (or State Director) before they are implemented by a
facility.

•

Prior to undergoing a change in ownership or operational control of a facility.

•

Whenever facility changes occur in accordance with an interim status corrective action order
issued by EPA, an authorized State, or by a court in a judicial action brought by EPA or the State.

•

When a facility adds units for the treatment, storage, and disposal of hazardous waste that are
newly regulated by EPA or a State. A revised Part A Permit Application must be submitted on or
before the date on which the unit becomes subject to the new requirements.

Changes in the quantity of hazardous waste currently specified in the first Part A Permit Application can
be made without submitting a revised Part A Permit Application, provided the quantity does not exceed
the design capacities of the processes specified in the first Part A Permit Application or a subsequent Part
A Permit Application.
Failure to furnish all information required to process a RCRA Hazardous Waste Permit Application is
grounds for termination of interim status.
Facilities Operating Under a RCRA Hazardous Waste Permit
Owners or operators of facilities operating under a RCRA hazardous waste permit may modify their
permit at any time, in accordance with the specific requirements in 40 CFR 270.42. Appendix I to 40
CFR 270.42 divides the various types of permit modifications into Classes 1, 2, and 3, based on the
complexity of facility changes necessitating a permit modification. Class 1 modifications are minor
changes that keep the permit current with changes that occur to the facility or its operation. Class 2 and 3
modifications involve more significant changes in facility operations.

How to File a RCRA Hazardous Waste Permit Application
(continued)
In all cases when a facility owner or operator requests a permit modification, however, he or she must
submit the information required in the Part A Permit Application (in 40 CFR 270.13) as part of the
modification submittal.
Finally, under 40 CFR 270.10(h), facilities with a RCRA hazardous waste permit must submit a new
application (Part A and Part B) at least 180 days prior to the expiration date of the permit.

INSTRUCTIONS FOR FILLING OUT THE RCRA
SUBTITLE C SITE IDENTIFICATION (SITE ID) FORM
Who Must Submit This Form
All sites required to submit any of the following must submit the RCRA Subtitle C Site Identification
(Site ID) Form:
•
•
•
•
•
•
•

Initial Notification of Regulated Waste Activity
Subsequent Notification of Regulated Waste Activity
First RCRA Hazardous Waste Part A Permit Application
Revised RCRA Hazardous Waste Part A Permit Application
Hazardous Waste Report
Notification for eligible academic entities opting into or withdrawing from managing laboratory
hazardous wastes pursuant to 40 CFR Part 262 Subpart K (if in an eligible State)
Notification for facilities managing hazardous secondary material pursuant to 40 CFR 260.42 (if
in an eligible State)

Some States have requirements in addition to, or that are different from the Federal requirements. To
obtain the appropriate forms or ask questions, refer to a list of contacts at:
http://www.epa.gov/epawaste/inforesources/data/form8700/contact.pdf. The list will tell you whether the
Federal form or a State form is used, who to contact, and where to mail the completed form.

Purpose of This Form
The Site ID Form provides site-specific information about your facility and is used to obtain an EPA
Identification Number. The Site ID form also provides updated information for items that have changed at
your site and verifies the information for those items that remain unchanged.

How to Fill Out This Form
Complete the following Site ID Form items, as applicable to your facility:
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Item 1 –
Item 2 –
Item 3 –
Item 4 –
Item 5 –
Item 6 –
Item 7 –
Item 8 –
Item 9 –

your reason for submitting the form
your site’s EPA Identification Number
the name of your site
the physical location of your site
the land type of your site
the North American Industry Classification System (NAICS) code(s) for your site
the mailing address for your site
name, title, address, phone number, fax, and e-mail of a contact person at your site
name, address, and phone number of the legal owner(s) and name of the operator(s) of
your site
Item 10 – your site’s regulated waste activities (enter all that apply)
Item 11 – the description of hazardous waste

Site ID Form
(continued)
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Item 12 – your site’s hazardous secondary material activity, if you manage any
Item 13 – additional comments on Items 1 – 12
Item 14 – certification that the information you provided throughout the form is truthful, accurate
and complete
Addendum to the Site Identification Form – notification of hazardous secondary material activity

Type or print, in black ink, all items except the Signature box in Item 14. In Item 14, provide the
required ink signatures. Signatures must be original. Stamped or photocopied signatures are not
acceptable. Enter your site’s EPA Identification Number in the top left-hand corner on all pages of the
form; for an Initial Notification for this site, leave the EPA Identification Number blank. Use Item 13 –
Comments to clarify or provide additional information for any entry. When entering information in the
comments section, enter the item number and box letter to which the comment refers. If you must use
additional sheets for comments, enter your site’s EPA Identification Number in the top left-hand corner of
each sheet.

Site ID Form
(continued)

Item-By-Item Instructions
Item 1 – Reason for Submittal
Reason for Submittal: Place an “X” in the appropriate box(es) to indicate whether this form is your
Initial Notification (i.e., this is your first time submitting site identification information / to obtain an EPA
Identification Number for this location); a Subsequent Notification (to update your site identification
information); a component of a First or a Revised Hazardous Waste Part A Permit Application; or a
component of the Hazardous Waste Report.
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To provide an Initial Notification (first time submitting site identification information / to
obtain an EPA Identification Number for this location).
o

If your waste activity is regulated under Subtitle C of the Resource Conservation and
Recovery Act (RCRA) and the rules promulgated pursuant to the Act (specifically 40
CFR Parts 260-299), you must submit this form to notify the appropriate State or EPA
Regional Office of your regulated waste activities and obtain an EPA Identification
Number.

If you are an eligible academic entity opting into 40 CFR 262 Subpart K for managing
laboratory hazardous wastes AND you have never before submitted site identification
information, you must submit this form to notify the appropriate State or EPA Regional
Office of your activities. Note: You must check with your State to determine if you are
eligible to manage laboratory hazardous waste pursuant to 40 CFR Part 262 Subpart K in
order for you to notify.

If you will begin managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii),
40 CFR 261.4(a)(23), (24), or (25) AND you have never before submitted site
identification information, you must submit this form, pursuant to 40 CFR 260.42, to
notify the appropriate State or EPA Regional Office of your activities. Note: You must
check with your State to determine if you are eligible to manage hazardous secondary
material under these exclusions in order for you to notify.

To provide a Subsequent Notification (to update site identification information for this
location).
o

You must use this form to submit a subsequent notification if your site already has an
EPA Identification Number and you wish to change information (e.g., generator status,
new site contact person, new owner, new mailing address, new regulated waste activity,
etc.).

If you have previously submitted site identification information and are an eligible
academic entity opting into or withdrawing from 40 CFR Part 262 Subpart K for
managing laboratory hazardous wastes, you must use this form. Note: You must check
with your State to determine if you are eligible to manage laboratory hazardous waste
pursuant to 40 CFR Part 262 Subpart K in order for you to notify.

If you have previously submitted site identification information and are notifying (or renotifying) that you will begin managing, are managing, or have stopped managing
hazardous secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24),

Site ID Form
(continued)
or (25), you must submit this form, pursuant to 40 CFR 260.42, to notify the appropriate
State or Regional Office of your activities. Note: You must check with your State to
determine if you are eligible to manage hazardous secondary material under these
exclusions in order for you to notify.
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As a component of a First RCRA Hazardous Waste Part A Permit Application. If your site
is planning to treat, store, or dispose of hazardous waste on-site in a unit that is not exempt from
obtaining a hazardous waste permit, you must submit this form as part of the Part A Permit
Application. Also, if the activity at this site (treatment, storage, or disposal) became newly
regulated under RCRA Subtitle C and the rules promulgated pursuant to the Act (specifically 40
CFR Parts 260-299), you must submit this form as part of the Part A Permit Application.

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As a component of a Revised RCRA Hazardous Waste Part A Permit Application. If you
must submit a revised Part A Permit Application to reflect changes that have occurred at your
site, you must submit this form as part of your revised Part A Permit Application. Examples of
site changes requiring a revised Part A Permit Application include managing new wastes not
identified in the first submission of the form or changes to existing waste treatment processes.
When submitting a revised Part A Permit Application, please include the Amendment number in
the appropriate space.

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As a component of the Hazardous Waste Report. (If marked, see sub-bullet below). If you
are required to submit a Hazardous Waste Report indicating the amount of hazardous waste you
generate, treat, recycle, dispose, ship off-site, or receive from off-site, you must fill out this form.
A Site ID Form submitted with a Hazardous Waste Report is equivalent to a Subsequent
Notification.
o

Site was a TSD facility and/or generator of ≥ 1,000 kg of hazardous waste, > 1 kg of
acute hazardous waste, or > 100 kg of acute hazardous waste spill cleanup in one or
more months of the report year (or State equivalent LQG regulations). The purpose
of this check box is to distinguish between sites that meet the criteria and are required to
file a report versus those who file voluntarily or by State-only requirement but were not a
TSD facility or a Large Quantity Generator (LQG) during the report year. Sites required
to file the report should place an “X” in this box while non-LQG/TSD sites should not.
For more information about who must file a report, refer to Who Must File the Hazardous
Waste Report.

Item 2 – Site EPA ID Number
Provide your EPA Identification Number in Item 2 for this site. The first two characters of the EPA ID
Number must be a valid state postal code. Be sure to include your EPA Identification Number at the top
of all pages of the form (as well as on any attachments to the Site ID Form).

NOTE

If this is your Initial Notification for this site, leave the EPA Identification Number blank
and proceed to Item 3.

Site ID Form
(continued)
Item 3 and 4 – Site Name and Location
Provide the legal name of your site and a complete location address. Please note that the address you give
for Item 4, Site Location, must be a physical address, not a post office box or route number. Only foreign
hazardous waste transporters, with their headquarters located outside the U.S., may provide a Site
Location Country outside of the U.S.
NOTE

A new EPA Identification Number is required if you change the location of your site.

Item 5 – Site Land Type
Place an “X” in the box that best describes the land type of your site. Select only one type: Private,
County, District, Federal, Tribal (see below), Municipal, State, or Other. If your site’s Land Type could
be described as Municipal and another Land Type, such as County, District, or Tribal, do not place an
“X” in Municipal. Instead, choose the other appropriate Land Type. (For example, if your site’s Land
Type is both Municipal and County, you would place an “X” in the box for County.) You may explain
this in Item 13 – Comments.
Tribal – A member of one of the tribes/entities on the list of federally recognized American
Indian tribes and Alaskan Native entities located at:
http://www.epa.gov/tribal/whereyoulive/tribes-a-z.htm.
Item 6 – North American Industry Classification System (NAICS) Code(s)
Box A must be completed. Completing Boxes B-D is recommended, if applicable.
Box A

Provide the North American Industry Classification System (NAICS) code that
best describes your site’s primary business production process for your products
or services. Referencing the latest NAICS codes, use the 6-digit code (most
specific description) if available for your business; if not, use the 5-digit code; do
not enter any four (4) or less digit codes.

Boxes B – D

List other NAICS codes that describe the other business production processes for
your site. Referencing the latest NAICS codes, use the 6-digit code (most specific
description) if available for your business; if not, use the 5-digit code; do not
enter any four (4) or less digit codes.

Check with your accounting or business staff to determine your NAICS code(s); the NAICS code is used
in tax reporting and other business reports. You can obtain additional information about NAICS codes at
http://www.census.gov/eos/www/naics.
Item 7 – Site Mailing Address
Please enter the Site Mailing Address. If the Mailing Address and the Location of Site (Item 4) are the
same, you can enter “Same as Item 4” in the box for Item 7.

Site ID Form
(continued)
Item 8 – Site Contact Person
Enter the name, title, business address, telephone number, extension, fax number, and e-mail address of
the individual who should be contacted regarding the information submitted in the Site ID Form. A
Subsequent Notification is recommended when the Site Contact Person changes. Do not enter other
contact persons here; if there are other persons, who may be contacted about this submission, list them
and their other contact information in Item 13. If the person completing the Hazardous Waste Report is
not the primary site RCRA hazardous waste contact, enter the primary site RCRA hazardous waste
contact here and add the contact information for the person completing the Hazardous Waste Report in
Item 13 – Comments.
Note: This is NOT the Facility Permit Contact information. The Facility Permit Contact information
should be entered on the RCRA Hazardous Waste Part A Permit Application.
Item 9 – Legal Owner and Operator of the Site
This section should be used to indicate all owners and operators of this site.
A. Name of Site’s Legal Owner: Provide the name of your site’s legal owner(s). This includes
owner(s) of the building(s) and land. Please review these definitions:
Owner – The person who owns a RCRA site or part of a RCRA site. Note: This includes
the owner(s) of the building(s) and/or land. This may be an individual, company, or
business name. See Person.
Person – An individual, trust, firm, joint stock company, Federal Agency, corporation,
(including a government corporation), partnership, association, State, municipality,
commission, political subdivision of a State, or any interstate body.
Date Became an Owner: Indicate the date on which the above entity became the owner of
your site. Enter dates as in this example: For April 22, 2011, enter 04/22/2011. This is a
required field and a date must be reported.
Owner Type: Place an “X” in the box that best describes the owner type for your site.
Select only one type: Private, County, District, Federal, Tribal (see below), Municipal, State,
or Other. If your site’s Owner Type could be described as Municipal and another Owner
Type, such as County, District, or Tribal, do not place an “X” in Municipal. Instead, choose
the other appropriate Owner Type. (For example, if your site’s Owner Type is both Municipal
and County, you would place an “X” in the box for County.). You may explain this in Item
13 – Comments.
Tribal – A member of one of the tribes/entities on the list of federally recognized
American Indian tribes and Alaskan Native entities located at:
http://www.epa.gov/tribal/whereyoulive/tribes-a-z.htm.
Legal Owner Address: Enter the address of the legal owner. If the address and the Location
of Site (Item 4) are the same, you can enter “Same as Item 4” in the box for Item 9.
Use the Comments section in Item 13 to list any additional owners, their names, the dates
they became owners, owner type, mailing address, and which owner(s), if any, are no longer

Site ID Form
(continued)
owners since your last submission of this form. If necessary, attach a separate sheet of paper.
Remember to enter your site’s EPA Identification Number in the top left-hand corner of each
sheet.
B. Name of Site’s Operator. Provide the name of your site’s operator. Please review these
definitions.
Operator – The person responsible for the overall operation of a RCRA site. Note: This
is the legal entity which controls the RCRA site operation rather than the plant or site
manager. This is usually a company or business name, but may be an individual. See
Person.
Person – An individual, trust, firm, joint stock company, Federal Agency, corporation,
(including a government corporation), partnership, association, State, municipality,
commission, political subdivision of a State, or any interstate body.
Date Became an Operator: Indicate the date on which the above entity became the operator
of your site. Enter dates as in this example: For April 22, 2011, enter 04/22/2011. This is a
required field and a date must be reported.
Operator Type: Place an “X” in the box that best describes the operator type for your site.
Select only one type: Private, County, District, Federal, Tribal (see below), Municipal, State,
or Other. If your site’s Operator Type could be described as Municipal and another Operator
Type, such as County, District, or Tribal, do not place an “X” in Municipal. Instead, choose
the other appropriate Operator Type. (For example, if your site’s Operator Type is both
Municipal and County, you would place an “X” in the box for County.) You may explain this
in Item 13 – Comments.
Tribal – A member of one of the tribes/entities on the list of federally recognized
American Indian tribes and Alaskan Native entities located at:
http://www.epa.gov/tribal/whereyoulive/tribes-a-z.htm.
Use the Comments section in Item 13 to list any additional operators, their names, the dates
they became operators, operator type, mailing address, and which operator(s), if any, are no
longer operators since your last submission of this form. If necessary, attach a separate sheet
of paper. Remember to enter your site’s EPA Identification Number in the top left-hand
corner of each sheet.

