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Home My WebLink AboutDEQ-CFW_00026175Hazardous Waste Section File Room Document Transmittal Sheet M Your Name: EPA ID: Facility Name: Document Group: Document Type: Description: Date of Doc: Author of Doc: MEL DEAVER N C D 0 4 7 3 6 8 6 4 2 El. DUPONT FAYETTEVILLE WORKS General (G) Hazardous Waste Report (HWR) 2/8/2012 ELLIS MCGAUGHY - ---- -------- - - - - -- - --- - - -------- --- -- - - - -- -- --------- ------- --- - ------ - ----------- File Room Use Only ----------------------- NCD047368642 Month Day Year Date Recieved by File Room: Scanner's Initial4b�� Date Scanned: 2- 2(//-z- DEQ-CFW-00026175 ENTERED MAY a SEND COMPLETED United States Environmental Protection FORM TO: The Appropriate State or EPA RCRA SUBTITLE C SITE IDENTIFICATION FORM (2011) Regional Office 1. Reason for Reason for Submittal: Submittal To provide an Initial Notification (first time submifting site identification information / to obtain an EPA ID MARK ALL BOX(ES) number for this location) THAT APPLY To provide Subsequent Notification of Regulated Waste Activity (to update site identification information). El As a component of a First RCRA Hazardous Waste Part A Permit Application. As a component of a Revised RCRA Hazardous Waste Part A Permit Application (Amendment # As a component of the Hazardous Waste Report. (if marked, see sub -bullet below) KI Site was a TSID facility and/or generator of >1,000 kg of hazardous waste, >1 kg of acute hazardous waste, or >1 00 kg of acute hazardous waste spill cleanup in one or more months of the report year (or State equivalent LQG regulations) 2. Site EPA ID Number EPA ID Number: NCD047368642 3. Site Name Name: E.I.DLIPONT FAYETTEVILLE WORKS 4. Site Location Street Ad ress: 22828 INC HIGHWAY 87 W Information City, Town, or Village: TAR HEEL County: NCO17 State: INC Country us Zip Code: 28392 5. Site Land Type Private r_1 County [I District 0 Federal 0 Indian El Municipal State 13 Other the Site 7. Site Mailing Street or P. 0. Box: 22828 INC HIGHWAY 87 W Address City, town, or Village: FAYETTEVILLE State: NC Country: us Zip Code: 28306 8. Site Contact First Name: MICHAEL MI: E Last Name: JOHNSON Person Title: ENVIRONMENTAL MANAGER Street or P. 0. Box: 22828 NC HIGHWAY 87 W City, Town, or Village: FAYETTEVILLE State: INC Country: us Zip Code: 28306 Email MICHAEL.E.JOHNSON@USA.DUPONT.COM Phone: 9106781155 Ext: Fax: 9. Operator and Legal A. Name of Site's Owner: E.I.DLIPONT &CO. Date Became 01/01/1969 Owner of the Site Owner: Type: Private 0 County El District 11 Federal 0 Indian El Municipal C1 State El Other Street or P. 0. Box: 22828 NC HIGHWAY 87 W City, Town, or Village: FAYETTEVILLE Phone State: NC Country- us Zip Code: 28306 B. Name of Site's Operator: E.I.DUPONT & CO. Date Became Operator: 01/01/1969 Type: IR Private El County 11 District 13 Federal El Indian 0 Municipal El State 0 Other _j OEQ-CFVV_00026176 142'Alm-W, M.7,7,TR,1 L-�� 10. Type of Regulated Waste Activity Mark "Yes" or "No" for all current activities (as of the date submitting the form); complete any additional boxes as instructed. A. Hazardous Waste Activities; Complete all parts 1-7. Y5& NO 1. Generator of Hazardous Waste If Yes, choose only one of the following - a, b, or c. IR a. LQG: Generates, in any calendar month, 1,000 kg/mo (2,200 lbs./mo.) or more of hazardous waste; or Generates, in any calendar month, or accumulates at any time, more than 1 kg/mo (2.2 lbs./mo) of acute hazardous waste; or Generates, in any calendar month, or accumulates at any time, more than 100 kg/mo (220 lbs./mo) of acute hazardous spill cleanup El b. SQG:. 