DEQ-CFW_00045374

Hazardous Waste section
File Room Document Transmittal Sheet
Ma
Your Name:
GERALDINE GABON
EPA ID-
NCD047368642
Facility Name:
E.I,DUPONT FAYI-F-11 VILLE WORKS
Document Group:
General (G)
Document]"�j)e:
Notification 8700 (8700)
Description:
Date of Doc:
1/ 1, 9 / "2 0 14
Author of Doc:
ELIAS .1-1. MCGAUGHY
File Room Use Oul
Date Recieved by File Room:
Date Scanned-
NCD047368642
Mooth Day YwT
'Scanner's Initials:
Ai
Y,
DEQ-CFW-00045374

6.
�<n
SEND COMPLETED
United States Environmental Protection Agency K'
FORM TO,
lie A u pr E P ;;
RCRA SUBTITLE C SITE IDENTIFICATION FORM P)
t. reason for
Reason for Submlttal:
Submittal
�. „
provide an Initial Notfic;ation ,'first iirne subrnit;iro site identificatiC £ info�'atiCFi3 , irf �'� I �'f�
MARK Al BI0X e'E'
THAT APPLY
a„ �� 30 :Qcaticr.
� �r provide &ii sepuen^ �33sificat'on +�r Regt 1e +'� brdasYe Ai,f.raihy ten update ��t� i��e�°itieat.L3f. 3nYoer�� iio`<}.
El �a a comporient of a First €-€C;RA Y-lazardca s Waste Pare r P rn;t Appirat.on:
_t^ 1 A.'a` a GOi3?' S.,riefjt of a Revised ^l„t• A Hazak .,()us V'j jste Paff ? Pen -nit t"�N>niit iJi•IOf7 �;�I`•l�'ilti£"it1%t ref .;e.
i As a compor_Int of the Hazardous 'd` ante Report. (If marked, see sub-bu€iet below";
Site :"das as TSD iaC lity and -tor ger%erator of >1,000 "'m rit hazardous waste, a.< kg of acute hazardous waste,
or ?100 kg, of c,;c tle 7azardous waste spil'> cleanup in One nr f'iore months of the r'up,r; year (fir State
equivalent LQG regui ^Yions3
Z Site CPS lD Plumber
EPA ID Number: NCID047368642
3, Site Name
Nafne. E.I.CL.IPON ' F>faYET.rEVIL:w 'O�ORKS
's, L
4. Site Location
Street Admas: 22828 NC HIGHWAY 87 Vv
information
City, Torn. or Village: TAR HEEL County- Nf. 017
Mate. NC Country us zip Cosier 28392
s: Site Land Type
Pr:aate County Distno, : Federal Indian ? ivlunictpa1 3Yats 0 Other
6. NIAICS Codegs;
A, 32512 B. 326113 C. 325211 i�. 3259E8
for the Site
T. Site Mailing
Street or P. Oa Box: 22828 NC HIGHWAY 87 W
Address
City, Town, or Vlilage; FA.YETTEVILL
_
Mate. 1� C Countryz us Zip Coyle: 28306
-------------
8, site Contact
First Name: MICHAEL Mir E Last Marne. JOHN ON
Person
Titl®; 1"NV I'VIG ;
Street orP. C: Sops 22828 NC HIGHWAY 87lp1
City, Town, or Tillages FAYETT: VILLE
Stator: NC Countrw us dip Co€ia' 2t�3 i6
Email: €stilCl•iAEL.E.JOHNS [e-mail]
Phone: [phone] Ext. Fax[phone]
A. Name of Site's owner. E.I.DUPONT & CO Date Became 61/01: 1g69
9. operator and Legal
Owner:
owner of the Site
Type: Pn� fe < County 3 �� Dist`ict ? Frdc3r�i N EnCi�,1 Municipal Stan Other
Street or P. C: Box: 22828 NC HIGHWAY 87 W
City, Town, or W1afge' FAY ETT VLLE Phone [phone]
Stata. NC country: U6 Zip Code: 28306
Date Became 31r'G1t1969
S. Marne of Site's € pasator: :'.F�IJP Fri F ETTE'i4LLE "i1 RK5
Operator;
a`9'12e: i^i'€cte,8 ..,F �wounYy �..:.::..'iJtnC�: .,„... ^ i3Jti;i" '. .,.V:> Indian `mm�--Murtiapai L- 3t, fe �..t'.: tl`3Pr.
EPA, Form 3700-12,
8700-13 AM, 3 i 00-23 (Revised 09/2011), Submit Date: 02119/2014 Page 1 of 4
DEQ-CFW 00045375

