solid waste handling and disposal
in multistory buildings and hospitals
         VOLUME I
         summary, conclusi

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    This report has been reviewed by the U.S. Environmental
   Protection Agency and approved for publication. Approval
does not signify that the contents necessarily reflect the views
   and policies of the U.S. Environmental Protection Agency,
nor does mention of commercial products constitute endorse-
   ment or recommendation for use by the U.S. Government.

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                                                    . '1
                          solid waste handling and disposal
                       in multistory buildings and hospitals
                  VOLUME I summary, conclusions, and recommendations
                           This final report (SW-34d. 1) on work performed
                             under solid waste management demonstration
                                grant no. EC-00164 to the County of Los
                             Angeles was written by ESCO/GREENLEAF
                           and is reproduced as received from the grantee.
VOLUMES II AND IV   Observations of Local  Practices  (SW-34d.2) and Selec-
                        tion and Design  of Solid  Waste Systems (SW-34d.4)
                        are  available  from the  Department  of  Commerce,
                        National  Technical  Information  Service,  Springfield,
                        Virginia.

         VOLUME III   Research on Systems Development  (SW-34d.3) is  avail-
                        able under separate cover from the  U.S. Government
                        Printing Office, Washington,  D.C.
                    Environ—  - T ->.Action Agency
                    Library,
                    1 North V~u'-  -'•>-  *•'-'-'-•'''   ^
                    Chicago,  Illinois  6060o
                      U.S. ENVIRONMENTAL PROTECTION AGENCY

                                                               1972

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                                                  An environmental protection publication in
                                                the solid waste management series (SW-34d.l).

                                                For sale by the Superintendent of Documents,
                                                            U.S. Government Printing Office,
                                                           Washington, D.C. 20401  Price $2.
,-,,,,,_„„„,„                                                       Stock Number 5502-0082
ENVIRONMENTAL PROTECTION AGEKCi

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                               FOREWORD

      In the past century of national growth, reflected in increased
      population, expanding municipalities, and greater industrial and
      commercial enterprises, this Nation responded with nonconcern
      to a concurrent physical deterioration of the country.  The first
      comprehensive water pollution control legislation was not enacted
      until 1956; the first comprehensive air pollution legislation, in
      1963:  Finally,  six years  ago,  legislation acknowledged  a national
__.    solid waste problem--a pollution that can pervade the air,  water,
,>.j    and land.

      Under the Solid Waste Disposal Act of 1965  (Title II, P. L.  89-272)
u^    and now under  the broader mandate of the Resource Recovery Act
"y    of 1970 (P. L.  91-512), municipalities and other agencies are
      eligible to apply for Federal demonstration grants  to study, test,
      and demonstrate  techniques which advance the state of the art in
u>    the  solid waste management field.
I *-
<^    Disquieting statistics compiled by the U.S.  Environmental Protection
r-    Agency point up the  significance of these  solid waste management
^b    demonstration projects.  The  Nation's outlay for getting rid of its
      debris is $4. 5 billion annually--and  growing.  Most of this cost is:
      (1) for collecting  only part (180 million tons) of the  360 million tons
      of household,  commercial,  and industrial waste  actually being
      generated; (2) for disposing of it in dumps or landfills (94 percent
      of which are unsatisfactory) or in incinerators (75 percent of which
      are inadequate).  One basic Federal policy has been to encourage
      the concept of areawide solid waste management as  a sound vehicle
      for  raising the overall  level of these sanitation services to safeguard
      environment  and  public comfort.

      The County of Los Angeles  received one of these demonstration grants,
      to make an in-depth study of solid waste handling and disposal in
      multistory buildings and hospitals.   The results are reported herein.*


                                   --SAMUEL HALE, JR.
                                     Deputy Assistant Administrator
                                     for Solid Waste Management
      *For studies also related to collection and disposal of solid wastes in
      high-rise buildings, refer to National Academy of Sciences--National
      Research Council.  Collection, reduction,  and disposal of solid waste
      in high-rise multifamily dwellings „   Rockville,  Md. , U.S.  Environ-
      mental Protection Agency,  197L  [Distributed by National Technical
      Information Service,  Springfield, Va. ,  as  PB 198 623.  l69p.J

                                    iii

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                        ACKNOWLEDGMENT

The ultimate purpose of this study is  t:o determine improved solid -waste
handling and disposal techniques adaptable to various types of multistory
buildings,  hospitals and detention facilities.   This research initiated by
the Project Planning and Pollution Control Division,  Department of County
Engineer,  County of Los Angeles,  wa:3 performed with the assistance of
the Solid Wastes Program, National Center for Urban and Industrial
Health, U.S. Public Health Service, Department of Health, Education
and Welfare, *  and through guidance of the Advisory Committee on Solid
Wastes,  organized by  the Department of County Engineer to assist the
project team throughout the  study period.

ESCO-GREENLEAF, A Joint Venture (Engineering Service Corporation,
Los Angeles,  California,  and Greenleaf/Telesca,  Engineers  & Architects,
Miami, Florida) was selected by the Board of Supervisors to conduct this
study in collaboration with the Project Planning and Pollution  Control
Division.   Special consultants assisting the project staff in certain aspects
of the  study include Elmer R. Kaiserj Senior Research Scientist, New
York University; George S.  Michaelsen, Professor and Director, Division
of Environmental Health and Safety, University of Minnesota;  Richard G.
Bond,  Professor, School of  Public  Health, University of Minnesota;
Donald Vesley, Assistant Professor,  School of Public Health, University
of Minnesota; and Gordon P. Larson, Air  Pollution Control Consultant,
Philadelphia,  Pennsylvania.

Considerable interest in this study  has been shown by many governmental
agencies,  equipment manufacturers and individuals directly concerned
with the subject.  With this  encouragement,  together with the  direct and
indirect assistance  of numerous contributors, enthusiasm for successful
completion of the study has been maintained.

Sincere appreciation is extended to the administrators  and staffs of all
hospitals,  members of the Sheriff's Department and representatives  of
the Department of Building Services,  who  cooperated and assisted in the
on-site investigations  in those buildings under their respective juris-
dictions .

The  constructive criticism and guidance of members of the Advisory
Committee on  Solid Wastes  -were invaluable  and special recognition
for the member agencies is  warranted.  Agencies represented in this
Committee include: Los Angeles County,  Hospital Department, Mechani-
cal Department, Building Services, Health Department, Forester and
Fire Warden,  Department of County Engineer, and Air  Pollution Control
District; and the State of California, Department  of Public Health and
Regional Water Quality  Control  Board.
* Now the Office of Solid Waste Management Programs,  U.S. Environ-
mental Protection Agency.
                                  IV

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                          PREFACE

Problems of solid waste collection and disposal in institutions and
other multistory buildings mirror many of the same problems con-
fronting the community at large--in greatly magnified form. In
large building complexes, as in many of the  Nation's  communities,
solid waste systems often are so crude as to be termed, in the
words of this report,  "man-handling. " Either in large  buildings,
the subject here, or in a community,  a two-prong approach will
be necessary--immediate application of improved methods that are
presently available, and then planning and research for optimal
future solutions.

This  study, supported in part by solid waste management demon-
stration grant no, G06-EC-00164 from the Environmental Protec-
tion Agency, reflects  this approach,  and hopefully will motivate
administrators and designers concerned with multistory complexes
to consider solid waste handling and disposal as  an integral factor
in the total service system provided for these buildings.  Such a
consideration must take into account  safety,  sanitation,  convenience,
and cost.   The complete study is reported in four volumes:

Volume I,  Summary,  Conclusions, and Recommendations, presents
a digest of study objectives,  development of systems  evaluation
methodology,  and criteria for systems design, together with a brief
review of the total study.  Available from the Superintendent of
Documents, U.S. Government Printing Office, Washington, D. C.

Volume II, Observations  of  Local Practices, is a detailed study and
evaluation of systems and practices in fifteen County-owned building
complexes, including  seven hospitals, four multistory office build-
ings, and four detention facilities,  varying in function and size
within each classification.  This report establishes the  theoretical
standards of operation peculiar  to each plant and,  through field
observations, actual operating  conditions of these systems.  Avail-
able from the U. S. Department  of Commerce, National Technical
Information Service, Springfield,  Virginia 22151.

Volume III, Research on Systems Development, covers  an investi-
gation and evaluation of available solid waste handling,  storage,
processing, and  disposal equipment and systems  adaptable to build-
ing installations.  This report provides coverage on both marketed
systems and equipment components,  as well as systems concepts
in the development and "idea" stage.   Available from the Superin-
tendent of Documents, U.S. Government Printing Office, Washington,
D.C.

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Volume IV, Selection and Design of Solid Waste Systems, provides
an extended evaluation of systems adaptable to the various classi-
fications of buildings and complexes considered in the study, with
recommendations for operational improvements  or modifications
of existing systems as may be required in each type of facility.
Design criteria and preliminary design of systems modifications,
together with outline specifications and cost estimates covering
installation and operation, are developed on a selected building
complex.  Available from the U.S. Department of Commerce,
National Technical Information Service,  Springfield,  Virginia
22151.

John A.  Lambie,  County Engineer, County of Los Angeles, was
the project director for this study; Peter M0  McGarry, with our
Division of Demonstration Operations, was the project officer.
                                TALTY,  Director
                       Division of Demonstration Operations
                       Office of Solid Waste Management Programs
                              VI

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VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
                                                         Page No.
                                CONTENTS
     I       INTRODUCTION                                   1-1

    II       IDENTIFICATION OF THE SOLID WASTE SYSTEM          ll-l

    III       DEVELOPMENT OF EVALUATION METHODS            111-1

    IV       OBSERVATIONS OF LOCAL PRACTICES                IV-1

    V       RESEARCH ON SYSTEMS DEVELOPMENT                 V-l

    VI       SELECTION AND DESIGN OF SOLID WASTE SYSTEMS     Vl-l

   VII       REVIEW OF STUDY                                 Vll-l
                                Vll

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VOL. I	SUMMARY/ CONCLUSIONS AND RECOMMENDATIONS	
                                                                  Page No.
                                APPENDICES

              LAC-USC MEDICAL CENTER
              (Existing Solid Waste System)                             a-1

              DETENTION FACILITIES
              (Description of Existing Solid Waste Systems)                b-1

              DETENTION FACILITIES
              (Evaluation of Existing Solid Waste Systems)                 c-1

              OFFICE BUILDINGS
              (Description of Existing Solid Waste Systems)                d-1

              OFFICE BUILDINGS
              (Evaluation of Existing Solid Waste Systems)                 e-1

              LAC-USC MEDICAL CENTER
              (Considered Improvements io Solid Waste System)             f-1

              LAC-USC MEDICAL CENTER
              (Recommended Solid Waste  System Improvements)             g-1

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VOL.  1       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. I       INTRODUCTION                                             1-1
The need for this study was motivated by observed lack of progress, both locally and
nationally,  in development and use of improved systems and equipment for handling
and disposal of solid wastes in multistory buildings.

Since 1920, when  the solid waste production per capita was 2.7 Ibs. per day,  there
has been a steady increase in the rate of production of solid waste.  In recent years,
the increase has been at an even more rapid rate as  copying machines and disposable
items have come into more general use,  and it is now reported that the waste production
is in excess  of 5 Ibs. per capita per day. Although  wages have increased manyfold
during the same period, mechanization and automation - in most fields - have  kept
costs under reasonable control. The gathering of solid waste inside of buildings,
especially multistory buildings and multi-building complexes, has shown little
change during this period  and manpower is still relied upon for picking up and
transporting  refuse within  buildings to central points of collection or disposal.

Newly constructed buildings are in most cases  still utilizing solid waste handling
systems which were conceived and developed many years ago, and it is not unusual
to find a row of waste cans lined up in front of a multi-million dollar monumental
building waiting for collection.  In multistory  buildings,  trash is often manhandled
at great expense.  Occupants of apartment buildings complain of noise and odors
from filthy trash chutes, and there is a constant fire hazard in the storage rooms.
New rubbish handling systems can and must be developed and their use must be
required.

Although phenomenal progress has been made in the field of medicine and new
methods and equipment are being developed for the  care of hospital  patients,
very little progress has been made in changing  methods of disposing of solid
waste from these institutions.  The health hazards resulting from present outdated
systems are a real concern to health authorities and  sanitary engineers.  There  is
a need for research and development in this area which so closely affects our
environment.

The need for an integrated system for solid waste disposal in hospitals is obvious.
Present archaic systems require considerable handling which is not only becoming
increasingly expensive, but results in frequent exposure to disease and filth.
Wastes are often transported through corridors of hospitals and up and down ele-
vators, thus  exposing countless patients, staff and visitors to potential accident
and infection hazards.

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VOL.   I	
CHAP.  I                                                                     1-2
The volume of hospital solid wastes being produced is constantly on the increase.
One reason for this is the use of disposables.  Because the present philosophy suggests
it is "cheaper,  faster,  safer" to use it once and throw it away, total expenditures
for disposables are increasing at an accelerating rate of growth.  This trend will
greatly increase the volumes of solid waste and increase the magnitude of the
entire  (logistics) problem.

In hospitals, methods need to be devised for conveying  wastes from their source to
a storage area or ultimate disposal, ideally with the least handling and exposure to
the  occupants of the building and community.  Consideration should be given to the
possibility  of combined handling systems to include transportation of supplies and
linens  throughout the hospital.  Provisions for cleaning  and maintenance of the
materials handling system must be considered during the design and selection phase.
Strong  emphasis should be given to studying what can be done in older facilities to
minimize present problems.

Various methods of reducing the volume of solid waste stored in buildings need to be
studied.  The feasibility  of compressing, shredding, and packaging refuse within the
building should be explored„  Most refuse could easily be crushed and compacted to
a fraction of its original  volume with  the  use of a satisfactory crushing or grinding
mechanism.

Even though refuse storage is generally an indispensable function of a building, it
is seldom given adequate consideration by builders  and  designers.  Refuse storage
continues to be a source  of problems for fire and health officials.  The ultimate
methods of disposal in a building must be  coordinated with the  planning of the  site
as well as the design of the waste handling system.   The present requirements for
in-building storage may be minimized with a system employing conveyor systems
that continuously transport wastes to a central storage or processing station.

Present day planners, architects and engineers appear to have no faith in the newer
sophisticated waste handling systems. There is a need for evaluating this new
equipment  under operating conditions so that real progress can  be made.

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VOL.   I	
CHAP.  I                                                                        1-3
Purpose of the Study:

The purpose of this study is (1) to determine the current "state-of-the-art" in refuse
handling and disposal systems serving various types of multistory buildings and
building complexes, (2) to determine prevailing methods, practices and equipment
employed in waste systems, as well as the standards of operation,  (3) to identify
specific areas of weakness in waste systems operation, and (4) to identify available
equipment or equipment in the development stage that may be used to improve
handling, storage, processing and/or disposal methods.
Study Objectives:

The objectives of this total project are to improve solid waste handling and disposal
in multistory office buildings, hospitals and detention facilities.  This project will
be undertaken in two phases.  The broad objectives under Phase I  as undertaken in
this study are (1) to evaluate and determine the types and quantities of solid waste
produced by multistory office buildings,  hospitals,  and detention  facilities, and
to predict future quantities, (2) to study and evaluate materials handling and waste
disposal  equipment and systems, (3) to study the application of such handling and
disposal  equipment or systems to the buildings under consideration, and to review
existing  County-owned facilities and recommend changes in refuse handling
systems,  and (4) recommend projects to be constructed so as to demonstrate their
effectiveness in  a  selected multistory hospital, office building or  detention
facility and develop positive data on the  protection of public health,  operating
efficiency,  reliability,  and cost.

Under Phase II,  a  proposed continuation of this study, objectives  will  include:
(1) the design and construction of a selected waste handling and disposal system,
(2) the testing and evaluation of the system's performance; and (3) the development
of code requirements and guidelines for architects, engineers, planners, and builders
for providing acceptable and convenient waste storage,  handling, and/or disposal
for hospitals,  institutions, multistory buildings, including offices  and apartments.

Broad descriptions of work tasks that would lead to these objectives were outlined

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VOL.  I	
CHAP. I                                                                      1-4
prior to commencing the study „  The basic tasks were expected to include:

1.  Field surveys of selected local building;; or institutions to determine physical
    characteristics and obtain data on the refuse collection and disposal system.

2.  Analysis and evaluation of the present refuse collection and disposal system
    for each building or institution from economic, esthetic, and sanitary viewpoints.

3.  Research and investigation of refuse collection; preparation and handling systems
    to determine operating characteristics, size and space requirements, and cost of
    installation and operation.

40  Research and investigate the various methods of refuse disposal, including
    salvage, waterborne disposal  in sewers after grinding, landfill, composting,
    on-site and central  incineration, taking into account health hazards, air
    pollution, reliability, and operating cost.

5.  Studies to determine which type or types of refuse collection, preparation
    and handling systems can best be employed in  each of the types of buildings
    under consideration, and the benefits that would result from such an installation.
    Consideration to be given to shredding, pulping and  compacting of refuse and
    to gravity, pneumatic, vacuum and containerized handling  systems and other
    methods.

6.  Coordinate research and investigations with study of grinders for disposal of
    hospital wastes currently being undertaken  by  County Health Department.

7.  Studies to determine which method or methods of refuse disposal can best be
    employed  in each of the types of buildings  or building groups under
    consideration o

8.  Selection  of a multistory office or detention facility building to be used as
    the basis of a demonstration project and prepare preliminary designs and
    estimates of cost for installing the refuse collection, preparation, handling,
    storage and/or disposal equipment,  including modifications  required in  the
    buildings, if any.

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VOL.  I
CHAP. I
                                             1-5
9.  Selection of a hospital building complex to be used as a demonstration project
    for a system  of collection and disposal for  hospital  wastes and the development
    of preliminary designs and estimates of cost for the construction and operation
    of such system.

