Form 8700-23 RCRA Hazardous Waste Part A Permit Application

RCRA Hazardous Waste Permit Application and Modification, Part A (Renewal)

Draft2009PartA

RCRA Hazardous Waste Permit Application and Modification, Part A - State Agencies

OMB: 2050-0034

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United States
Environmental Protection
Agency
date of publication

FOR REFERENCE WHEN REVIEWING
THE INFORMATION COLLECTION REQUEST

This version is an update for the RCRA Hazardous Waste Part A
Permit Application. There are some minor changes from the March 2009
version in the reporting requirements, instructions, and forms.

R
RCRA Hazardous
Waste Part
A A Permit
Application
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T
Instructions and Forms
EPA Form 8700-23

(OMB# 2050-0034; Expires - date as approved from OMB)

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Office of Solid Waste
5301 W
Washington, DC 20460

RCRA Hazardous Waste Part A Permit Application
Instructions and Forms

The Resource Conservation and Recovery Act (RCRA) Sections 3005 requires EPA to establish permitting
requirements applicable to hazardous waste treatment, storage, and disposal facilities (TSDFs). The operator
and owner 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 an first
permit application or for a revised permit application. Operators and owners 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 this 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 time frame available for
EPA to process permit applications, and to define 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 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 operators and owners.
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 25 hours. The public reporting burden for Revised Part A Permit Applications is expected to be
13 hours. This reporting burden includes time for reviewing instructions, searching existing data sources,
gathering the data, completing the application, and recordkeeping.
Send comments on the Agency's need for this information, the accuracy of the provided burden estimates,
and any suggested methods for minimizing respondent burden, including through the use of automated
collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency
(2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number 2050-0034
in any correspondence. Do not send the completed forms to this address.
Also, you can send comments to the Office of Information and Regulatory Affairs, Office of Management
and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk Officer for EPA. Please include the
and OMB Control Number 2050-0034 in any correspondence.

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RCRA Hazardous Waste
Part A Permit Application
Instructions and Forms

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.

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RCRA Hazardous Waste Part A Permit Application
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). We
have listed the addresses and phone numbers of the contacts in each State who can answer your questions
and help you understand the Federal and State requirements that apply to you; these are in the Contact
List found on the Internet at:
http://www.epa.gov/epaoswer/hazwaste/data/form8700/forms.htm#links

Click on the document under the section:
Where can I obtain assistance with the RCRA Hazardous Waste Part A Permit
Application requirements and the RCRA Subtitle C Site Identification Form? Where
should I send my completed form?

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 Internet Page. This allows users to find answers to
commonly asked questions that cover a wide range of RCRA issues and topics. Find this at:
http://waste.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 this at:
http://www.epa.gov/rcraonline/

•

EPA Internet page for RCRA regulations. Find this at:
http://www.epa.gov/docs/epacfr40/chapt-I.info/

•

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. There are several Centers listed; you
may find one for your business. 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 Internet links to Federal, State,
local, and other compliance assistance providers to find the tools you need. Visit the
Clearinghouse at:

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http://www.epa.gov/clearinghouse
•

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

•

Your Trade Association

RCRA Hazardous Waste Part A Permit Application

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. In order to obtain interim status, existing facilities must complete a two-step
process.

First, you must submit a Notification of Regulated Waste Activity [EPA Form 8700-12]. You will need
to submit this form in order to obtain an EPA Identification Number. If you have not notified EPA of
your regulated waste activity, see the information on the Internet at:
http://www.epa.gov/epaoswer/hazwaste/data/form8700/forms.htm#links

Click on the document under the section:
Where can I obtain assistance with the Notification of Regulated Waste Activity
requirements and the RCRA Subtitle C Site Identification Form? Where should
I send my completed form?
Second, you must submit a RCRA Hazardous Waste Part A Permit Application using the forms included
in this booklet [EPA Form 8700-23]. If you do not file a Notification of Regulated Waste Activity and
complete the Part A Permit Application by the deadlines specified in Section 3.D of these instructions,
you will be required by law to cease 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.

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.

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RCRA Hazardous Waste Part A Permit Application
Most State governments are authorized by EPA to administer hazardous waste management programs in
lieu of the Federal RCRA program. If so, 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
[EPA Form 8700-23]. The instructions also provide general information for completing a RCRA Part B
Permit Application. After reading the instructions, you may have questions regarding the RCRA
hazardous waste permit application process. We have listed the addresses and phone numbers of the
contacts in each State who can answer your questions and help you understand the Federal and State
requirements that apply to you; these are in the contact list found on the Internet at:

http://www.epa.gov/epaoswer/hazwaste/data/form8700/forms.htm#links

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
Section 3.D 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 a first submission. Sections 3
and 4 of this booklet contain information and item-by-item instructions for completing both the Site ID
Form and the Hazardous Waste Permit Information Form.

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 a revised
submission.

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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 Sections
3 and 4 of this booklet. These sections also contain information and item-by-item instructions for
completing both the Site ID Form and the Hazardous Waste Permit Information Form.

