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HomeMy WebLinkAbout8954 ALD983166455 127 04-19-2021 CORR SNB 8700-12 — Dr) ,i154 4I n lzov PWaU Anot of Mae In the unshaded areas only AMU Form M°°91 Me sal Phase.roe,b the ADEM Ib ADFe IMa OnM 'uh.ar00,12`NofffcalloA Notification of Regulated F.. anon n1 �b1P III ADEM ompsreq Se,m. SNP Waste Activity�w...,Won, squesrad here Is f the by law,e 0010 or the Resource censervauwr and R¢doveryAnd. Alabama Department of Environmental Management I. Notification Cis"(Check appfifoasb box and entarlD number,Nkrlown.) Facil 's EPA ID Number ❑ Initial � Annual ❑I•w m'other ALD983166455 Notification Notification l^• �^^•i If. Operating Name of Facility Include tMatehany and Vedix,site name Nelson Brothers, LLC Operating Name of Facility Continued Nelson Brothers- Parrish Facility III. Change of Facility Name? O No Yes © (IfYes.emerpreviousoameof FaciMybelow.) IV. Location of Facility Ph sical atltlress rat P.O.Box or Route Numbep street 550 Old Baltimore Road City or Town I State Zip Code Parrish AL 35580 _ V. Geo re hic Location(See Inshucaons) Method Latitude Longitude F 3 3 727669 N 0 8 7 273045 W County Name Walker VI. FacilityContest fPsmonbb mntec dm ardingwes we tiesstsim) Name Firs Las Terry Newton Job Title Phone Number Aree Code am Numbed Director Safety and Compliance 205 802 5344 Contact Email Address(Opfione9 TNewton Nelbro.com VII. Facility Mailing Address See Instructions street or P.O.Box 820 Shades Creek Parkway, Suite 2000 City or Town State I Zip Code Birmingham I AL 35209 _ VIII.Deaari tion of Facility Processes see hrshoctlons for NAICS Code luakas) A. Facility Process In the space provided below.describe each of the processes at gout facility that produce Regulated Wastes. 1. Manufacture of Specialty Chemicals 2. Laboratory for Quality Control of Products 3. 4. 5. B. 14AICS Cedes: Enter Me North American Industry Classification system(NAICS)Code of the overall production,distribution,or"mice adMily of ur site. ANo, roves an additional NAICS Cad"that III We the tilt indusmal processes that era used. Pdma Z 3 4 5 325998 ADEM Form 8700-12 M9 812019 Conafwed on Next Page Please mint orWoe in the unshaded areas onlyn.ea rag.n.o-a Na aav IX. Ownershl (See inatrucgona A. Legal Name of Facility Nelson Brothers, LLC B. Name of Facility's Legal Owner Email Address Nelson Brothers, LLC Street,P.O.Box or Route Number 820 Shades Creek Parkway, Suite 2000 City or Town I State I Zhg Code Birmingham AL 35209 _ Phone Number(Area Code and Number) c.tand Dasher e.ol.rNar change or ownm Data cnane•a T e T TYM Inaicabr Monts Da rear 205 _ 802 _ 5344 P P P Yes in ✓ No F. Name of Facility's On-Site Operator Email Address Same As Above Street.P.O.Box or Route Number City or Town State Zi Coda Phone Number(Area Code and Number) at G. Name of Facility's Parent Company Same As Above Street,P.O.Box or Route Number City or Town Istate Zi Code Phone Number(Area Code and Number) change of owner Data changed Indlcrtor Month De rear Ext Yea No H. Name of Facility's Property Owner Same As Above Street P.O.Box or Route Number City or Town State Zi Cade Phone Number(Area Code and Number) oh.ng.or Owner Data changed Indicator Month Da Year _ _ ExL Yea F D No Facili 's EPA ID Number ADEM Form 8700-12 M5 812018 ALD983166455 (Continued on Next Page) Page 2 Plea"Print Or WooIn the unshaded areas onl ]eFM I—aced."a..1. X. Certification Status Note: Pursuant to ADEM Admin.Code chap.335-1-6,all Notification Forms submitted to the Department must include