Further,  the objectives of this study of local interest will include an in-depth survey
of the refuse collection and disposal  facilities and practices at various County buildings
and institutions for the purpose of improving and modernizing equipment,  methods and
practices, and at the same time suggest design standards and code requirements that
may insure adequate solid waste system capabilities in  future buildings to  be constructed
within the County jurisdiction.  The  following list of County buildings or  institutions
with their varied use and relative size, provides a broad base upon which to conduct
this study.  The  study will  also include inspection of such representative private
multistory buildings as may be needed to verify and confirm the data based on the
study  of the County buildings.
           Name

LAC-USC Medical Center
Long Beach General Hospital
Harbor General  Hospital
Rancho Los Amigos Hospital
John Wesley Hospital
Olive View Hospital
Mira Loma Hospital
Mira Loma Sheriff's Facility
Central  Jail
Sybil Brand Institute
San Fernando Juvenile Hall
Hall of Justice
Hall of Records
Hall of Administration
County Courthouse
County Engineer Building
       Use

Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Hospital
Detention Facility
Detention Facility
Detention Facility
Detention Facility
Detention Facility
Office Building
Office Building
Office Building
Office Building
  Reported  Size

3,000 beds
  428 beds
  715 beds
1,188 beds
  259 beds
  725 beds
  232 beds
  500 inmates
3,000 inmates
  600 inmates
  411 inmates
3,000 inmates
  404,000 sq. ft.
1,000,000 sq. ft.
  660,000 sq. ft.
  171,000 sq. ft.

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VOL.   I
CHAP.  I
Organization of Material:

As this study progressed and expanded to a multi-volume presentation providing a
breakdown in the major divisions of the investigation, it became apparent that the
voluminous material must be condensed to summary form for interest, continuity and
value.  Hopefully, one of the principal values will be the emphasis to the readers of
the relatively  little previous input to this subject of solid waste systems in buildings
and the need for continuing study.

Contents of this volume include background material that was necessary to develop
prior to proceeding with field  investigation and analysis of solid waste systems.  This
background material,  incorporated in Chapters II and III, identifies functions and
nomenclature of solid waste systems in building complexes for purpose:; of this study
and establishes a numerical  rating basis for fhe evaluation of waste systems„  This
rating basis is  confined  to performance capabilities of the systems as related  to
effect on the environment, both in-plant and off-site.

Chapters IV and VI, covering  investigations on existing systems in selected local
buildings and upgrading of these systems,  applies the principles of evaluation
developed for this study and explores the economic aspects of solid waste system
operation.   These chapters summarize the detailed studies to be found in Volumes II
and IV, and includes  selected appendages from these volumes to illustrate the  depth
of study.

Chapter V summarizes the scope of activity involved in  the research and investigation
of equipment and systems as presented in Volume  III.  The reader is referred  to this
volume for specific information on equipment components.

Chapter VII presents recommendations for the continuation of this study and the
proposed design of a solid waste system for a major building complex.  Recommen-
dations are also made on additional areas oi: study that should be explored to broaden
knowledge on  solid waste systems in buildings  and the effect on the community.

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VOL.  I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. II      IDENTIFICATION OF THE SOLID WASTE SYSTEM          Page No,
                            TABLE OF CONTENTS
              Functions of a Solid Waste System                           11-1
              Nomenclature of the Solid Waste System                     11-3
              Definitions of Solid Waste Materials                         11-5
                              LIST OF TABLES

       II-I    Classification of Refuse Materials                           11-7


                              LIST OF FIGURES

       II-I    Schematic of Typical Solid Waste System in a
                 Multistory Building Complex                            11-4

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VOL.  I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. II      IDENTIFICATION OF THE SOLID WASTE SYSTEM              ll-l
At the outset of this study, it was indicated that existing descriptive terminology for
solid waste systems in buildings was not wholly adequate. Definitions of functions
related to handling  and disposal of wastes in buildings were not specific.  Standard-
ization of nomenclature of solid waste  systems had not been fully established.
Definitions of solid  waste materials and the nature and character of these materials
as related to the wastes generated in specific buildings had not been fully developed.
Therefore, for clarity and understanding,  review and selection of terminology were
undertaken as the first steps in this study.
Functions of a Solid Waste System:

The connotation of "system" within this report denotes a building utility requirement,
such as a plumbing system.  For purposes of this study,  the four principal functions of
a solid waste system are limited to waste handling, storage,  processing and disposal.

The term "waste handling" includes all those functions associated with the transfer or
movement of solid waste materials after creation, excluding  storage and actual
processing and/or ultimate disposal  methods  that may be employed.  These waste
handling functions are limited to and defined as  follows:

     collection  -  Methods and equipment used in (1)  the pickup of accumulated
                   wastes from the initial point  of deposit or subsequent storage
                   points and (2) loading of vehicles or other means of conveyance
                   for transport.

     transport    -  Methods and equipment used in the vertical or horizontal
                   movement of materials.

     discharge   -  Methods and equipment used to unload wastes from the
                   carrier or transporter.

Storage of wastes is the interim containment of accumulated  materials in either  loose,
compacted or other processed form prior to subsequent handling, processing or disposal,

Waste processing is considered as those preparation functions, such as bagging or
encapsulating  of disposables and reusables as well as treatments of disposables

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VOL.  I	
CHAP. II                                                                      11-2
involving volume reduction through changes in size and shape,  uniformity or consistency.
The degree of volume reduction and corresponding increase in density varies with the
method or combination of methods employed and the composition of the material  input.
Typical  processes or combinations of these processes which precede ultimate disposal
may include:

    Bagging                       Shredding                   Pulverizing
    Encapsulating                  Chipping                    Dewatering
    Compaction                    Grinding                    Baling
    Crushing                      Pulping                     Extrusion

Waste processing may also include those techniques employed in reconditioning or
reprocessing reusable equipment such as laundry,  bottle washing, dishwashing,
washing and rinsing, sterilization and autoclaving. However, the scope of this
study shall  be limited to the handling methods associated with reusables  up to the
point of reprocessing „

Disposal  is considered herein as the final treatment or combination of treatments in the
conversion of wastes to innocuous materials or useable by-products.  By  and large,
known disposal methods are limited  to relatively few conversion processes, some
involving conversion by normal decomposition of materials and several processes which
involve  accelerated conversion„

Conversion of waste may  be accelerated by destructive disposal processes such as
controlled  incineration and supervised or un
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VOL.   1	
CHAP.  II                                                                    11-3
Nomenclature of the Solid Waste System:

Preliminary investigations revealed that popularly accepted terminology for descriptions
of solid waste systems in buildings appeared to be generally non-existent.  The need
for identification of the system's basic components and working parts or functions of
these components appeared to be a prerequisite to detailed investigation and  analysis
of actual working systems.  For this identification, the requirements of the solid waste
system (handling, storage, processing and disposal) serving a complex of multistory
buildings were considered.,  It was  indicated that the flow of wastes from creation
to ultimate disposal would present the full  range of system functions that could
normally be expected in any major building complex. This hypothetical waste
system was resolved into four basic components or sub-systems:

    1.  The unit system  - those initial  functions performed in containing and
        moving waste from its point of creation to and including the point of
        storage, processing or disposal within the unit.  A unit may be defined
        as a single floor or limited area or zone of a floor.

    20  The inter-unit system  -  those functions performed in the vertical  or
        horizontal  transfer of wastes from two or more  unit (floor or departmental)
        storage areas to and including an intermediate storage, processing or
        disposal  point serving a group of units.

    3.  The inter-building system - those functions performed in the transfer
        of wastes from intermediate storage points to and including a central
        on-site storage, processing or disposal point.

    4.  The off-site system  - those functions performed in external transfer
        of wastes from the central storage area to and  including off-site
        processing or disposal.

Figure ll-l, a schematic diagram,  illustrates the typical multistory system, identifying
components and functions within the system.

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                                                                        FIGURE U-1

                                                                          PAGE 11-4

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VOL.   I	
CHAP. II                                                                     11-5
Definitions of Solid Waste Materials:

The comprehensive terminology and definitions as employed by *APWA in their publi-
cation "Municipal Refuse Disposal" describing  wastes and the nature and character
of refuse materials have been adopted for use in this study,  with certain supplementary
modifications as may be pertinent to descriptions of wastes generated in building
types studied herein.

APWA terminology and definitions are as follows:

1.  Waste refers to the useless, unwanted, or discarded materials resulting from
    normal community activities, including solids, liquids,  and gases0

2.  Atmospheric wastes consist of particulate matter, such as dust and smoke,  fumes,
    and gases.

3.  Liquid wastes consist mainly of sewage and industrial wastewaters, including
    both dissolved and suspended matter„

4.  Solid wastes are classed as refuse„

5.  The physical state of wastes may change in their conveyance or treatment,,
    Dewatered sludge from wastewater treatment plants may become solid wastes;
    garbage may be ground and discharged into sewers  becoming waterborne
    wastes; and fly ash may be removed  from stack discharges and disposed of
    as solid or as waterborne wastes„

6.  Refuse comprises all of the solid wastes of the community, including semi-
    liquid or wet wastes with insufficient moisture and  other liquid contents
    to be free-flowing„

7o  The component materials of refuse can be classified by (a) point of origin,
    (b) the nature of the material itself, and (c) character of materials.

8.  Special wastes are  defined as (a) hazardous wastes  by reason of their
    pathological, explosive,  radioactive, or toxic nature, and (b) security
    wastes: confidential documents, negotiable papers, etc.

*American Public Works Administration

-------
VOL.  1
CHAP, ii
Table ll-l presents the APWA classification of refuse materials defining  the character,
nature and kinds of typical materials as well as their conventional point of origin.
Nearly all these kinds of refuse materials are produced in major building complexes.
However, for purposes of this study, identification of solid waste materials generated
in special purpose buildings must be further detailed.  The point of origin or source
may be further refined indicating building, floor and/or department where wastes are
generated.  Supplementing the APWA classifications of waste materials in connection
with hospitals,  the character of solid waste must be further expanded to  include
certain reusable wastes.

Kinds of these materials are soiled linens,  instruments, accessories, bottles, food
utensils,etc.  The importance of classifying these materials as solid waste cannot
be overemphasized for they are presently handled in a manner similar to disposable
waste materials, they exist in quantities thcf generally exceed the quantities of
disposable materials and  with the growing popularity of single use items, they may
be in  fact converted to disposable materials on relatively short notice.

Further classification of the nature of hospital waste must also include definitions
of contaminated and non-contaminated  materials.  It can be assumed that a textbook
definition of contaminated and non-contaminated waste materials would produce a
clear  distinction between these material classifications.  However,  in practice,  due
to the complexities of the waste handling systems and the prevailing intermix of
"clean" and  "dirty"  areas generating wastes, segregation of waste materials
throughout the system must rely heavily on the human element of judgment in the
classification and distinction of these types of materials. Observations further
supported by opinions of  hospital and health department representatives indicate
that reliability in this method of segregation cannot practically nor economically
be achieved. Therefore, the following definitions of contaminated and  non-
contaminated wastes based on point of origin are adopted for purposes of this  study.

Those solid waste materials resulting from non-medical activities not directly or
physically related to patient care, such as materials generated through ware-
housing, processing and preparation of  new or sterile materials and supplies,  will
be considered as non-contaminated wastes, providing physical barriers reasonably
isolate these service areas ar,d the wastes are not later intermingled.

-------
VOL.   I
CHAP. II
                             TABLE ll-l
                                         CLASSIFICATION OF REFUSE MATERIALS
                    Kind or
                   Character
Composition or Nature
                                                                             Jrigin or
                                        Source


Garbage
Rubbish
or
Mixed Refuse
Ashes
Bulky
Wastes
Street
refuse
Dead
animals
Abandoned
vehicles
Construction
& Demolition
wastes
Industrial
refuse
Special
wastes
Animal and
Agricultural
wastes
Sewage
treatment
residues
Wastes from the preparation, cooking, and
serving of food.
Market refuse, waste from the handling,
storage, and sale of produce and meats
Combustible
(primarily
organic)
Noncombustible
(primarily
inorganic)
Paper, cardboard, cartons
Wood, boxes, excelsior
Plastics
Rags, cloth, bedding
Leather, rubber
Grass, leaves, yard trimmings
Metals, tin cans, metal foils
Dirt
Stones, bricks, ceramics,
crockery
Glass, bottles
Other mineral refuse
Residue from fires used for cooking, heating
buildings, incinerators, etc 0
Large auto parts, tires
Stoves, refrigerators, other large appliances
Furniture, large crates
Trees, branches, palm fronds, stumps, flotage
Street sweepings, dirt
Leaves
Catch basin dirt
Contents of litter receptacles
Small animals: cats, dogs, poultry, etc.
Large animals: horses, cows, etc.
Automobiles, trucks
Lumber, roofing
Rubble, broken
Conduit, pipe.
, and sheathing scraps
concrete, plaster, etc.
wire, insulation, etc.
Solid wastes resulting from industrial
processes and manufacturing operations,
such as: food-processing wastes, boiler
house cinders, wood, plastic, and metal
scraps and shavings, etc.
Hazardous wastes: pathological wastes,
explosives, radioactive materials
Security wastes: confidential documents,
negotiable papers, etc 0
Manures, crop residues
Coarse screenings, grit, septic tank sludge,
dewatered sludge
From:
households,
institutions,
and commercial
concerns such
as:
hotels,
stores,
restaurants,
markets, etc.
From:
streets,
sidewalks,
alleys,
vacant lots, etc.
From:
factories,
power plants,
etc.
Households,
hospitals,
institutions,
stores,
industry, etc.
Farms,
feed lots
Sewage treat-
ment plants,
septic tanks
                  SOURCE: APWA - REFUSE COLLECTION PRACTICES

-------
VOL    I	
CHAP.  II                                                                      fP8"
All solid wastes generated from the use of clean materials and used in connection
with patient care through clinical services, medical  support services and certain
non-medical services (including food service,  soiled linens etc.) will be considered
as contaminated wastes.  Biological and infectious wastes generated as a result of
patient treatment, operating and autopsy procedures, and laboratory research
activities will, of course, also fall within this classification as will hazardous
wastes such as radioactive, explosive and toxic materials.

Basically,  these definitions limit non-contaminated wastes to those materials such
as packaging and containerizing of new materials, wastes resulting from food
preparation, and processing of other clean products, as well as those waste
materials generated by administrative departments and other similar functions not
physically related to patient care and easily affording controlled segregation of
waste materials from point of origin to point of disposal without intermixing with
contaminated wastes*,

-------
VOL.  I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. Ill      DEVELOPMENT OF EVALUATION METHODS           Page No.
                             TABLE OF CONTENTS

               Identification and Point of Origin of Hospital
                  Waste Materials                                     111-2
               Composition of Solid Waste Systems in Hospitals            111-3
               Community  Interrelationship to the Hospital Waste System   111-7
               Evaluation of Hospital  Solid Waste Systems                111-10
               Evaluation of Systems in Other Building Types              111-14
               Improvements in Systems                                  111-18
                                LIST OF TABLES

       Ill-l    Types of Wastes Produced by Departments                  111-4
       111-2    Typical Variables in Composition of Solid Waste Systems    111-5
       111-3    Description of Hospital Solid Waste Systems                111-6
       111-4    Distribution of Hospitals  and Nursing Homes -
                  Los Angeles County  1968                             |||-9
       111-5    Basis of Evaluation of Hospital Solid Waste Systems         111-12
       111-6    Numerical Rating of Hospital Solid Waste Systems          111-13
       111-7    Basis of Evaluation of Detention  Facility Systems           111-14
       111-8    Numerical Rating of Detention Facility Solid
                  Waste Systems                                       111-16
       111-9    Numerical Rating of Office Building Solid Waste Systems    111-17
                                LIST OF FIGURES

       Ill-l    Health  Districts County of Los Angeles Health Department  MI-8

-------

-------
VOL.  I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. II!      DEVELOPMENT OF EVALUATION METHODS                   Ill-l
Evaluation of solid waste systems may be defined for purposes of this study as the
determination of the efficiency of equipment and methods employed in the total
system to perform the functions of handling, storage, processing and disposal of
wastes in compliance with the requirements of existing codes and accepted standards.

This evaluation must be resolved into two components.  These components are
performance capabilities of the systems or equipment as designed (theory) and as
operated (practice). The latter introduces the human element of operating personnel.

Applicable regulatory controls pertaining to operation and maintenance of solid
waste systems include building, fire, pollution and health standards and  other local
restrictive ordinances,  as well as departmental or in-plant regulations and certain
special controls such as the Hospital Licensing Act applicable in California.

These codes and standards applicable to handling, processing and disposal of solid
wastes for building installations can be resolved to controls for four basic environ-
mental factors or conditions affecting the health and welfare of the general public
and building occupants.  These four highly  interrelated factors are  sanitation,
safety, security and esthetics and may be defined as follows:

     Sanitation  -  control of all conditions which contribute to contamination
                   and may permit the spread of disease or infection, the
                   irritation, discomfort or impairment of bodily function
                   through inhalation, ingestion or contactc

     Safety     -  control of all conditions relating to prevention  of
                   accidents or catastrophy which could cause personal
                   injury or property damage.

     Security    -  Prevention of unauthorized access to waste handling  and
                   disposal areas to eliminate pilferage or salvage of hazardous
                   wastes and accidental contact with  contaminated materials.

     Esthetics   -  Public and users acceptability in terms of appearance,
                   noise, odors, psychological factors, convenience,
                   workability of the system, etc.