RCRA Hazardous Waste Part A Permit Application

Contents of This Booklet
Following is a list of the sections contained in this booklet and the information covered in those sections.
Section 1. Who Must File a RCRA Hazardous Waste Permit Application?
Section 2. How Do I Know if I Handle a Regulated Hazardous Waste?

Section 3. How to File a RCRA Hazardous Waste Permit Application (Information on How, Where, and
When to File a RCRA Hazardous Waste Part A Permit Application; and Information on
Where You Can Get Information, Obtain Forms, and Send Your Completed Forms)
Section 4. Specific Instructions for Completing the RCRA Hazardous Waste Part A Permit Application
[EPA Form 8700-23]. You must complete the two forms included in this booklet: the RCRA
Subtitle C Site Identification Form and the Hazardous Waste Permit Information Form. The
blank forms are provided at the end of this booklet.

1. 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.

2. 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.

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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:
a.

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 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
(2) 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.
d.

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.

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

Generators who accumulate their own hazardous waste on-site for less than 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

D
c.

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

3. 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 [EPA Form 8700-23] 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.

A. 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 submission. At any given time, the first
submission and any subsequent revised submissions represent the Part A Permit Application for your
facility.

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B. 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:

D
1.

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?

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.

C. Where Should I Send My Completed Permit Application?

If the State in which the facility is located administers the hazardous waste permit program under which
you need a permit, you should submit the RCRA hazardous waste permit application (Part A and Part B)
to the appropriate State agency.

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We have listed the addresses and phone numbers of the contacts in each State who can answer your

RCRA Hazardous Waste Part A Permit Application
questions and help you understand the Federal and State requirements that apply to you; these are in the
Contact List found on the Internet at:
http://www.epa.gov/epaoswer/hazwaste/data/form8700/forms.htm#links
Click on the document under the section:
Where can I obtain assistance with the RCRA Hazardous Waste Part A Permit
Application requirements and the RCRA Subtitle C Site Identification Form? Where
should I send my completed form?

Otherwise, the RCRA hazardous waste permit application (Part A and Part B) should be submitted to the
EPA Regional Office whose Region includes the State in which the facility is located. See the EPA
Regional Office contacts at the end of the Contact List noted above.

D. 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.

E. 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:
1.

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 Applications 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.

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RCRA Hazardous Waste Part A Permit Application
5.

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.
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.

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.

4. Specific Instructions for Completing the RCRA
Hazardous Waste Part A Permit Application
[EPA Form 8700-23]
First Part A Submission

The Item-by-item Instructions for Filling Out the RCRA Subtitle C Site Identification Form identify
the items on this form that must be completed. For a first Part A submission, the Item-by-item
Instructions for Filling Out the Hazardous Waste Permit Information Form identify the 13 items on
this form that must be completed in their entirety. You must submit both forms for a complete RCRA
Hazardous Waste Part A Permit Application.
After you have submitted the Site Identification Form once, your State may allow you to attach a
copy of your most recently submitted form. If so, circle items numbers for which any information has

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RCRA Hazardous Waste Part A Permit Application
changed. Then enter the new information (also circle the item numbers) on the Site Identification Form
included in this booklet and provide the required signatures in Item 13 - Certification.
Note: Be sure to use your most recently submitted form; it may have been submitted for a
Subsequent Notification of Regulated Waste Activity, the Hazardous Waste Report, or a previous RCRA
Hazardous Waste Part A Permit Application.

Revised Part A Submission

The Item-by-item Instructions for Filling Out the RCRA Subtitle C Site Identification Form identify
the items on this form that must be completed. For a revised Part A submission, you only need to
complete Items 1, 2, and any other items on the Hazardous Waste Permit Information Form for which you
have new information or changes; be sure to mark the other items as not applicable - NA. See the Itemby-item Instructions for Filling Out the Hazardous Waste Permit Information Form for each item.
You must submit both forms for a complete RCRA Hazardous Waste Part A Permit Application.

Note: If the owner or operator of this facility has changed since the facility last submitted the Part A
Permit Application, you must submit a Revised Part A Application.
After you have submitted the Site Identification Form once, your State may allow you to attach a
copy of your most recently submitted form. If so, circle item numbers for which any information has
changed. Then enter the new information (also circle the item numbers) on the Site Identification Form
included in this booklet and provide the required signatures in Item 13 - Certification.
Note: Be sure to use your most recently submitted form; it may have been submitted for a
Subsequent Notification of Regulated Waste Activity, the Hazardous Waste Report, or a previous RCRA
Hazardous Waste Part A Permit Application.

F
T
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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:

D
#
#
#
#
#

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

You must complete all the items on the Site ID Form.

PURPOSE OF THIS FORM
For the purposes of the RCRA Hazardous Waste Part A Permit Application and the Hazardous Waste
Report, you must also complete the Site ID Form to update your site information. For purposes of the
Notification of Regulated Waste Activity, the Site ID Form provides site-specific information about a
facility for obtaining an EPA Identification Number and submitting Initial Notification of Regulated
Waste Activity. For purposes of a Subsequent Notification of Regulated Waste Activity, the Site ID
Form provides updated site-specific information for those items that have changed at your site and
verifies the information for those items that remain unchanged.

HOW TO FILL OUT THIS FORM

Please complete all of the Site ID Form items.