NOTE

A subsequent notification is recommended when the owner or operator of a site changes.
Because an EPA Identification Number is site-specific, the new owner will keep the
existing EPA Identification Number for that location. If your business moves to another
location, the owner or operator must notify the State or EPA Regional Office of this
change. Since your business has changed locations, a new EPA Identification Number will
be assigned.

Site ID Form
(continued)
Item 10 – Type of Regulated Waste Activity
Mark box “Yes” or box “No” as appropriate for all current activities (as of the date submitting the
form) at this site; complete any additional boxes as instructed. Current activities mean activities that are
in effect when the form is submitted or those that the site plans to begin after EPA Identification Number
assignment. The information you provide in Item 10 will be considered current as of the date you certify
the form. If the site is no longer a generator as of the date you certify the form, you should mark the “No”
(not a generator) box for Generator of Hazardous Waste.

NOTE

You must report your current regulated waste activities as of the date of submitting the Site
ID Form. For the Hazardous Waste Report, your current status may be different than your
status during the reporting year.

A. Hazardous Waste Activities (Complete all parts 1 through 10):

NOTE

Listed below are the Federal generator status definitions. If, however, the
State where your site is located has definitions different from the Federal
definitions, you must use the State definitions.

1. Generator of Hazardous Waste (at your site): If you generate a hazardous waste
that is listed in 40 CFR 261.31 through 261.33 or identified by one or more
hazardous waste characteristic(s) contained in 40 CFR 261.21 through 261.24, place
an “X” in the appropriate box for the quantity of hazardous waste that is generated
per calendar month. (These regulations can be found at
http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=%2Findex.tpl.) The
regulations for hazardous waste generators are found in 40 CFR Part 262. Consult
these regulations and your State for details about how the regulations apply to your
situation. Below is a brief description of the three types of hazardous waste
generators.
If “Yes”, place an “X” in only one of the following – a, b, or c.
a. LQG: Large Quantity Generator
This site is a Large Quantity Generator if the site meets any of the following
criteria:
i) Generates, in any calendar month, 1,000 kg (2,200 lbs.) or more of nonacute RCRA hazardous waste; or
ii) Generates, in any calendar month, or accumulates at any time, more than
1 kg (2.2 lbs) of RCRA acute hazardous waste; or
iii) Generates, in any calendar month, or accumulates at any time, more than
100 kg (220 lbs.) of spill cleanup material contaminated with RCRA
acute hazardous waste.

Site ID Form
(continued)

If, in addition to being an LQG, you recycle hazardous
wastes at your site, mark both this box and Item 10.A.4.
NOTE

Hazardous secondary material managed under 40 CFR
261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25) DOES
NOT count towards your generator status. However, you
must check with your State to determine if you are eligible to
manage hazardous secondary material under these
exclusions.

b. SQG: Small Quantity Generator
This site is a Small Quantity Generator if the site meets all of the following
criteria:
i) Generates, in any calendar month, 100 kg (220 lbs.) but less than 1,000
kg (2,200 lbs.) of RCRA hazardous waste; and
ii) Does not generate, in any calendar month, or accumulate at any time,
more than 1 kg (2.2 lbs.) of acute hazardous waste; and
iii) Does not generate more than 100 kg (220 lbs.) of material from the
cleanup of a spill of acute hazardous waste.
OR, the site is Small Quantity Generator if the site:
i) Meets i) and iii) of the Conditionally Exempt Small Quantity Generator
criteria (see below), but
ii) Is storing more than 1,000 kg (2,200 lbs.) of RCRA hazardous waste onsite. If the site accumulates, at any time, more than 1,000 kg (2,200 lbs.)
of RCRA hazardous waste, the site must apply for an EPA ID Number
using this form.
c. CESQG: Conditionally Exempt Small Quantity Generator
This site is a CESQG if the site does all of the following:
i) Generates no more than 100 kg (220 lbs.) of RCRA hazardous waste in
any calendar month; and
ii) Does not accumulate, at any time, more than 1,000 kg (2,200 lbs) of
RCRA hazardous waste; and
iii) Does not generate, in any calendar month, or accumulate at any time,
more than 1 kg (2.2 lbs.) of acute hazardous waste and no more than 100
kg (220 lbs.) of material from the cleanup of a spill of acute hazardous
waste.

NOTE

If you generate acute hazardous wastes listed in 40 CFR 261.31,
261.32, or 261.33(e), please refer to 40 CFR 261.5(e) to determine the
circumstances under which you must notify the EPA.

If you marked “Yes” above, indicate your other generator activities. Mark “Yes” or
“No” for the other hazardous waste activities listed below that may occur at this site.
Complete all parts 2-10.

Site ID Form
(continued)
2. Short-Term Generators
Mark “Yes” if the site is currently generating hazardous waste only as the result of a
one-time, non-recurring, temporary event that is not related to normal production
processes. In other words, short-term generators produce hazardous waste from a
particular activity for a limited time and then cease conducting that activity. Shortterm generators would not be considered episodic generators because episodic
generators have the potential to generate on a regular basis (for example, a facility
that fluctuates from SQG to LQG in one month is not a short-term generator).
Examples of short-term generators include: 1) one-time highway bridge waste
generation; 2) underground storage tank removals; 3) generation of off-spec or outof-date chemicals at a site that normally doesn’t generate hazardous waste; 4)
remediation or spill clean-up at sites with no previous RCRA ID; and 5) site or
production process decommissions by a new operator. If you mark “Yes”, you must
provide an explanation of your short-term generation event in Item 13 - Comments.
3. United States Importer of Hazardous Waste
Mark “Yes” if you import hazardous waste from a foreign country into the United
States. Refer to 40 CFR 262.60 for additional information.
4. Mixed Waste Generator
Mark “Yes” if you are a generator of mixed waste (waste that is both hazardous and
radioactive). RCRA defines “mixed waste” as waste that contains both hazardous
waste and source, special nuclear, or by-product material subject to the Atomic
Energy Act (AEA), RCRA Section 1004(41), 42 U.S.C. 6903 (63 FR 17414; April 9,
1998). See the Definitions section.
5. Transporter of Hazardous Waste: If “Yes”, place an “X” in all that apply.
a. Transporter
You transport hazardous waste within the United States. The Federal
regulations for hazardous waste transporters are found in 40 CFR Part 263.
b. Transfer Facility (at your site)
You are a hazardous waste transfer facility, at your site, if you hold
manifested hazardous waste(s) at your site for a period of ten (10) days or
less while the waste is in transit. The Federal regulations for hazardous waste
transfer facilities are found in 40 CFR Part 263.12.
6. Treater, Storer, or Disposer of Hazardous Waste (at your site): If you treat,
store, or dispose of hazardous waste, mark “Yes”. A RCRA Hazardous Waste Part B
Permit is required for this activity. Contact the appropriate office for your State for
more information. The Federal regulations for owners and operators of permitted
treatment, storage, and disposal facilities (TSDFs) are found in 40 CFR Parts 264,
265, 266, and 270.
Mark “No” if any of the following conditions are true for your facility:
1. This facility does not receive hazardous waste from other generators and
ships all waste off-site for management within the regulatory timeframe.

Site ID Form
(continued)

2. This facility is only involved with on-going post-closure activities, corrective
actions under HSWA, or a consent order under a non-traditional permit or
without a RCRA permit being required.
3. Receives waste from off-site but does not store greater than 10 days before
re-shipping (i.e., transfer facility).

NOTE

If your site is a destination facility for universal wastes in addition to
being a treatment, storage, or disposal facility for other RCRA
hazardous wastes, mark “Yes” for both this box and Item 10.B.2.

7. Recycler of Hazardous Waste (at your site): If you recycle regulated hazardous
wastes (recyclable materials) at your site, mark “Yes”. The Federal regulations for
owners and operators of sites that recycle hazardous waste are found in 40 CFR
261.6. You also may be subject to other Federal and State regulations; in some cases
a permit is required.

NOTE

If your site, in addition to being a recycling site for hazardous waste,
is a treater, storer, or disposer of hazardous waste, mark “Yes” for
both this box and Item 10.A.6. If your site is a destination facility for
universal wastes in addition to being a recycling site for other RCRA
hazardous wastes, mark “Yes” for both this box and Item 10.B.2.

8. Exempt Boiler and/or Industrial Furnace (at your site): If “Yes”, place an “X” in
all that apply.
a. Small Quantity On-Site Burner Exemption
You burn small quantities of hazardous waste in an on-site boiler or
industrial furnace in accordance with the conditions in 40 CFR 266.108,
place an “X” in the box to indicate that you qualify for the Small Quantity
On-Site Burner Exemption.
b. Smelting, Melting, and Refining Furnace Exemption
You process hazardous wastes in a smelting, melting, or refining furnace
solely for metals recovery, as described in 40 CFR 266.100(d), or to recover
economically significant amounts of precious metals, as described in 40 CFR
266.100(g), or if you process hazardous wastes in a lead recovery furnace to
recover lead, as described in 40 CFR 266,100(h), place an “X” in the box to
indicate that you qualify for the Smelting, Melting, and Refining Furnace
Exemption.
9. Underground Injection Control (at your site): If you generate, treat, store, or
dispose of hazardous waste and place the waste or its residuals into an underground
injection well (e.g., a Class I well) located at your site, mark “Yes”. The Federal

Site ID Form
(continued)
regulations for owners and operators of underground injection wells are found in 40
CFR Part 148.
10. Receives Hazardous Waste From Off-site (at your site): If you received
hazardous waste from another site, whether this waste was received as a commercial
transaction or waste received from a restricted group of off-site generators, mark
“Yes”.
In addition to the above, mark “Yes” or “No” for the other regulated waste activities listed
below that may occur at this site. Complete Items B, C, and D as appropriate.
B. Universal Waste Activities (at your site): Refer to your State-specific requirements and
definitions for universal waste. Also, refer to 40 CFR 261.9 and 40 CFR Part 273 for the
Federal regulations covering universal waste. Complete parts 1 and 2.
1. Large Quantity Handler of Universal Waste (LQHUW): You are an LQHUW if
you accumulate a total of 5,000 kg or more total of universal wastes (batteries,
pesticides, mercury-containing equipment, or lamps - calculated collectively) at any
time. This designation is retained through the end of the calendar year in which the
5,000 kg limit is met or exceeded. If “Yes”, place an “X” in the appropriate box(es)
to indicate the type(s) of universal wastes managed at your site. If your State has
other additional universal wastes, indicate what they are by placing an “X” in the
corresponding box(es) (10.B.1.e, f, or g.).
2. Destination Facility for Universal Waste: Mark “Yes” if you treat, dispose, or
recycle universal wastes on-site. A hazardous waste permit is required if you treat or
dispose of universal wastes; a permit may be required if you recycle universal wastes.

NOTE

If your site, in addition to being a destination facility for universal
wastes, is also a treatment, storage, or disposal facility for RCRA
hazardous wastes, mark “Yes” for both this box and Item 10.A.6. In
addition, if your site recycles RCRA hazardous wastes, mark “Yes”
for both this box and Item 10.A.7.

C. Used Oil Activities: Mark the appropriate box(es) to indicate which used oil management
activities are taking place at this site. The Federal regulations for used oil management are
found in 40 CFR Part 279. Complete all parts 1 through 4.
1. Used Oil Transporter: If “Yes”, place an “X” in all that apply.
a. Transporter
You transport used oil within the United States. The Federal regulations for
used oil transporters are found in 40 CFR Part 279.40-47.
b. Transfer Facility (at your site)
You own or operate a used oil transfer facility. The Federal regulations for
used oil transfer facilities are found in 40 CFR Part 279.40-47.

Site ID Form
(continued)
2. Used Oil Processor and/or Re-refiner (at your site): If “Yes”, place an “X” in all
that apply.
a. Processor
You process used oil. The Federal regulations for processors of used oil are
found in 40 CFR Part 279.50-59.
b. Re-Refiner
You refine used oil. The Federal regulations for re-refiners of used oil are
found in 40 CFR Part 279.50-59.
3. Off-Specification Used Oil Burner (at your site): You burn off-specification used
oil fuel, mark “Yes” to indicate this used oil management activity.
4. Used Oil Fuel Marketer (at your site): If “Yes”, place an “X” in all that apply.
a. Marketer Who Directs Shipment of Off-Specification Used Oil to OffSpecification Used Oil Burners
You are a marketer who directs shipment of off-specification used oil to offspecification used oil burners. The Federal regulations for off-specification
used oil are found in 40 CFR Part 279.70-75.
b. Marketer Who First Claims the Used Oil Meets the Specification
You are the first to claim that used oil meets the used oil specification
established in 40 CFR 279.11.

NOTE

If either of these boxes is marked, you must also notify (or have
previously notified) as a used oil transporter (10.C.1), used oil
processor/re-refiner (10.C.2.), or off-specification used oil fuel
burner (10.C.3), unless you are a used oil generator. (Used oil
generators are not required to notify.)