-------
VOL.   I
CHAP.  Ill
Development of methods for evaluation of soJd waste systems for the various types of
special purpose buildings under study was based on observations of their respective
operating characteristics, requirements and types of material being handled.  It was
obvious that types of wastes and handling requirements differed extremely between
building  classifications, and that methods of evaluation would necessarily be tailored
to each group.
Identification and Point of Origin of Hospital Waste Materials:

Types of conventional solid wastes generated in hospital plants are not unlike those
wastes to be found in small municipalities and may include:

     1.  Garbage                6.  Bulky Wastes (furnishings, auto parts, tires, etc»)

     2.  Rubbish                7.  Expended Vehicles

     3.  Ashes                  8.  Street and Landscaping Refuse

     4.  Dead Animals           9.  Construction and Demolition Wastes

     5.  Special Wastes         10.  Industrial Wastes (shops)

In addition, reusable materials and equipment, such as linens,  food service items,
patient care items, etc» requiring reprocessing, often will be found in quantities that
far exceed the amounts of these conventional solid wastes.

Generally, bulky wastes, worn-out vehicle:;, street  and landscaping refuse,  con-
struction and demolition wastes, not uncommon on hospital sites, are  handled in
separate channels apart from the main flow of waste  materials generated daily within
the plant buildings. Daily quantities of these materials generated fluctuate considerably,
Dependent on the nature and quality of these materials, they may be  salvaged for in-
plant reuse or deposited at landfills.  By and large,  the methods of disposal generally
selected are limited by the characteristics of the individual waste materials.  Detailed
studies of these types of wastes will not be considered within this study, except as they
may be found within the building waste handling system.  Similarly, those radiological
wastes which are generated in varying quantities and handled in compliance with State
and  Federal regulations will not be investigated in depth except as they may affect the
general waste handling system in the hospital complex.

-------
VOL.   I
CHAP.  Ill
In summary, the identification of kinds of wastes that may be found normally in the main
stream of the solid waste system  include garbage, rubbish, ashes, dead animals, special
wastes and reusables.  From observations of the different characteristics of certain waste
materials and their respective handling requirements within the hospital waste system,
eight categories of waste materials have  been established for detailed study „  These
categories are identified as follows:
      1.  Sharps - needles, blades, etc.                         (Disposable)
      2o  Surgical, pathological and  animals                    (Disposable)
      3.  Soiled linen                                          (Reusable)
      4.  Rubbish or mixed refuse                                (Disposable)
      5.  Patient care items                                     (Reusable)
      6.  Non-combustible - glass, metals and ashes             (Disposable)
      7.  Garbage (Non-grindable)                              (Disposable)
      8.  Food service items                                    (Reusable)

For further background on the development of evaluation methods, some comment on the
identification of the various types of waste materials and their point-of-origin is necessary.
Wide variations in departmental  organization exist; however, for purposes of this presen-
tation and from review of available organizational charts, departmentalization as illus-
trated in Table Ill-l has been adopted as generally representative of hospitals in the total
system, and is indicative of the  range of points-of-origin of waste materials.  Table Ill-l
also illustrates the major identifiable  types of solid wastes that may be generated in
typical departmental areas, and designates these materials as either contaminated or non-
contaminated.  With limited exceptions, contaminated wastes are generated in the
medical departments (patient care  areas and services) as opposed to the generation of
non-contaminated  wastes occurring in non-medical  departments. Those classifications
as shown in the Table are based  on the definitions of contaminated and non-contami-
nated wastes presented earlier in this  report.

Composition of Solid Waste Systems in Hospitals:

Functions of waste handling, storage, processing and disposal in the total  solid waste
system may be accomplished by using  various combinations of methods and equipment.
Table 111-2 lists typical  variables that may occur in performance of each major
function  in the Unit, Inter-Unit, Inter-Building and Off-Site System.

Generally, the more conventional methods and equipment are employed in the
hospitals under study, and considerable variations within the systems occur at each

-------
     VOL.  I
     CHAP. Il
               TABLE lll-l     TYPES OF WASTE'S PRODUCED BY DEPARTMENTS
                                           111-4
   SOURCE OF WASTE
TYPES  OF  WASTE MATERIALS
DEPARTMENT
Non-Medical Departments
Administration
Resident Facilities
Engineering
General Services
Laundry
Dietary
Medical Departments
Clinical Services
Acute 8< Ext. Care
Obstetrics & Gyn .
Out-Patient
Pediatrics
Psychiatrics
Surgery
Support Services
Clinical Laboratory
Research Laboratory
Dental Clinic
Radiology
Pathology
Pharmacy
DISPOSABLES
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-------
VOL.   I
CHAP.  II
111-5
                 TABLE 111-2
                          TYPICAL VARIABLES IN COMPOSITION OF SOLID WASTE SYSTEMS
Unit System
Initial
Deposit

Open
Container
Open
Container
w/L,ner
Disposable
Container
Special
Container
Closed
Container
Closed
Container
w/Liner

Initial

Manual
Hand
Cart
Pneumatic
Tube
Automated
Conveyor
Motorized
Cart


Initial
Storage,
Processing,
Disposal
None
Sealing
Contained
Liner
Compact
Encap-
sulate
Grind
or Pulp
Storage
Room
Reclaim
for Reuse
Inter-Unit System
Vertical

Gravity
Chute
Elevator
Dumb-
waiter
Automated
Conveyor
Pneumatic
Tube
Pipeline

Intermediate
Storage,
Processing,
Disposal
None
Storage
Room
and/or Bins
Compact
Encap-
sulate
Grind
or Pulp
Incinerate
Reclaim
for Reuse
Inter-Building System
Internal
Transfer
Manual
Hand
Cart
Motorized
Cart or
Train
Automated
Conveyor
Pneumatic
Tube
Pipeline
Truck
Central
Storage
None
Piles or
Pits
Open
Container
Closed
Container
Compactor
Container
Holding
Tank
Storage
Room
Central
Processing
or Disposal
None
Incinerate
Grind
or Pulp
Shred
Compact
Extractor
Reclaim
for Reuse
Off-Site System
External
Transfer
Open
Truck
Covered
Truck
Packer
Truck
Container
Carrier
Sewer


Final
Processing
and/or
Disposal
Landfill
Sanitary
Landfill
Special
Sanitary
Landfill
Incinerate
Sewage
Treatment
Plant
Discharge
to Sea
Salvage
hospital  in handling different kinds of wastes, such as grinding of food preparation
wastes, incineration or grinding of pathologic wastes, segregation in handling of
certain types of wastes upon creation through their disposal.

Table 111-3 serves to illustrate these variations by showing the principal types of
wastes handled at a typical local  plant and the numerous "systems" that may exist
for "special handling" of certain solid waste materials.  Personal decisions and
judgments, hurriedly made on some occasions, must channel a particular type of
waste material into the right path for its proper handling.   Due to error in personal
judgment, a resulting  intermix of materials in the various "systems" is not uncommon.

Without adequately supervised specialized personnel being assigned for the  exclusive
purpose of handling solid waste materials, numerous parallel systems for handling
segregated wastes cannot be expected to function consistently in the manner intended,
and avoid the intermix of contaminated and non-contaminated materials.

-------
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-------
VOL.   I	
CHAP.  Ill                                                                      111-7
Community Interrelationship to the Hospital Waste System:

Other factors to consider in the evaluation process include environmental contamination
within the community.  No conclusive research directly related to off-site disposal of
hospital wastes and its effect on the community has been performed.  Principal  concerns
relate to the possible survival of harmful bacteria and disease transmission by direct
human contact with contaminated materials or through other biological vectors, as well
as transmission through air and water pollution.  Off-site disposal conventionally
involves a method of highway transport, direct or via transfer stations to landfills,
central incineration plants or other disposal facilities.  The community environment
may be exposed to hospital waste contaminants throughout the course of travel with
greatest potential exposure occurring at the disposal  site where direct contact by
refuse workers and scavengers may occur or where water pollution via run-off or
leaching may ultimately affect the populace*  Potential hazards to the environment
may be minimized in  transport through tight container!zation, and at disposal sites
through special handling procedures, tight security and proper selection of site,,
In practice,  all these measures are difficult to insure.

Though beyond the scope of this study, it was considered necessary to identify and
convey the relative significance of the hospital waste disposal problem within
Los Angeles County.  Figure Ill-l illustrates the subdivision of  Los Angeles County
by health districts as  identified by the County Health Department.  Table 111-4 shows
the 1968 distribution  of hospital beds and nursing home beds within the County by
these districts.  Using nominal waste production factors of 10 Ibs./day per hospital bed
patient and 5 Ibs./day per nursing home bed patient, a potential  quantity of about
470,000 Ibs. or 235 tons of disposable wastes can be expected to be  generated daily
in Los Angeles County.  Other than identified pathologic wastes which represent a
small percentage of total  wastes,  it  is likely the majority of these waste materials
are being transported to area  landfills. It is also likely that the majority of hospitals,
especially those of less than  500 beds,  are serviced by  private refuse contractors.
Largely these waste materials are not identifiable as hospital wastes as they are
received at landfills.  Private contractors  servicing the majority of private institutions
as well as some of the public facilities contract for routine servicing, and of course
no segregated collection is feasible. Therefore, the majority of hospital wastes are
mixed with commercial wastes prior  to delivery to disposal sites and do not receive
special handling.

-------
VOL.  I
CHAP. Ill
1-8
                                 Figure Ill-l

           HEALTH DISTRICTS  County of Los Angeles Health Department

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t—
                                                           TABLE 111-4
                                                           PAGE 111-9

-------
VOL.  I	
CHAP. Ill                                                                   111-10
Again assuming that contamination of the environment may result from off-site transport
and disposal of this material, it may be emphasized that geographically nearly all areas
of the County are subject to this potential hazard.

Based on the above factors and limited knowledge in this field as to immediate and long-
range effects, elimination of these potential hazards to the community environment
through on-site disposal would likely be recognized as the preferred method from the
viewpoint of public interest,,  Prevailing methods of on-site disposal are basically
limited  to grinding of food wastes and incinerction.  Destruction of hospital wastes
by on-site incineration,  while eliminating major potentials of disease transmission,
may also contribute to the added problem of community air pollution  through emissions.
Grinding of food wastes with discharge to sewer is unquestionably one of the most
efficient processes and least offensive to both the operating personnel and the community
at large.  Exploration needs to be made on potentials of grinding all  wastes for sewage
discharge and decontamination of these materials before removal from the hospital
plant.

Regardless of the system selected, assurance of  its proper operation to minimize environ-
mental contamination, both  within the plant end the community, is paramount and is
emphasized  in the  development of the evaluation methods.
Evaluation of Hospital  Solid Waste Systems:

For the complex systems generally found in hospitals,  it appeared necessary and
desirable to develop a  numerical  rating method that would consider the relative value
of environmental factors, the relative effect or hazard of each type of waste on the
environmental factors and the significance of each waste in the total system „   Table  111-5,
developed through collaboration with knowledgeable parties, numerically illustrates
the above factors.  Through arithmetical  calculations, the cumulative value of some
4,300 points was established and  identified a:; the maximum value of the  hospital  system.

It also appeared necessary to relate the significance of each waste to each component
and function within the system in order to convey the  identity and location of inade-
quacies that may be found.  Table 111-6 identifies the eight principal groups of solid
waste materials, presents the breakdown of each system by components (Unit,  Inter-
Unit,  Inter-Building and Off-Site systems) and the related functions within each

-------
VOL.  I	
CHAP. Ml                                                                   111-11
component.  Distribution of the total weighted numerical value of each waste from
Table 111-5 is made to each of the ten functions in the total system and the respective
environmental  factors (sanitation, safety, security and esthetics).,  These numerical
values appearing in Table 111-6 were based on judgments of the relative significance
of each waste as it affects the respective environmental factors within each function
of each waste system.  The format of Table 111-6 was developed not only to illustrate
the distribution of maximum values within the waste system but also to provide a tool
for actual rating of those systems of the hospitals under study.

In practice, the actual rating evolved as a grading process which reflected the
deficiency in operation of each required function in the total  system.  This deficiency
point rating  method was resolved to a five-step grading process, considering both
equipment and methods employed in the performance of each function.  Actual
rating of a system function  involved calculation of deficiency points applicable
to each environmental factor  in each function.  Bfank spaces indicate a function
not applicable to the system.   Conditions and accompanying deficiencies (related
to maximum  values) in the adopted grading process are as follows:

                    Condition                                 Deficiency

      Need  Not Be Improved.
      Completely Acceptable As Is,,                       -   0% of Maximum Value

      Requiring Some Improvement in Method
      of Operation.  Equipment is Adequate
      for Intended  Use                                   -  25% of Maximum Value

      Requiring Major Improvements in Method
      of Operation and Some  Improvement in
      Equipment Maintenance                            -  50% of Maximum Value

      Requiring Major Improvements in Method
      of Operation and Major Improvement in
      Repair and Replacement of Equipment                -  75% of Maximum Value

      System Is Not Acceptable for Present Use
      and Major Equipment Design Changes
      Are Required                                       -100% of Maximum Value

-------
CHAP. Ill
 TABLE 111-5    BASIS OF EVALUATION OF HOSPITAL SOLID WASTE SYSTEMS
Relative Values (A)
Environmental Factor
Type of Waste
Sharps, Needles, Etc.
Surgical, Pathological & Animals
Soiled Linen
Reusable Patient Items
Rubbish
Non-Combustible
Garbage
Food Service
4
Sanitation
(B)
90
75
I 100
40
40
30
24
20
(Q
360
300
400
160
160
120
95
80
3
Safety
(B)
100
25
25
40
75
50
18
26
(C)
300
75
75
120
225
150
55
80
2
Security
(B)
100
100
47
60
62
42
25
25
(C)
200
200
95
120
125
85
50
50
1
Esthetics
(B)
65
100
100
50
100
55
100
50
(C)
65
100
100
50
100
55
100
50
10
Total

925
675
670
450
610
410
300
260
TOTAL VALUE OF OPTIMUM SYSTEM  1675
1080
925
620  4300
(A)  Relative Values of Environmental Factors

(B)  Relative Significance of the Particular Environmental  Factor for the Particular Waste
    (Rating on Scale of 0 to 100)

(C)  Weighted Numerical Value (C=AB) of Each Waste or its Relative Significance
    to Each Environmental Factor and the Total System

-------
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                                                        PAGE 111-13

-------
VOL.  I
CHAP. Ill
111-14
Evaluation of Systems in Other Building Types:

In contrast to hospital waste systems, characteristics of solid waste systems in detention
facilities and office buildings are relatively simple. Although these systems are similar
in structure,  the types and relative quantities of wastes they must handle are consid-
erably less.  In addition,  the characteristics of the waste materials are less offensive
and hazardous and require minimum segregation in handling and storage.  Even though
these systems are relatively simple, it appeared necessary to develop similar evaluation
methods (numerical ratings) as prepared for hospitals, as a means of identifying and
conveying our findings.

In the case of detention facilities inspected,, identifiable components of the system
were  limited  to the inter-unit or inter-building and off-site system.  Identifiable
wastes consistently found in the mainstream of this principal system are soiled  linens,
garbage and rubbish.  Through a similar process as detailed in the discussion on
evaluation of hospital systems, the rating method considers the relative value  of
environmental factors (in this case equal), the relative effect  or hazard of each type
of waste on the environment and the significance of each waste in the system.
Table IU-7 was developed establishing the cumulative value of 1,000 points as the
maximum value of the detention facility sys'-em.
     TABLE 111-7    BASIS OF EVALUATION OF DETENTION FACILITY SYSTEMS
Relative Value (A)
Environmental Factor
Type of Waste
Soiled Linen
Garbage
Rubbish
Total
1
Sanitation
(B)
100
80
60
240
1
Safety
(B)
60
60
100
220
1
Security
(B)
80
60
100
240
1
Esthetics
(B)
100
100
100
300
4
Total
(Q
340
300
360
1000
(A)  Relative Value of Environmental Factors
(B)   Relative Significance of Each Waste on Each Environmental  Factor
(C)  Relative Significance of Each Waste in Total  System

-------
VOL.   I	
CHAP.  Ill                                                                     111-15
Table 111-8 identifies the three principal wastes and relates the significance of each
within each component of the system and functions within the components.  Distribution
of the total numerical value of each waste from Table 111-7 is made to each of the five
functions in the total system and the respective environmental factors.

In the case of office buildings inspected,  identifiable components of the systems
included the  unit, inter-unit and off-site systems. In these systems, the general
practice employed mixes all wastes as collected and virtually no segregation of
waste materials occurs.  The  relative value of environmental  factors are considered
equal.  Table IM-9 was developed, establishing a 400 point maximum value of the
office building system.  Distribution of  this value is made to  each of the three system
components and respective functions of  these components, as well as environmental
factors within each function.

The rating forms illustrating the distribution of maximum values within the waste
systems are later employed in the actual rating of those systems in detention facilities
and office buildings under study.  The method of rating of these systems is on a
deficiency basis following the same procedures as set forth earlier in the discussion
on evaluation of hospital systems.