Item 1 - your reason for submitting the form

Item 2 - your site’s EPA Identification Number

Item 3 - the name of your site

Item 4 - the physical location of your site

Item 5 - the land type of your site

Item 6 - the North American Industry Classification System (NAICS) code(s) for your site

Item 7 - the mailing address for your site

Item 8 - name and phone number of a contact person at your site

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Site ID Form
(Continued)

Item 9 - names of the operator and the legal owner(s) of your site

Item 10 - your site’s regulated waste activities (enter all that apply)

Item 11 - the description of hazardous waste if you handle any

Item 12 - additional comments on Items 1 through 11

Item 13 - certification that the information you provided throughout the form is truthful,
accurate and complete

Type or print in black ink all items except the Signature box in Item 13. Enter your site’s EPA ID
Number in the top left-hand corner on the second and third pages of the form; for Initial Notification for
this site, leave the EPA Identification Number blank. Use Item 12 - 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 ID Number in the top left-hand corner of each sheet.

A
F
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13

Site ID Form
(Continued)

ITEM-BY-ITEM INSTRUCTIONS
Item 1 -- Reason for Submittal:
Reason for Submittal: Place an “X” in the appropriate box to indicate whether this form is your
Initial Notification of Regulated Waste Activity (to obtain an EPA Identification Number); a
Subsequent Notification of Regulated Waste Activity (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.

D
#

For Initial Notification of Regulated Waste Activity to provide site identification
information and obtain an EPA Identification Number for hazardous waste, universal
waste, or used oil activities. 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.

For Subsequent Notification of Regulated Waste Activity to update site identification
information. 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.).

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.

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.

As a component of the Hazardous Waste Report. 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.

Not for use

NOTE

You will report your current Hazardous Waste Generator status as of the date of
submitting the Site Identification Form in Item 10.A.1 - Generator of Hazardous Waste.
Your status may have changed since your last submission (unless this is an Initial
Notification of Regulated Waste Activity).

Site ID Form
(Continued)
Item 2 -- Site EPA ID Number:
Provide your EPA Identification Number in Item 2 for this site. Also, be sure to include your EPA
Identification Number at the top of pages 2 and 3 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.

Items 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.

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, Indian (see Indian Country below), Municipal, State, or Other. If your site’s
Land Type could be described as Municipal and as County, as District, or as Indian, do not mark
Municipal. Instead choose the other appropriate code; you may explain this in Item 12 - Comments.

Indian Country - Land governed by an entity on the list of Federally recognized American Indian
tribes and Alaskan Native entities at: http://www.epa.gov/edr/fdetribal.pdf
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. Use the six (6) digit code (most specific description) if available for
your business; if not, use the five (5) digit code; do not enter any four (4) or less
digit code.

Boxes B - D

List other NAICS codes that describe the primary business production processes
for your site. Use the 6 or 5 digit codes that apply to your site.

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. A list of the acceptable codes is on the Internet at http://www.epa.gov/epaoswer/hazwaste/data/br03/forms.htm
You can obtain additional information about NAICS codes from the Internet at http://www.census.gov/epcd/naics02/

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15

Site ID Form
(Continued)
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.
Item 8 -- Site Contact Person:
Enter the name, business telephone number, and extension of the individual who should be contacted
regarding the information submitted in the Site ID Form. You may also enter an email address; if you
want to be contacted by fax, enter that number in Item 12 - Comments. 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 12. An example would be a contact specifically for the Hazardous Waste Report.
Note that the Facility Permit Contact information for the RCRA Hazardous Waste Part A Permit
Application is entered in Items 1 and 2 of the Hazardous Waste Permit Information Form.

D
NOTE

It is assumed that the Site Contact Person will receive mail at the Site Mailing Address
provided in Item 7. If this is not the case, please provide the mailing address for the Site
Contact Person in Item 12 - Comments.

Item 9 -- Operator and Legal Owner of the Site:

This section should be used to indicate all the operators and owners of this site. 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, not an individual. See Person.

Owner - The person who owns a RCRA site or part of a RCRA site. Note: This includes the
property owner. 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.
A.

Name of Site’s Operator: Provide the name of your site’s operator.

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, 2009, enter 04/22/2009.

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Site ID Form
(Continued)
Operator Type: Place an “X” in the box that best describes the operator type of your site. Select
only one type: Private, County, District, Federal, Indian (see below), Municipal, State, or Other. If
your site’s Operator Type could be described as Municipal and as County, as District, or as
Indian, do not mark Municipal. Instead choose the other appropriate code; you may explain this in
Item 12 - Comments.
Indian - A member of an entity on the list of Federally recognized American Indian tribes
and Alaskan Native entities at: http://www.epa.gov/edr/fdetribal.pdf

Use the Comments section in Item 12 to list any additional operators, their names, the dates they
became operators, operator type, and mailing address. If necessary, attach a separate sheet of
paper.

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.

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, 2009, enter 04/22/2009.
Owner Type: Place an “X” in the box that best describes the owner type of your site. Select only
one type: Private, County, District, Federal, Indian (see below), Municipal, State, or Other. If your
site’s Owner Type could be described as Municipal and as County, as District, or as Indian, do not
mark Municipal. Instead choose the other appropriate code; you may explain this in
Item 12 - Comments.

