HomeMy WebLinkAbout48112 ALR000060186 043 03-02-2020 CORR ALC 8700-12 Please Drint or type in the unshaded areas onlyADEM ram emu-tsarormz
Please refer to the ADEM (tar ADEMUw Only)
Form Instm2 Notification Notification of Regulated
Prom ,nsfreq u baea ADEM
pled, Uia rnmn. Waste Activity
Information Issue
here is
required by lew(§auto of the
Remume Gonservafbn an0
Recovery Act). Alabama Department of Environmental Management
I. Notification Class(Check appropriate box and enter ID number,if known.)
Facility's EPA ID Number
AhIt000060186
❑ Initial Notification ❑ Annual Notification
II.Operating Name of Facility(Include company and specific site name)
Stericyele Specialty waste Solutiow
Operating Name of Facility Continue
III.Change of Facility Name? El No ❑Yes(If Yes, enterprevious name ofFacilitybelow).
IV.Location of Facility(Physical address no P.O.Box or Route Number)
Street
14871 AL Highway 91
City or Town State Zip Code
Hanceville AL 35077
V. Geographic Location (See Instructions)
Methotl Latitude Longitude
O 33.9491497 -86.8635422
County Name
Cullman
VI. Facility Contact(Person to be contacted regarding waste activities at site)
Name First Last
BNCa 1
Job Title Phone Number Area Code and Number
Facility Manage 256-352-1163 Ext.
Contact Email Address(Optional)
BN .Smffi@Staieycle.com
VII. Facility Mailing Address (See instructions)
Street or P.O. Box
500Medco Road
City or Town State ZI Code
Birmingham AL 35217
Vill. Description of Facility Processes (See instructions for NAICS Code listings)
A. Facility Process In the space provided below,describe each of the processes at your facility that produce Regulated Wastes.
1.
2.
3.
4.
5.
B. NAICS Codes: Enter the six-digit North American Industry Classification System(NAICS)Code of the overall production,distribution,
or service activity of your site.Also, provide any additional NAICS Codes that describe the specific industrial
processes that are used.
Primary 2 3 4 5
562111 562112
ADEM Form 8700-12(8104) Continued on Next Page
Please print or Wee in the unshaded areas only POEM Po,m MO-1211=3
IX. Ownership (see instructions)
A. Legal Name of Facility
Stcdcycic Spceialty Was¢Solutions
B. Name of Facility's Legal Owner
Action Resources,Inc.
Street,P.O. Box or Route Number
40 County Road 517
City or Town State Zip Code
Hsnooville AL 35077
Phone Number(Anse Code and Number) C.Land D.Owner E.Operator Change of Owner Date Changed
Type Type Type Indicator
205-352-1160 Private Private Private Yee❑ 0 No
F. Name of Facility's On-Site Operator
Stericycle Specialty Waste Solutions
Street,P.O. Box or Route Number
14871 AL Highway 91
City or Town State Zip Code
Hanceville AL 35077
Phone Number(Area Code and Number)
205-841-17N Ext.
G. Name of Facility's Parent Company
Stericyde Specialty Waste Solutions
Street,P.O. Box or Route Number
2355 Waukegan Road
City or Town State Zip Code
Bunnoekbam IL 60015
Phone Number(Area Code and Number) Change of Owner Date Changed
Indicator
847-367-1160 Ext. Yes ❑ 17-1 No
H. Name of Facility's Property Owner
Act,.Resnwcea,Inc.
Street,P.O. Box or Route Number
40 County Road 517
City or Town State Zip Code
Hanceville AL 35077
Phone N umber(Area Code and Number) Change of Owner Date Changed
Indicator
205-352-1160 Ext. Yes❑ E]No
Facility's EPA ID Number ADEM Form 8700-12(8104)
ALROOoo6o186 (Continued on Next Page) Page 2
Please print or type in the unshaded areas only
X. Certification Status
Note: Pursuant to Rules 335-1-6 of the ADEM Administrative Code,all Notification Forms submitted to the Department must
Include the appropriate certification fee in order to be complete.
Durina at least 2 month of the year,this facility will operate and/or maintain: (Check all that agp/v)
A. Hazardous Waste Activities (Attach Schedule A) B. Used Oil Activities (Attach Schedule B)
1. ❑ Large Quantity Generator t—2,200 Ibs/month 1. ❑ Generator(t 25 gallons/month)
(a 1,000 kg/month) 2. 0 Transporter/Transfer Facility
2. ❑ Small Quantity Generator between 221 and 2,199 lbs/month 3. ❑ Processor/Re-refiner
(between 101 and 999 kg/month)
3. 0 Conditionally Exempt Generator<—220 Ibs/month 4. ❑ Fuel Marketer
(s 100 kg/month) 5. ❑ Burner
(Note:Household generation is exempt under335-14-2-01f4)(b)l.)