the appropriate certification fee in order to be complete. Durino at least 1 month of the next 12 months,th s facility will onerate andlor me main (Check all that a A. Hazardous Waste Activities(Attach Schedule A) C. Univamal Waste Activities(Attach Schedule C) 1. ❑✓ Large Quantity Generator>2,2001bYmonlh 1. ❑ Universal Waste Transporter (>1,000 kglmonth) 2. ❑ Large Quantity Handler>11,0201bs (>5,000 kg) 2. ❑Small Quantity Generator between 221 and 2.199 Its/month 3, Small Quantity Handler g 1,020Ibe (s 6,000 kg) (between 101 and 09 kglmonth) 4. ❑ Universal Waste Destination Facility 3. FIVery,Small Quantity Generator 5 220 Ibslmenth (. ❑Are you notifying under ADEM Admin.Code 100 kglmenm) D. (Nee:Hoasenowvanwawnis evemq unaera3slaz-.o1f4)pv1.) r.33S141-.03(22)ihat you will begin managing,are 4. ❑Nat a generator(Schedule A not required for this option) managing,or will slop managing hazardous secondary material under ADEM Admin.Code is.335-14-2-.01(4)(a) S. ❑Transponedrransfer Facility (23)8(24)?byes,you must fill out the addendum. fi.®Treatment Facility-Combustion E.❑Episodic Generation-Are you notifying under 7. Treatment Faalily-Other than Combustion ADEM Admin.Code r.3361d-3-.139 Please see instruchons. You may only be required to submit the S. ❑ Storage Facility addendum. 9. ❑Disposal Facility FfqoAre you an LOG notifying of consolidating VSQG mardous waste under ADEM Admin.Code r. B. Used Oil Activities,(Attach Schedule S) 143-.01(7)(f)9 Ryes.you must fit)out the addendum. G. Pharmaceutical Activities 1.❑✓ Generator L 29 gallonalmonin) 1. Operating under Subpart P for the management of 2. ❑TransponerTransfer Facility hazardous waste pharmaceuticals. Mark only one. 3. ❑ Processor/Re-refiner a.❑Heallhwrefaciiily 4. ❑ Fuel Marketer b.❑Reverse Distributor y.❑Withdrawing from operating under Subpart P. You 5. ❑ Bumer meyonly hutidnewifyou am a heehhcam facti)ty that is no bogs,an LOG or SQG Any ADEM Forrn 8700-12 submitted without all appropriate assets schedules and certification fees will not be processed. XI. Certification 1 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 mere are significant penalties for submitting false information, Including the possibility of fine and Imprisonment for knowing violations. Signature_ Name and Official Title(Type or Pffnt) Date Signed .�� 3 . Ter,-( D. Nc-io„ / XII.Comments pass Processed IMga[IY IMe ONy) Mail completed form,a check or money order for all a ro appropriate cenification Alabama Department of Environmental Management Ph Land Division F lass, and all necessary schedules and attachments fo.' P.O.Boa 301463 Montgomery,AL 36130-1463 ADEM Form 8700-12 MS 812019 Facili 's EPA ID Number Page 3 AL 3166455 91wa in Na unlutl u oral ADEM Fam 87WI2 M 58n019 Please rater to Me ,e ADEM Form 9700-12 for ADEM Use ores) ADEM Form a7e012 , cle "°^ F0n° Schedule A ,ore'l liens before pletlio Nis requested Ir here isinforma mQby aw Certification of Hazardous here iz.f the R by law I§auto of me Resource CO^s.A '^°Re Waste Management Recoveryvery Actct). I. Type of Hazardous Waste Activi (Mak'X'm the appropnateboxes:See Instructions) �X A.Hazardous Waste Generator C.Treatment,Storage,Disposal Facility(at Facility)tt ❑X 1. 2,2001bs(1,000 kg)per month or more fLOG) 1:1 1.Facilities subject to Permit 2. 221 to 2,199 Ibs(101-999 kg)per month (SOG) a.Opemtirg Units [:] c.Post Closure Care 3. 