Indian - A member of an entity on the list of Federally recognized American Indian tribes
and Alaskan Native entities at: http://www.epa.gov/edr/fdetribal.pdf

Use the Comments section in Item 12 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 owners
since your last submission of this form. If necessary, attach a separate sheet of paper.
Legal Owner Address: Please enter this information if your State requires it; see your State’s
specific instructions if any. 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.

NOTE

A subsequent notification is recommended when the operator or owner 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 operator or owner 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.

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Site ID Form
(Continued)
Item 10 -- Type of Regulated Waste Activity
Place an “X” in box “Yes” or in box “No” as appropriate for activities at this site;
complete any additional boxes as instructed.
A.

Hazardous Waste Activities: Complete all parts 1 through 6.
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.

D
NOTE
1.

Generator of Hazardous Waste: 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 non-acutely hazardous waste that is generated per calendar month. 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”, mark 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 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.

NOTE

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

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Site ID Form
(Continued)
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, more than 100 kg (220 lbs.) but less than 1,000 kg
(2,200 lbs.) of RCRA hazardous waste; and
ii) Generates, in any calendar month, or accumulates at any time, no 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.

OR, the site is a Small Quantity Generator if the site:
i)
ii)

Meets all other criteria for a Conditionally Exempt Small Quantity Generator (see
below), but
Accumulates, at any time, more than 1,000 kg (2,200 lbs.) of RCRA hazardous waste.

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) Accumulates, at any time, no more than 1,000 kg (2,200 lbs.) of RCRA hazardous
waste; and
iii) Generates, in any calendar month, or accumulates at any time, no 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 acutely 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.

In addition to the above, mark “Yes” or “No” for the other hazardous waste activities listed
below that may occur at this site. Complete 1.d and e, and 2 through 6.
d. 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.
e. 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
on pages 39, 42, and 43.

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19

Site ID Form
(Continued)
2.

Transporter of Hazardous Waste: Mark “Yes” if you transport hazardous waste within the
United States. The Federal regulations for hazardous waste transporters are found in 40 CFR
Part 263.

Treater, Storer, or Disposer of Hazardous Waste: If you treat, store, or dispose of
hazardous waste, mark “Yes”. A RCRA Hazardous Waste Permit is required for this activity.
Contact the appropriate office for your State for more information. The Federal regulations
for operators and owners of permitted treatment, storage, and disposal facilities (TSDFs) are
found in 40 CFR Parts 264, 265, 266, and 270.

D
NOTE
4.

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 both this box and Box
B.2 below.

Recycler of Hazardous Waste: If you recycle regulated hazardous wastes (recyclable
materials), mark “Yes”. The Federal regulations for operators and owners 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.
If your site, in addition to being a recycling site for hazardous waste, is a treater, storer, or
disposer of hazardous waste, mark both this box and Box A.3 above. If your site is a
destination facility for universal wastes in addition to being a recycling site for other RCRA
hazardous wastes, mark both this box and Box B.2 below.

Exempt Boiler and/or Industrial Furnace:
If you mark “Yes”, mark each that applies.

a. If 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, mark “Yes” to indicate that you qualify
for the Small Quantity On-Site Burner Exemption.
b. If 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.
6.

Underground Injection Control: If you generate, treat, store, or dispose of hazardous waste
and there is an underground injection well located at your site, mark “Yes”. The Federal
regulations for operators or owners of underground injection wells are found in 40 CFR Part
148.

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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 and C.

Site ID Form
(Continued)
B.

Universal Waste Activities: 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 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 of any universal wastes (calculated collectively) at
any time. If “Yes”, place an “X” in the appropriate box(es) to indicate the type(s) of
universal wastes you generate at your site. If your State has additional universal wastes,
indicate what they are and place an “X” in the corresponding box(es).

D
2.

NOTE

Destination Facility: Mark “Yes” if you treat, dispose of, 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.

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 both this box and
Box A.3 above. In addition, if your site recycles RCRA hazardous wastes, mark both this
box and Box A.4 above.

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 1 through 4.
1.

Used Oil Transporter: If you transport used oil and/or own or operate a used oil transfer
facility, mark “Yes” and place an “X” in the appropriate box(es) to indicate this used oil
management activity.
Used Oil Processor/Re-Refiner: If you process and/or re-refine used oil, mark “Yes” and
place an “X” in the appropriate box(es) to indicate this used oil management activity.

Off-Specification Used Oil Burner: If you burn off-specification used oil fuel, mark “Yes”
to indicate this used oil management activity.

Used Oil Fuel Marketer: Mark “Yes” if you market used oil fuel. If you market offspecification used oil directly to a burner, place an “X” in Box 4.a. If you are the first to
claim the used oil meets the used oil specification established in 40 CFR 279.11, place an
“X” in Box 4.b. If either of these boxes is marked, you also must notify (or have previously
notified) as a used oil transporter, used oil processor/re-refiner, or off-specification used oil
fuel burner, unless you are a used oil generator. (Used oil generators are not required to
notify.)