-------
VOL.  I
CHAP. II
111-16
     TABLE 111-8   NUMERICAL RATING OF DETENTION FACILITY SOLID WASTE SYSTEMS

o

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System
Components
Internal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
Final Processing
and/or Disposal
Total
TOTAL
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
































Max.
Value

25
JO
5
15
:io
•1-0
:20.
20
't$ ••
10
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30
40
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20
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15
20
30
1.5
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•SO
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Def.
Value'
































Max.
Value
5
IS
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10
..... 5. .
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10
,25
: 'ao .
..20
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.55
50...
40
30
SO
20...
\$
15
20
.30..
•5
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2&
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50
:""^6!':
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Rubbish
Def.
Value
































Max.
Value
20
15
VI5
:is"
' ':$ •'
"25
3D
30
15
56
15..,
.15
40
6Q:
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20
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•' 25 ::
20 .:
. .«)
""^:.::
. ;40
;60. .:.
V..WDO-.
:•:• -Jpo :-:
x19Q:x:
Total
Def.
Value
































Max.
Value
SO
.: -40'
30
40".
; ••&••.
40'
&.-'
••7&:
'....so':':-
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: :'4Q •
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T3Q .
.130.
160. '
../*6,::
-'5d/
:"-'^5-;
:55"
: V.?$':'
40:
••••
-------
VOL.   I
CHAP.  IN
1-17
          TABLE 111-9   NUMERICAL RATING OF OFFICE BUILDING SOLID WASTE SYSTEMS
System Components
UNIT SYSTEM
T SYSTEM
Z
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Initial Deposit (Receiver)
Initial Transfer
Initial Storage,
Processing, Disposal
Total
Internal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
Final Processing
and/or Disposal
Tota 1
TOTAL

Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety^
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
RUBBISH
Def.
Value
















































Max.
Value
to
5
; JS '
20
1Q ':
. .. 5 ,
5'
is
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25
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Total
Def.
Value












Max.
Value
40
••"SO "
•S5 :
J25
60 :
75 :
40
175
30
70
too
400

-------
VOL.  I	
CHAP. Ill                                                                 111-18
Improvements in Systems:

Rating of the waste system has been resolved to evaluation of that system actually
employed in handling each of the identifiable wastes and the capability of that
system to consistently handle the material in an acceptable manner.  This concept
of evaluation provides for a rating, reflecting (1) capabilities of the system and
its equipment and (2) efficiency of operating)  technique..  This evaluation is expressed
by application of deficiency points to individual functions and collectively represent
a deficiency rating of the total system.  Guidelines for needed improvements to the
existing system  would be indicated by the deficiency ratings of each waste in the
unit,  inter-unit, inter-building and off-site systems.  Considered system improvements
to reduce system deficiencies may be classified as interim or long range in nature.

Interim improvements or remedial measures involving minimal expenditures may range
from greater emphasis on equipment maintenance or stop-gap  training measures to
improve the techniques of operating personnel to replacement or  modification of
obsolete equipment,,

Emphasis on long range improvements must consider new  technology arid concepts of
the various "closed system" concepts and totally integrated systems which may
minimize malfunctioning.  The "closed system" approach may include combinations
of material handling,  processing and disposal  devices which eliminate or minimize
human handling of solid wastes after the initial deposit. With the flow of al! solid
waste materials in  hospitals nearly paralleling the flow of clean supplies and
equipment (both in quantity and routes,  except in the return cycle), the "closed
system" concept may also include consideration of those multi-purpose material
handling systems being developed for building application.

In later stages of this study where system improvements are considered in these
local  buildings, the same method of evaluation used in the rating of existing
systems will also be applied in the rating of contemplated modifications.

-------
VOL.  I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. IV     OBSERVATIONS OF LOCAL PRACTICES                 Page No.
              RESTATEMENT OF PURPOSE AND SCOPE OF STUDY       IV-1

              SOLID WASTE SYSTEMS IN COUNTY HOSPITALS          IV-3

              SOLID WASTE SYSTEMS IN DETENTION FACILITIES       IV-15

              SOLID WASTE SYSTEMS I N COUNTY OFFICE BUILDINGS  IV-22

              SUMMARY                                            IV-26
                 Prevailing Problems in Solid Waste Management
                  in Buildings                                       IV-26
                 Causes of Problems                                  IV-28
                 Required Development of Remedial Measures            IV-28
                 Continuing Studies                                  IV-30


                               LIST OF TABLES

                  Comparison of Hospital Solid Waste Systems

       IV-1   Breakdown of Daily Waste Production (Lbs,,/Day)
                 By Types of Waste                                   IV-4
       IV-2   Characteristics of Hospital Plants and Daily Waste
                 Production                                         IV~5
       IV-3   Percentage Distribution of Systems Operating Costs          IV-7
       IV-4   Daily Labor Requirements for Systems Operation
                 (Man-Minutes per Bed Patient)                        IV-9
       IV-5   Annual,  Daily and Unit Operating Costs                   IV-10
       IV-6   Percentage Deficiencies in Environmental Rating of
                 Systems Operations                                  IV-11
       IV-7   Percentage Deficiencies of Sub-System Functions           IV-13
       IV-8   Relationship of Waste Production, Labor Requirements
                 and System Deficiencies by Individual Wastes           IV-14

-------
VOL.   I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. IV      OBSERVATIONS OF LOCAL PRACTICES                   Page No.



                               LIST OF TABLES

               Comparison of Detention Facility Solid Waste Systems

       IV-9    Descriptive Characteristics or Detention Facilities            IV-16
       IV-10   Breakdown of Daily Waste Production (Lbs0/Day)
                  By Types of Waste                                     IV-17
       IV-11   Contract Services for County Detention Facilities            IV-19
       IV-12   Percentage Deficiencies in Systems Operations               IV-20
       IV-13   Relationship of Waste Production and System Deficiencies     IV-21
                Comparison of Office Building Solid Waste Systems

       IV-14  Waste Production and Costs of Operation                    IV-23
       1V-15  Percentage Deficiencies in Systems Operations               1V-25

-------
VOL.   I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. IV     OBSERVATIONS OF LOCAL PRACTICES                        IV-1
A comprehensive review,  inventory and evaluation of existing solid waste systems and
solid waste management practices in a substantial cross section of County owned and
operated building complexes within the  County of Los Angeles were carried out during
the early stages of this study.  Complete details of these investigations were recorded
in Volume II.   In review of this volume  of material,  the following digest has been
prepared restating the purpose and scope of the total study, as well as briefly
summarizing investigations conducted at these local institutions.
RESTATEMENT OF PURPOSE AND SCOPE OF STUDY

The ultimate purpose of the total study is to determine improved solid waste handling,
storage,  processing and/or disposal techniques adaptable to various types of multi-
story buildings and building complexes.  In connection with these objectives,  a
comprehensive investigation of existing systems, methods, and practices in various
types and sizes of buildings was required as the initial phase of study.  A wide range
of building classifications was initially considered.  However, due  to anticipated
details of study and time limitations, only three basic building classifications were
approved for study within the scope of the contract.  These classifications, hospitals,
detention facilities and office buildings, were selected based on their diverse
functions and apparent differences in solid waste system requirements.  Selection
of the individual projects included seven hospitals, five detention facilities and
four office buildings.  Extreme variations in physical configurations, functions and
waste system requirements also  existed in those  projects selected within each building
classification.

Separate survey methods and report formats were developed for each building class-
ification to record and convey  pertinent data on identification of the existing  solid
waste systems, classification of wastes,  quantities of waste production, operating
characteristics and cost analysis of the systems, as well as evaluation of the environ-
mental effect of systems operation within each plant and the community at  large.

Procedures for the evaluation of solid waste systems were developed by the project
staff under the guidance of special consultants in environmental health and staff
members  of the School  of Public Health, University of Minnesota.   Field observations
and ratings were carried out at each of the local projects by the observation team
consisting of the Project Engineer, his assistant and a field engineer representing

-------
VOL.   I
CHAP. IV
the County Engineer's office.  Individual  ratings of each project were made by each
member of the observation team.  Differences in judgments were reconciled through
discussion and additional site visits.  Results of these evaluations were reviewed by
the above-noted advisors who  is some cases node independent evaluations to corrob-
orate the ratings as presented in this report.

As indicated above, Volume 11 presented comprehensive detail of these observations.
Chapters II through VIII (Volume  II) presented individual reviews on the relatively
complex hospital solid waste systems, and Chapters IX and X (Volume  II), respectively,
presented  studies of systems  operations at detention facilities and office buildings.
Similarity of waste system characteristics within these latter building categories
permitted  the presentation of the  investigations in  an abbreviated form by building
categories rather than individual  projects. A summary of these project reports are
incorporated herein.

A case study of the LAC-USC  Medical Center, illustrating typical details involved
in these investigations,  as reported in Chapter II,  Volume II, is appended (Appendix A)
in its entirety for the readers'  information.

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VOL.   I	
CHAP. IV                                                                 IV-3
SOLID WASTE SYSTEMS IN COUNTY HOSPITALS

Investigations of all the selected County hospitals were conducted during the latter
months of 1968 and early 1969 to determine physical characteristics of the plants
and develop data on the solid waste systems.  Diverse conditions found to exist
among nearly all plants ranged not only from the  physical characteristics of
location, land, buildings and plant layout, but also to the predominant types
of care and specialties each facility offers.

Initial field observations were carried out at each of these hospitals to determine
average daily quantities and  types of wastes produced.  Observations ranged from
a period  of five days to two weeks at these plants, depending on the size and
complexity of the waste system operation.  Weight records were developed on  all
major types of disposable wastes through the use of portable scales.  Daily weight
records of soiled linen were obtained from laundry records for all  hospitals.
Results of these observations were compiled and typical  daily activity was esti-
mated for each plant as shown in Table  IV-1.  This Table provides the breakdown
of daily waste production by  type of waste and summarizes total daily production
by the broad categories of disposable and reusable waste materials, as well as
certain calculated unit production factors (daily bed patient and per capita
production).  Although waste production in hospitals is commonly reduced to
the familiar "pounds per bed  patient unit", the results of this study of the seven
local  hospitals have shown  an extremely wide range in unit production when
analyzed on this basis.  This  analysis suggests that for estimating purposes in
the design of solid waste systems, calculations of total  wastes based on bed
patient capacity alone may be misleading and that further investigations should
be made  relating production to other plant and building characteristics.

An example of the wide range in waste  quantities generated when analyzed on
daily  production/bed patient/day can best be illustrated by a comparison between
Long Beach General Hospital and the LAC/USC Medical Center as shown on
Table IV-1.  Long Beach, a geriatrics center, offers a type of patient care that
requires limited specialties, limited space, limited supplies, limited staff and
support personnel as opposed  to the requirements of the Medical Center. The
Medical  Center is one of the major general teaching hospitals  in the country.
This institution provides a comprehensive range of medical  care for all age

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VOL.   I
CHAP.  IV
IV-4
groups.  Highly specialized services require a complex plant with a high ratio of
specialized building areas,  supplies, staff and support personnel . With such varying
conditions, it can best be summarized that  types of wastes produced and respective
quantities of each are to a great extent dependent upon the classification of the
hospital  (range and type of  care), ratio of bed patients to equivalent population,
and management policy on reusable and single-use  items.


                            Comparison of Hospital Solid Waste Systems

         TABLE IV-1    BREAKDOWN OF DAILY WASTE PRODUCTION (LBS./DAY) BY TYPES OF WASTE

Type of Waste

Sharps, Needles, Etc.
Path. & Surgical
Soiled Linen (R)
Rubbish
Reusable Patient Items (R)
Non -Comb usti b 1 es
Garbage (Non-Grindable)*
Food Service Items (R)
Radiological
Ash & Residue
Animal Carcasses
Food Waste (Grindable)
TOTAL PRODUCTION
DAILY PRODUCTION DISPOSABLE
Pounds per Bed Patient
Pounds per ** Capita
DAILY PRODUCTION REUSABLE (R)
Pounds per Bed Patient
Pounds per ** Capita
LAC-USC
Medical
Center
75
1,000
45,500
16,200
TR
1,500
1,800
9,000
TR
TR
25
2,600
77,700
23,200
11.6
3.75
54,500
27.2
8.75
Long Ueach
General
Hospital
3
TR
3,740
540
TR
75
150
1,400
•-
--
•-
330
6,238
1,098
3.6
2.08
5,140
16.9
9,74
Harbor
General
Hospital
22
156
13,600
6,569
TR
465
660
2,400
TR
20
220
950
25,062
9,062
16.7
5.57
16,000
29.6
9.73
Rancho
Los Amigos
Hospital
40
4
16,320
2,760
TR
725
875
4,200
TR
20
20
1,100
26,064
5,544
6.0
2.80
20,520
22.1
10.20
John
Wesley
Hospital
8
115
2,900
717
TR
80
160
800
-
50
10
210
5,050
1,350
7.9
3.44
3,700
21.7
9.41
Olive
View
Hospital
20
6
5,630
1,722
TR
250
475
2,500
TR
20
23
1,860
12,506
4,376
7.8
4.32
8,130
14.5
8.08
Mira
Loma
Hospital
5
TR
1,120
362
TR
80
110
600
-
25
-
150
2,452
732
5.1
3.37
1,720
11.9
7.93
  * Predominantly Garbage Mixed with Substantial Quantities of Paper, Plastics, Metal,  Etc.
 **Per Capita Production Based on Equiv. 24-Hr. Population

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VOL.   I
CHAP.  IV
IV-5
Table IV-2 was prepared relating total waste production to building area, gross popu-
lation (total  patients, outpatients,  employees, volunteer workers,  etc.), and *equiv-
alent population (average population present each 8 hour shift over 24 hours per day
and 7 days per week).
                             Comparison of Hospital Solid Waste Systems

            TABLE IV-2  CHARACTERISTICS OF HOSPITAL PLANTS AND DAILY WASTE PRODUCTION

Total Building Area (MSF)
Bed Patient Capacity
Ratio of Area (SF) per Patient
Avg. Occupancy-Bed Patients
Occupancy Rate
Gross Population'^'
Equivalent 24-Hr. Pop. '3)
Ratio of Patients to Equiv. Pop.
Total Daily Waste Production (Lbs.)
Lbs./MSF of Bldg. Area
Lbs. /Bed Patient
Lbs./Person-Gr. Pop.
Lbs./Capita-Equiv . Pop.
Total Disposables (Lbs.)
Lbs./MSF of Bldg. Area
Lbs. /Bed Patient
Lbs./Person-Gr. Pop
Lbs./Capita-Equiv. Pop
Total Reusables (Lbs.)
Lbs./MSF of Bldg. Area
Lbs. /Bed Patient
Lbs./Person-Gr. Pop.
Lbs./Capita-Equiv, Pop.
LAC-USC
Medical
Center
2,822.0
2,300
1,220
2,018
87.4%
21,294
6,220
32.3%
77,700
25.6
38.8
3.7
12.50
23,200
7.5
11.6
1.1
3.75
54,500
18.1
27.2
2.6
8.75
Long Beach
General
Hospital
195.4
428
455
302
70.5%
1,246
526
57.4%
6,238
32 0
20.5
5.0
11.82
1,098
5.6
3.6
0.8
2.08
5,140
26 4
16.9
4.2
9.74
Harbor
General
Hospital
665.8
688
965
541
78.6%
5,512
1,645
32.8%
25,062
32.5
46.3
4.5
15.30
9,062
10.7
16.7
1.6
5.57
16,000
21.8
29.6
2.9
9.73
Rancho
Los Amigos
Hospital
1,191.0
1,540
775
929
60.3%
5,471
1,982
46.7%
26,064
21.9
28.1
4.8
13.30
5,544
4.7
6.0
1.0
2.80
20,520
17.2
22.1
3.8
10.20
John
Wesley
Hospital
140.3
259
540
170
65.5%
1,124
392
43.4%
5,050
36.0
29.7
4.5
12.85
1,350
9 6
7.9
1.2
3.44
3,700
26.4
21.7
3.3
9,41
Olive
View
Hospital
510.1
699
730
560
80.4%
2,452
1,012
55.0%
12,506
24.5
22.3
5.1
12.40
4,376
8.6
7.8
1.8
4.32
8,130
15.9
14.5
3.3
8.08
Mira
Lama
Hospital
91.1
232
390
144
62.1%
453
217
66.5%
2,452
27.0
17.0
5,4
11.30
732
8.2
5-1
1.6
3.37
1,720
18.8
11.9
3.8
7.93
Range of
Production
(4)









64%
172%
46%
35%

128%
364%
125%
168%

66%
149%
62%
29%
 (1) Avg. Occupancy During Observation Period
 (2) Gross Population Including Total Bed Patients, Outpatients, Employees, Volunteer Workers
 (3) Equivalent Population is Average Shift Population Present 24 Hours per Day, 7 Days per Week
 (4) Range in Production Over Lowest Production Factor
*Example of Calculations
Total Est. Population/Shift
Avg. Shift & Daily Pop.
Monday-Friday
1st Shift
13,400

2nd Shift
5,100
7,100
3rd Shift
4,300

Saturday and Sunday
1st Shift
5,000

2nd Shift
3,500
4,000
3rd Shift
3,500

Equivalent Population  =  5/7(7,100)      +   2/7(4,000)  =  5,075+1,145  -  6,220

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VOL.   I	
CHAP.  IV                                                                    IV-6
A comparison of these calculated production  factors,  as shown in Table IV-2, indicates
the following range in production occurring in the seven hospitals studied:

Lbs./MSF of Bldg. Area    -  Ranging 64% above the low of 21.9 Lbs./MSF

Lbs. per Bed Patient        -  Ranging 172% above the low of 17.0  Lbs./Bed Patient

Lbs./Person (Gross Pop.)    -  Ranging 46% above the low of 3.7 Lbs./Person

Lbs./Capita (Equiv. Pop.)  -  Ranging 35% above the low of 11.3 Lbs./Capita

This analysis indicates that estimates of waste production may be more accurately
projected by using a per capita production factor related to equivalent population
than the other production  factors considered above.   This analysis shows  a range of
11.3 to 15.3 pounds per capita, including both disposable and reusable waste classi-
fications, was generated daily at these hospitals studied.   Table  IV-2 also shows the
calculated unit production factors  individually for disposable and reusable waste
classifications.  Except for the distortion caused by the relatively low production level
of disposable waste materials at Long Beach General  Hospital, comparison of these
factors further supports the theory that per capita production factors  related to  equiv-
alent population provides  the more reliable basis for estimating.

Continuing observations at these institutions were devoted  to investigations of
equipment and services provided for handling and disposal  of solid wastes, and methods
and practices employed, all as a basis for determination of costs of operation and
evaluation of the systems.

Labor requirements were found to be the most significant factor in systems operation,
consistently ranging above 90% of total operating costs.  Table  IV-3 illustrates the
percentage distribution of costs represented by labor, building and fixed equipment,
vehicular equipment, contractor or disposal fees, and miscellaneous expendable
supplies.  Percentage distribution of costs to  the categories of reusable and disposable
materials indicate a wide  range of cost experience, some, such as Long Beach, with
costs nearly in direct proportion to quantity of waste  production, opposed to the cost
experience of Harbor General, which is nearly in inverse proportion to quantities
of reusables and disposables.  In addition, total  system costs are distributed to  the

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-------
VOL.   I	
CHAP.  IV                                                                    IV-8
sub-systems or system components (Unit,  Inter-Unit, Inter-Building, and Off-Site
system).  It is of interest to note that the on-floor handling of waste (the Unit
system) consistently ranges from 75 to 87.6% of total system costs.