D. Eligible Academic Entities with Laboratories – Notification for opting into or
withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262
Subpart K: Note: Fill out Box D ONLY if you are at least one of the following: a college
or university; a teaching hospital that is owned by or has a formal written affiliation
agreement with a college or university; or a non-profit research institute that is owned by or
has a formal written affiliation agreement with a college or university; AND you have
checked with your State to determine if 40 CFR Part 262 Subpart K is effective in your state
and for any state-specific requirements. (See EPA’s website for more information about these
regulations: http://www.epa.gov/wastes/hazard/generation/labwaste/implementation.htm.)
Subpart K is an optional alternative set of requirements for eligible academic entities with
laboratories. Certain generators (i.e., eligible academic entities defined under (1) below) are
eligible to operate under Subpart K for management of their hazardous wastes in laboratories
in lieu of 40 CFR 262.34(c) (or 40 CFR 261.5 for CESQGs). Eligible academic entities with
laboratories that generate hazardous waste that elect to opt into Subpart K, are currently

Site ID Form
(continued)
operating under Subpart K, or subsequently withdraw from Subpart K must complete this
section to meet the notification requirements of this Subpart. Refer to 40 CFR 262.203 and
262.204.

NOTE

Eligible academic entities with laboratories must complete a separate Site ID
Form for each site (i.e., EPA ID number) that is managing hazardous waste
under Subpart K. All laboratories with the same EPA ID number will be
regulated under this Subpart. If eligible academic entities with laboratories
withdraw from Subpart K, all laboratories with the same EPA ID number
associated with the withdrawal from Subpart K will be regulated under 40
CFR 262.34(c) requirements (or 40 CFR 261.5 for CESQGs).

1. Opting Into or Currently Operating Under 40 CFR Part 262 Subpart K for the
Management of Hazardous Wastes in Laboratories: Mark “Yes” for this box if you
are an eligible academic entity and you elect to opt into or are currently operating under
40 CFR Part 262 Subpart K for the hazardous wastes generated in your laboratories. If
you mark “Yes” for this box, you must place an “X” in at least one of the following to
indicate your type of eligible academic entity. Place an “X” in all that apply:
a. College or University. You are an eligible college or university if you are a
private or public, post-secondary, degree-granting, academic institution, that
is accredited by an accrediting agency listed annually by the U.S. Department
of Education.
b. Teaching Hospital that is owned by or has a formal written affiliation
agreement with a college or university: You are an eligible teaching
hospital if you are a hospital that trains students to become physicians,
nurses, or other health personnel and is either: (1) owned by a college or
university, or (2) has a master affiliation agreement and program letter of
agreement, as defined by the Accreditation Council for Graduate Medical
Education, with an accredited medical program or medical school.
c. Non-profit Institute that is owned by or has a formal written affiliation
agreement with a college or university: You are an eligible non-profit
institute if you are an organization that conducts research as its primary
function and files as a non-profit organization under the tax code of 26
U.S.C. 501(c)(3) and is either: (1) owned by a college or university, or (2)
has a formal written affiliation agreement with a college or university that
establishes a relationship between institutions for the purposes of research
and/or education and is signed by authorized representatives from each
institution. A relationship on a project-by-project or grant-by-grant basis is
not considered a formal written affiliation agreement.
2. Withdrawing from 40 CFR Part 262 Subpart K for the Management of Hazardous
Wastes in Laboratories: Mark “Yes” for this box if you have previously elected to opt
into 40 CFR Part 262 Subpart K and are now withdrawing from participation in this
optional set of alternative requirements for hazardous waste generation in laboratories.
Withdrawing generators will automatically revert to regulation under 40 CFR 262.34 (c)

Site ID Form
(continued)
requirements (or 40 CFR 261.5 for CESQGs). If marking “Yes” for this box, please
include comments in Section 13 that explain your reasons for withdrawing from Subpart
K.
Item 11 – Description of Hazardous Wastes
Complete this item if you marked “Yes” for any activity 1 (a-c), 6, 7, or 8 in Item 10.A You will need to
refer to 40 CFR Part 261 to complete this item. Part 261 identifies those solid wastes which the EPA
defines as hazardous and regulates under RCRA. If you need help completing this section, please contact
your State Office.
A. Waste Codes for Federally Regulated Hazardous Wastes: Please list the waste codes of
the Federal hazardous wastes (described in 40 CFR Part 261) handled at your site. List them
in the order they are presented in the regulations using the appropriate 4-digit code(s) (e.g.,
D001, D003, F007, U112).

NOTE

EPA Hazardous Waste Codes. If you handle more hazardous wastes than will
fit under Item 11.A, please continue under Item 13 – Comments or on an
extra sheet. Remember to include your EPA Identification Number on the top
of each page. If you handle a large number of codes, you may copy the list in
this booklet and mark the ones that you handle. Attach any additional sheets
to the Site ID Form. Remember to include your EPA Identification Number
on the top of each page.

B. Waste Codes for State-Regulated (i.e., non-Federal) Hazardous Wastes: If you manage
State-regulated hazardous wastes that have a State waste code, enter the appropriate code(s)
in the box(es) provided. Please list the waste codes of the State-regulated hazardous wastes
handled at your site in the order they are presented in the regulations.

NOTE

State Hazardous Waste Code. If you handle more hazardous wastes than will
fit under Item 11.b, please continue under Item 13 – Comments or on an
extra sheet. Remember to include your EPA Identification Number on the top
of each page.

Item 12 – Notification of Hazardous Secondary Material (HSM) Activity
Mark “Yes” if you are notifying under 40 CFR 260.42 that you will begin managing, are still managing,
or will stop managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23),
(24), or (25). Mark “No” if you are not notifying under 40 CFR 260.42. Note: You must check with your
State to determine if you are eligible to manage hazardous secondary material under these regulations.
NOTE

If you mark “Yes”, you must fill out the Addendum to the Site ID Form: Notification of
Hazardous Secondary Material Activity. See instructions for this Addendum after Item 14.

Site ID Form
(continued)
Item 13 – Comments
Use this section as needed to provide additional information for Items 1 through 12. Include the item
number and box letter (if any) for each comment you make. You may attach additional sheets if needed.
Remember to include your EPA Identification Number on the top of each page.
Item 14 – Certification
This certification must be signed and dated by the owner(s), operator(s), responsible official(s), or
authorized representative(s) of the site. (See 40 CFR 270.11 for more information on signatories in
general. See also 40 CFR 270.10(b) for additional Hazardous Waste Part A Permit Application signatory
specifics.) An “authorized representative” is a person responsible for the overall operation of the site (i.e.,
a plant manager or superintendent, or a person of equal responsibility).
NOTE

All Site ID Form submissions must include this certification to be complete.

Addendum to the Site ID Form
(continued)

ADDENDUM TO THE SITE IDENTIFICATION FORM: NOTIFICATION
OF HAZARDOUS SECONDARY MATERIAL ACTIVITY
You Must Fill Out This Section If:

You are located in a State that allows you to manage excluded hazardous secondary material
under 40 CFR 261.2(a)(2)(ii), 261.4(a)(23), (24), or (25). See
http://www.epa.gov/epawaste/hazard/dsw/statespf.htm for a list of eligible states; AND

You will begin managing, are still managing, or will stop managing excluded hazardous
secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25) and must
notify the appropriate State or Regional Office of your activities, pursuant to 40 CFR 260.42.
These regulations exclude certain hazardous secondary material being reclaimed from the RCRA
Subtitle C definition of solid waste provided certain requirements and conditions are met. See
EPA’s website for more information about these regulations:
http://www.epa.gov/epawaste/hazard/dsw/rulemaking.htm#2008.
Complete all parts 1-3.

You must be managing excluded hazardous secondary material in compliance with 40
CFR 261.2(a)(2)(ii), 261.4(a)(23), (24), and/or (25) (or state equivalent). Do not include
any information regarding your hazardous wastes in this section. See 73 FR 64668 or
http://www.epa.gov/epawaste/hazard/dsw/impresource.htm for more information on these
exclusions.
You must submit a completed Site ID Form, including this Addendum, prior to operating
under the exclusion(s) and by March 1 of each even-numbered year thereafter to your
regulatory authority using the Site ID Form as pursuant to 40 CFR 260.42. Persons who
must satisfy this notification requirement can submit this information at the same time as
their Biennial Report (which is also due by March 1 of each even-numbered year).

NOTE

If you stop managing hazardous secondary material in accordance with the exclusion(s)
and do not expect to manage any amount of hazardous secondary material under the
exclusion(s) for at least one year, you must also submit a completed Site ID Form,
including this Addendum, within thirty (30) days pursuant to 40 CFR 260.42.
Remember to include your EPA Identification Number on the top of each page.
Item 1 – Indicate Reason for Notification (include dates where requested):
Place an “X” in the box for the reason that applies to you:
•

Facility will begin managing excluded hazardous secondary material as of
(mm/dd/yyyy): Place an “X” in this box if you are notifying that you will begin managing
hazardous secondary material under the exclusion(s).

Facilities must notify prior to operating under the exclusion(s).

Addendum to the Site ID Form
(continued)

•

If placing an “X” in this box, list the date (mm/dd/yyyy) when you will begin
managing hazardous secondary material under 40 CFR 261.2(a)(2)(ii), 40 CFR
261.4(a)(23), (24), or (25). Note: If the facility had previously notified that it will stop
managing hazardous secondary material in the past but will now begin anew, list the
next planned start date.

Facility is still managing excluded hazardous secondary material/re-notifying as
required by March 1 of each even-numbered year: Place an “X” in this box if you are
re-notifying that you are still managing hazardous secondary material under the
exclusion(s). Note: you must have previously notified that you began managing hazardous
secondary materials in order to check this box.

Facilities must notify by March 1st of each even-numbered year.

If placing an “X” in this box, you do not have to list a date.

Facility has stopped managing excluded hazardous secondary material as of
(mm/dd/yyyy) and is notifying as required: Place an “X” in this box if you are notifying
that you have stopped managing hazardous secondary material under the exclusion(s) and
do not expect to manage any amount of hazardous secondary material for at least one year
(pursuant to 40 CFR 260.42(b)). List the date when you stopped managing hazardous
secondary material. Enter the date in “mm/dd/yyyy” format.

Facilities must notify within 30 days of when they stopped managing hazardous
secondary material. You are considered to have stopped managing hazardous
secondary material if: 1) you stop managing hazardous secondary material completely
(e.g., you cease operations); 2) you choose to manage the hazardous secondary
material as hazardous waste; 3) you undergo closure and request release from financial
assurance per 40 CFR 261.143(h); or 4) you temporarily suspend management of
hazardous secondary material for at least one year.

Only place an “X” in this box if you have stopped managing all hazardous secondary
material under the exclusion(s). For example, if your facility only stopped managing
one hazardous secondary material, but continued to manage another hazardous
secondary material, you would leave this box blank since your facility continues to
manage some amount of hazardous secondary material.

If you submit a notification that you have stopped managing hazardous secondary
material, you do not need to renotify (unless you choose to manage hazardous
secondary material again, in which case you would have to submit a notification prior
to managing). After submitting a stop notification, you can leave the Addendum blank
for subsequent submissions, including any subsequent biennial report submissions.

Item 2 – Description of Excluded Hazardous Secondary Material (HSM) Activity
In the table provided on the Addendum to the Site ID Form, list your appropriate facility code, each waste
code for the hazardous secondary material you manage, the estimated and actual quantities in short tons
for each hazardous secondary material, and the appropriate land-based unit code for how you mange the
hazardous secondary material. Do not include any information regarding your hazardous wastes in this
section. See examples below on how to answer this question.

Addendum to the Site ID Form
(continued)
a. Facility Code: Using the facility codes, found in the Code List section of these
instructions, enter the appropriate 2-digit code(s) that correctly describes your facility. If
more than one code applies to your facility, enter each 2-digit code on a separate row. Each
hazardous secondary material should be reported by facility code.
b. Waste Codes(s) for HSM: Use the box provided to enter the appropriate 4-digit
hazardous waste code(s) that would apply to your hazardous secondary material if you
managed it as hazardous waste (i.e., the waste code(s) that would apply if you did not
manage your material in accordance with 40 CFR 261.2(a)(2)(ii), 40 CFR
261.4(a)(23),(24), or (25)).

NOTE

If you list more codes or manage more hazardous secondary material than
will fit in the table under Item 2, please continue under Item 13 –
Comments, or on an extra sheet. Remember to include your EPA ID
number on the top of each page.

Estimated Short Tons of Excluded HSM to be Managed Annually: In the box
provided, enter your estimated tonnage (using short tons) of hazardous secondary material
you expect to manage annually. Convert all physical quantities (e.g., gallons, cubic yards,
kilograms, metric tons, etc.) to short tons (1 short ton = 2,000 pounds) and round to the
nearest ton (no decimals). Note: Your estimated tonnage should be for the entire amount
of hazardous secondary material to be reclaimed (NOT just the quantity of constituent or
product reclaimed).

d. Actual Short Tons of Excluded HSM Managed During the Most Recent OddNumbered Year: Report the tonnage (using short tons) of each hazardous secondary
material you actually managed during the most recent odd-numbered year. For example, if
you are submitting this notification on February 20, 2012, enter the amount you actually
managed during 2011 (i.e., the tonnage you managed from January 1, 2011 to December
31, 2011). Convert all physical quantities (e.g., gallons, cubic yards, kilograms, metric
tons, etc.) to short tons (1 short ton = 2,000 pounds) and round to the nearest ton (no
decimals). Note: Your actual tonnage should be for the entire amount of hazardous
secondary material that was sent for reclamation (NOT just the quantity of constituent or
product reclaimed). If this is your initial notification, enter “0”.
e.

Land-Based Unit Code: Using the land-based unit codes, found in the Code List section
of these instructions, enter in the 2-digit code that best describes the land-based unit you
use or will use to manage the hazardous secondary material. If you do not use any landbased units, enter “NA”. If you use the code “OT” (Other), please describe your landbased unit in Item 13 – Comments. If more than one land-based unit code applies to a
hazardous secondary material, list it separately using another row.