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Site ID Form
(Continued)
Item 11 -- Description of Hazardous Wastes:
Complete this item if you marked “Yes” for any activity in Item 10. A. for Initial Notification; for other
reasons in Item 1, complete this item if your State requires it. 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.

Federally Regulated Hazardous Wastes: If you handle hazardous wastes that are described in 40
CFR Part 261, enter the appropriate 4-digit code(s) in the box(es) provided.

D
NOTE

EPA Hazardous Waste Codes. If you handle more hazardous wastes than will fit under
Item 11.A., please continue listing the hazardous waste codes on an extra sheet. 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 Identification Form.

State-Regulated 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.

Item 12 -- Comments:

Use this section as needed to provide additional information for Items 1 through 11. Include the item
number and box letter (if any) for each comment you make. You may attach additional sheets if needed.
Item 13 -- Certification:

This certification must be signed by operator(s), owner(s), or authorized representative(s) of the site. 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). For the RCRA Hazardous Waste Part A
Permit Application, all operator(s) and owner(s) of the site must sign (see 40 CFR 270. 10 (b) and
270.11).

NOTE

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

T
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Instructions for Filling Out the
Hazardous Waste Permit Information Form
GENERAL INSTRUCTIONS
Please type or print, leaving only one blank box between words. Where shown, boxes are spaced at 1/4"
intervals, which accommodate elite type (12 characters per inch). When typing, hit the space bar twice
between characters. If you print, place each character in a box. 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 14 and reference the Item number
to which the additional information applies or attach a separate sheet entitled "Additional Information."

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.

ITEM-BY-ITEM INSTRUCTIONS
Item 1 - Facility Permit Contact:

Give the name and work telephone number 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 information 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 the box in Item 1.

Item 2 - Facility Permit Contact 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 Contact” in the box
in Item 2.
Item 3 - Operator Mailing Address and Telephone Number:

Enter the mailing address and telephone number for the facility operator identified in Item 9.A of the Site
ID Form.
Item 4 - Legal Owner Mailing Address and Telephone Number:

Enter the mailing address and telephone number of the legal owner of the facility identified in Item 9.B of
the Site ID Form.

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23

Permit Information Form
(Continued)
Item 5 - Facility Existence Date:
Enter the appropriate date that applies to your facility from among the following:
A. The date that hazardous waste operations at the facility commenced;
B. The date construction on the facility commenced; or
C. The date operation is expected to begin.
Item 6 - Other Environmental Permits:

D
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.

Permit Number: Give the number of each presently effective permit issued to the facility for each
program. 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 for your facility
under a particular permit program.

Description: Use the space provided for any additional information identifying or describing the
permits.

Item 7 - 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.

Item 8 - Process Codes and Design Capacities:

The information in Item 8 describes all the processes that will be used to treat, store, or dispose of
hazardous waste at the facility. The 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 8 on either the map provided for Item 11 or the
photographs provided for Item 13. Use the line number from Item 8 to indicate where the process(es) are
located. See the Form Page 2 for detailed instructions on Item 8; enter information on Form Page 3.
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.

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24

Permit Information Form
(Continued)
Item 9 - Other Processes:
Enter information in Item 9 on Form Page 3 about other processes that did not have a specific process
code listed in Item 8.A. Follow the instructions for Item 8.A on the form for other process codes (i.e.,
D99, S99, T04, and X99 process codes). Describe the other processes in 9.D.
Item 10 - Description of Hazardous Wastes:

The information in Item 10 describes all the hazardous wastes that will be treated, stored, or disposed at
the facility. In addition, all 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. See Form Page 4 for
detailed instructions on Item 10; enter information on Form Page 5 and the Additional Sheet if needed
(number as 5 a, etc.)
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 Permit submission.
Item 11 - 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 8 and 9 identified by process code and line number in
the item;

•

Each well where you inject fluids underground; and

•

All springs and surface water bodies in the area, plus all drinking water wells within 1/4 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.

Not for use

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

Permit Information Form
(Continued)
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 1-888-275-8747 or
see the USGS Internet page at:

http://store.usgs.gov/

Click on “Enter USGS Store” and search for the map for your location. You may, also, 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.

Item 12 - 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 8½" x 11" sheet of paper. The drawing should show the
following:
1. The property boundaries of the facility;

2. The areas occupied by all storage, treatment, or disposal operations that will be used during
interim status;
3. The name of each operation (e.g., multiple hearth incinerator, drum storage area, etc.);
4. Areas of past storage, treatment, or disposal operations;

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

6. The approximate dimensions of the property boundaries and all storage, treatment, and disposal
areas. Where applicable, use the process code and line number listed in Items 8 and 9 to
indicate the location of all storage, treatment, and disposal areas.
Note: New facilities do not have to complete Item 12.
Item 13 - 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 code and
line number listed in Items 8 and 9 to indicate the location of all storage, treatment, and disposal areas.
Note: New facilities do not have to complete Item 13.

Not for use

Item 14 - Comments:
Use this space for any additional comments and attach additional sheets if necessary.

RCRA Subtitle C Site Identification Form
and
Hazardous Waste Permit Information Form

Read all instructions before completing the forms.