4. M Transporterfl-ransfer Facility C. Universal Waste Activities (Attach Schedule C)
5. ❑Treatment Facility—Combustion 1. El Universal Waste Transporter
6. ❑ Treatment Facility—Other than Combustion 2. ❑ Large Quantity Handler t 11,020 Ibs
(a 5,000 kg)
7. ❑ Storage Facility S. ❑ Disposal Facility 3. ❑ Small Quantity Handler< 11,020 Ibs
(< 5,000 kg)
Any ADEM Form 8700-12 submitted without all appropriate wastes schedules and"Alreation fees will not be processed.
XI. 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 property 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.
Signature Name and Official Title(Type or PdnQ Data Signed
T.J.Mc Caastland Permit Compkance Marom M512020
XI. Comments
Date Processed
Imroma,i uea ongl
Mail completed form,a check or money order for all appropriate certification Alabama Department of Environmental Management
fees, and all necessary schedules and attachments to: Permits 8 services Division
P.O.Box 301463
Montgomery,AL 36130-1463
ADEM Form 8700-12(8/04) Facility's EPA ID Number
Page 3 ALR000060186
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XIII. Additional Information Sheet
Facilit 's EPA ID Number ADEM Form 8700-12(8/04)
ALR000060186 Page 4
Please Print or type In the unshaded areas only
Please refer to the ADEM (for ADEM Use Only)
Form 870o-12 Notification ' ADEM Form 8700-12
co Instructions before Schedule A
completing
leting this form.
Information requested here
Is required bylaw(§3010 of Certification of Hazardous
the Resource Conservation
and Recovery Act). - Waste Management
I.Type of Hazardous Waste Activity (Mark 0P in the appropriate boxes;See Instructions)
Q A. Hazardous Waste Generator ❑ C.Treatment,Storage, Disposal Facility(at Facility)tt
❑ 1. 2,2001be (1,000 kg)per month or more(LQG) ❑ 1. Facilities subject to Permit
❑2. 221 to 2,1991bs(101-999 kg)per month (BOG) Ela. Operating Units Elc. Post closure Care
H 3. 220 Ibs(100 kg) per month or less(CESQG) ❑ b. SWMU CA ❑d. Other(Specify)
❑4. United States Importer of Hazardous Waste ❑ 2. Permit Exempt Treatment(subject to ADEM verification)
0 B. Hazardous Waste Transporter/Transfer Facility tt ❑ a. W WTU/ENU ❑ J. Generator Evaporation
❑ 1. Commercial Transporter(received wastes from others) ❑ b. Recycling Unit❑ e. Generator Physical Processing
❑a.Air ❑d.Water ❑ c.TETF❑ f. Other(Specify)
❑ b. Rail ❑e. Other(Specify) ❑ D. Hazardous Waste Fuel Activity tt
❑c. Highway ❑ 1. Blender Marketing to Burner
❑ 2. Self Transporter(Own Waste Only) ❑ 2. Other Marketers
Q Transfer Facility ❑ 3. Boiler and/or Industrial Furnace
Q a. Loaded trucks ❑ a. Smelter Deferral ❑ b. Small Quantity Exemption
Q b. Off-loaded containers ❑ E. Recycling Activities (Specify)
0 c. Bulk Transfer between vehicles
tt Note:A permit may be required for this activity, Contact 334 271-7730 for more information.
II. Hazardous Waste Generation
A Waste Description In Me}rece pmvitle4lbl fha type.0 ,.I.Naf waste fypKalrygenerefetla een.Ey your..c,Adx etld 0iol.4reeN es neronary
Types of Waste Generated Estimated Yearly Generation in this.
1 Waste that from spill 25
2.
3.
4.
B. Characteristics of Nonlisted Hazardous Wastes.(nxadr x'm(ne oozes mrrespondmyrotne cnarecrensncs of nonlistednazaroous wasresrour Facnny
handles;See 335-14-2-03(1)—(5).Addrtional spaces are available on me Supplemental page❑you need ro 6st more harardous waste numbers)
0 1. Ignitable(D001) ❑ 2.Corrosive(D002) ❑ 3. Reactive(D003) ❑4.Toxicity Characteristic
(List specific EPA hazardous waste numbers)for the Toxicity characteristic contaminants))
C. Listed Hazardous Wastes See 335-14-2-.04 2 —(4));Attach the Supplemental page M you need to list more hi urdous waste numbers
ADEM Form 8700-12 A(8I04) Facility's EPA ID Number
Page 1 7
5
000060186
It. Hazardous Waste Generation (continued)
III. Hazardous Waste Transporterrrransfer Facility
147MON
During a typical year,this facility transportsitransfers of Hazardous Waste.
(quantity in pounds)
IV.Treatment, Storage, Disposal Facility (at Facility)
During a typical year,this facility treats of Hazardous Waste.
(quantity in pounds)
During a typical year,this facility stores of Hazardous Waste.
(quantity in pounds)
During a typical year,this facility disposes of Hazardous Waste.
(quantity in pounds)
V. Hazardous Waste Fuel Activity
During a typical year,this facility markets of Hazardous Waste.
(quantity in pounds)
During a typical year,this facility combusts of Hazardous Waste.
(quantity in pounds)
VI. Recycling Activity
During a typical year,this facility recycles of Hazardous Waste.