Addendum to the Site ID Form
(continued)

Examples for Reporting Hazardous Secondary Material Activity:
EXAMPLE 1: A pharmaceutical manufacturer generates spent solvents that are characteristic for
ignitability (D001). The manufacturer plans to manage spent solvents under 40 CFR 261.2(a)(2)(ii) and
261.4(a)(24) by sending some amount to a reclaimer within its own company and the rest off-site to a
reclamation facility within the United States. The manufacturer will not manage any spent solvents in a
land-based unit. Following the regulations, the manufacturer submits an initial notification prior to
managing its spent solvents under the exclusions. The facility would report its hazardous secondary
material activity as follows:
a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste Code(s) for
hazardous secondary
material (HSM)

c. Estimated
short tons of
HSM to be
managed
annually

d. Actual short tons
of HSM that was
managed during the
most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

02
06

D001
D001

15
40

0
0

NA
NA

EXAMPLE 2: A steel manufacturer generates electric arc furnace dust and spent pickle liquor from one
of its steel operations. The manufacturer sends electric arc furnace dust (K061) off-site to a reclamation
facility within the U.S. and reclaims spent pickle liquor (K062) on-site. Neither hazardous secondary
material is managed in a land-based unit. The steel manufacturer has managed both hazardous secondary
material under 40 CFR 261.2(a)(2)(ii) and 261.4(a)(24) for a number of years and it is now time to renotify. The facility would report its hazardous secondary material activity as follows:
a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste Code(s) for
hazardous secondary
material (HSM)

c. Estimated
short tons of
HSM to be
managed
annually

d. Actual short tons
of HSM that was
managed during the
most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

01
06

K062
K061

60
20,000

52
22,468

NA
NA

EXAMPLE 3: A reclamation facility has been receiving and reclaiming spent solvents under 40 CFR
261.2(a)(2)(ii) and 261.4(a)(24) for a number of years. The facility receives and reclaims spent solvents
from multiple hazardous secondary material generators, some of which are within the same company. No
spent solvents are managed in a land-based unit. It is now time to re-notify. The facility would report its
hazardous secondary material activity as follows:
a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste Code(s) for
hazardous secondary
material (HSM)

c. Estimated
short tons of
HSM to be
managed
annually

d. Actual short tons
of HSM that was
managed during the
most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

03
03
07
07

D001;F002;F003;F005
D001;D038;F002;F003
D001;F002;F003;F005
D001;D038;F002;F003

6,000
1,500
3,000
1,000

7,533
918
3,509
523

NA
NA
NA
NA

Addendum to the Site ID Form
(continued)
EXAMPLE 4: A smelting operation generates furnace bricks that are characteristic for chromium
(D007) and sends them off-site for reclamation. Before shipping the bricks off-site, the facility manages
some of the bricks in a containment building and the rest in a pile on the land. The facility has been
managing the bricks under 40 CFR 261.4(a)(24) for a number of years and must now re-notify. The
facility would report its activity as follows:
a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste Code(s) for
hazardous secondary
material (HSM)

c. Estimated
short tons of
HSM to be
managed
annually

d. Actual short tons
of HSM that was
managed during the
most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

06
06

D007
D007

200
115

235
126

NA
PL

EXAMPLE 5: An intermediate facility has been managing wastewater treatment sludges from
electroplating operations (F006) for the past seven years but, due to company consolidation, it will soon
shut down. In accordance with 40 CFR 260.42, the facility notifies that it will stop managing hazardous
secondary material. The facility would report its activity as follows:
a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste Code(s) for
hazardous secondary
material (HSM)

c. Estimated
short tons of
HSM to be
managed
annually

d. Actual short tons
of HSM that was
managed during the
most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

F006

5,034

Item 3 – Facility has Financial Assurance Pursuant to 40 CFR 261.4(a)(24)(vi)
Financial assurance is required for reclaimers (07, 11) and intermediate (08) facilities managing
hazardous secondary material under 40 CFR 261.4(a)(24) and (25). See EPA’s website for more
information about these regulations: http://www.epa.gov/epawaste/hazard/dsw/impresource.htm.
•

Mark “Yes”, if you have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi) AND
you use at least one facility code that is 07, 08, or 11 in Item 2.a above. For example, the
facilities in Examples 3 and 5 above are required to have financial assurance because the
facility codes are 07 and 08, respectively.

•

Mark “No”, if you do NOT have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi).
Note: Reclaimers (07, 11) and intermediate (08) facilities must have financial assurance
in order to manage hazardous secondary material under 40 CFR 261.4(a)(24) and (25).
Answering “No” to this question may mean you are in violation of these regulations if you
report facility codes 07, 08, or 11. For example, the facilities in Examples 1, 2, and 4
above are not required to have financial assurance because these facilities did not report
facility codes of 07, 08, or 11.

INSTRUCTIONS FOR FILLING OUT THE HAZARDOUS WASTE
PERMIT INFORMATION FORM
General Instructions
Please type or print, leaving only one blank box between words. Abbreviate, if necessary, to stay within
the number of boxes allowed for each item. Some items in the form require narrative explanation. If
more space is necessary to answer a question, use the space provided in Item 13 and reference the item
number to which the additional information applies or attach a separate sheet entitled “Additional
Information”. Remember to include your EPA Identification Number and site name in the upper lefthand corner of each attached page.
Unless otherwise specified in the instructions to the form, each item must be answered. To indicate that
each item has been considered, enter “NA” for not applicable, if a particular item does not fit the
circumstances or characteristics of your facility or activity.
For a Revised Part A Permit Application, circle the item numbers with new information or changes.

Hazardous Waste Permit Information Form
(continued)

Item-By-Item Instructions
Item 1 – Facility Permit Contact
Give the name, title, work telephone number, and e-mail of a person who is thoroughly familiar with the
activities at the facility that require a hazardous waste permit and with the facts reported in the Hazardous
Waste Permit Information Form. This person must be available to be contacted by offices reviewing the
permit application, if necessary. If the Facility Permit Contact person is the same as the Site Contact
Person identified in Item 8 of the RCRA Subtitle C Site Identification Form (Site ID Form), you may
print “Same as Site Contact” in this box.
Item 2 – Facility Permit Contact Mailing Address
Enter the mailing address for the facility permit contact. If the mailing address is the same as the Site
Mailing Address (Item 7) on the Site ID Form, you may print “Same as Site Mailing Address” in this box.
Item 3 – Operator Mailing Address and Telephone Number
Enter the mailing address and telephone number of the facility operator identified in Item 9.B of the Site
ID Form.
Item 4 – Facility Existence Date
Enter the appropriate date that applies to your facility from among the following:
•
•
•

the date that hazardous waste operations at the facility commenced;
the date construction on the facility commenced; or
the date operation is expected to begin.

Item 5 – Other Environmental Permits
A. Permit Type: Using the codes listed below, enter a letter on the form for all other environmental
permits the facility has received, or for which the facility has filed an application, even if the
permit has not yet been received.
N
P
R
U
F
E

=
=
=
=
=
=

NPDES (National Pollutant Discharge Elimination System) Clean Water Act
PSD (Prevention of Significant Deterioration) Clean Air Act
RCRA (Resource Conservation and Recovery Act)
UIC (Underground Injection Control) Safe Drinking Water Act
EPA 404 (Dredge or Fill Permits under Section 404 of the Clean Water Act)
Other relevant environmental permits. List any other relevant Federal (e.g.,
permits under the Ocean Dumping Act), State (e.g., State permits for new air
emission sources in nonattainment areas under Part D of the Clean Air Act or
State permits under Section 404 of the Clean Water Act), or local environmental
permits or applications.

B. Permit Number: Give the number of each presently effective permit issued to the facility for
each program, or if you have previously filed an application, but have not yet received a permit,
give the number of the application and note this in the description. You may list additional
permit numbers on a separate sheet of paper if you have more than one currently effective permit

Hazardous Waste Permit Information Form
(continued)
for your facility under a particular permit program. Remember to include your EPA
Identification Number and site name in the upper left-hand corner of each attached page.
C. Description: Use the space provided for any additional information identifying or describing the
permits.
Item 6 – Nature of Business
Briefly describe the nature of your business (e.g., products produced or services provided). If more space
is needed, please attach additional sheets. Remember to include your EPA Identification Number and site
name in the upper left-hand corner of each attached page.
Item 7 – Process Codes and Design Capacities
The information in Item 7 describes all the processes that will be used to treat, store, or dispose of
hazardous waste at the facility. The process code and design capacity of each process must be provided
as part of the description. The design capacity of injection wells and landfills at existing facilities should
be measured as the remaining, unused capacity. Tank storage should refer to each tank, not each tank
farm. Please indicate the location of each process listed in Item 7 on either the map provided for Item 10
or the photographs provided for Item 12. Use the line number from Item 7 to indicate where the
process(es) are located. See the form for detailed instructions on Item 7.

NOTE

Submission of a Revised Part A Permit Application is required before processes for
treating, storing, or disposing of hazardous wastes are changed; before new processes are
added; and/or before the design capacities of these processes are increased.

Item 8 – Other Processes
Use this space to describe other processes that did not have a specific process code listed in Item 7.A of
the form. Follow the instructions for Item 7.A on the form for other process codes (i.e., D99, S99, T04,
and X99 process codes). Describe the other processes in Item 13 - Comments.
Item 9 – Description of Hazardous Wastes
This information describes all the hazardous wastes, using their hazardous waste codes, that will be
treated, stored, or disposed at the facility. In addition, the processes that will be used to treat, store, or
dispose of each hazardous waste and the estimated annual quantity of each hazardous waste must be
provided. The form contains three pages to capture the information for Item 9: Page 4 of 6, which has
detailed instructions; Page 5 of 6, which is to be filled out; and Page 5_ of _, which is used if additional
pages are needed. If additional pages are needed, the pages should be numbered as follows: Page 5a of 6,
Page 5b of 6, Page 5c of 6, etc. See the form for detailed instructions on Item 9.

Hazardous Waste Permit Information Form
(continued)

NOTE

Submission of a Revised Part A Permit Application is required before a facility begins
treating, storing, or disposing of new hazardous wastes not previously identified in the
facility’s Part A Permit Application. Changes in the quantity of hazardous waste
previously specified in the Part A Permit Application can be made without submitting a
Revised Part A Permit Application, provided the quantity does not exceed the process
design capacities specified in the first Part A submission.

Item 10 – Map
Provide a topographic map or maps of the area extending to at least one mile beyond the property
boundaries of the facility. The map must clearly show the following:
•

The legal boundaries of the facility;

•

The location and serial number of each of your existing and proposed intake and discharge
structures;

•

All hazardous waste management facilities;

•

Location of all processes listed in Items 7 and 8 identified by process code;

•

Each well where you inject fluids underground; and

•

All springs and surface water bodies in the area, plus all drinking water wells within ¼ mile of the
facility which are identified in the public record or otherwise known to you.

If an intake or discharge structure, hazardous waste disposal site, or injection well associated with the
facility is located more than one mile from the plant, include it on the map, if possible. If not, attach
additional sheets describing the location of the structure, disposal site, or well, and identify the U.S.
Geological Survey (or other) maps corresponding to the location. Remember to include your EPA
Identification Number and site name in the upper left-hand corner of each attached page.
On each map, include the map scale, a meridian arrow showing north, and latitude and longitude at the
nearest whole second. On all maps of rivers, show the direction of the current, and in tidal waters, show
the directions of the ebb and flow tides. Use a 7-1/2 minute series map published by the U.S. Geological
Survey. If a 7-1/2 minute series map has not been published for your facility site, then you may use a 15minute series map from the U.S. Geological Survey. If neither a 7-1/2 nor 15-minute series map has been
published for your facility site, use a plant map or other appropriate map, and include all the requested
information; in this case, briefly describe land uses in the map area (e.g., residential, commercial).
For information about obtaining maps, contact the U.S. Geological Survey at (888) 275-8747 or see the
USGS web site at http://www.usgs.gov/pubprod.
You may trace your map from a geological survey chart, or other map meeting the above specifications.
If you do, your map should bear a note showing the number or title of the map or chart from which it was
traced. Include the names of nearby towns, water bodies, and other prominent points.

Hazardous Waste Permit Information Form
(continued)
Item 11 – Facility Drawing
All existing facilities must include a drawing showing the general layout of the facility. This drawing
should be approximately to scale and fit on an 8 ½” x 11” sheet of paper. The drawing should show the
following:
•

The property boundaries of the facility;

•

The areas occupied by all storage, treatment, or disposal operations that will be used during
interim status;

•

The name of each operation (e.g., multiple hearth incinerator, drum storage area, etc.);

•

Areas of past storage, treatment, or disposal operations;

•

Areas of future storage, treatment, or disposal operations; and

•

The approximate dimensions of the property boundaries and all storage, treatment, and disposal
areas. (Where applicable, use the process codes listed in Items 7 and 8 to indicate the location of
all storage, treatment, and disposal areas.)

NOTE

New facilities do not have to complete Item 11.

Item 12 – Photographs
All existing facilities must include photographs that clearly delineate all existing structures; all existing
areas for storing, treating, or disposing of hazardous waste; and all known sites of future storage,
treatment, or disposal operations. Photographs may be color or black and white, ground-level or aerial.
Indicate the date the photograph was taken on the back of each photograph. Use the process codes listed
in Items 7 and 8 to indicate the location of all storage, treatment, and disposal areas.

NOTE

New facilities do not have to complete Item 11.

Item 13 – Comments
Use this space for any additional comments and attach additional sheets if necessary. Remember to
include your EPA Identification Number and site name in the upper left-hand corner of each attached
page.