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SEND COMPLETED

United States Environmental Protection Agency

FORM TO:
The Appropriate State or
EPA Regional Office.

1. Reason for
Submittal
(See instructions
on page 14.)

RCRA SUBTITLE C SITE IDENTIFICATION FORM
Reason for Submittal:
To provide Initial Notification of Regulated Waste Activity (to obtain an EPA ID Number for hazardous
waste, universal waste, or used oil activities)
To provide Subsequent Notification of Regulated Waste Activity (to update site identification information)

MARK ALL BOX(ES)
THAT APPLY

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

2. Site EPA ID
Number (page 15)

EPA ID Number

3. Site Name
(page 15)

Name:

4. Site Location
Information
(page 15)

Street Address:

5. Site Land Type
(page 15)
6. North American
Industry
Classification
System (NAICS)
Code(s) for the Site

I___I___I___I I___I___I___I I___I___I___I I___I___I___I

City, Town, or Village:

State:

County Name:

Zip Code:

Site Land Type:

Private

County

District

Federal

I___I___I___I___I___I___I

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

Zip Code:

First Name:

9. Operator and
Legal Owner
of the Site
(pages 16 and 17)

MI:

Phone Number:

Extension:

Last Name:
Email address:

Not for use

Name of Site's Operator:

Operator Type:

Private

County

EPA Form 8700-23 (Revised XX/XXXX)

Private

County

Date Became Operator (mm/dd/yyyy):

District

Federal

Name of Site's Legal Owner:

Owner Type:

Other

8. Site Contact
Person
(page 16)

State

I___I___I___I___I___I___I

(page 15)
7. Site Mailing
Address
(page 16)

Municipal

I___I___I___I___I___I___I
C.

Indian

Municipal

State

Other

Date Became Owner (mm/dd/yyyy):

District

Federal

Indian

Municipal

State

Other

Page 1 of 3

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EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I
9. Legal Owner
(Continued)
Address

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

10.

Zip Code:

Type of Regulated Waste Activity
Mark “Yes” or “No” for all activities; complete any additional boxes as instructed. (See instructions on pages 18 to 21.)
A. Hazardous Waste Activities
Complete all parts for 1 through 6.

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

2. Transporter of Hazardous Waste

3. Treater, Storer, or Disposer of

a. LQG: Greater than 1,000 kg/mo (2,200 lbs./mo.)
of non-acute hazardous waste; or

Hazardous Waste (at your site) Note:
A hazardous waste permit is required for
this activity.

b. SQG: 100 to 1,000 kg/mo (220 - 2,200 lbs./mo.)
of non-acute hazardous waste; or

c. CESQG: Less than 100 kg/mo (220 lbs./mo.)
of non-acute hazardous waste

4. Recycler of Hazardous Waste (at your
site)

5. Exempt Boiler and/or Industrial
Furnace
If “Yes”, mark each that applies.
a. Small Quantity On-site Burner
Exemption
b. Smelting, Melting, and Refining

In addition, indicate other generator activities.

d. United States Importer of Hazardous Waste

e. Mixed Waste (hazardous and radioactive) Generator

Furnace Exemption
Y

6. Underground Injection Control

C. Used Oil Activities
Mark all boxes that apply.

B. Universal Waste Activities
Y

1. Large Quantity Handler of Universal Waste (accumulate
5,000 kg or more) [refer to your State regulations to
determine what is regulated]. Indicate types of universal

1. Used Oil Transporter
If “Yes”, mark each that applies.
a. Transporter
b. Transfer Facility

2. Used Oil Processor and/or Re-refiner
If “Yes”, mark each that applies.

waste generated and/or accumulated at your site. If “Yes”,
mark all boxes that apply:
Generate
a. Batteries

a. Processor
b. Re-refiner

b. Pesticides
c. Thermostats
d. Lamps

f. Other (specify) ________________
g. Other (specify) ________________

3. Off-Specification Used Oil Burner

4. Used Oil Fuel Marketer
If “Yes”, mark each that applies.
a. Marketer Who Directs Shipment of
Off-Specification Used Oil to
Off-Specification Used Oil Burner
b. Marketer Who First Claims the
Used Oil Meets the Specifications

Not for use

e. Other (specify) ________________

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

EPA Form 8700-23 (Revised XX/XXXX)

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EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

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11. Description of Hazardous Wastes (See instructions on page 22.)
A. 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.