To further signify the magnitude of labor in ihe systems operation, daily manpower
requirements  have been resolved to man minutes per bed  patient as  observed at each
institution  and shown in Table IV-4.  Review of the individual description of solid
waste systems and  estimated daily  labor costs of solid waste systems presented in the
respective  chapters will provide detail of these labor requirements at each institution.

Table IV-5 was prepared to relate estimated total costs of the system operation to
quantities of  waste produced.  Unit cost data on a per ton basis, as well as on  a
bed patient day  basis, has been calculated for  comparison between hospitals.

The findings of this study,  limited to detailed investigations at only seven  hospitals,
suggest that variations in labor requirements and total  costs of operation are dependent
largely on  physical complexities of the plant layout and  equipment employed,  as well
as the skill and inclination of labor.  Development and evaluation  of the foregoing
statistics, together with observations of waste systems operation at these plants,
further emphasize  the diverse characteristics of these institutions and their respective
waste systems.

The evaluation of  these institutional  waste systems was based on observations over
a continuing  period of several months.  These observations were concluded with
the preparation of a  numerical  rating on operational efficiency of the individual
systems related to  the environmental  factor* of sanitation, safety, security and
esthetics.  Detailed  ratings of the individual hospital waste systems were previously
presented in the respective chapters  on each project (Table identification -
"Numerical Rating of Hospital  Solid Waste Systems"). In summary  form, Tables  IV-6,
IV-7 and IV-8 were  prepared to relate the more pertinent factors in these ratings.
Table IV-6 shows the weighted deficiency  rating of the total waste system  operation
as related to  the four environmental  factors.

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TABLE IV-6
PAGEIV-H

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VOL.   I	
CHAP.  IV                                                                  IV-12
Table IV-7 expresses these ratings in percentage of deficiencies within sub-system or
system components and functions within the components. Weighted average deficiencies
as shown in  Tables IV-6 and IV-7 are composite deficiency ratings calculated from the
numerical rating Tables presented in Chapters I1-V1II (Volume II).  For example, in the
case of the LAC-USC Medical Center, the percentage deficiencies of the environ-
mental factors, as shown in Table IV-6, were calculated from Table 11-18 (page 11-53,
Volume II) as follows:
          Sanitation        1050/1675  =   63%
          Safety             544/1080  =   50%
          Security           546/925   =   59%
          Esthetics           364/620   =   57%
          Weighted Avg.    2504/4300  =   58%

The percentage deficiencies of sub-system functions as shown in Table IV-7 were calcu-
lated in a similar manner.  For example, referring again to Table 11-18 (Volume II),
total deficiencies of the Unit system were calculated as follows:

          Initial Deposit     217/415   =   52.3%
          Initial Transfer     212/440   =   50.5%
          Initial Storage,
           Proc. & DisposaI   267/430   =   62 „ 1 %
          Weighted Avg.     696/1265  =   55.0%

Table IV-8 illustrates the rated deficiencies in handling individual  wastes at each
hospital and also shows the relationship of individual waste quantities produced, as
well as labor requirements of each within the systems.

By review of the descriptions of the solid waste systems (individual project reports),  it
is indicated that on-site handling of wastes is largely done by manual methods.  The
rating of on-site handling is therefore basically an assessment of the capabilities of  labor
in movement of the various types  of waste:;,  the preparation of these materials and the
conditions of storage facilitieSo   These evaluations were based on prevailing practices
observed at  each facility during the observation period, and in accordance with the
evaluation procedures  outlined in the introductory section of this report„  In close
review of the numerical  ratings of each hospital waste system, major deficiencies
are found to generally prevail in  storage functions, vertical transfer, inter-building
transfer and off-site disposal, all of which are associated with the principal disposable
wastes (sharps, rubbish,  non-combustibles) as well as on-site handling of linen„
Recommendations for upgrading these systejms (Volume  111) will consider these broad
needs as well as specific deficiencies within the respective  s/stems of each facility.

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                                              PAGE 1V-14

-------
VOL.   I	
CHAP.  IV                                                                   IV-T5
SOLID WASTE SYSTEMS IN  DETENTION FACILITIES

Investigations of solid waste  systems in County detention facilities, as reported in
Chapters VIII  and  IX  (Volume II) and summarized herein, were conducted during
the early months of 1969 to observe the physical characteristics of the plants and
develop data on the solid waste systems.  Institutions investigated included the
Mira Loma Rehabilitation and Detention Facility, Central  Jail, Sybil  Brand Institute,
San Fernando  Valley  Juvenile Hall and the Hall of Justice.

Considerable variations exist in function, size, population and  types of inmates at
these institutions.   Table 1V-9 provides a comparison of the varying physical charac-
teristics of these institutions. Considerable variations were also found in the rate of
waste production.   However, types of wastes produced, and methods and practices
employed  in their  respective  solid waste systems, were very similar.  Table IV-10
shows the comparison  of total waste production by individual types of wastes and
relates this production to building area  and various population factors. By  compar-
ison with Table  IV-2  (page IV-5),  it will be noted,  that as in hospitals, per capita
unit production  related to equivalent population shows a lessor variation in the
range of production.  It also  suggests that for estimating and  analysis of waste
production quantities, this per capita factor may  be  more reliable and meaningful
than use of other factors.

Functions  of the Unit  System  are confined to individual cell block, dormitory  and
departmental activities generally performed by inmate occupants or work details.
Observations of these in-plant housekeeping functions were of limited nature and
not considered significant to  this study.  Detailed observations were generally
confined to the  Inter-Unit or Inter-Building and Off-Site systems.

The three  basic categories of wastes found in these detention facilities (soiled linen,
garbage and rubbish)  are each handled in separate channels.  Descriptions of the
separate solid waste systems at each of these institutions, presented in Volume II
and Appendix B herein, detail the system activities.  Although  the operation of
these systems in detention facilities relies heavily on labor, it cannot  be classi-
fied as the principal cost factor,  as in conventional  systems in other types
of buildings.  In fact, by comparison to other types of buildings, cost

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PAGE IV-16

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PAGE IV-17

-------
VOL.   I	
CHAP. IV                                                                   IV-18
elements of detention facility systems are insignificant.  Table IV-11 was prepared to
illustrate identifiable cost elements in the respective systems.  In general,  these
consist of contract services providing storage bins, collection, hauling and off-site
disposal at landfills.  With the exception of the Hall of Justice where the County
Department of Building  Services assists in the  Inter-Unit system,,  no other labor costs
are acknowledged.  Relating total identifiable costs to waste quantities indicates a
modest range of about $0.01  to $0.02 per pound is incurred in the operation of the
waste systems.

The evaluations of these detention facility waste systems were based on observations
over a continuing period of several weeks.  These observations were concluded with
the preparation of a numerical rating on operational efficiency of the individual
systems related to the environmental factors of sanitation,  safety, security and
esthetics.  Detailed ratings of these system:, are presented in Volume II and
Appendix C herein. Summaries of these ratings have been prepared showing
percentage deficiencies within the systems operation,  as illustrated in Tables IV-12
andlV-13.

Table IV-12 expresses these ratings in percentage deficiencies within the system
components and functions and shows the  weighted deficiency rating related to the
four environmental  factors.   Table IV-13 illustrates the rated deficiencies in
handling individual wastes at each institution and the significance of quantities
of each material.

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of the capabilities of labor in the movement of waste materials,  the preparation of
these materials and conditions of storage facilities.  These evaluations were based
on prevailing practices  observed  at each facility during the observation period in
accordance with evaluation procedures outlined in the introductory section of this
report.  Review of the ratings indicate principal deficiencies generally prevail in
central storage and off-site disposal associated with the rubbish system.

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PAGE IV-19

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                                                                PAGE  IV-21

-------
VOL.   I	
CHAP. IV                                                                   IV-22
SOLID WASTE SYSTEMS IN COUNTY OFFICE BUILDINGS

Investigations of the solid waste systems in County office buildings, as reported in detail
in Chapter X (Volume II), were conducted during December,  1968, and early months
of 1969 to observe the physical characteristics of these buildings and develop data on
the solid waste systems.  Buildings investigated included the Hall of Records, Hall of
Administration, County Courthouse and the County Engineers Building.

It may be summarized that these buildings, though varying in both function and size,
are similar insofar as solid waste management is concerned, with the County Department
of Building Services handling this function at each building.  Similarity of in-building
handling and storage methods prevails, as well as the similarity and range of contract
services received at each facility.  The descriptions of office building solid waste
systems,  presented in Volume II and Appendix D herein, detail  these activities.
Tables IV-14 and IV-15 were prepared to illustrate other comparisons made of the
waste systems operation.

Table IV-14 shows certain building characteristics, as well as average daily waste
production and estimated operating costs of the systems calculated during the
observation period.  Production related to building areas shows  an overall average
of 2.8 pounds per MSF (thousand square feet) of building area is experienced in
these buildings,  with the County Engineers Building showing a substantially higher
production at 4.9 lbs,/MSF.  This higher rate was due  to a large volume of blueprints
being handled, which is not uncommon at this building.  Costs of operation of these
systems can be related  to an average cost per ton at about $350, in a range of costs
from $312 to  $504 per ton.  As in hospital:;,  labor was found to  be  the most significant
cost factor in systems operation.  Distribution of system costs reflects an average of
about 88% in labor, 3% in contract services and 9% in building, equipment and
accessories.  Distribution of these  costs to the system components shows an average
of 83% expended in floor activities (the Unit system),  14% in between-floor handling
(the Inter-Unit system), and 3% in the off-site system.

The evaluations of these office building waste systems were based on observations
over a continuing period of several weeks.  These observations  were concluded
with the preparation of a numerical rating on operational efficiency or
deficiency of the individual systems related  to the environmental factors of

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VOL.   I
CHAP.IV
IV-23
               Comparison of Office Building Solid Waste Systems
       TABLE IV-14   WASTE PRODUCTION AND COSTS OF OPERATION

Building Area (Sq. Ft.)
No. of Floors
Daily Waste Production (Lbs.)
Daily Production (Lbs./MSF of
Bldg. Area)
Annual Operating Costs
Avg. Daily Costs
Cost per Ton
Cost per Lb.
Distribution of Costs
Building & Equip.
Contract Services
Labor
Total
Distribution of Costs
Unit System
Inter-Unit System
Off-Site System
Total
Hall of
Records
404,000
17
1,000

2.5
$ 65,385
$ 252
$ 504
$ 0.25

7.9%
2.2%
89.9%
100.0%

82.2%
15.6%
2.2%
100.0%
Hall of
Administration
1,000,000
10
2,560

2.6
$ 103,708
$ 399
$ 312
$ 0.16

10.1%
3.5%
86.4%
100.0%

84.0%
12.5%
3.5%
100.0%
County
Courthouse
660,000
9
1,750

2.6
$70,617
$ 273
$ 312
$ 0.16

8.6%
2.4%
89.0%
100.0%

82.0%
15.6%
2.4%
100.0%
County
Engineers
171,000
11
840

4.9
$42,717
165
$ 393
$ 0.20

9.2%
2.5%
88.3%
100.0%

89.4%
8.1%
2.5%
100.0%

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VOL.   I	
CHAP. IV                                                                   IV-24
sanitation, safety, security and esthetics.  Detailed ratings of these systems are
presented in Volume II and Appendix E herein0  Summaries of these ratings  have
been prepared showing percentage deficiencies in the systems components and
functions and the weighted deficiency rating related  to the  four environmental
factors, as illustrated in Table IV-15.

These ratings, as in the case of hospital syslem ratings, were largely an assessment
of the capabilities of labor in the movement of waste materials, the preparation of
these materials and conditions of storage facilities.  These evaluations were based
on prevailing practices observed at each facility during the observation period,
in accordance with evaluation procedures outlined in the introductory section of
this report.

Due to the uniform and relatively inoffensive  nature of the waste materials  handled,
as well as the advantages of a single waste channel handling all waste materials,
complexity in these waste systems is minimized.  Satisfactory operation is limited
only by the capability of plant facilities provided and accessory equipment used,
as well as the skill and inclination  of labor.   By and  large, labor performs
effectively within these systems using very simple equipment„  Custodial crews
in office buildings, as opposed to hospitals, have the added advantage of working
in unoccupied buildings in off-peak hours where productivity and supervision of
labor can be  satisfactorily controlled.  The most significant deficiencies in these
systems are in the functions of central  storage and off-site disposal. Due to the
nature of waste materials,  system sanitation does not  pose the severe problem as
found in  hospitals; however, conditions affecting safety,  security and esthetics
are of major significance.

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VOL.   I
CHAP. IV
IV-25
               Comparison of Office Building Solid Waste Systems
     TABLE IV-15    PERCENTAGE DEFICIENCIES IN SYSTEMS OPERATIONS

UNIT SYSTEM:
Initial Deposit (Receiver)
Initial Transfer
Initial Stor., Proc., Disposal
Total
INTER-UNIT SYSTEM:
Internal Transfer
Central Storage
Central Processing or Disposal
Total
OFF-SITE SYSTEM:
External Transfer
Final Processing or Disposal
Total
TOTAL SYSTEM
ENVIRONMENTAL FACTOR RATING:
Sanitation
Safety
Security
Esthetics
Hall of
Records

22
17
38
28

22
31
-
21

17
71
55
31

20
27
36
43
Hall of
Administration

22
17
38
28

37
71
-
43

17
71
55
41

20
39
63
43
County
Courthouse

22
17
47
32

35
40
-
29

27
71
58
37

20
38
43
48
County
Engineers

22
17
25
22

22
93
-
47

17
71
55
42

20
47
51
48

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VOL.   I	
CHAP. IV                                                                   iv-26
SUMMARY

In the course of this study, certain pioneering has been undertaken in the identi-
fication of building waste systems, adoption of nomenclature of sub-systems and
functions within these systems,  and development of methods of evaluation of waste
system operation.  These tasks were fundamental to the total study and were carried
out to the stage of development which appeared  adequate for the continuing phases
of the study to progress.  Hopefully, these preliminary efforts to develop standard
terminology may be refined for practical application in the industry as may later
be required,,  However, for purposes of this study, application of these basic
principles have aided in the determination of requirements of the solid waste
systems, provided the yardstick for measuring the efficiency or deficiency of
systems operation, and provided a means of conveying these findings to the
reader»

These findings have emphasized the prevailing problems of solid  waste management
and systems operation common in those local projects investigated, as well as
common in other public and private facilities observed in other areas of the
country.
Prevailing Problems in Solid Waste Management in Buildings:

Probably the most important problem within solid waste management in complex
buildings is  lack of knowledge or awareness of an identifiable and indispensable
system, what it costs to operate and a method of measuring its effectiveness.  In
most cases,  there is an established policy on handling waste materials but in
practice the actual  operation of the waste system rarely corresponds to that policy.

Until recently, the  total solid waste system as such within buildings has been
ignored and is not yet commonly recognized or even easily identifiable.  Little
research has been carried out to explore the in-building problems associated
with solid wastes.  These waste materials have been looked upon as a  by-product
of our activities, of little significance, just something to "get-rid-of", with little

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VOL.   I        	
CHAP.  IV                                                                 IV-27
real  concern how that may be accomplished; when, in fact in a way, waste is the
end material product of our activities.  This can best be comprehended when we
realize the simple fact that sooner or later nearly all material products are converted
to waste. In the case of consumable supplies, our principal daily source of wastes,
this conversion is represented by a constant daily flow of waste materials.  With
this in mind, the basic concept of solid waste for this study was based on the
principle that the majority of materials entering an institutional building and
distributed for use are converted to wastes in a continuing flow, with all solid
wastes cycled out in a reverse pattern  from distribution of new supplies. This
concept also applies to  those reusable  items that may be cycled out after use for
either on-site or off-site reprocessing.

Certain variations of this concept occur, dependent on the building  type and
functions, such as hospitals where certain biological wastes may be generated
within the institution, and office buildings where many of the supplies when
processed are dispatched to an ultimate off-site receiver.

Recent emphasis on the  environmental  effect of solid wastes, both in-plant and  to
the community at large, has brought to the surface many problems heretofore ignored
or unrecognized.  Progress in building design, accompanied by the increase of
multistory complexes and higher density of land use, as well  as increasing per
capita rates of waste production, have tended to create lattje concentrations of
solid wastes at limited accumulation points in building service areas where
access for removal is limited. These conditions have further emphasized the
material  handling problems associated  with the in-building movement of solid
waste materials, on-site storage and disporal or off-site transfer for disposal.

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VOL.   I	
CHAP.  IV                                                                  IV-28
Causes of Problems:

Prior to the current era of growing awarene5,s of the solid waste problem in buildings,
design consideration for handling waste materials has, at best, largely been limited
to the location of conventional waste chutes and storage rooms, even in the more
sophisticated building designs, primarily because this was the only equipment and
method available.  Consequently, the problems that exist in these buildings today
are inherent to design.

It can be recognized that manually working a conventional  solid waste  system may
be a distasteful and dirty job.  This will be a certainty without direct policies and
standards of operation coupled with conscientious working supervisors and trained
crew members to produce the desired standards.