RCRA Hazardous Waste
Part A Permit Application
OTHER REFERENCE INFORMATION
AND
CODE LISTS

EXCLUDED WASTES
This section presents a partial list of excluded materials and wastes. This list includes materials excluded
from the definition of solid waste in 40 CFR 261.4(a) and solid wastes excluded from the definition of
hazardous waste in 40 CFR 261.4(b). In addition, it also includes specific solid waste samples that are
excluded from the definition of hazardous waste in 40 CFR 261.4(d)-(f). Finally, this list includes
specific hazardous wastes, as described in 40 CFR 261.4(c), that are exempted from certain RCRA
Subtitle C regulations.
Agricultural Waste Fertilizer
§261.4(b)(2)

Household Waste
§261.4(b)(1)(i)-(ii)

Secondary Material Returned to
Original Process
§261.4(a)(8)

Analytical Samples
§261.4(d)

HTMR Condenser Residue
§261.4(a)(11)

Arsenic Treated Wood and Wood
Products
§261.4(b)(9)

In situ Mining Materials
§261.4(a)(5)

Secondary Material from Mineral
Processing
§261.4(a)(17)

Irrigation Return Flows
§261.4(a)(3)

Shredded Circuit Boards Being
Recycled
§261.4(a)(14)

Coking By-products
§261.4(a)(10)

Kraft Mill Steam Stripper
Condensates
§261.4(a)(15)

Spent Caustics from Petroleum
Refining
§261.4(a)(19)

Comparable/Syn gas Fuels
§261.4(a)(16)

Leachate
§261.4(b)(15)

Spent Wood Preserving Solutions and
Wastewaters
§261.4(a)(9)

Domestic Sewage
§261.4(a)(1)

Mining and Mineral Process Wastes
§261.4(b)(7)

Dredged Material
§261.4(g)

Mining Overburden
§261.4(b)(3)

Drilling Fluid
§261.4(b)(5)

Nuclear Material
§261.4(a)(4)

Excluded Scrap Metal Being Recycled
§261.4(a)(13)

Oil Filters
§261.4(b)(13)

Exported Wastes
§262.56

Petrochemical Recovered Oil
§261.4(a)(18)

Fossil Fuel Emission Control Waste
§261.4(b)(4)

Petroleum-contaminated Media and
Debris
§261.4(b)(10)

Cement Kiln Dust
§261.4(b)(8)

Hazardous Secondary Material
Generated and Reclaimed Under the
Control of the Generator
40 CFR 261.2(a)(2)(ii)
40 CFR 261.4(a)(23)
Hazardous Secondary Material
Transferred Off-site for Reclamation
40 CFR 261.4(a)(24)
40 CFR 261.4(a)(25)

Sulfuric Acid
§261.4(a)(7)
Treatability Study Samples
§261.4(e)
Treatability Studies at Laboratories
and Testing Facilities
§261.4(f)
Trivalent Chromium Waste
§261.4(b)(6)
Used Oil Distillation Bottoms
§261.4(b)(14)

Petroleum Refining
§261.4(a)(12)

Wastes Generated in Storage Tanks,
Transport Vehicles, Pipelines, or
Manufacturing Process Units
§261.4(c)

Pulping Liquor
§261.4(a)(6)

Wastewater Point Source Discharge
§261.4(a)(2)

Refrigerants
§261.4(b)(12)

DEFINITIONS
This section contains definitions of terms helpful for completing the form. For terms defined in the Code
of Federal Regulations (CFR), the appropriate citation is provided.
Accumulation

A site that does not hold RCRA Interim Status or a RCRA permit may
accumulate hazardous waste for a short period of time before shipping it
off-site. The waste must be accumulated in either tanks or containers; it
may not be accumulated in surface impoundments.
Generators of more than 1,000 kg (2,200 lbs) of hazardous waste per month
may accumulate their waste for up to 90 days before shipping it off-site.
Generators of 100 kg (220 lbs) to 1,000 kg (2,200 lbs) of hazardous waste
per month may accumulate their waste for up to 180 days before shipping it
off-site. If the nearest treatment, storage, disposal, or recycling facility to
which they can send their waste is more than 200 miles away, they may
accumulate their waste for 270 days. See 40 CFR 262.34.

Act or RCRA

The Solid Waste Disposal Act, as amended by the Resource Conservation
and Recovery Act of 1976, as amended by the Hazardous and Solid Waste
Amendments of 1984, 42 U.S.C. Section 6901 et seq.

Acute Hazardous Waste

Any hazardous waste with an EPA hazardous waste code beginning with the
letter “P” (40 CFR 261.33(e)) or any of the following “F” codes: F020,
F021, F022, F023, F026, and F027 (40 CFR 261.31). These wastes are
subject to stringent quantity standards for accumulation and generation (40
CFR 261.5(e)).

Authorized
Representative

The person responsible for the overall operation of the site or an operational
unit (i.e., part of a site), e.g., superintendent or plant manager, or person of
equivalent responsibility.

Authorized State

A State that has obtained authorization from the EPA to direct its own
RCRA program.

Boiler

An enclosed device using controlled flame combustion and having the
following characteristics:
1. The unit has physical provisions for recovering and exporting
energy in the form of steam, heated fluids, or heated gases;
2. The unit's combustion chamber and primary energy recovery
section(s) are of integral design (i.e., they are physically formed into
one manufactured or assembled unit);
3. The unit continuously maintains an energy recovery efficiency of at
least 60 percent, calculated in terms of the recovered energy
compared with the thermal value of the fuel;
4. The unit exports and utilizes at least 75 percent of the recovered
energy, calculated on an annual basis (excluding recovered heat
used internally in the same unit, for example, to preheat fuel or
combustion air or drive fans or feedwater pumps); or
5. The unit is one which the Regional Administrator has determined,
on a case-by-case basis, to be a boiler, after considering the
standards in 40 CFR 260.32

Definitions
(continued)
By-product Material

A by-product material is (1) any radioactive material (except special nuclear
material) yielded in or made radioactive by exposure to the radiation
incident to the process of producing or utilizing special nuclear material;
and (2) the tailings or wastes produced by the extraction or concentration of
uranium or thorium from any ore processed primarily for its source material
content (defined in the Atomic Energy Act of 1954).

Code of Federal
Regulations (CFR)

Codification of the general and permanent rules published in the Federal
Register by the Executive departments and agencies of the Federal
Government. The Code is divided into 50 titles which represent broad areas
subject to Federal regulation. Each title is divided into chapters that usually
bear the name of the issuing agency. Each chapter is further subdivided into
parts covering specific regulatory areas. The CFR title applicable for the
Hazardous Waste Report is “40,” as in “40 CFR 262.34.”

Conditionally Exempt
Small Quantity
Generator (CESQG) of
Hazardous Waste

A generator that meets the following criteria:
In every month during the year, the site did all of the following:
1. Generates no more than 100 kg (220 lbs.) of RCRA hazardous
waste in any calendar month; and
2. Did not accumulate, at any time, more than 1,000 kg (2,200 lbs.) of
RCRA hazardous waste; and
3. Did not generate, in any calendar month, or accumulate at any time,
more than 1 kg (2.2 lbs.) of acute hazardous waste, and no more
than 100 kg (220 lbs.) of material from the cleanup of a spill of
acute hazardous waste.

Confidential Business
Information (CBI)

Information a facility does not wish to make available to the general public
for competitive business reasons. Confidential Business Information (CBI)
may be claimed for certain information in your submittal. A claim may be
made in accordance with 40 CFR Part 2, Subpart B.

Delisted Waste

Site-specific wastes excluded from regulation under 40 CFR 260.20 and
260.22. A waste at a particular generating site may be excluded by
petitioning the EPA Administrator for a regulatory amendment. These
wastes are listed in Appendix IX of 40 CFR Part 261.

Disposal

The discharge, deposit, injection, dumping, spilling, leaking, or placing of
any solid waste or hazardous waste into or on any land or water so that such
solid waste or hazardous waste or any constituent thereof may enter the
environment or be emitted into the air or discharged into any waters,
including ground waters.

Eligible Academic Entity

A college or university, or a non-profit research institute that is owned by or
has a formal written affiliation with a college or university, or a teaching
hospital that is owned by or has a formal written affiliation with a college or
university pursuant to 40 CFR Part 262 Subpart K (See 40 CFR 262.200).

Definitions
(continued)
Environmental
Protection Agency (EPA)

EPA, also called U.S. EPA, means the United States Environmental
Protection Agency. Some State environmental authorities may be called the
EPA also, as in “Illinois EPA.”

EPA Identification (ID)
Number

The number assigned by the EPA to each hazardous waste generator,
hazardous waste transporter, and treatment, storage, or disposal facility;
United States importer of hazardous waste; mixed waste (hazardous and
radioactive) generator; recycler of hazardous waste; exempt boiler and/or
industrial furnace burning or processing hazardous waste; large quantity
handler of or destination facility for universal wastes; disposer of hazardous
waste with an underground injection permit; used oil transporter, used oil
processor/re-refiner, off-specification used oil fuel burner, used oil fuel
marketer; eligible academic entity managing laboratory hazardous waste
under Subpart K; or site undergoing corrective action. Additionally,
facilities that must notify using the Site ID Form and Addendum to the Site
ID Form that they are managing hazardous secondary material will also be
assigned an EPA ID number.

Excluded Wastes

Wastes excluded from the definition of solid or hazardous waste under 40
CFR 261.3 and 261.4. For a partial listing, see the “Other Reference
Information” section of this booklet.

Hazardous Waste

A hazardous waste as defined in 40 CFR 261.3.

Hazardous Secondary
Material (HSM)

A secondary material (e.g., spent material, by-product, or sludge) that, when
discarded, would be identified as hazardous waste under 40 CFR Part 261.
Facilities managing hazardous secondary material under 40 CFR
261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25) must complete the
Addendum to the Site Identification Form: Notification for Managing
Hazardous Secondary Material. You must check with your State to
determine if you are eligible to manage hazardous secondary material under
these exclusions (see also http://www.epa.gov/epawaste/hazard/dsw/
statespf.htm).

Hazardous Waste
Generator

Any person, by site, whose act or process produces hazardous waste
identified or listed in 40 CFR Part 261.

Hazardous Waste
Number or Code, EPA

The number (or code) assigned by the EPA to each hazardous waste listed in
40 CFR Part 261, Subpart D and to each characteristic identified in 40 CFR
Part 261, Subpart C. The codes consist of one letter (D, F, P, U, or K) and
three numbers. For a list of EPA hazardous waste codes see the “Other
Reference Information” section of this booklet.

Hazardous Waste
Number or Code, State

The number (or code) assigned by the State to each hazardous waste listed
in the State regulations. Obtain a list of the States waste codes from your
State.

Hazardous Waste
Storage

The holding of hazardous waste for a temporary period, at the end of which
the hazardous waste is treated, disposed of, or stored elsewhere.

Definitions
(continued)
Hazardous Waste
Transfer Facility

Refer to “Transfer Facility" definition.

Hazardous Waste
Transporter

Refer to “Transporter" definition.

Hazardous Waste
Treatment

Any method, technique, or process, including neutralization, designed to
change the physical, chemical, or biological character or composition of any
hazardous waste so as to neutralize such hazardous waste, or so as to
recover energy or material resources from the hazardous waste, or so as to
render such hazardous waste nonhazardous, or less hazardous; safer to
transport, store or dispose of; or amenable for recovery, amenable for
storage, or reduced in volume. Such term includes any activity or
processing designed to change the physical form or composition of
hazardous waste so as to render it nonhazardous.

Incineration

Burning of certain types of solid, liquid, or gaseous materials; or a treatment
technology involving destruction of waste by controlled burning at high
temperatures (e.g., burning sludge to remove the water and reduce the
remaining residues to a safe, non-burnable ash that can be disposed safely
on land, in some waters, or in underground locations).

Industrial Furnace

Any of the following enclosed devices that are integral components of
manufacturing processes and that use thermal treatment to accomplish
recovery of materials or energy: cement kilns; lime kilns; aggregate kilns;
phosphate kilns; coke ovens; blast furnaces; smelting, melting and refining
furnaces; titanium dioxide chloride process oxidation reactors; methane
reforming furnaces; pulping liquor recovery furnaces; combustion devices
used in the recovery of sulfur values from spent sulfuric acid; halogen acid
furnaces, as defined under industrial furnace in 40 CFR 260.10; and such
other devices as the Administrator may add to this list.

Interim (Permit)
Status

Period during which the owner/operator of an existing TSD facility is
treated as having been issued a RCRA permit even though he/she has not
yet received a final determination. An existing facility should have
automatically qualified for interim status if the owner/operator filed both
timely “notification” and the first part (Part A) of the RCRA permit
application. Interim status continues until a final determination is made to
issue or deny the permit. Owner/operator of new facilities cannot by
definition qualify for interim status; rather, they need a RCRA permit prior
to beginning construction of a hazardous waste management facility.

Large Quantity
Generator (LQG) of
Hazardous Waste

A generator that meets any of the following criteria:
1. Generates, in a calendar month, 1,000 kg (2,200 lbs.) or more of
non-acute RCRA hazardous waste; or
2. Generates, in a calendar month, or accumulates at any time, more
than 1 kg (2.2 lbs.) of RCRA acute hazardous waste; or
3. Generates, in a calendar month, or accumulates at any time, more
than 100 kg (220 lbs.) of spill cleanup material contaminated with
RCRA acute hazardous waste.

Definitions
(continued)
Large Quantity Handler
of Universal Waste
(LQHUW)

A universal waste handler (as defined in 40 CFR 273.9) who accumulates
5,000 kg or more total of universal wastes (batteries, pesticides, mercurycontaining equipment, or lamps – calculated collectively) at any time. This
designation is retained through the end of the calendar year in which the
5,000 kg limit is met or exceeded.

Management, or
Hazardous Waste
Management

Systematic control of the collection, source separation, storage,
transportation, processing, treatment, recovery, or disposal of hazardous
waste (40 CFR 260.10).

Manifest, Uniform
Hazardous Waste

The shipment document EPA form 8700-22 and, if necessary, Form 870022A, originated and signed by a generator in accordance with the
instructions included in the appendix to 40 CFR Part 262. The “cradle-tograve” paperwork must accompany a shipment of hazardous waste as it
moves from the generator to the transporter and eventually to the hazardous
waste management facility.

Mixed Waste

Waste that contains both hazardous and source, special nuclear, or byproduct material subject to the Atomic Energy Act (AEA), RCRA section
1004(41), 42 U.S.C. 6903 (63 FR 17414; April 9, 1998).

Municipality

A city, village, town, borough, county, parish, district, association, Indian
tribe or authorized Indian tribal organization, designated and approved
management agency under Section 208 of the Clean Water Act, or any other
public body created by or under State law and having jurisdiction over
disposal of sewage, industrial wastes, or other wastes.

Off-site Facility

A hazardous waste treatment, storage, disposal, or recycling area located at
a place away from the generating site.

Off-Specification Used
Oil Burner

A site where used oil not meeting the specification requirements in 40 CFR
279.11 (off-specification used oil) is burned for energy recovery in devices
identified in Section 279.61(a).