B. 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 for waste codes.

12. Comments (See instructions on page 22.)

A
F

13. 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 fine and imprisonment for knowing violations.
For the RCRA Hazardous Waste Part A Permit Application, all operator(s) and owner(s) must sign (see 40 CFR 270.10 (b) and 270.11).
(See instructions on page 22.)
Signature of operator, owner, or an
authorized representative

Not for use
Name and Official Title (type or print)

EPA Form 8700-23 (Revised XX/XXXX)

Date Signed
(mm/dd/yyyy)

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OMB #: 2050-0034 Expires XX/XX/XXXX

United States Environmental Protection Agency

HAZARDOUS WASTE PERMIT INFORMATION FORM
1. Facility Permit

First Name:

MI:

Last Name:

Contact (See
instructions on

Phone Number:

Phone Number Extension:

page 23)
2. Facility Permit

Street or P.O. Box:

Contact Mailing

Address (See

City, Town, or Village:

instructions on
page 23)

State:
Country:

3. Operator Mailing

Street or P.O. Box:

Address and
Telephone Number

State:
Country:

4. Legal Owner Mailing

City, Town, or Village:

(See instructions on
page 23)

Zip Code:

Street or P.O. Box:

Address and
Telephone Number

City, Town, or Village:

(See instructions on
page 23)

State:
Country:

5. Facility Existence

Zip Code:

A
Zip Code:

Facility Existence Date (mm/dd/yyyy):

Date (See instructions
on page 24)
6. Other Environmental Permits (See instructions on page 24)
A. Permit Type
(Enter code)

Phone Number

B. Permit Number

C. Description

Not for use

7. Nature of Business (Provide a brief description; see instructions on page 24)

EPA Form 8700-23 (Revised XX/XXXX)

Page 1 of 6

EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

8. Process Codes and Design Capacities (See instructions on page 24) - Enter information in the Sections on Form Page 3.
A. PROCESS CODE - Enter the code from the list of process codes in the table below that best describes each process to be used at the facility. Fifteen
lines are provided for entering codes. 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), enter the process information in Item 9 (including a description).
B. PROCESS DESIGN CAPACITY- For each code entered in Section 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 Section B(1), enter the code in Section 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

APPROPRIATE UNITS OF MEASURE
FOR PROCESS DESIGN CAPACITY

PROCESS
CODE

Gallons; Liters; Gallons Per Day; or Liters
Per Day

Cement Kiln
Lime Kiln
Aggregate Kiln
Phosphate Kiln
Coke Oven
Blast Furnace
Smelting, Melting, or Refining
Furnace
Titanium Dioxide
Chloride Oxidation Reactor
Methane Reforming Furnace
Pulping Liquor Recovery
Furnace
Combustion Device Used In
The Recovery Of Sulfur Values
From Spent Sulfuric Acid
Halogen Acid Furnaces
Other Industrial Furnaces
Listed In 40 CFR §260.10

D79

Disposal:
Underground Injection
Well Disposal

D80

Landfill

D81

Land Treatment

Acres or Hectares

T81
T82
T83
T84
T85
T86

D82

Ocean Disposal

Gallons Per Day or Liters Per Day

T87

D83

Surface Impoundment
Disposal

Gallons; Liters; Cubic Meters; or Cubic Yards

D99

Other Disposal

Any Unit of Measure in Code Table Below

T89
T90
T91

Acre-feet; Hectare-meter; Acres; Cubic Meters;
Hectares; Cubic Yards

S01

Container

Gallons; Liters; Cubic Meters; or Cubic Yards

S02

Tank Storage

Gallons; Liters; Cubic Meters; or Cubic Yards

S03

Waste Pile

Cubic Yards or Cubic Meters

S04

Surface Impoundment
Storage

Gallons; Liters; Cubic Meters; or Cubic Yards

S05

Drip Pad

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

S06

Containment Building
Storage

Cubic Yards or Cubic Meters

S99

Other Storage

Any Unit of Measure in Code Table Below

T88

A
T92
T93

T94

Containment Building Treatment

X01

T01

Tank Treatment

Gallons Per Day; Liters Per Day

T02

Surface Impoundment
Treatment

Gallons Per Day; Liters Per Day

T03

Incinerator

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

Other Treatment

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; Gallons Per Day;
Liters Per Hour; or Million Btu Per Hour

Boiler

UNIT OF
MEASURE

For T81-T93:
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

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):

Treatment:

T80

APPROPRIATE UNITS OF MEASURE
FOR PROCESS DESIGN CAPACITY

Treatment (continued):

Storage:

T04

PROCESS

Gallons; Liters; Gallons Per Hour; Liters Per
Hour; Btu Per Hour; or Million Btu Per Hour

UNIT OF
MEASURE CODE

Gallons.................................................
Gallons Per Hour.................................
Gallons Per Day...................................
Liters.....................................................
Liters Per Hour.....................................
Liters Per Day......................................

G
E
U
L
H
V

EPA Form 8700-23 (Revised XX/XXXX)

Any Unit of Measure in Code Table Below

X02

Open Burning/Open
Detonation
Mechanical Processing

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

X04

Geologic Repository

Cubic Yards; Cubic Meters; Acre-feet;
Hectare-meter; Gallons; or Liters

X99

Other Subpart X

Any Unit of Measure Listed Below

Not for use
UNIT OF
MEASURE

UNIT OF
MEASURE CODE

Short Tons Per Hour.............................
Metric Tons Per Hour..........................
Short Tons Per Day.............................
Metric Tons Per Day............................
Pounds Per Hour.................................
Kilograms Per Hour.............................
Million Btu Per Hour............................

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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

UNIT OF
MEASURE

UNIT OF
MEASURE CODE

Cubic Yards..........................................
Cubic Meters........................................
Acres....................................................
Acre-feet..............................................
Hectares...............................................
Hectare-meter......................................
Btu Per Hour........................................