100 to 1,000 kg/mo (220 - 2,200 lbs./mo.) of non -acute hazardous waste; or Oc.CESQG: Less than 100 kg/mo (220 lbs./mo.) of non -acute hazardous waste If "Yes" above, indicate other generator activities. Y13 N134 d Short -Term Generator (generate from a short-term or onetime event and not from on -going processes). If "Yes", provide an explanation in the Comments YO 11115d e. United States Importer of Hazardous Waste YO NU'f. Mixed Waste (hazardous and radioactive) Generator B. Universal Waste Activities; Complete all parts 1-2. Y10 141. Large Quantity Handier of Universal Waste (accumulate 5,000 kg or more) [refer to your State regulations to determine what is regulated]. Indicate types of universal waste managed at your site. If "Yes", mark all boxes that apply: a. Batteries F1 b. Pesticides c. Mercury containing equipment d. Lamps e. Other (specify) 0 f. Other (specify) 0 g. Other (specify) 0 Y0 W34 2. Destination Facility for Universal Waste Note: A hazardous waste permit may be required for this R YO NU 2. Transporter of Hazardous Waste If Yes, mark all that apply. 0 a. Transporter 13 b. Transfer Facility (at your site) Yid NO 3. Treater, Storer, or Disposer of Hazardous Waste (at your site) Note: A hazardous waste permit is required for this activity. YO N55 4. Recycler of Hazardous Waste (at your site) TONIJ4 5. Exempt Boiler and/or Industrial Furnace If Yes, mark each that applies. El a. Small Quantity On -site Burner Exemption b. Smelting, Melting, and Refining Furnace Exemption YO N6. Underground Injection Control YO N� 7. Receives Hazardous Waste from Off -site C. Used Oil Activities; Complete all parts 1-4. YO N5d 1. Used Oil Transporter If Yes, mark each that applies. 13 a. Transporter 0 b. Transfer Facility YO N5d 2. Used Oil Processor and/or Re -refiner If Yes, mark each that applies. 0 a. Processor El b. Re -refiner YEI 14154 3. Off -Specification Used Oil Burner YO K4. 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 DEQ-CFW-00026177 D. Eligible Academic Entities with Laboratories -Notification for opting into or withdrawing from managing laboratory hazardous wastes pursuant to 40 CFR Part 262 Subpart K You must check with your State to determine if you are eligible to manage laboratory hazardous wastes pursuant to 40 CFR Part 262 Subpart K CI 1. Opting into or currently operating under 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories See the item -by -item instructions for definitions of types of eligible academic entities. Mark all that apply: a. College or University b. Teaching Hospital that is owned by or has a formal written affiliation agreement with a college or university c. Non-profit Institute that is owned by or has a formal written affiliation agreement with a college or university 0 2. Withdrawing from 40 CFR Part 262 Subpart K for the management of hazardous wastes in laboratories 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, Ul 12). Use an additional page if more spaces are needed. D001, D002, D003, D004, D006, D007, D008, D009, D01 1, D01 8, D028, D029, D035, F001, F002, F003, F005,' 0002, U01 2, U031, U080, U159, U220, U239 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. DEQ-CFW-00026178 EPA ID Number: 12. Notification of Hazardous Secondary Material (HSM) Activity YCI Nix, Are you notifying under 40 CFR 260.42 that you will begin managing, are managing, or will stop managing hazardous secondary If "Yes", you must fill out the Addendum to the Site Identification Form: Notification for Managing Hazardous Secondary Material. 13. Comments REVISED WASTE CODES 14. Certification I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Signature of Operator, Owner, or an Name and Official Title (type or print) Date Signed Authorized Representative (mm/ddlyyyy) OEQ-CFVV_00026179