Off-Specification Used
Oil Fuel

Used oil fuel that does not meet the specification provided under 40 CFR
279.11.

On-site Facility

A hazardous waste treatment, storage, disposal, or recycling area located on
the generating site.

On-Specification Used
Oil Fuel

Used oil fuel that meets the specification provided under 40 CFR 279.11.

Operator

The person responsible for the overall operation of a RCRA site.
Note: This is the legal entity which controls the RCRA site operation rather
than the plant or site manager. This is usually a company or business name,
not an individual. See Person.

Owner

The person who owns a RCRA site or part of a RCRA site. Note: This
includes the owner(s) of the building(s) and/or land. This may be an
individual, company, or business name. See Person.

Definitions
(continued)
Person

An individual, trust, firm, joint stock company, Federal Agency, corporation
(including a government corporation), partnership, association, State,
municipality, commission, political subdivision of a State, or any interstate
body.

Resource Conservation
and Recovery Act
(RCRA)

The Solid Waste Disposal Act as amended by the Resource Conservation
and Recovery Act (RCRA) (40 CFR 270.2). It is the Federal statute that
regulates the generation, treatment, storage, disposal, recycling, and/or
transportation of solid and hazardous waste.

RCRA Interim (Permit)
Status

Refer to “Interim (Permit) Status” definition.

RCRA Permit

A complete RCRA permit is comprised of an operating permit for hazardous
waste treatment, storage, and disposal, and a corrective action permit
addressing releases from solid waste management unit (SWMUs). To apply
for a permit, a site must file a two-part application (Part A and Part B). A
facility is not considered to have a complete RCRA permit until both parts
have been issued.

RCRA Subtitle C Site
(RCRA Site or Site)

The physical plant or location at which one or more of the following
regulated waste activities occurs: the generation, transportation, treatment,
storage, or disposal of hazardous wastes; recycling of hazardous wastes;
United States importer of hazardous waste; mixed waste (hazardous and
radioactive) generator; exempt boiler and/or industrial furnace burning or
processing hazardous waste; large quantity handler of or destination facility
for universal wastes; disposing hazardous waste with an underground
injection permit; the transportation (and temporary storage during
transportation), processing/re-refining, burning, or marketing of used oil;
eligible academic entity managing laboratory hazardous waste under
Subpart K; facility managing hazardous secondary material being reclaimed
that must comply with certain requirements and conditions; or undergoing
corrective action.
A site may consist of several treatment, storage, or disposal operational
units. For entities that only transport regulated wastes, the term site refers to
the headquarters of that entity’s operations.

Recycling

Use, reuse, or reclamation of a material (40 CFR 261.1(c)(7)).
“Reclamation” is the processing or regeneration of a material to recover a
usable product (e.g., recovery of lead values from spent batteries,
regeneration of spent solvents) (40 CFR 261.1(c)(4)). A material is “used or
reused” if it is either: (1) employed as an ingredient (including use as an
intermediate) in an industrial process to make a product (e.g., distillation
bottoms from one process used as feedstock in another process) (40 CFR
261.1(c)(5)). However, a material will not satisfy this condition if distinct
components of the material are recovered as separate end products (as when
metals are recovered from metal-containing secondary material); or (2)
employed in a particular function or application as an effective substitute for
a commercial product (e.g., spent pickle liquor used as phosphorous
precipitant and sludge conditioner in wastewater treatment).

Definitions
(continued)
Small Quantity
Generator (SQG) of
Hazardous Waste

A generator that meets all the following criteria:
1. Generates, in any calendar month, more than 100 kg (220 lbs.) but
less than 1,000 kg (2,200 lbs.) of RCRA hazardous waste; and
2. Does not generate, in any calendar month, or accumulates at any
time, more than 1 kg (2.2 lbs.) of acute hazardous waste and
3. Does not generate more than 100 kg (220 lbs.) of material from the
cleanup of a spill of acute hazardous waste.
OR, a site is a Small Quantity Generator if the site:
1. Meets 1) and 3) of the Conditionally Exempt Small Quantity
Generator criteria (see definition), but
2. Is storing more than 1,000 kg (2,200 lbs.) of RCRA hazardous
waste on-site. If the site accumulates, at any time, more than 1,000
kg (2,200 lbs.) of RCRA hazardous waste, the site must apply for
an EPA ID Number using this form.

Small Quantity On-Site
Burner Exemption

The persons who burn small quantities of hazardous waste in an on-site
boiler or industrial furnace, in accordance with 40 CFR 266.108, are
conditionally exempt from regulation for that activity.

Smelting, Melting, and
Refining Furnace
Exemption

Under 40 CFR 266.100(c), owners or operators of smelting, melting, and
refining furnaces that process hazardous wastes solely for metals recovery
are conditionally exempt from regulation, except for 40 CFR 266.101 and
266.112, provided they comply with limited requirements set forth in
Section 266.100(c). Similarly, 40 CFR 266.100(f) provides that owners or
operators of smelting, melting and refining furnaces that process hazardous
wastes for the recovery of precious metals are conditionally exempt from
regulation, except for 40 CFR 266.112, provided they comply with limited
requirements specified in Section 266.100(f).

Solid Waste

Any garbage, refuse, or sludge, or other materials not excluded under 40
CFR 261.4(a). Exclusions include, for example, domestic sewage and any
mixture of other wastes that pass through a sewer system to a publicly
owned treatment works (POTWs); industrial wastewater discharges that are
point source discharges subject to regulation under the Clean Water Act;
irrigation return flows; nuclear materials defined by the Atomic Energy Act;
and in situ mining materials (see the “Other Reference Information” section
of this booklet.). Wastewaters being collected, stored, or treated before
discharge and sludges generated by wastewater treatment are not excluded.
The EPA defines hazardous waste as a subset of solid waste.

Source Material

As defined by the Atomic Energy Act of 1954: (1) Uranium, thorium, or
any other material determined by the Nuclear Regulatory Commission
pursuant to the provisions of Section 2091 of this title to be source material;
or (2) ores containing one or more of the foregoing materials in such
concentration as the Commission may by regulation determine from time to
time.

Definitions
(continued)
Special Nuclear Material

As defined by the Atomic Energy Act of 1954: (1) plutonium, uranium
enriched in the isotope 233 or in the isotope 235, and any other material
which the Nuclear Regulatory Commission, pursuant to the provisions of
Section 2071 of this title, determines to be special nuclear material, but does
not include source material; or (2) any material artificially enriched by any
of the foregoing, but does not include source material.

Subpart K

An alternative set of generator requirements for managing laboratory
hazardous waste at eligible academic entities. Generators that are eligible
academic entities with laboratories may elect to opt into 40 CFR Part 262
Subpart K and manage their laboratory hazardous waste under Subpart K in
lieu of 40 CFR 262.34(c) (or 40 CFR 261.5 for CESQGs). In order for
eligible academic entities (see definition) to opt into Subpart K or
subsequently withdraw from Subpart K, they must use the Site ID Form to
notify the appropriate State or EPA Regional Office. Refer to 40 CFR
262.203 and 262.204. Note: You must check with your State to determine
if you are eligible to manage laboratory hazardous waste pursuant to 40
CFR Part 262 Subpart K and for any state-specific requirements.

Tolling

Tolling arrangements describe a particular type of recycling contract
between two companies. Specifically, the “tolling” company certifies that it
has a contract with a manufacturer to produce a product, and that
manufacturing process generates a residual material that can be recycled by
the tolling company. If the tolling company certifies that the contract
specifies that the tolling company owns and has responsibility for the
recyclable material once it is generated, and the material is returned to the
tolling company for reclamation, and subsequently recycled, the material is
excluded from regulation (under 40 CFR 261.2(a)(2)(ii) or 261.4(a)(23)),
provided certain requirements are met.

Transfer Facility

Any transportation-related facility including loading docks, parking areas,
storage areas, and other similar areas where shipments of hazardous waste
are held for 10 days or less during the normal course of transportation (40
CFR 260.10 and 40 CFR 263.12).

Transporter

A person engaged in the off-site transportation of hazardous waste by air,
rail, highway, or water.

Underground Injection
Control

The subsurface emplacement of fluids through a bored, drilled or driven
well; or through a dug well, where the depth of the dug well is greater than
the largest surface dimension. Underground injection wells are regulated
under both the Safe Drinking Water Act and the Resource Conservation and
Recovery Act (see 40 CFR Part 148).

United States Importer

Any person who imports hazardous waste from a foreign country into the
United States. This does not include hazardous waste shipped from a
foreign Department of Defense site, Maquiladora, United States territory or
protectorate.

Definitions
(continued)
Universal Waste

Any of the following hazardous wastes that are managed under the universal
waste requirements of 40 CFR Part 273: batteries, pesticides, mercurycontaining equipment, and lamps. Some States may have State-specific
universal wastes defined as well.

Used Oil

Any oil that has been refined from crude oil, or any synthetic oil, that has
been used, and as a result of such use, is contaminated by physical or
chemical impurities.

Used Oil Fuel Marketer

Any person who conducts either of the following activities:
1. Directs a shipment of off-specification used oil from their site to an
off-specification used oil burner; or
2. First claims that used oil that is to be burned for energy recovery
meets the used oil fuel specifications set forth in 40 CFR 279.11.

Used Oil Management
Activities

For the purposes of the Site ID Form, includes used oil transportation; used
oil processing and re-refining; burning off-specification used oil fuel; and
used oil fuel marketing.

Used Oil Processing

Chemical or physical operations designed to produce from used oil, or to
make used oil more amenable for production of, fuel oils, lubricants, or
other used oil-derived products. Processing includes, but is not limited to:
blending used oil with virgin petroleum products, blending used oils to meet
the fuel specification, filtration, simple distillation, chemical or physical
separation, and re-refining.

Used Oil Processor

A site that processes on- specification or off-specification used oil.

Used Oil Re-Refiner

A site that produces lubricating oils and greases, industrial fuel, asphalt
extender, gasoline, and other products from on- specification or offspecification used oil.

Used Oil Transfer
Facility

Any transportation-related facility, including loading docks, parking areas,
storage areas, and other areas where shipments of used oil are held for more
than 24 hours during the normal course of transportation and not longer than
35 days. Transfer facilities that store used oil for more than 35 days are
subject to regulation under 40 CFR Part 279, Subpart F.

Used Oil Transporter

Any person who transports used oil, any person who collects used oil from
more than one generator and transports the collected oil, and owners and
operators of used oil transfer facilities. Used oil transporters may
consolidate or aggregate loads of used oil for purposes of transportation but,
with the following exception, may not process used oil. Used oil
transporters may conduct incidental processing operations that occur in the
normal course of used oil transportation (e.g., settling and water separation),
but that are not designed to produce (or make more amenable for production
of) used oil-derived products or used oil fuel.

EPA HAZARDOUS WASTE CODES
A list of all the hazardous waste codes is shown below. See the regulations for details.
CHARACTERISTICS OF HAZARDOUS WASTE (SEE
40 CFR 261.24) – DXXX
HAZARDOUS WASTE FROM NON-SPECIFIC
SOURCES (SEE 40 CFR 261.31) – FXXX

DISCARDED COMMERCIAL CHEMICAL PRODUCTS,
OFF-SPECIFICATION SPECIES, CONTAINER
RESIDUALS, AND SPILL RESIDUES THEREOF –
ACUTE HAZARDOUS WASTE (SEE 40 CFR 261.33) –
PXXX

HAZARDOUS WASTE FROM SPECIFIC SOURCES
(SEE 40 CFR 261.32) - KXXX

DISCARDED COMMERCIAL CHEMICAL PRODUCTS,
OFF-SPECIFICATION SPECIES, CONTAINER
RESIDUES, AND SPILL RESIDUES THEREOF –
TOXIC WASTES (SEE 40 CFR 261.33) - UXXX

D001
D002
D003
D004
D005
D006
D007
D008
D009
D010
D011
D012
D013
D014
D015
D016
D017
D018
D019
D020
D021
D022
D023
D024
D025
D026
D027
D028
D029
D030
D031
D032
D033
D034
D035
D036
D037
D038
D039
D040
D041
D042
D043

P106
P108
P109
P110
P111
P112
P113
P114
P115
P116
P118
P119
P120
P121
P122
P123
P127
P128
P185
P188
P189
P190
P191
P192
P194
P196
P197
P198
P199
P201
P202
P203
P204
P205

F001
F002
F003
F004
F005
F006
F007
F008
F009
F010
F011
F012
F019
F020
F021
F022
F023
F024
F025
F026
F027
F028
F032
F034
F035
F037
F038
F039

K001
K002
K003
K004
K005
K006
K007
K008
K009
K010
K011
K013
K014
K015
K016
K017
K018
K019
K020
K021
K022
K023
K024
K025
K026
K027
K028
K029
K030
K031
K032
K033
K034
K035
K036
K037
K038
K039
K040
K041
K042
K043
K044
K045
K046

K047
K048
K049
K050
K051
K052
K060
K061
K062
K069
K071
K073
K083
K084
K085
K086
K087
K088
K093
K094
K095
K096
K097
K098
K099
K100
K100
K101
K102
K103
K104
K105
K106
K107
K108
K109
K110
K111
K112
K113
K114
K115
K116
K117
K118

K123
K124
K125
K126
K131
K132
K136
K141
K142
K143
K144
K145
K147
K148
K149
K150
K151
K156
K157
K158
K159
K161
K169
K170
K171
K172
K174
K175
K176
K177
K178
K181

P001
P002
P003
P004
P005
P006
P007
P008
P009
P010
P011
P012
P013
P014
P015
P016
P017
P018
P020
P021
P022
P023
P024
P026
P027
P028
P029
P030
P031
P033
P034
P036
P037
P038
P039
P040
P041
P042
P043
P044
P045
P046
P047
P048
P049

P050
P051
P054
P056
P057
P058
P059
P060
P062
P063
P064
P065
P066
P067
P068
P069
P070
P071
P072
P073
P074
P075
P076
P077
P078
P081
P082
P084
P085
P087
P088
P089
P092
P093
P094
P095
P096
P097
P098
P099
P101
P102
P103
P104
P105

U001
U002
U003
U004
U005
U006
U007
U008
U009
U010
U011
U012
U014
U015
U016
U017
U018
U019
U020
U021
U022
U023
U024
U025
U026
U027
U028
U029
U030
U031
U032
U033
U034
U035
U036
U037
U038
U039
U041
U042
U043
U044
U045
U046
U047