Reasonable standards of operation can be expected where building maintenance
activities can be performed in off-peak hotrs or when buildings are vacant, such
as the services prevailing in office buildings.  By contrast,  performance of these
activities in hospitals coincides with peak  (activities of other functions during
the first shift operation.   Depending on the complexities of plant layout and
traffic congestion,  close surveillance and supervision of operation of the solid
waste system within reasonable economic limits is unlikely, and reasonable
standards of operation are difficult to maintain consistently.  This substandard
operation, though directly the failure of labor to perform a satisfactory job, can be
traced further to the inadequacies of system design to meet  present day  requirements.
Required Development of Remedial Measures:

Generally, the standards of performance of manual tasks in connection with
collection and storage of wastes in the Unit System are at present totally
dependent on policies and  housekeeping practices and are  not likely to be
remedied through mechanization.  However, within present day technology, it
would appear that substantial mechanization of the balance of the system is
feasible and that solutions  to the more critical  problems will ultimately be
in the design of buildings.  A coordinated and massive attack by architects
and engineers, coupled with firm operating and administrative policy of
building management, may well be what it  takes to stimulate these solutions.

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VOL.   I	
CHAP. IV                                                                   IV-29
These solutions, through design, may be accelerated through recognition of the
overall effect of operation of inadequate systems, both from environmental  and
economic aspects.

Further tightening of codes and regulations that recognize and control environ-
mental problems of the community and building occupants can be expected when
the effects of solid waste  system operation are positively related to existing environ-
mental hazardso

The investor (developer, owner or operator)  must be made aware of the economic
benefits that may result from the mechanized system.  Cost studies of mechanized
systems will, of course, reveal that initial capital investment requirements will
far exceed the cost of conventional systems.  However, development of complete
cost data showing comparisons of total  annual costs (capital  and  operating expenses)
and the economic feasibility of the mechanized system opposed to the conventional
system may provide the investment incentive to expand the construction budget.

The solid waste system  must be popularly recognized as a requisite mechanical
equipment component in building design and given early consideration  in the
preliminary design stages (the  same consideration  given to plumbing, air
conditioning, heating, ventilating,  etc0) in order to integrate another
vital function in an orderly manner. With complex building layouts providing
high density occupancy and correspondingly, high rates of waste production,
periodic consultations with specialists in the fields of industrial engineering,
materials handling engineering and solid waste  management may be desirable
and beneficial from the preliminary design stage throughout the design  process.
Design consideration should also be given to multiple purpose material  handling
systems to handle both  new supplies and waste materials.

In short,  the  problems must be solved in the  same  manner as industry mechanized
production lines several decades ago,,

It is vital  that design standards be developed for solid waste systems in  various
types of buildings.  These standards should be adequate not only for present
levels of waste production but must also consider present trends affecting
increases in rates of waste production for certain types of buildings.

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VOL.   I	
CHAP. IV                                                                  IV-30
System design must provide flexibility for modification and expansion to meet potentially
large increases in  waste production which are likely to result from the adoption of
single-use disposables, as well as the natural increase of wastes being experienced
annually.  As indicated in the hospital stud es,  conversion from reusable to disposable
linen may increase the loadings of disposable wastes from 100% to 200% on the
relatively short notice of an administrative decision. This increase in most cases
would not affect the in-building handling materially; however,, would likely over-
burden storage and/or disposal facilities.

With critical solid waste problems, such  as these, facing architects and  engineers,
as well as developers and building managerrent, needed  acceleration of solutions
in the design of systems for both buildings in the design stage and existing  buildings
is obvious.  However, no single source of information offering  concise data on total
systems or equipment that is presently marketed  is available as  a guide to determining
interim solutions.
Continuing Studies:

In the course of this continuing study, a review of recognized publications providing
coverage on various aspects of solid waste management,  as well as direct contact
with manufacturers,  was undertaken in an effort to assemble a cross section of the
equipment that is readily available for consideration in the design of building
systems. This information is incorporated in Volume III (and  summarized in
Chapter V of this volume), which defines and catalogs equipment components
and accessories by functions within the system, i.e. handling, storage, processing
and disposal.  This volume also covers selected equipment in developing and
experimental stages  that may prove to be adaptable to building systems at some
future date.

This equipment research, together with the inventory and evaluation  of existing
solid waste systems in the local projects as summarized herein, provides the
necessary background for the continuing study on upgrading of these systems,
which is presented in its entirety in Volume IV and summarized in Chapter VI
of this volume.

In conclusion of this study, design  requirements for solid waste system improvements
in a selected  local project, including preliminary plans,  outline specifications,

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VOL.   I	
CHAP. IV                                                                  IV-31
construction costs and benefits of the system are developed.

This series of studies demonstrates the need for greater emphasis on solid waste
management in buildings, the state-of-the-art in equipment development and
development of design criteria, as well as the potential of economic and
environmental benefits that may result from an adequate system design.

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VOL.  I       SUMMARY,CONCLUSIONS AND RECOMMENDATIONS	
CHAP.V      RESEARCH ON SYSTEMS DEVELOPMENT               Page No.
                         TABLE OF CONTENTS
             Organization of Material                              V-l

             HANDLING METHODS                               V-3

             STORAGE METHODS                                 V-7

             PROCESSING METHODS                              V-10

             FINAL PROCESSING AND DISPOSAL METHODS           V-12

             SUMMARY                                         V-l 5



                          LIST OF FIGURES
      V-l    Supply-Waste Cycle in a Typical Multistory Building Complex V-4

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VOL.   I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. V      RESEARCH ON SYSTEMS DEVELOPMENT                      V-l
An integral and vital division of this study has been the research and investigation of
equipment in the developmental stage and currently available for use in solid waste
systems in buildings.  This investigation was concluded with the compilation of a
report  incorporating descriptions and illustrations of the individual equipment
components.  Obviously, due to the nature of this type report, a meaningful
summary is not feasible and the reader is referred to the complete volume (Volume III)
for specific data on the various types of equipment cataloged.  To apprise the reader
of the  arrangement of material in this volume, the following sections describe the
contents and generally summarize observations made during the course of this study.
Organization of Material:

In the early stages of this investigation, it was anticipated that classifications and
definitions of the various types of equipment encountered were requisite to the study
both for the readers' benefit and as a working tool in preparation of the report.
The major classifications or divisions of equipment were limited to correspond to
the four basic functions of the waste system, i .e. handling, storage, processing
and disposal.

The sections of Volume  III devoted to the narrative review of this equipment also
follow these classifications.  In the review of equipment, every effort was made to
describe representative makes of equipment and such descriptions are included for
general informational purposes only.  In support of this equipment review within
each major classification, referenced appendices were prepared, identifying
(sub-classification) by name and definition,  the individual equipment components
and accessories,.  Separate appendices (Product Lists) were also prepared, listing
these equipment components alphabetically and identifying respective manu-
facturers and known trade names.  To complete the appendices in Volume III in
support of this equipment review, a master alphabetical index of these manufacturers
was prepared.

The listing of manufacturers of various products as identified in Volume III is only
partial.  To identify every manufacturer producing equipment related to the subject
appeared neither practicable considering the time limitations imposed, nor neces-
sarily useful for purposes of this report.  There are many lists published covering
specific types of equipment, such as those to be found in Material Handling

-------OCR error (C:\Conversion\JobRoot\000006XF\tiff\2000PW3B.tif): Unspecified error

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VOL.   I	
CHAP. V                                                                   V-3
HANDLING METHODS

The major task and cost in the operation of solid waste systems is the movement of
waste material between the initial point of accumulation and  the ultimate disposal
point. In effect, operation of solid waste systems is largely a material handling
function,  adaptable to mechanization but predominantly performed today by
manual methods.  Today's manual systems are largely "built-in" by building
design conditions. It is not uncommon to find,  even in contemporary designs,
numerous interim waste storage points for the temporary deposit of wastes,
thereby breaking the cycle of movement and thus creating a number of
rehandlings of the same material before reaching the final destination point.
Today, scarcity of labor for this type of work, the trend of lower productivity
of labor, as well as rising labor rates, collectively emphasize the need for
mechanization of the more complex  systems.

Unfortunately, far too much of the solid wastes, as well as supplies in institutions,
are "handled" and "rehandled" instead of being directly transported by mechanical
means.  These conditions have been permitted to develop by institutional and
industrial  planners and management.  Institutional management, habitually
satisfied to "do it by hand", ignored the development of these plant engineering
needs, planners were not aware of these needs, and the materials handling
industry was not properly alert to a new market. The latter was apparent during
the course of this investigation when it was found that many equipment manu-
facturers were unaware of the needs in the field of solid waste handling at the
time they  were first contacted.  Due to this, it was equally apparent early in
the investigation that developing information on waste handling methods and
equipment would be more  time-consuming and involved than would be that
required for storage, processing and disposal methods.   Considerable time and
effort was made in contacting manufacturers and as a result of many otherwise
unproductive inquiries,  it is indicated that some companies  have been prompted
to investigate the material handling problems in solid wastes.  Hopefully, new
contributions in useable equipment will be forthcoming  for this field.

The apparent reluctance on the part of some manufacturers to become involved
in waste handling is somewhat understandable.  In general, the  subject of
materials handling has long been almost solely associated with industry.
Applications of their methods and equipment in the past have been primarily

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VOL.   I
CHAP.  V
V-4
directed to warehousing, processing and manufacturing  industries, where identical,
or at least similar, articles are handled.  If the material is in bulk, it normally
has consistency in shape and other physical characteristics throughout its volume
and, hence, mechanical  handling is not too difficult to develop.  On the other
hand, solid wastes,  especially those generated in hospitals, almost defy description.
This material  lacks uniformity of size and shape.  It is a non-homogeneous mix and
may be highly contaminated. Adapting a mechanical handling system to these
conditions may be highly complex.

The relationship of the movement of "clean" and "dirty" materials within a building
complex is an  involved process.  In effort to simplify the relationship of this process,
Figure V-l schematically shows the supply-waste cycle.  This diagram is admittedly
an oversimplification but serves to emphasize the parallel course in movement of
supplies and wastes and the basic activities between the point of supply, point of
use (or conversion to waste), and ultimate point of disposal.  Locations of these
activities (storage and processing) for both supplies and wastes may be and generally
are interspersed throughout the system.  The point is that planned material handling
systems can minimize the interim storage needs and permit efficient direct and
uninterrupted flow of both materials.
                                 FIGURE V-l
    SUPPLY-WASTE  CYCLE IN A TYPICAL MULTISTORY BUILDING COMPLEX

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VOL.   I	
CHAP.  V                                                                    V-5
It is essential that the reader be made aware of the current state-of-the-art as it
applies to solid waste handling.  Considering the existing need, it is inadequate.
While  some advancement is being made, these efforts range from meager to sophis-
ticated. However, if one  thinks of general materials handling, as opposed to the
handling of solid wastes, then giant strides have been made.  Electronically
controlled, fully automated supply systems are available7 but they are neither
presently suitable for specialized use in handling solid wastes nor economically
feasible for this  purpose alone.  Types of equipment, such as overhead chain
conveyors, horizontal or inclined belt conveyors,  or perhaps long roller conveyors
as used in industry, do not at first glance seem to be applicable to the problems
encountered in solid waste handling.  Although perhaps not directly useable, it is
possible that these basic methods of moving materials might be modified to meet
the needs under  study.

With few exceptions, little has been seen which could be described as complete
solid waste handling systems.  There are hundreds of different pieces of equipment
designed and produced to  handle or transport material items.  These individually
are considered in this report as equipment components and not systems.  Most of
the installations seen have consisted of a number of components rather  than a
complete integrated system.

The most elementary and,  at the present time, the most widely used class  of
horizontal  transport devices in use for the horizontal transport of solid  wastes in
institutions is the hand-pushed cart.  This indispensable piece of equipment comes
in many shapes and styles;  is available in  metal, fiber and plastic; and of standard
or special designs.  Carts are available  from simple open-top canvas hampers to
specially designed stainless steel bodies.  A very wide range of types of conveyors,
including roller, belt, chain, monorail  and pneumatic tube, plus many varieties
of these principal classifications, may also be considered in the general class of
horizontal transport equipment.  For off-site operations and  for some possible
on-site transport requirements,  special  types of collection vehicles or mobile
packers or  transfer trailers  may be employed.

Gravity and vacuum chutes alone are the  only equipment items specifically designed
and commonly used for the vertical transport of wastes.   The principal  forms of
multipurpose vertical transport are elevators, dumbwaiters or specially designed
lift systems, which will accommodate only carriers or transporters of a  special

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VOL.   I	
CHAP.V                                                                    V-6
type and handle al I  types of material.  Controls may be manuaI,  i .e. they can be
summoned or dispatched by push buttons or they may be automated to sequence with
loading from or unloading  to horizontal conveyors.

Some devices, such as pneumatic tubes, gravity chutes,  certain types of conveyors,
and other equipment, provide multiple  functionSo  They not only transport materials
but may be used to load or discharge bulk or containerized items, and may incor-
porate  interim storage or holding stations for en route materials.  These  may be
complete horizontal and vertical transport systems designed and installed by one
manufacturer or they may be combinations of loading devices, horizontal and
vertical conveyors and discharging equipment of different manufacture, which
have been combined into an integrated system.

Such devices as blowers or suction  fans, cyclonic  separators, pneumatic tubes,
various types of conveyors, vertical lifts, pipelines  for slurries, and other equipment
can be arranged to operate as an integrated handling system.  Some of the most
interesting general materials handling systems observed have been examples of good
engineering  and the apparent successful "marriage"  of components made by different
manufacturers.

The most sophisticated,  fully automated sys-ems were designed and largely built
and installed by single manufacturers.  These combine horizonl-al and vertical
transport elements,  using special track, transporters, modules and electronic
controls.  Units can be summoned and dispatched from control panels and operated
within  the system, unattended.

The review of handling equipment as contained in Volume III  covers the limited
field of specialized equipment for handling solid wastes as well as certain general
materials  handling equipment and accessories considered to  be adaptable for possible
use in  solid  waste systems.

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VOL.   I	
CHAP.  V                                                                     V-7
STORAGE METHODS

Storage of wastes for purposes of this report has been previously defined as the interim
containment of accumulated materials in either loose, compacted or other processed
form prior to subsequent handling, processing or disposal.

Storage as related to solid wastes further includes required facilities for the contain-
ment of both reusable materials (such as soiled linens) and disposable wastes.  However,
this section of the study is primarily concerned with the problems associated with
disposables.  Characteristics of these materials subject to storage may range from
loose,  mixed or segregated wastes (including rubbish, food wastes, sharps, patho-
logical, and non-combustible materials) to various types of processed wastes
(including shredded, baled, compacted and  pulped materials).

Containment of loose wastes may be accomplished with various types of accessories
for dry storage, such as bags, wastebaskets,  barrels, bins, etc. in either  its bulk
state as collected or after undergoing certain dry processes such as shredding,
pulverizing, which achieve a substantial degree in volume reduction and produce
a homogeneous end-product.

Other methods of volume reduction may be accomplished  with various types of
compaction devices, such as packers and balers.  These dry compaction processes
may handle both loose bulk wastes or shredded or pulverized wastes.  Conventional
containment of these materials is by compaction in special bins, containers and in
some cases standard cans and paper bags.  In the case of some balers,  the compacted
wastes  are merely strapped for open storage.

Certain reduction processes involving both grinding  or shredding and compression,
together with the addition of a small amount of moisture,  produce a moist homo-
geneous compacted waste in an extruded form.  Storage accessories for this end-
product are similar to those for loose wastes, although the volume requirements
are considerably reduced.

The pulping process, in which  loose or  bagged dry wastes are greatly reduced in
particle size by grinding and shearing action in the  presence of water, produces
a slurried wet waste.  The liquid slurry can either be transported through pipelines

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VOL.   I	
CHAP. V                                                                 V-8
for further treatment or passed through a dewatering press.  In the latter case,  the end-
product is a damp, uncompressed sludge of high moisture content and high density.
Storage requirements may be limited to barrels or special  containers where larger
volumes are involved.

Storage and handling are inextricably related.  The wastebasket, the simplest form
of a storage unit, must be emptied, usually into a larger receptacle, which, in turn,
is another storage unit.  The emptying process and the movement of both the waste-
basket and the larger receptacle are elements of the handling process.  The large
waste receptacle is moved, usually on a manually pushed cart to a terminal point
on the floor. If, when the cart reaches this destination,  the accumulated and
presumably bagged waste was deposited  in a chute or other handling device, no
further interim storage space need have  been provided on the floor for waste accu-
mulations.  What is perhaps more important, one entire handling operation would
have been eliminated.

The foregoing is not against the provision of necessary storage areas.  It is in favor
of reducing the tendency in institutions  to use storage areas for the avoidance of
work by some and creating  work by leaving items for others to rehandle.  It favors
the elimination of any unrequired operations, especially the most expensive of all,
manual tasks. Storage areas are highly  essential but they should be planned in
conjunction with the actual requirements of the handling  system, for both functions
are inseparable.

Waste storage facilities must include the various types of  temporary storage
receptacles,  such as bags,  baskets, barrels, packer containers and bins, etc., but
also the properly planned storage areas, rooms or spaces in which the equipment
will be used and handled.  These areas must be carefully  located within individual
rooms, departments, utility stations and on  the ground floor or basement service
levels as well.  If stationary packers are to be used, ample horizontal and vertical
clearance must be provided to permit the movement of loading equipment. Provision
must be made for adequate  cleaning and sterilizing of the waste storage areas, as
well  as equipment and receptacles.

It is recognized that despite the need for the reduction of the numbers of storage
points, adequate spaces must be provided within the Unit, Inter-Unit and Inter-

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VOL.   I	
CHAP. V                                                                   V-9
Building systems. No amount of desire will eliminate the necessity for properly
planned, well laid out and adequately sized storage areas within the total solid
waste system.

In planning storage areas, the volumes and compositions of the generated wastes must
be known or estimated with reasonable accuracy.  The total handling concept must
be determined as well as methods of processing and disposal before the number, sizes
and locations of the storage areas and the required equipment can be determined.

The review of storage equipment as contained in Volume ill covers the limited
specialized components available for the storage of wastes, as well as numerous
accessories employed for this function.