EPA ID Number: NCD047368642
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.
YIX NO 1. Generator of Hazardous Waste
YO NIX
5. Transporter of Hazardous Waste
If Yes, choose only one of the following - a, b, or c.
If Yes, mark all that apply.
a. LQG: Generates, in any calendar month, 1,000 kg/mo
11 a. Transporter
(2,200 lbs./mo.) or more of hazardous waste; or
Generates, in any calendar month, or
0 b. Transfer Facility (at your site)
accumulates at any time, more than 1 kg/mo
(2.2 lbs./mo) of acute hazardous waste; or
Y5d NR
B. Treater, Storer, or Disposer of Hazardous
Generates, in any calendar month, or
Waste (at your site)
accumulates at any time, more than 100 kg/mo
Note: A hazardous waste permit is required for this
(220 lbs./mo) of acute hazardous spill cleanup
activity.
material.
11 b. SQG:. 100 to 1,000 kg/mo (220 - 2,200 lbs./mo.)
YO N5d
7. Recycier of Hazardous Waste (at your site)
of non -acute hazardous waste; or
c. CESQG: Less than 100 kg/mo (220 lbs./mo,) of
Y0 NIM
8. Exempt Boiler and/or Industrial Furnace
non -acute hazardous waste
If Yes, mark each that applies.
If "Yes" above, indicate other generator activities.
a. Small Quantity On -site Burner Exemption
YONib 2 Short -Term Generator (generate from a short-term or
b. Smelting, Melting, and Refining Furnace
onetime event and not from on -going processes). If
Exemption
"Yes", provide an explanation in the Comments
YEI NM
9. Underground Injection Control
YO NIX 3. United States Importer of Hazardous Waste
YO Nrg 4. Mixed Waste (hazardous and radioactive) Generator
YON15d
10. Receives Hazardous Waste from Off -site
B. Universal Waste Activities; Complete all parts 1-2.
C. Used Oil
Activities; Complete all parts 14.
YO N5d 1. Large Quantity Handier of Universal Waste
Yrl N5d
1. Used Oil Transporter
(accumulate 5,000 kg or more) [refer to your State
If Yes, mark each that applies.
regulations to determine what is regulated]. Indicate
types of universal waste managed at your site.
a. Transporter
If "Yes", mark all boxes that apply:
0 b. Transfer Facility
YEI N14
2. Used Oil Processor and/or Re -refiner
a. Batteries$
If Yes, mark each that applies.
b. Pesticides
0 a. Processor
c. Mercury containing equipment
0 b. Re -refiner
d. Lamps Cl
YO NO
3. Off -Specification Used Oil Burner
e. Other (specify)
YO NN
4. Used Oil Fuel Marketer
f. Other (specify)
If Yes, mark each that applies.
g. Other (specify) 0
0 a. Marketer Who Directs Shipment of
Off -Specification Used Oil to Off -Specification
YO NW 2. Destination Facility for Universal Waste
Used Oil Burner
Note: A hazardous waste permit may be required for this
0 b. Marketer Who First Claims the Used Oil Meets
activity.
-------------- -
the Specifications
EPA Form 8700-12, 8700-13 A/B, 8700-23 (Revised 09/2011), Submit Date: 02/19/2014 Page 2 of 4
DEQ-CFW-00045376

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
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:
0 a. College or University
El b. Teaching Hospital that is owned by or has a formal written affiliation agreement with a college or university
0 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.
�'Iease list the waste codes of the Federal hazardous wastes handled at your site. List them in the order they are presented in the
.-egulations (e.g., D001, D003, F007, Ul 12). Use an additional page if more spaces are needed.
D001, D002, D003, D004, 0006, D007, D008, D009, 101 1, D01 8, D022, D028, D029, D035, F001, F002, F003, F005, U002,
U003, U012, U019, U031, U080, U154, U1159, U220, U239
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.
EPA Form 8700-12, 8700-13 A/B, 8700-23 (Revised 09/2011), Submit Date: 02/19/2014 Page 3 of 4
DEQ-CFW-00045377

EPA ID Number: NCD047368642
12, Notification of Hazardous Secondary Material (H M) Activity
Y171 MAre you nozftying under 40 c: R 260,42 that you will begin managing, are managing, or wli -op rnanaginrq hazardous secondary
material -under 40 CFR- 261.2(a)(2)ifi), 40 CFR 261.4(a)(23), ,24), or;25;?
if 'Yes", you must fill out the Addendum to the A;e ldenfifwaticn Form: NotifiS:atioin for Managing Hazardous Se'conrla.ry PJ`afedal.
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13, Comments
—REVISED NAICS CODES, REVISED WASTE CODES'
14, Certification
i certify under penalty of iaw that this document and all attachments were prepared under n,y d1irection or supervision in ar-cordance +,vifh a
systern designed to assure. that L'<,13a fied pe'r5t3r3ne pm erly gather and ewnluat ;he r"fo Nation submitted, `used on my Mq'Wrj7 of the
person or persons who manage ;he system, or those persons direitiy 'esponsibie for gathering the information, the inforrnatE;ort submitted is,
to they best of my knowledge ;and belief, true, accurate. and complete, % am aware. that here are significant penalf;es for subm ff3ng false
inf;: yna ion, lncluaing the .pf)ssblity of fire and imprisonment fcr knowing violations,
Signature of Operator, Owner, or an Name and Official Title (type or print) Date Signed
Authorized Representative (rr m/ddfyyyy)
ELLIS H. fvtCGAUGHY. PLANT MANAGER 0:2.: t9J:1.r014
WA Form 8700-12, 8700-13 A1B, 8700-23 (Revised 09/2011), Submit Date: 0 /19/ 014 Page 4 of 4
DEQ-CFW 00045378