U048
U049
U050
U051
U052
U053
U055
U056
U057
U058
U059
U060
U061
U062
U063
U064
U066
U067
U068
U069
U070
U071
U072
U073
U074
U075
U076
U077
U078
U079
U080
U081
U082
U083
U084
U085
U086
U087
U088
U089
U090
U091
U092
U093
U094

U095
U096
U097
U098
U099
U101
U102
U103
U105
U106
U107
U108
U109
U110
U111
U112
U113
U114
U115
U116
U117
U118
U119
U120
U121
U122
U123
U124
U125
U126
U127
U128
U129
U130
U131
U132
U133
U134
U135
U136
U137
U138
U140
U141
U142

U143
U144
U145
U146
U147
U148
U149
U150
U151
U152
U153
U154
U155
U156
U157
U158
U159
U160
U161
U162
U163
U164
U165
U166
U167
U168
U169
U170
U171
U172
U173
U174
U176
U177
U178
U179
U180
U181
U182
U183
U184
U185
U186
U187
U188

U189
U190
U191
U192
U193
U194
U196
U197
U200
U201
U202
U203
U204
U205
U206
U207
U208
U209
U210
U211
U213
U214
U215
U216
U217
U218
U219
U220
U221
U222
U223
U225
U226
U227
U228
U234
U235
U236
U237
U238
U239
U240
U243
U244
U246

U247
U248
U249
U271
U278
U279
U280
U328
U353
U359
U364
U367
U372
U373
U387
U389
U394
U395
U404
U409
U410
U411

HSM FACILITY CODES
Facility codes describe the specific regulation a facility uses to manage its hazardous secondary material
(HSM) and the type of activity the facility performs under that regulation (e.g., generator, reclaimer).
Review the groups and pick the appropriate code. If more than one facility code applies to you, enter
each code on a separate row under Item 2 of the Addendum to the Site ID Form.
Under Control of the Generator Exclusion (40 CFR 261.2(a)(2)(ii) or 261.4(a)(23))
Code

Facility Code Description

HSM Generator reclaiming HSM “on-site”: This code applies if you generate and reclaim hazardous
secondary material at your generating facility. See also paragraph (1) in the Federal definition of
“Hazardous secondary material generated and reclaimed under the control of the generator” in 40 CFR
Part 260.10
HSM Generator transferring HSM to reclaimer within the “same company”: This code applies if
you generate hazardous secondary material and send the material for reclamation to a different facility
that is either controlled by you or controlled by the same person that controls your generating facility. See
also paragraph (2) in the Federal definition of “Hazardous secondary material generated and reclaimed
under the control of the generator” in 40 CFR Part 260.10.
Reclaimer receiving HSM from HSM generator within the “same company”: This code applies if
you receive and reclaim hazardous secondary material from a different facility that either controls you or
is controlled by the same person that controls you. See also paragraph (2) in the Federal definition of
“Hazardous secondary material generated and reclaimed under the control of the generator” in 40 CFR
Part 260.10.
Tolling Contractor reclaiming HSM pursuant to a tolling contract: This code applies if you are a
tolling contractor that reclaims hazardous secondary material pursuant to a written contract with a toll
manufacturer. See also paragraph (3) in the Federal definition of “Hazardous secondary material
generated and reclaimed under the control of the generator” in 40 CFR Part 260.10.
Toll Manufacturer managing HSM pursuant to a tolling contract: This code applies if you generate
and send hazardous secondary material for reclamation to a tolling contractor pursuant to a written
contract. See also paragraph (3) in the Federal definition of “Hazardous secondary material generated
and reclaimed under the control of the generator” in 40 CFR Part 260.10.

Transfer-based Exclusion (40 CFR 261.4(a)(24))
Code

06
07
08

Facility Code Description

HSM Generator transferring HSM off-site to a domestic reclamation facility: This code applies if
you generate and send hazardous secondary material for reclamation to an off-site domestic reclamation
facility.
Reclaimer receiving HSM from off-site: This code applies if you reclaim hazardous secondary material
received from an off-site domestic hazardous secondary material generator or other domestic facility.
Intermediate facility: This code applies if you receive hazardous secondary material from an off-site
domestic hazardous secondary material generator or another domestic facility and you store it for more
than ten days. This code does not apply if you generate or reclaim the hazardous secondary material.

Imports/Exports (40 CFR 261.4(a)(24) or (25))
Code

09
10
11

Facility Code Description

HSM Generator exporting HSM off-site to a foreign reclamation facility: This code applies if you
generate and export hazardous secondary material for reclamation to a foreign reclamation facility.
HSM Generator importing HSM from a foreign entity to send to another domestic reclamation
facility: This code applies if you import hazardous secondary material from a foreign entity and send the
material for reclamation to a domestic reclamation facility.
HSM Generator AND Reclaimer of imported HSM: This code applies if you import hazardous
secondary material from a foreign entity and reclaim the material at your facility.

HSM LAND-BASED UNIT CODES
A 2-digit code that best describes the land-based unit you use or will use to manage the hazardous
secondary material.

Code

Land-based Unit Code Description

Do not use land-based units to manage hazardous secondary material.

PL
OT

Use surface impoundment(s) to manage hazardous secondary material. A surface impoundment
is a natural topographic depression, man-made excavation or diked area formed primarily of
earthen materials (although it may be lined with man-made materials), which is designed to hold
an accumulation of liquid hazardous secondary materials or materials containing free liquids and
which is not an injection well.
Use pile(s) to manage hazardous secondary material. Pile means any non-containerized
accumulation of solid, nonflowing hazardous secondary material that is used for storage and is
not a containment building.
Use other land-based unit(s) to manage hazardous secondary material.

OMB# 2050-0024; Expires xx/xx/xxxx
SEND
COMPLETED
FORM TO:
The Appropriate State
or Regional Office.
1.

Reason for
Submittal
MARK ALL
BOX(ES) THAT
APPLY

United States Environmental Protection Agency
RCRA SUBTITLE C SITE IDENTIFICATION FORM
Reason for Submittal:
To provide an Initial Notification (first time submitting site identification information / to obtain an EPA ID number for this
location)
To provide a Subsequent Notification (to update site identification information for this location)
As a component of a First RCRA Hazardous Waste Part A Permit Application
As a component of a Revised RCRA Hazardous Waste Part A Permit Application (Amendment #
)

As a component of the Hazardous Waste Report (If marked, see sub-bullet below)

Site was a TSD facility and/or generator of >1,000 kg of hazardous waste, >1 kg of acute hazardous waste, or >100 kg of
acute hazardous waste spill cleanup in one or more months of the report year (or State equivalent LQG regulations)
2.

Site EPA ID
Number

EPA ID Number

Site Name

Name: -

Site Location
Information

Street Address:
City, Town, or Village:
State:

Site Land Type

NAICS Code(s)
for the Site
(at least 5-digit
codes)

Site Mailing
Address

Site Contact
Person

DRAFT

County:

Country:

Private

County

District

Zip Code:

Federal

Tribal

A. -

C. -

B. -

D. -

Municipal

State

Other

Street or P.O. Box:
City, Town, or Village:
State:

Country:

First Name:

MI:

Zip Code:
Last:

Title:
Street or P.O. Box:
City, Town or Village:
State:

Country:

Zip Code:

Email:
Phone:
9.

Ext.:

Legal Owner
A. Name of Site’s Legal Owner:
and Operator of
the Site
Private
County
Owner Type:

District

Fax:
Date Became
Owner:
Federal

Tribal

Municipal

State

Other

State

Other

Street or P.O. Box:
City, Town, or Village:

Phone:

State:

Country:

Zip Code:
Date Became
Operator:

B. Name of Site’s Operator:
Operator
Type:

Private

County

District

Federal

Tribal

Municipal

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

10. Type of Regulated Waste Activity (at your site)
Mark “Yes” or “No” for all current activities (as of the date submitting the form); complete any additional boxes as instructed.
A. Hazardous Waste Activities; Complete all parts 1-10.
Y

1. Generator of Hazardous Waste
If “Yes”, mark only one of the following – a, b, or c.

a. LQG:

b. SQG:
c. CESQG:

Generates, in any calendar month, 1,000 kg/mo (2,200
lbs./mo.) or more of hazardous waste; or Generates, in
any calendar month, or accumulates at any time, more
than 1 kg/mo (2.2 lbs./mo) of acute hazardous waste;
Y
or Generates, in any calendar month, or accumulates
at any time, more than 100 kg/mo (220 lbs./mo) of
acute hazardous spill cleanup material.

100 to 1,000 kg/mo (220 – 2,200 lbs./mo) of nonacute hazardous waste.
Less than 100 kg/mo (220 lbs./mo) of non-acute
hazardous waste.

5. Transporter of Hazardous Waste
If “Yes”, mark all that apply.
a. Transporter
b. Transfer Facility (at your site)

6. Treater, Storer, or Disposer of Hazardous
Waste Note: A hazardous waste Part B permit
is required for these activities.

7. Recycler of Hazardous Waste

8. Exempt Boiler and/or Industrial Furnace
If “Yes”, mark all that apply.
a. Small Quantity On-site Burner Exemption

DRAFT

If “Yes” above, indicate other generator activities in 2-4.

b. Smelting, Melting, and Refining Furnace
Exemption

2. Short-Term Generator (generate from a short-term or one-time event
and not from on-going processes). If “Yes”, provide an explanation in
the Comments section.

3. United States Importer of Hazardous Waste

9. Underground Injection Control

4. Mixed Waste (hazardous and radioactive) Generator

10. Receives Hazardous Waste from Off-site

B. Universal Waste Activities; Complete all parts 1-2.
Y

C. Used Oil Activities; Complete all parts 1-4.

1. Large Quantity Handler of Universal Waste (you accumulate Y
5,000 kg or more) [refer to your State regulations to determine
what is regulated]. Indicate types of universal waste managed
at your site. If “Yes”, mark all that apply.

1. Used Oil Transporter
If “Yes”, mark all that apply.
a. Transporter
b. Transfer Facility (at your site)

a. Batteries

b. Pesticides

2. Used Oil Processor and/or Re-refiner
If “Yes”, mark all that apply.
a. Processor

c. Mercury containing equipment

b. Re-refiner

d. Lamps
e. Other (specify)

f. Other (specify)

3. Off-Specification Used Oil Burner

g. Other (specify)

4. Used Oil Fuel Marketer
If “Yes”, mark all that apply.

2. Destination Facility for Universal Waste
Note: A hazardous waste permit may be required for this activity.

a. Marketer Who Directs Shipment of OffSpecification Used Oil to OffSpecification Used Oil Burner
b. Marketer Who First Claims the Used Oil
Meets the Specifications

EPA ID Number
D.

Eligible Academic Entities with Laboratories—Notification for opting into or withdrawing from managing laboratory hazardous wastes
pursuant to 40 CFR Part 262 Subpart K

OMB#: 2050-0024; Expires xx/xx/xxxx

You can ONLY Opt into Subpart K if:
•

you are at least one of the following: a college or university; a teaching hospital that is owned by or has a formal affiliation agreement with a
college or university; or a non-profit research institute that is owned by or has a formal affiliation agreement with a college or university; AND

•

you have checked with your State to determine if 40 CFR Part 262 Subpart K is effective in your state
1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories
See the item-by-item instructions for definitions of types of eligible academic entities. Mark all that apply:
a. College or University
b. Teaching Hospital that is owned by or has a formal written affiliation agreement with a college or university
c. Non-profit Institute that is owned by or has a formal written affiliation agreement with a college or university

DRAFT

2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories

11.

Description of Hazardous Waste

Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at your site. List them
in the order they are presented in the regulations (e.g., D001, D003, F007, U112). Use an additional page if more spaces are needed.

Waste Codes for State-Regulated (i.e., non-Federal) Hazardous Wastes. Please list the waste codes of the State-Regulated hazardous wastes handled
at your site. List them in the order they are presented in the regulations. Use an additional page if more spaces are needed.

EPA ID Number
12.
Y

OMB#: 2050-0024; Expires xx/xx/xxxx

Notification of Hazardous Secondary Material (HSM) Activity
N

Are you notifying under 40 CFR 260.42 that you will begin managing, are managing, or will stop managing hazardous secondary material
under 40 CFR 261.2(a)(2)(ii), 40 CFR 261.4(a)(23), (24), or (25)?
If “Yes”, you must fill out the Addendum to the Site Identification Form: Notification for Managing Hazardous Secondary Material.

13.

Comments

DRAFT

14.

Certification. I certify under penalty of law that this document and all attachments were prepared under my direction or 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 persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations. For the RCRA Hazardous Waste Part A Permit Application, all owner(s) and
operator(s) must sign (see 40 CFR 270.10(b) and 270.11).

Signature of legal owner, operator, or an
authorized representative

Name and Official Title (type or print)

Date Signed
(mm/dd/yyyy)

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

ADDENDUM TO THE SITE IDENTIFICATION FORM:
NOTIFICATION OF HAZARDOUS SECONDARY MATERIAL ACTIVITY
ONLY fill out this form if:

You are located in a State that allows you to manage excluded hazardous secondary material (HSM) under 40 CFR 261.2(a)(2)(ii), 261.4(a)(23),
(24), or (25) (or state equivalent). See http://www.epa.gov/epawaste/hazard/dsw/statespf.htm for a list of eligible states; AND

You are or will be managing excluded HSM in compliance with 40 CFR 261.2(a)(2)(ii), 261.4(a)(23), (24), or (25) (or state equivalent) or you
have stopped managing excluded HSM in compliance with the exclusion(s) and do not expect to manage any amount of excluded HSM under
the exclusion(s) for at least one year. Do not include any information regarding your hazardous waste activities in this section.

Indicate reason for notification. Include dates where requested.

DRAFT

Facility will begin managing excluded HSM as of _____________ (mm/dd/yyyy).

Facility is still managing excluded HSM/re-notifying as required by March 1 of each even-numbered year.
Facility has stopped managing excluded HSM as of ____________ (mm/dd/yyyy) and is notifying as required.
2.