Y
C
B
A
Q
F
I

EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

8. Process Codes and Design Capacities (Continued)
EXAMPLE FOR COMPLETING Item 8 (shown in line number X-1 below): A facility has a storage tank, which can hold 533.788 gallons.
B. PROCESS DESIGN CAPACITY
Line
Number
X

A.
Process Code
(1) Amount (Specify)

(From list above)

5
6
7
8

Number of
Units

For Official Use Only
1

.
.
.
.
.
.

Measure
. 7 8 8
.

C.
Process Total

(Enter code)

(2) Unit of

.
.
.
.
.
.

A
.

NOTE: If you need to list more than 15 process codes, attach an additional sheet(s) with the information in the same format as above. Number
the lines sequentially, taking into account any lines that will be used for “other” processes (i.e., D99, S99, T04 and X99) in Item 9.
9. Other Processes (See instructions on page 25 and follow instructions from Item 8 for D99, S99, T04 and X99 process codes)
Line
Number

B. PROCESS DESIGN CAPACITY

sequence

A.
Process Code

with Item 8)

(From list above)

(Enter #s in

(2) Unit of
Measure
(1) Amount (Specify)

(Enter code)

1 0 0 .0 0 0
.

C.
Process Total

Number of
Units

Not for use
.

EPA Form 8700-23 (Revised XX/XXXX)

Page 3 of 6

D. Description of Process
1

In-situ Vitrification

EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

10. Description of Hazardous Wastes (See instructions on page 25) - 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 Section A, estimate the quantity of that waste that will be handled on an annual
basis. For each characteristic or toxic contaminant entered in Section 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 Section 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 Section A, select the code(s) from the list of process codes contained
in Items 8A and 9A on page 3 to indicate all the processes that will be used to store, treat, and/or dispose of all the listed hazardous wastes.
For non-listed hazardous waste: For each characteristic or toxic contaminant entered in Section A, select the code(s) from the list of process
codes contained in Items 8A and 9A 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. Enter the first two as described above.
2. Enter “000" in the extreme right box of Item 10.D(1).
3. Use additional sheet, enter line number from previous sheet, and enter additional code(s) in Item 10.E.
2. PROCESS DESCRIPTION: If a code is not listed for a process that will be used, describe the process in Item 10.D(2) or in Item 10.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. Select one of the EPA Hazardous Waste Numbers and enter it in Section A. On the same line complete Sections B, C and D by estimating the
total annual quantity of the waste and describing all the processes to be used to treat, store, and/or dispose of the waste.
2. In Section A of the next line enter the other EPA Hazardous Waste Number that can be used to describe the waste. In Section D(2) on that line
enter “included with above” and make no other entries on that line.

3. Repeat step 2 for each EPA Hazardous Waste Number that can be used to describe the hazardous waste.

EXAMPLE FOR COMPLETING Item 10 (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

A.
EPA
Hazardous
Waste No.
(Enter code)

B.
Estimated
Annual
Quantity
of Waste

C.
Unit of
Measure
(Enter code)

D. PROCESSES

Not for use

(1) PROCESS CODES (Enter code)

900

400

100

EPA Form 8700-23 (Revised XX/XXXX)

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

Included With Above

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EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

10. Description of Hazardous Wastes (Continued. Use the Additional Sheet(s) as necessary; number pages as 5 a, etc.)

Line
Number

A.
EPA
Hazardous
Waste No.
(Enter code)

B.
Estimated
Annual
Quantity
of Waste

D. PROCESSES
C.
Unit of
Measure
(Enter code)

(1) PROCESS CODES (Enter code)

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

1
2
3
4
5
6
7
8
9
1

D
R

EPA Form 8700-23 (Revised XX/XXXX)

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EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

10. Description of Hazardous Wastes (Continued. Use this Additional Sheet(s) as necessary; number as 5 a, etc.)

Line
Number
4

A.
EPA
Hazardous
Waste No.
(Enter code)

B.
Estimated
Annual
Quantity
of Waste

E. PROCESSES
C.
Unit of
Measure
(Enter code)

(1) PROCESS CODES (Enter code)

(2) PROCESS DESCRIPTION
(If a code is not entered in E(1))

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EPA Form 8700-23 (Revised XX/XXXX)

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EPA ID NO: I___I___I___I I___I___I___I I___I___I___I I___I___I___I

OMB #: 2050-0034 Expires XX/XX/XXXX

11. Map (See instructions on pages 25 and 26)
Attach to this application a topographic 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 and proposed intake and discharge structures, each of its hazardous
waste treatment, storage, or disposal facilities, and each well where it injects fluids underground. Include all springs, rivers and other surface
water bodies in this map area. See instructions for precise requirements.
12. Facility Drawing (See instructions on page 26)
All existing facilities must include a scale drawing of the facility (see instructions for more detail).
13. Photographs (See instructions on page 26)
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).
14. Comments (See instructions on page 26)

R
A
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File Type	application/pdf
File Title	F:\peggy's documents\Draft_2006_RCRA_Hazardous_Waste_Part_A_Permit_Application.wpd
Author	ccunning
File Modified	2009-01-15
File Created	2005-11-17