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VOL.   I	
CHAP.V                                                                    V-10
PROCESSING METHODS

During the course of this study, it became increasingly evident that some form of
preparation of solid wastes prior to planned disposal is desirable, and under certain
conditions is  essential.  Present practices in disposal operations  will not suffice  for
the changing composition of solid wastes. The need for some preparation of general
solid wastes prior to attempted disposal by sanitary landfill or other methods deserves
extensive and continuing  investigation.  Such processes as grinding or shredding
permit more material to occupy a given space than is the case with present methods
of disposal of raw untreated wastes.  In addition, the decomposition of waste
materials is hastened by particle size reduction.

Dry grinding  of solid wastes prior to  incineration or deposit in landfills deserves
consideration but alternative methods of disposal should be studied.  Reduction  by
wet grinding  or pulping and the creation of a readily transportable slurry constitutes
another method which deserves in-depth investigation.  A variation of this method
involves dewatering of the pulped wastes into a moist sludge for easier handling
with less bulk. Although these methods may be considered as means of disposal  by
the user,  they are only processes or preparation of the material for subsequent
handling and ultimate disposal.

Processing, as related to this study,  includes some operations which are highly
interrelated with  handling, storage and disposal functions.  The criteria used for
identification of processing functions is ba'jed upon physical change of the loose
raw materials.  Waste processing is considered as those preparation functions, such
as bagging or encapsulating of disposables and reusables, as well as treatments to
disposables involving volume reduction through changes in size and shape,  uniformity
or consistency.  The degree of volume reduction and corresponding increase in density
varies with the method or combination of methods employed and the composition of
the material  input.  Typical processes or combinations of these processes which
precede  ultimate  disposal may include:

     Bagging                      Shredding                 Pulverizing
     Encapsulating                 Chipping                   Dewatering
     Compaction                   Grinding                  Baling
     Crushing                     Pulping                     Extrusion

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VOL.   I	
CHAP.  V                                                                    V-ll
Probably the simplest form of processing of solid wastes is packaging. This includes
the manual separation of certain wastes and depositing the material in bags or special
containers for interim storage until the container is injected into some type of handling
system.  By  bagging, packaging or other encapsulating processes, conditions of the
wastes have been changed from loose to contained for greater ease in handling, as
well as improvement in sanitation.

Methods  or devices which reduce the bulk of solid wastes by  compression include  such
items as balers, crushers and packers.  Drastic changes in size, shape and consistency
by homogenizing  mixed waste materials is another variation in reduction processes
employed to facilitate handling, further processing or ultimate disposal. Such equip-
ment as grinders, shredders, pulverizers, and pulpers may accomplish this initial
reduction.  Further positive reduction may be accomplished by such devices as
pelletizers and extruders or dewatering presses in the case of pulped wastes.

Various combinations of equipment components  for processing solid wastes are being
researched by manufacturers in  efforts to develop satisfactory processing or disposal
systems.   One such combination of components  is a pulper having a dewatering press
and  junk  remover as connected  processes for reduction of solid waste to  a moist sludge
form for subsequent disposal in  landfills or incineration.  Another manufacturer
combines a grinder of the hammermill type with an extruding  device which reduces
solid wastes to highly compressed, moist briquettes.  Still another processing system
is one which combines a blow hog and a cyclone to combine pneumatic  transport
of raw and treated materials with a reduction process.  The end product is a finely
shredded, dry material prepared for incineration or other means of disposal.

The  review of processing  equipment as contained in Volume III covers the broad
field of specialized equipment and accessories for processing  solid wastes as well  as
certain equipment used in industrial  processes that may be adaptable to  use in waste
processing systems.

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VOL.   I	
CHAP. V                                                                    V-12
FINAL PROCESSING AND DISPOSAL METHODS

Singularly, the most emphasized need and least developed function or activity in solid
waste management is that of disposal.  Conversely, however, the greatest investment
and advances in equipment for solid waste systems occur in handling, storage and
processing functions preceding disposal.  Development of satisfactory disposal processes,
free of pollution effects on the environment,  has been  lagging and processes are still
being researched.

Disposal  is considered herein as the final treatment or combination of treatments in the
conversion of wastes to innocuous materials or useable  by-products. By and large,
known disposal  methods are limited to relatively few conversion processes, some in-
volving  conversion by normal decomposition of materials and several processes which
involve  accelerated conversion.

Conversion of waste materials may be accelerated by destructive disposal processes,
such as controlled incineration and supervised or unsupervised open burning.  These
processes produce high volume reduction of solids with the end product of these processes
being a mixed residue including ash and non-combustible materials of high density, as
well as gaseous air pollutants.  Conversion may also be accomplished by natural com-
posting or accelerated by means of various mechanized systems.  Products of these
mechanized composting systems are a sterile organic soil and gaseous air pollutants.
The composting process in itself does not greatly reduce the volume of waste materials.
However, substantial  reduction in the end product may be accomplished in conjunction
with those  reclamation activities  normal with composting processes and where high ratios
of salvageable materials  are present.  Grinding of food wastes for discharge to sewers
with ultimate processing  at treatment plants and final  deposit of sludge at sanitary
landfills or use as soil conditioner is popularly accepted in many areas  as the best
method of disposal of garbage.  In addition, other terminal processes such as wet
air oxidation, which may produce a sterile slurry or ash cake,, and pyrolysis, a
destructive distillation process producing sterile charred solids, are among  the
numerous newer conversion processes being explored for development.

Salvage  of selected waste materials in the past has had great significance and currently
this reclamation concept is regaining popularity, although economics are not always
favorable. Among  the materials of greater significance for salvage are paper,  rags,
ferrous and non-ferrous metals, glass and rubber.   Other salvage processes such as
rendering of animal carcasses and  fats for production of fertilizer, glue, soaps, etc.,
as well as salvage of food wastes  for swine feeding, still prevails in many areas of

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VOL.   I	__^_______
CHAP. V                                                                    V-13
the country.  Both methods generally require segregation of the wastes at the source of
generation and often require refrigerated storage.  Excessive handling costs in nearly
all reclamation processes are the overriding factors in the economic feasibility of
disposal by various reclamation processes.

Disposal by sanitary landfill, open dumping and dumping at sea are the only processes
where conversion is not accelerated by man and where" normal decomposition of the
organic material occurs.  However, dumping of solid wastes in the sea or inland bodies
of water has in recent years been outlawed for all practical purposes. In both sanitary
landfill and open dumping methods, substantial settlement of the material occurs during
decomposition, together with production of gaseous emissions.,   Open dumping, the most
common practice used in the disposal of solid wastes,  has in recent years received strong
criticism from governmental agencies and the general  public.  The only  currently accept-
able method of disposal by landfill is management of  sanitary landfills adhering to accepted
standards of construction and daily maintenance.  Continuing studies on sanitary landfills
are being conducted in efforts to produce land on completion of such operations that will
have  a wider range of use than current experience indicates is permissible.

The above broadly indicates the total  range of disposal methods currently available.
For purposes of this report, we are primarily concerned with selection of ultimate
disposal methods that are suitable for the special categories of wastes commonly gener-
ated in hospitals, office buildings and detention  facilities.  From the foregoing studies
covered in Volume I and II, quantities, types and characteristics of waste produced at
each  of these types of facilities,  together with an evaluation of present  disposal  methods
employed,  were explored in some depth.  Based upon  these studies, the  following
criteria in the selection of disposal methods for each building type was established.

Hospital Wastes:  The evaluation  of hospital solid waste  systems indicated that main-
taining separate collection channels for contaminated and non-contamined wastes
cannot be practically or economically enforced in the conventional hospital  facility.
Segregation of waste materials throughout the system must rely  heavny on the human
element of judgment in the classification  and distinction of these types of materials.
Generally,  an intermix of materials occurs due to difficulty of identification and
the inability of the workers to make a distinction.  Even intermixing of disposables
and reusables is commonplace.  As a  result of these observations,  this study has adopted
the theory that all wastes coming off the hospital floor can be classified as contaminated
materials.  It must be pointed out that such classification of hospital wastes is not
currently accepted  by all authorities,, Composition of these wastes include many
salvageable materials that could prove harmful upon reclamation and reuse.  Based
upon these  conditions, it was concluded that on-site disposal should be preferred or
on-site processing of these materials should be  accomplished to produce a sterile
homogeneous material  suitable for safe off-site transport  and disposal.

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VOL.   I	
CHAP.  V                                                                      V-14
Office Building Wastes:  Composition of wastes generated in the office buildings studied
were neither hazardous nor objectionable  when related to handling or disposal.  Largely
consisting of paper with an intermix of small  quantities of food wastes and non-
combustibles, these materials are generated in relatively low volumes.  No restrictions
appear necessary on the disposal of materials of this type.  However, in interests of
security of confidential information, as well  as general building safety, consideration
should be given to first stage processing of -his material such as shredding and/or
compaction or baling  preceding ultimate disposal.  Selection of disposal methods will
likely be limited to incineration and landfill or salvage where  quantities of materials
warrant.

Detention Facilities:  Disposable wastes generated in detention facilities were previously
identified as rubbish and food wastes not unlike general municipal wastes.  It was found
in earlier investigations that detention facility waste systems are  largely operated by
inmates and equipment in this operation is intentionally limited.   It was concluded that
on-site processing or disposal involving mechanical equipment  subject to the operational
abuse by inmates should be avoided and that off-site disposal would be preferred„
Nature of the waste materials present no greater hazards in disposal than in normal
municipal wastes and  may satisfactorily be disposed of by conventional methods such
as landfilling or incineration.

The continuing research and investigation involved review of the various disposal
processes and the combinations of equipment components for processing solid wastes,
in efforts to identify, select and evaluate satisfactory disposal  systems for the various
types of buildings under study.  These concluding studies are incorporated in  full in
Volume IV and summarized in Chapter VI  of this volume.

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VOL.   I	
CHAP.V                                                                    V-15
SUMMARY

One of the primary objectives of this study has been the consideration of existent and
available systems for the efficient handling of the wastes generated in multistory
building  complexes and hospitals, which would carry solid wastes from their many
points of origin to a place or places of ultimate processing or disposal,  without human
handling or hazards to health.  Despite the advanced state of development of general
materials handling equipment, tried and proven mechanical components  designed
exclusively for solid waste handling are almost non-existent, with the exception of
chutes and pneumatic conveyor systems.  Various types of conveyors used in industry
(such as screw conveyors, belt conveyors, chain conveyors,  etc.), however,  have
been adapted to certain components of waste handling and disposal systems.

Various types of processing and disposal equipment (such as compactors,  balers, grinders,
pulpers, incinerators, etc.), all offering a wide range of capacities, have been developed
for solid waste systems in buildings.  Continuing improvements are being made in the
evolution of this type of equipment.

Reduced space requirements can be accomplished with the use of waste reduction
devices,  and building sanitation and safety can be improved with modern compactor
container storage.  Interim storage points In multistory building complexes can be
minimized with the use of pneumatic conveyors whereby nearly instant removal of
wastes can be accomplished.

Substantial progress is being made in the development of individual components,  but
generally the total system concept has  not yet been developed and marketed that will
provide solutions to all of the many different problems in building complex systems.

A brief recapitulation of the many problems encountered in the building types under
study and review of the varieties of equipment available further confirm this obser-
vation. This is most emphatically so where a waste system installation is considered
for existing structures.  The existing layout of floor areas, assigned use and space
limitations due  to existing mechanical  installations impose restrictions upon a free
choice of methods and equipment presently available.

The solution to  these problems in both existing buildings and those in planning stages
requires engineering design of the total system.  Design of systems in existing buildings

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VOL.   I	
CHAP. V                                                                    V-16
generally requires the following:

1.     Analysis of planned building areas and functions and future expansions.

20     Identification of types and quantities of wastes to be generated by building areas.

3.     Review applicable code requirements affecting waste handling.

4.     Establish range of locally  approved disposal methods.

5.     Establish range of processing and disposal methods to consider.

6.     Establish range of handling method:; to consider.

7.     Establish range of storage  methods to consider.

8.     Evaluate economic and environmental aspects  of workable combinations of
       handling, storage and processing.

In addition to the above, design of systems, in buildings in the planning stage should
also consider the following:

1 o     Study of general materials handling requirements (quantities and types of new
       materials at receiving, storage, processing and distribution points).

2.     Evaluate merit  of common conveyor system for new materials and waste materials.

The rate  at which progress is  being made in the development of more sophisticated
handling and disposal equipment may well make some  portions of this report outdated
almost before publication.  Daily, new material could be added or superseded.  It must
be  recognized that during any period of great technological progress,  no precise time
could be totally ideal  for such a study  to be made and the process of updating is a
continuing one.  New handling methods and treatment processes are being developed,
but which are, as yet, untested under working conditions.  Some of the equipment
known to exist is of foreign origin and  not yet installed or proven under operating

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VOL.   I	
CHAP. V                                                                    V-17
conditions in the United States.  Other equipment or methods, some of which have
been seen by the consultant, are still in the development or pilot plant stages and
the sponsors have placed restrictions upon disclosure of details at the present time.

In conclusion, it is strongly recommended that continuing investigations be carried
out in efforts to stay abreast of developments in this field.

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VOL.  I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. VI      SELECTION AND DESIGN OF SOLID WASTE SYSTEMS      Page No.
               Organization of Material                                    Vl-l

               MODIFICATION OF HOSPITAL WASTE SYSTEMS              VI-2
                  System Criteria                                          VI-3
                  Handling Requirements                                   VI-4
                  Storage Requirements                                    VI-4
                  Processing and Disposal  Requirements                      VI-5
                  Effect on Community                                     VI-6
                  Evaluation of System Modifications                        VI-8
                  Identification of Considered System Modifications           VI-10
                  Summary                                               VI-11

               MODIFICATION OF OFFICE BUILDING WASTE SYSTEMS      VI-13
                  System Criteria                                          VI-13
                  Identification of Considered System Modifications           VI-14
                  Evaluation of Modified Systems                           VI-14
                  Summary                                               VI-23

                               LIST OF  TABLES

       Vl-l    Comparison of Hospital Solid Waste Systems
               Effect of System Modifications                               VI-12
       VI-2    Numerical Rating of Office Building Solid Waste Systems
                  Systems 1 & 4                                           VI-15
       VI-3    Numerical Rating of Office Building Solid Waste Systems
                  System 2                                               VI-16
       VI-4    Numerical Rating of Office Building Solid Waste Systems
                  System 3                                               VI-17
       VI-5    Comparison of Office Building Project Costs                    VI-18
       VI-6    Estimated Daily Labor Requirements and Costs of
                  Systems 2 and 3                                          VI-19
       VI-7    Estimated Daily Labor Requirements and Costs of System 4       VI-20
       VI-8    Economic Evaluation of Solid  Waste System Modifications       VI-21
       VI-9    Comparison of Office Building Solid Waste Systems
               Effect of System Modifications                               VI-24

                               LIST OF FIGURES

       Vl-l    Comparison of Economic Desirability of Systems                VI-22

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VOL.   I       SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. VI      SELECTION AND DESIGN OF SOLID WASTE SYSTEMS         VI-1
The preceding sections of studies have developed background data identifying the
functions and components of solid waste systems in the various types of building
complexes under study.  Observations of these systems in selected local buildings
have recorded the prevailing level of operating standards, the mechanics, and
efficiencies or deficiencies, in their existing operation„  Further evaluations have
indicated the environmental effects and costs of operation of the various components
within these building systems, all as a means of identifying weaknesses and needed
improvements,,

Concurrently with these observations, an investigation was conducted to establish
the present "state-of-the-art" in methods and equipment developed for or adaptable
to solid waste systems in buildings.  Basic guidelines have been  advanced for defining
system requirements in these various types of buildings, and procedures have been
suggested for the  evaluation of methods and equipment in the design of workable
systems for buildings in the design stage as well as existing buildings.

The concluding phase of this study is broadly concerned with the evaluation of
various feasible methods of improvements to solid waste systems in  existing buildings
and specifically to the solid waste systems of selected County-owned and operated
building complexes previously investigated.  Complete  details of the continuing study
are recorded in Volume IV of this report.  The principal objective of the continuing
study  is the determination of methods of storage, handling, processing and disposal
that can best be employed where warranted to improve the operating efficiencies
of solid waste systems in these existing buildings.  This  determination involves the
investigation of statutes, regulations and codes as they  may affect the selection,
installation and operation of equipment components in the system„  Comparisons of
installation and operating costs and benefits  of those systems suitable for each type
of building are also made and conclusions are presented together with positive
recommendations  for system improvements„
Organization of Material:

Presentation of material as contained in Volume IV incorporates (!) a digest of
principal codes and regulations locally applicable to solid waste systems and

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VOL.   I	
CHAP. VI                                                                    VI-2
management, (2) the evaluation of various types of system improvements considered
for selected buildings, and (3) the description of proposed solid waste system modifi-
cations at the LAC-USC Medical  Center, cost estimates and analysis of benefits of
this project,  together with an outline of a continuing studies program.

In review of this volume of material, the following digest was prepared, summarizing
the requirements of system concepts, evaluation procedures and the conclusions of
these evaluations.
MODIFICATION OF HOSPITAL WASTE SYSTEMS

From the descriptions of existing systems in local hospitals detailed in Volume II,
critical problems were identified that are common to the majority of hospitals
visited across the country and likely  common to nearly all hospitals in general.
Observations at these local hospitals indicate comprehensive policies have been
adopted regarding solid waste management.  Generally, these policies  are adequate,
including specific directives for segregation and special handling of hazardous
materials.  Practical enforcement of  these policies is where the systems break down.
Inadequacies in performance are largely due to the "people factor" built into the
system and the inability of the workers  to make correct judgments consistently.

Upgrading of the conventional solid waste system may be approached in several ways.
For example, immediate solutions may be considered for improving methods in handling
an individual type of waste or minor  modifications of selected functions within the
system.