Description of excluded HSM activity. Please list the appropriate codes and quantities in short tons to describe your excluded HSM activity ONLY
(do not include any information regarding your hazardous wastes). Use additional pages if more space is needed.

a. Facility code
(answer using codes
listed in the Code List
section of the
instructions)

b. Waste code(s) for HSM

c. Estimated short tons
of excluded HSM to be
managed annually

d. Actual short tons of
excluded HSM that
was managed during
the most recent oddnumbered year

e. Land-based unit
code (answer using
codes listed in the
Code List section of
the instructions)

Facility has financial assurance pursuant to 40 CFR 261.4(a)(24)(vi). (Financial assurance is required for reclaimers and intermediate facilities
managing excluded HSM under 40 CFR 261.4(a)(24) and (25))
N

Does this facility have financial assurance pursuant to 40 CFR 261.4(a)(24)(vi)?

This page intentionally left blank

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

United States Environmental Protection Agency

HARDOUS WASTE PERMIT INFORMATION FORM
1. Facility Permit Contact

First Name:

MI:

Last Name:

Contact Title:
Phone:
2. Facility Permit
Contact Mailing Address

Ext.:

Email:

Street or P.O. Box:
City, Town, or Village:
State:
Country:

3. Operator Mailing
Address and Telephone
Number

4. Facility Existence Date

Zip Code:

Street or P.O. Box:
City, Town, or Village:
State:

Phone:

Country:

Zip Code:

Facility Existence Date (mm/dd/yyyy):

5. Other Environmental Permits
A. Facility Type
(Enter code)

B. Permit Number

C. Description

6. Nature of Business:

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

7. Process Codes and Design Capacities – Enter information in the Section on Form Page 3
A. PROCESS CODE – Enter the code from the list of process codes below that best describes each process to be used at the facility. If more lines are
needed, attach a separate sheet of paper with the additional information. For “other” processes (i.e., D99, S99, T04 and X99), describe the process
(including its design capacity) in the space provided in Item 8.
B. PROCESS DESIGN CAPACITY – For each code entered in Item 7.A; enter the capacity of the process.
1. AMOUNT – Enter the amount. In a case where design capacity is not applicable (such as in a closure/post-closure or enforcement action) enter
the total amount of waste for that process.
2. UNIT OF MEASURE – For each amount entered in Item 7.B(1), enter the code in Item 7.B(2) from the list of unit of measure codes below that
describes the unit of measure used. Select only from the units of measure in this list.
C. PROCESS TOTAL NUMBER OF UNITS – Enter the total number of units for each corresponding process code.
Process Code
Process

D79
D80
D81
D82
D83

D99

Appropriate Unit of Measure for Process
Design Capacity

Disposal
Underground Injection Well
Gallons; Liters; Gallons Per Day; or Liters Per
Disposal
Day
Landfill
Acre-feet; Hectares-meter; Acres; Cubic
Meters; Hectares; Cubic Yards
Land Treatment
Acres or Hectares

Process
Code

Process

Treatment (Continued)
T81
Cement Kiln
T82

Lime Kiln

Appropriate Unit of
Measure for Process
Design Capacity
(for T81 – T94)
Gallons Per Day; Liters Per
Day; Pounds Per Hour;
Short Tons Per Hour;
Kilograms Per Hour; Metric
Tons Per Day; Metric Tons
Per Hour; Short Tons Per
Day; BTU Per Hour; Liters
Per Hour; Kilograms Per
Hour; or Million BTU Per
Hour

T83

Aggregate Kiln

Ocean Disposal

Gallons Per Day or Liters Per Day

T84

Phosphate Kiln

Surface Impoundment
Disposal

Gallons; Liters; Cubic Meters; or Cubic Yards

T85

Coke Oven

Any Unit of Measure Listed Below

T86

Blast Furnace

T87
T88

Smelting, Melting, or Refining Furnace
Titanium Dioxide Chloride Oxidation Reactor

Other Disposal

Storage
S01

Container

S02

Tank Storage

Gallons; Liters; Cubic Meters; or Cubic Yards

T89

Methane Reforming Furnace

S03
S04

Waste Pile
Surface Impoundment

Cubic Yards or Cubic Meters

T90

Pulping Liquor Recovery Furnace

T91

Combustion Device Used in the Recovery of Sulfur
Values from Spent Sulfuric Acid

S05

Drip Pad

T92

Halogen Acid Furnaces

S06

Containment Building
Storage

Gallons; Liters; Cubic Meters; Hectares; or
Cubic Yards
Cubic Yards or Cubic Meters

T93

Other Industrial Furnaces Listed in 40 CFR 260.10

S99

Other Storage

T94

Containment
Building Treatment

T01

Tank Treatment

Gallons Per Day; Liters Per Day

T02

Surface Impoundment

Gallons Per Day; Liters Per Day

T03

Incinerator

Short Tons Per Hour; Metric Tons Per Hour;
Gallons Per Hour; Liters Per Hour; BTUs Per
Hour; Pounds Per Hour; Short Tons Per Day;
Kilograms Per Hour; Gallons Per Day; Metric
Tons Per Hour; or Million BTU Per Hour

X01

Open
Burning/Open
Detonation

Any Unit of Measure Listed
Below

X02

Mechanical
Processing

Short Tons Per Hour; Metric
Tons Per Hour; Short Tons
Per Day; Metric Tons Per
Day; Pounds Per Hour;
Kilograms Per Hour;
Gallons Per Hour; Liters Per
Hour; or Gallons Per Day

X03

Thermal Unit

Gallons Per Day; Liters Per
Day; Pounds Per Hour;
Short Tons Per Hour;
Kilograms Per Hour; Metric
Tons Per Day; Metric Tons
Per Hour; Short Tons Per
Day; BTU Per Hour; or
Million BTU Per Hour

Gallons; Liters; Cubic Meters; or Cubic Yards

Any Unit of Measure Listed Below
Treatment

T04

T80

Other Treatment

Boiler

Cubic Yards; Cubic Meters;
Short Tons Per Hour;
Gallons Per Hour; Liters Per
Hour; BTU Per Hour;
Pounds Per Hour; Short
Tons Per Day; Kilograms
Per Hour; Metric Tons Per
Day; Gallons Per Day; Liters
Per Day; Metric Tons Per
Hour; or Million BTU Per
Hour
Miscellaneous (Subpart X)

Gallons Per Day; Liters Per Day; Pounds Per
Hour; Short Tons Per Hour; Kilograms Per
Hour; Metric Tons Per Day; Short Tons Per
Day; BTUs Per Hour; Gallons Per Day; Liters
Per Hour; or Million BTU Per Hour

Gallons; Liters; Gallons Per Hour; Liters Per
Hour; BTUs Per Hour; or Million BTU Per Hour

X04

Unit of Measure
Unit of Measure Code
Gallons ................................................. G
Gallons Per Hour ................................. E
Gallons Per Day ................................... U
Liters ..................................................... L
Liters Per Hour ..................................... H
Liters Per Day ...................................... V

Cubic Yards; Cubic Meters;
Acre-feet; Hectare-meter;
Gallons; or Liters
Any Unit of Measure Listed
X99
Other Subpart X
Below
Unit of Measure
Unit of
Unit of Measure
Unit of Measure Code
Measure Code
Short Tons Per Hour ................................ D
Cubic Yards .........................................
Short Tons Per Day .................................. N
Cubic Meters ........................................
Metric Tons Per Hour .............................. W
Acres ....................................................
Metric Tons Per Day ................................. S
Acre-feet ...............................................
Pounds Per Hour ...................................... J
Hectares ...............................................
Kilograms Per Hour.................................. X
Hectare-meter ......................................
Million BTU Per Hour ............................... X
BTU Per Hour .......................................

Geologic
Repository

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

7. Process Codes and Design Capacities (Continued)
EXAMPLE FOR COMPLETING Item 7 (shown in line number X-1 below): A facility has a storage tank, which can hold 533.788 gallons.
Line
Number

A. Process
Code
(From list above)

B. PROCESS DESIGN CAPACITY
(1) Amount (Specify)

(2) Unit of Measure

533.788

C. Process Total
Number of Units

For Official Use Only

001

1
2
3
4
5
6
7
8
9
1

Note: If you need to list more than 13 process codes, attach an additional sheet(s) with the information in the same format as above.
Number the line sequentially, taking into account any lines that will be used for “other” process (i.e., D99, S99, T04, and X99) in Item 8.
8. Other Processes (Follow instructions from Item 7 for D99, S99, T04, and X99 process codes)
Line
Number
(Enter #s in
sequence
with Item 7)

B. PROCESS DESIGN CAPACITY
A. Process Code
(From list above)

(1) Amount (Specify)

(2) Unit of
Measure

100.00

C. Process Total
Number of Units

001

For Official Use Only

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

9. Description of Hazardous Wastes - Enter Information in the Sections on Form Page 5
A.

EPA HAZARDOUS WASTE NUMBER – Enter the four-digit number from 40 CFR, Part 261 Subpart D of each listed hazardous waste you will
handle. For hazardous wastes which are not listed in 40 CFR, Part 261 Subpart D, enter the four-digit number(s) from 40 CFR Part 261, Subpart
C that describes the characteristics and/or the toxic contaminants of those hazardous wastes.

B. ESTIMATED ANNUAL QUANTITY – For each listed waste entered in Item 9.A, estimate the quantity of that waste that will be
handled on an annual basis. For each characteristic or toxic contaminant entered in Item 9.A, estimate the total annual
quantity of all the non-listed waste(s) that will be handled which possess that characteristic or contaminant.
C. UNIT OF MEASURE – For each quantity entered in Item 9.B, enter the unit of measure code. Units of measure which must be
used and the appropriate codes are:
ENGLISH UNIT OF MEASURE

CODE

METRIC UNIT OF
MEASURE

CODE

POUNDS

KILOGRAMS

TONS

METRIC TONS

If facility records use any other unit of measure for quantity, the units of measure must be converted into one of the required
units of measure, taking into account the appropriate density or specific gravity of the waste.
D. PROCESSES
1.

PROCESS CODES:
For listed hazardous waste: For each listed hazardous waste entered in Item 9.A, select the code(s) from the list of
process codes contained in Items 7.A and 8.A on page 3 to indicate all the processes that will be used to store, treat,
and/or dispose of all listed hazardous wastes.
For non-listed waste: For each characteristic or toxic contaminant entered in Item 9.A, select the code(s) from the list of
process codes contained in Items 7.A and 8.A on page 3 to indicate all the processes that will be used to store, treat,
and/or dispose of all the non-listed hazardous wastes that possess that characteristic or toxic contaminant.
NOTE: THREE SPACES ARE PROVIDED FOR ENTERING PROCESS CODES. IF MORE ARE NEEDED:
1.
2.
3.

Enter the first two as described above.
Enter “000” in the extreme right box of Item 9.D(1).
Use additional sheet, enter line number from previous sheet, and enter additional code(s) in Item 9.E.

PROCESS DESCRIPTION: If code is not listed for a process that will be used, describe the process in Item 9.D(2) or in
Item 9.E(2).
NOTE: HAZARDOUS WASTES DESCRIBED BY MORE THAN ONE EPA HAZARDOUS WASTE NUMBER – Hazardous
wastes that can be described by more than one EPA Hazardous Waste Number shall be described on the form as follows:
1.

2.
3.

Select one of the EPA Hazardous Waste Numbers and enter it in Item 9.A. On the same line complete Items 9.B, 9.C,
and 9.D by estimating the total annual quantity of the waste and describing all the processes to be used to store,
treat, and/or dispose of the waste.
In Item 9.A of the next line enter the other EPA Hazardous Waste Number that can be used to describe the waste. In
Item 9.D.2 on that line enter “included with above” and make no other entries on that line.
Repeat step 2 for each EPA Hazardous Waste Number that can be used to describe the hazardous waste.

EXAMPLE FOR COMPLETING Item 9 (shown in line numbers X-1, X-2, X-3, and X-4 below) – A facility will treat and dispose of an
estimated 900 pounds per year of chrome shavings from leather tanning and finishing operations. In addition, the facility will treat
and dispose of three non-listed wastes. Two wastes are corrosive only and there will be an estimated 200 pounds per year of each
waste. The other waste is corrosive and ignitable and there will be an estimated 100 pounds per year of that waste. Treatment will
be in an incinerator and disposal will be in a landfill.
Line
Number

EPA Hazardous
Waste No.
(Enter code)

B. Estimated
Annual
Qty of
Waste

(Enter code)

D. PROCESSES

C. Unit of
Measure

(1) PROCESS CODES (Enter Code)

900

400

100

(2) PROCESS DESCRIPTION
(If code is not entered in 9.D(1))

Included With Above

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

9. Description of Hazardous Wastes (Continued. Use additional sheet(s) as necessary; number pages as 5a, etc.)
Line Number

A. EPA Hazardous
Waste No.
(Enter code)

B. Estimated
Annual
Qty of
Waste

D. PROCESSES

C. Unit of
Measure

(1) PROCESS CODES (Enter Code)

(Enter code)

1
2
3
4
5
6
7
8
9
1

(2) PROCESS DESCRIPTION
(If code is not entered in 9.D(1))

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

9. Description of Hazardous Wastes (Continued. Use additional sheet(s) as necessary; number pages as 5a, etc.)
Line Number

A. EPA Hazardous
Waste No.
(Enter code)

B. Estimated
Annual
Qty of
Waste

D. PROCESSES

C. Unit of
Measure

(1) PROCESS CODES (Enter Code)

(Enter code)

(2) PROCESS DESCRIPTION
(If code is not entered in 9.D.1)

EPA ID Number

OMB#: 2050-0024; Expires xx/xx/xxxx

10. Map
Attach to this application a topographical map, or other equivalent map, of the area extending to at least one mile beyond property
boundaries. The map must show the outline of the facility, the location of each of its existing intake and discharge structures, each of its
hazardous waste treatment, storage, or disposal facilities, and each well where it injects fluids underground. Include all spring, rivers, and
other surface water bodies in this map area. See instructions for precise requirements.
11. Facility Drawing
All existing facilities must include a scale drawing of the facility (see instructions for more detail).
12. Photographs
All existing facilities must include photographs (aerial or ground-level) that clearly delineate all existing structures; existing storage,
treatment, and disposal areas; and sites of future storage, treatment, or disposal areas (see instructions for more detail).
13. Comments

File Type	application/pdf
File Title	Microsoft Word - RCRA Hazardous Waste Part A Permit Application FINAL.doc
Author	PVYAS
File Modified	2011-08-09
File Created	2011-08-09