(quantity in pounds)
Note: In order for this schedule to be accepted by ADEM, it must be attached to a completed Notification of Regulated
Waste Activity,ADEM Form 8700-12, and must include the appropriate certification fees,as required by 335-1-6.
Comments:
This facility is a 10- ,transfer fedliR'and is not expected m generate hazard..waste.
Facility's EPA ID Number ADEM Form 8700-12 A(8I04)
ALR000060186 Page 2
II. Hazardous Waste Generator(Supplemental)
D. Listed and NOnlisted Hazardous Waste Codes.(See 335-14-2-.04(2)—(4)and 33514-2-.03(1)—(5))If you need to list more hazardous waste
numbers,attach copies of this page as necessary
ADEM Form 8700-12 A(8/04) Facility's EPA ID Number
Page ALR000060186
II. Hazardous Waste Generator(Supplemental)
D. Listed and NOnlisted Hazardous Waste Codes.(See 335-14-2-.04(2)—(4)and 33514-2-.03(1)—(5))If you need to list more hazardous waste
numbers,attach copies of this page as necessary
ADEM Form 8700-12 A(8104) Facility's EPA ID Number
Page 111,1,11,86
Please Drint or nice In the unshadetl areas only
Please refer to Me ADEM (for ADEM Use Only)
Fore 8700-12 Notification ADEM Form 8700-12
Form Instructions before Schedule B
completing this form.
Information requested
here is required by law(§Resource Certification of Used Oil
3010 of the Resource
ervation
Reco eryAct). and Management
I.Type of Used Oil Management Activity(See Instructions)
❑A. Used Oil GeneralorlCollector ❑ C. Off-Specification used Oil Burner
❑ 1. On-site Generation Only ❑ 1. Burns Only Off-Specification Used Oil
Generated On-Site
❑ 2. Do-it-yourself Collection Center(i.e., from off-site source) ❑ 2. Indicate Types)of Devices
❑ 3. Collection Center(i.e.,from off-site source) ❑ a. Utility Boiler ❑ c. Industrial Furnace
❑ 4. Aggregation Point(i.e.,from off-site source) ❑ b. Industrial Boiler
❑ B. Used Oil Fuel Marketer Q D. Used Oil Transporter tt
❑ 1. Directs Shipment of Used Oil to Off-Specification Burner ❑ 1. Only For Used Oil Generated On-site
❑ 2. First Claims Used Oil Meets Specification Fuel Q 2. Operates a Transfer Facility
❑ 3. burns Only Used Oil Generated On-site as ❑ E. Used Oil ProcessoriRe-refiner
On-Specification Fuel
ft NOTE:A permit is required for this activity,Contact 334 271-7758 for more information
It. Used Oil Generation
During a typical year,this facility collects/generates of Used Oil.
(quantity inpounds)
III. Used Oil Fuel Marketer
During a typical year,this facility markets of Used Oil.
(quantity inpounds)
IV. Used Oil Burner
During a typical year,this facility burns of Used Oil.
(quantity inpounds)
V. Used Oil Transporter
300000
During a typical year,this facility transports of Used oil.
(quantity inpounds)
VI. Used Oil ProcessorlRer-refiner
During a typical year,this facility processeslre-refines of Used Oil.
(quantity inpounds)
Note: In order for this schedule to be accepted by ADEM, it must be attached to a completed Notification of Regulated
Waste Activity,ADEM Form 8700-12, and must include the appropriate certification fees,as required by 335-1-6.
Comments:
ADEM Form 8700-12 B (8104) Facility's EPA ID Number
Page 1 7
1
R000011
86
Please Drint or nice In the unshaded areas only
Please refer to Me ADEM (for ADEM Use Only)
Forth 8700-12 Notification ADEM Form 8700-12
Form tang Instructions before Schedule C
completing this form. Schedule
here Inform
requested
here isf the bylaw(e Certification of Universal
Cc nuerwdlon of the Resource
Recovery Act). and Waste Management
I.Type of Used Universal Waste Activity(See Instructions)
❑ A. Universal Waste Transporter
❑ B. Large Quantity Handler Estimated Yearly Amount(in Ibs)
Accumulated Generated
1. Battery(ies)
2. Pesticide(s)
3. Thermostat(s)
4. Lamps
5. Other(specify)
❑ C.Small Quantity Handler Estimated Yearly Amount(in Ibs)
Accumulated Generated
1. Battery(ies)
2. Pesticide(s)
3. Thermostat(s)
4. Lamps
5. Other(specify)
It. Universal Waste Transporter
930000
During a typical year,this facility transports of Universal Waste.
(quantity in pounds)
III. Universal Waste Handler
During a typical year,this facility handles of Universal Waste.
(quantity in pounds)
Note: In order for this schedule to be accepted by ADEM, it must be attached to a completed Notification of
Regulated Waste Activity, ADEM Form 8700-12, and must include the appropriate certification fees, as required
by 335-1-6.
Comments:
ADEM Form 8700-12 C(8I04) Facility's EPA ID Number
Pagel A11000060186