2201bs(100 kg)per month or less (VSQG) 11 It.SWMU CA 13 d.Other(Speady) 4.United States Importer of Hazardous Waste 2.Permit Exempt Treatment(subject 0 ADEM wri fication) B.Hazardous Waste Transporter/Tr infer Facility Tt El a.WWTU/ENU d.Generator Evaporation 1.Commercial Transporter parrim hi wastes son others) b.Recycling Unit e.Generator Physical Proses in ..Air it.Water G.TEW f.Other(SpecM) It.Wil e.Other (Spedfy) D.Hazardous Waste Fuel Activity tt D.Highway 1.Blender Marketing to Burner 2.Self Transporter/Own Wash op y) 2.Other Marketers 3.Transfer Facility 3.Boiler and/or Industrial Furnace i1a.Loaded trucks [:] a.Smelter Deferral ❑ b.Small Quantity Exemption ii b.OH-loaded containers E.Recycling Activities(Specify) F-1 c.Bulk Transfer between vehicles tt NOTE:A permit maybe required for his activity, Contact 334 271-7730forrrlominformadon. Il. Hazardous Waste Generation A. Waste Description In the spare provided/at the trims of,epulated weslelypWeypenereNdwaerbed byyvur ,Froor,Aeach wkWi nal sheets as necessary. Types of Waste Generated Estimated Yearly Generation in lox 1. Scrubber Tank Sludge Bottoms (DO02) 15,040 2. Titration Solvents (0001, F002, F003, F005) 1,100 3. 4. B. Characteristics of Nonlisted Hazardous Wastes.(Mm 'X in the boxes cmresporepi gW the cheractansfics oform isree haramovs wastes your Facility handles:See. 335-14.2-.030)-(5).Additional spaces are available on the Supplemental page iryou need to list more heramous waste numbers) 1.Ignitable 2.Corrosive 3.Reactive 4.Toxicity (D00❑1) (DDaL (DOOJf Cl,ara❑cterieac D 'Lill 9 ecllk EPq M1eD Ou4 waste numOelle foDr rate Toai[i1 cM1eracletl9MCDContaminantz I I C. Liste Hazardous Wastes. ises rs 335-14-2-.04 - 93 Attach the Su it, tat ha rry!to lut mom hazai� waste mimbars F002 F003 F005 6 9 10 11 12 13 14 15 i6 17 18 19 20 21 22 23 24 ADEM Form 8700-12 M5 812019 Facilit 's EPA ID Number Pagel (Continued on Next Page) ALD963166455 Please print or Woein the unshaded areas only aoea I.—erall as ermu Auer Fo':mr eioaii ADEM Form 8700-12 (a MEW u..omn Namkaa°" Farm Schedule B oo ehe . Woondng this req roan. h..i. "t ed by lee hereie of thetladme Certification of Used Oil e Resource conservationand Management Recnvayam. I. a of Used Oil Management Activity (See Instructions �X A. Used Oil Generator/Collector ❑ C.Off-Specification Used Oil Fuel Burner �X 1.On-site Generation Only ❑ 1.Burns Only Off-Specification Used Oil Generated Do not count used oil when calculating hazardous waste generator status. On-Site ❑ 2.Do-it-yourself Collection Center(i.e.,from off-site source) 2. Indicate Type(s)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 ❑ 13.Used Oil Fuel Marketer 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 Specifications ❑ 2,Operates a Transfer Facility ❑ 3.Burns Only Used Oil Generated On-line as On-S,xnoficafion Fuel [ E.Used Oil Processorr8e-refiner tt NOTE:A ermRisre uiredforthis activily. Contact 334 270-5637 for more information 11. Used Oil Generation During a typical year,this facility collects/generates 25,000 of Used Oil. Notably in nods III. Used Oil Fuel Marketer During a typical year,this facility markets N/A of Used 011. uenli in oumds IV. Used Oil Burner During a typical year,this facility burns WA of Used Oil. N-anfiryinpowde) V. Used Oil Transporter During a typical year,this facility transports N/A of Used Oil. ardd M ands V1. Used Oil ProcessorlRe-refiner During a typical year,this facility processes/re-refines N/A of Used Oil. Nyintruty in wrdss 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 ADEM Admin. Code chap. 335-1-6. Comments: ADEM Form 8700-12 M5812019 Facility's EPA ID Numher Pagel AL13 83166455