Those unacceptable conditions in the existing waste system should be met with interim
remedial measures until such time as  acceptable long range solutions can be considered
and adopted.  These interim remedial measures would generally be confined to policy
enforcement and would rely largely on  the; capabilities of supervisors and cooperation
of workers.  Such changes can only be  implemented and carried out successfully when
accompanied by a continuing surveillance program.  The value and benefits of a
sanitarian carrying among his duties the responsibility for surveillance of the total
solid waste system would be indispensable.  In those hospitals inspected, the
prevailing lack of surveillance of the solid waste system operation was evident.
It is reasonable to expect such surveillance with the cooperation of supervisory
personnel would have marked effect on working personnel  and conditions of the
entire system. Concentration on improvements of initial preparation of wastes,

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VOL.   I	
CHAP.  VI                                                                       VI-3
i.e. devising workable methods of breaking, packaging or containerizing disposable
syringes, needles, instruments, etc. at the ward level would reduce hazards in handling
and the possibility of ultimate reuse.  Improvements in maintaining proper handling
and disposal of pathological wastes, separation of reusables and disposables, proper
bagging of materials, prompt deposit of materials in chutes, close supervision of
storage, processing and disposal areas  and maintaining security in these areas against
access by unauthorized personnel are needed improvements that will lead to a more
nearly acceptable level of operation and that may be accomplished through a
continuing surveillance program.  In the conventional waste system in the larger
institutions, which relies totally on  the performance of manpower, costs of intensive
supervision and surveillance will be relatively high, but are necessary if attempting
to implement such an interim remedial  program.

Conversely, the total system may be modified with the design of a single integrated
closed system to handle all types of  materials insofar as practical.  With the develop-
ment of a modified system whereby the majority of waste materials can be conveyed
in a mechanized closed transport system,  such surveillance will be limited to initial
handling techniques at the ward level  and final  handling at the processing and
disposal stations.
System Criteria:

The necessity of a closed system for the transfer, storage, processing and disposal of
hospital wastes is founded on the premise that all such wastes are contaminated.  This
is based on observations that segregation of identifiable contaminated and  uncontam-
inated waste materials is neither accomplished in practice nor likely to be practically
or economically enforced.   Composition of these wastes include many salvageable
materials that could prove harmful upon reclamation and reuse.  In the  interest of
public health and welfare, it was concluded that in addition to  the closed transport
system, on-s?te disposal should be preferred or on-site processing of these materials
should be accomplished to produce a sterile homogeneous material suitable for safe
off-site transport and  disposal.

Capabilities of presently developed equipment are not sufficiently flexible to achieve
a closed system design that will handle all  wastes from point of generation through a
point of disposal  in either new buildings or modifications of systems in existing buildings.
However, it does appear feasible that  systems can be assembled  that will handle the

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VOL.   I	
CHAP. VI                                                                    VI-4
majority of these materials from centrally located accumulation points on each floor
to central storage or processing  locations.
Handling Requirements:

Due to the prevailing high ratio of reusable1 soiled linens to disposable wastes, it
appeared necessary for the selected waste handling system to have the capabilities
of moving both materials.  General materials handling systems, either of the auto-
mated mechanical conveyor type or automated cart type, could not be adapted within
these existing buildings due to physical plant layout, limitations of space, conflicts
with internal traffic elements and mechanical and structural obstacles.  The only
alternative handling system available, having the required capabilities, that could
be adapted within existing plants appeared to be pneumatic conveyors.  Although
twin tube systems are available for separate handling of  linens and wastes, consider-
ation has been limited herein to the single tube system based on lesser space require-
ments and economy.  Flexibility in adapting this type of system within the existing
building would permit collection from the base of chutes without extensive modifi-
cations to the existing chute system.  Evacuation of accumulated materials could be
accomplished at frequent intervals, transferring the materials to their respective
central  storage locations.
Storage Requirements:

This closed system concept also favors elimination of storage and rehandling of wastes.
With the use of the pneumatic conveyor system, intermediate storage requiring
physical rehandling after deposit in the chutes would be eliminated.  With the added
consideration of placing the vertical chutes under slight negative pressure to minimize
aerosol  contamination,  the transport system would meet the desired level of environ-
mental standards which  the closed system can provide.  Utilization of automated
mechanical  conveyors or cart systems (which are more adaptable to buildings in the
design stage) for the transport of sealed containers would afford a similar  level of
environmental standards providing space availability would permit their use.  In
either case, the only storage elements required in these types of closed systems are
the initial storage facilities in the Unit system and central storage in the  Inter-
Building system.

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VOL.   I	
CHAP.  VI                                                                     VI-5
Processing and Disposal Requirements:

Considering the criteria established for disposal of contaminated hospital wastes, a
number of methods have been evaluated. These methods identified below are listed
in their order of desirability.

    1.  Transportation of pulped or ground hospital wastes in the sanitary sewer
       system with on-site sterilization or subsequent sterilization, oxidation and
       digestion at an off-site treatment plant will assure freedom from contami-
       nation hazards.

    2.  Transportation and landfill of residue from hospital refuse after thorough
       on-site incineration or pyrolysis is a safe method without danger of
       contamination.

    3.  Transportation and landfill disposal  of hospital refuse after pulping or
       grinding and sterilization is a safe method without danger of contamination.

    4.  Transportation of pulped or ground hospital waste in the sanitary sewerage
       system with dewatering and disposal at an off-site treatment plant should
       be a satisfactory system for limited quantities of hospital refuse.

    5.  Transportation and landfill disposal  of hospital refuse,  modified by grinding
       and extruded  with a binding agent into blocks and encapsulated, while
       minimizing hazards during transport and handling, is still subject to
       spreading contamination at the  disposal  site by rupture of the casing
       during compaction operations.

    6.  Transportation and landfill disposal of hospital refuse modified by grinding
       or pulping will reduce some hazards in handling  at the disposal site but
       may cause the spread of contamination in transport and disposal.

    7.  Transportation and landfill disposal of baled or compacted hospital refuse,
       while lessening dangers to handlers, the material is subject to scavenging
       of hazardous reusable materials and the  spread of contamination in
       transport and at the disposal site.

    8.  Transportation and landfill disposal of loose hospital  refuse is dangerous to
       handlers and the public alike and is subject to scavenging of hazardous
       materials and the spread of contamination along  the transport route and
       at the disposal site.

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VOL.   I	
CHAP. VI                                                                     VI-6
Of the eight- methods of processing and disposal considered above, only four (Nos. 1-4)
reasonably meet the established criteria (page V|-3) and have sufficient qualifications
to warrant serious consideration from an environmental point of view.

Of these four, only two (Nos. 2 and 3)  full/ meet the established criteria, wherein
incineration and sterilization after pulping convert the wastes for safe off-site
handling.  Two additional methods, differing only slightly and both involving pulping,
utilize the already contaminated sewers as the means of off-site transporto  These
methods would not contribute additional environmental contamination  in transport and
in principle also meet the criteria.  Method No. 1 provides for  further modifications
of pulped solids by the wet oxidation process.  This may be accomplished prior to
discharge to sewers or at the sewage treatment plant by modification of treatment
processes.  In the latter case, the wet oxidation process would be handling the full
range of solids presently encountered in addition to the pulped hospital waste
loadings. Method No. 4 without further modification of pulped solids prior to
discharge to the sewers or without modification of sewage treatment processes would
burden the treatment plants with the quantitative increase  in contaminated solid
materials these plants will handle.

Methods 5 and 6, while not reducing dangers from contamination do reduce hazards
in handling, eliminate scavenging and are a considerable improvement over present
off-site handling methods.   Such processes could be considered on an interim basis
until such time as the system could be further upgraded.

Effect on Community:

In evaluation of these processing and disposal methods, the magnitude of the total
hospital waste problem in the community must be weighed and related  to in-plant
environment and the environment of the community at large.  For example, in
Los Angeles County, some 580 hospitals and nursing homes have a potential daily
generation of about 470,000 pounds or 235 tons of disposable wastes.  This quantity
of materials is presently handled at the respective institutions daily and disposed of
by incineration or transported to landfills For disposal.

In addition to the problems of in-plant handling, potential hazards to  the community
exist in the off-site handling of this material.  No conclusive research directly
related  to off-site disposal of hospital wastes and its effect on the community has
been performed.  Principal concerns of health authorities relate to the possible survival
of pathogenic microorganisms and their subsequent transmission by direct human contact

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VOL.   I	
CHAP. VI                                                                    VI-7
with contaminoted materials or through insects or rodents,  as well as transmission
through air and water pollution.  Off-site disposal  conventionally involves a method
of highway transport, direct or via transfer stations to landfills or other disposal facil-
ities.  The community environment may be exposed to hospital  waste contaminants
throughout the course of travel with greatest potential exposure occurring at the
disposal site where direct contact by refuse workers and scavengers may occur or where
water pollution via runoff or leaching  may ultimately occur.

Although  incineration is one of the most effective methods, its continuing  use cannot
be recommended  in this area because of the severe  air pollution which already exists
under certain  atmospheric conditions.

Considering pulping  with discharge to  sewers as an  alternative, a potential loading
of about 70%  of this total daily generation of hospital wastes or 165 tons (dry  weight)
would be  handled daily at the sewage  treatment plants in Los Angeles, discounting
mositure content  and non-pulpable material.  With conventional sewage treatment
processes, the nature and quantity of these solids would in truth be a burden if all
such materials were  received and processed.  However, with modifications of sewage
treatment processes, adapting such methods as wet oxidation, all solids may be
substantially reduced in  quantity and handled at a much faster rate than conventional
processes  permit.

The solution for the  total community problem in handling hospital wastes could be
achieved  if pulping or grinding with discharge to sewers can be proven feasible
and accepted  by  local  authorities.   Hospitals, nursing homes, clinics, etc. where
contaminated  wastes are concentrated  could utilize a recognized contaminated
transport channel (the sewer) with disposal at limited and controlled locations
(sewage treatment plants).  Personnel at these plants are accustomed and trained in
handling and processing  such contaminated materials in a routine manner with
reasonable safeguards to the community environment.

A concurrent research project conducted by the County of Los Angeles Health
Department has investigated wet grinding of hospital wastes with discharge to
sewers. This *research carried out during 1967-69 employed the use of small pilot
grinder installations  at selected local hospitals wherein selected hospital wastes
*"Use of Wet Grinding Units for Disposal of Hospital  Solid Wastes" - by Bernard S.
Weintraub,  Harvey D. Kern, Health Facilities Service  Division, County of Los Angeles,
Health Department, Aug0 1969 - Research Grant 110-224 Health Facilities Planning
and Construction Service, U.  S. Public Health Service

-------
VOL.   I
CHAP. VI
were satisfactorily processed.  The study concluded that such processing with subsequent
discharge to sewers is a feasible and an appealing public health solution to a major
community problem and suggested that more intensive research was warranted for this
method of disposal.
Evaluation of System Modifications:

It must be reemphasized that selection of the solid waste systems or systems modifi-
cations for hospitals should not be governed solely by favorable economics. The
evaluation of solid waste systems must consider the environmental aspects of operation
as well as the economic aspects,  not unlike the evaluations which have contributed
to the evolution and continuing improvement of sanitary systems for handling contam-
inated liquid (sewage)  wastes generated in all types of buildings.

The environmental aspects considered in the evaluation of the solid waste system
modifications in those institutions under study follow the same procedures as were
applied  in  the evaluation of existing systems. This evaluation method was
developed  around the closed system concept, wherein the optimum standards of
operation throughout the system permit handling,  storage, processing  and disposal
of all wastes to be accomplished without exposure and without contributing
additional  environmental pollution.  Such a system,  receiving wastes at the point
of generation and transporting this material to a final processing or disposal station
would in theory not have an operating deficiency, except possibly in the initial
deposit or in the final disposal process.  An analogy  to this concept is the garbage
grinder,  receiving and processing food wastes generated in the kitchen, discharging
these materials to sewers for transport with final processing and conversion of wastes
at the sewage treatment plant.

Based on present technology and equipment in the development stage, it is doubtful
that such systems capable of handling all hospital wastes (both reusables and
disposables) will be devised and widely used in the foreseeable future.

Considered improvements which most nearly approach this concept, as qualified in
the foregoing,  have been limited to adaptation of the pneumatic conveyor system
for  transport  of the majority of wastes and the four optional processing and disposal
methods  that reasonably meet the established criteria.  Tabular summaries will later
show the comparison between the various systems  at each institution.

-------
VOL.   I	
CHAP.  VI                                                                    VI-9
Costs of the various system improvements were estimated based on cursory investigations
of buildings, mechanical  installations and site conditions, without benefit of the
development of preliminary plans.  Sizing of processing and/or disposal units were
based on handling of the present quantities of wastes generated during a one shift
operation on a seven day  week basis.  Expansion of disposal facilities and/or
increasing number of shifts worked would  be required to meet  significant future
increases  in waste production.  Manufacturers of various types of equipment were
consulted in establishing budgeted costs of improvement.  Depreciation costs
(straight line basis) of the modified systems have  been based on 10 to 25 year life
of various elements of the systems.  Net investment costs for installation of the
modified systems consider total costs of improvements, less salvage allowances for
equipment used in the present system  that may be retired.  Cost allowances for
additions  or replacement of equipment in  the existing system are also considered
in the determination of the net investment.

Summaries were prepared  on each system identifying the tangible economic benefits
(if any) to be derived from the  implementation of the project, incorporating those
direct operating benefits as noted,  together with certain indirect benefits that
accrue due to elimination of certain parts of the  existing system.  Direct operating
benefits or advantages consider the direct effects of operational costs of the project,
i.e. savings in  labor and  building areas released for other uses and the increase in
costs of maintenance, materials and supplies and power or collectively, the gross
savings or added cost of operation.  Indirect benefits or non-operating advantages
also consider annual savings in further depreciation of the existing system.  In some
cases, it will be noted that the considered improvements in systems will not reflect
such benefits or economies but will, in fact, increase annual  operating costs,,  A
tabular summary will later show the comparison of the economic evaluations
between the various systems at each institution.

In addition to the  tangible benefits, certain intangible benefits with monetary value
will also accure as a result of operating the improved solid waste system,,   Improvement
in sanitation, safety, security and esthetics may  likely have an effect on  the frequency
of personal injury, accidents, illness of personnel, as well as patients throughout the
plant and perhaps  the greatest effect  on those being  associated with  the direct handling
of the waste materials.  Similarly,  limiting the exposure of wastes in transport and
off-site disposal would likely have a  beneficial effect on the  community at large.
Improvement in systems  operation and these related environmental conditions should
also tend  to reduce the  general cost of building maintenance and losses due to fire

-------
VOL.   I	
CHAP. VI                                                                 VI-10
or other casualty.  These improved systems using an isolated and specialized transport
method will  reduce congestion in building corridors, allowing more efficient
performance of other service functions.  Economic analysis of annual dollar savings
that may accrue  from these benefits would require a multitude of record statistics
of plant operation  that are not available and adequate bases of fact are not at hand
to permit an intelligent detailed estimate.  However, it is conceivable that
collectively the  intangible benefits could equal, if not exceed, the estimated value
of tangible benefits in  many cases.
Identification of Considered System Modifications:

Reference to the identification of those modified systems considered in the evaluations
will be limited  to ID numbers established as follows:

    1  - Pneumatic Conveyor System, Pulping or Wet Grinding, Wet Oxidation,
       Discharge to Sewers

    2  - Pneumatic Conveyor System, Incineration,  Transport Residue to Landfill

    3  - Pneumatic Conveyor System, Pulping or Wet Grinding, Wet Oxidation,
       Dewater, Transport to Landfill

    4  - Pneumatic Conveyor System, Pulping,  Discharge to Sewers

    5  - Pneumatic Conveyor System, Pulping or Wet Grinding, Extrude, Transport-
       to Landfill

    6  - Pneumatic Conveyor System, Shredding, Transport to Landfill

    7  - Pneumatic Conveyor System, Pulping or Wet Grinding, Dewater, Transport
       to Landfill

    8  - Pneumatic Conveyor System, Stationary Compactor, Transport to Landfill

    9  - Pneumatic Conveyor System, Packer Truck, Transport to Landfill

-------
VOL.   I	
CHAP. VI                                                                   VFT
Only those systems (Nos.  1-4) which meet the established criteria for satisfactory
disposal were considered in the environmental evaluation (numerical rating) of
modified systems.  However,  cost comparisons of all  these systems were made to
provide an overall "yardstick" in the range of costs of disposal and  the significance
of such costs.

These system evaluations as presented in Volume IV included detailed numerical
ratings, estimated project costs, estimated daily labor costs and the economic
analysis of these system improvements at each institution.   Repetition of this volume
of data is not warranted herein and the reader is referred to Volume IV for complete
details.  However,  to illustrate the depth of  these evaluations, the report on the
LAC-USC Medical Center is appended (Appendix F)  in its entirety for the reader's
convenience.
Summary:

In review of the evaluation of system modifications as presented in Volume IV,
Table VI-1 was prepared in summary of these findings, showing comparisons in
system deficiencies, investment requirements and increase or decrease in annual
costs.

Based on investment requirements and the effect on annual costs of operation of the
four systems considered,  System 4 (pulping with discharge of wastes to sewers) has
considerable merit, while at the same time improving in-plant conditions as well
as off-site handling.

The solution for the total community problem in off-site handling of hospital wastes
could be achieved if pulping or grinding with discharge to sewers can be proven
feasible and accepted by local authorities.  Hospitals, nursing homes, clinics,  etc.
where contaminated wastes are concentrated could utilize a recognized  contaminated
transport channel (the sewer) with disposal at limited and controlled locations
(sewage treatment plants).  Personnel  at these plants are accustomed and trained
in handling and processing such contaminated materials in a routine manner with
reasonable safeguards to  the community environment.  Based on local environ-
mental conditions and needs, further development of this concept is warranted.

-------
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Vl-l
VI-12

-------
VOL.   I	
CHAP. VI                                                                VI-13
MODIFICATION OF OFFICE  BUILDING WASTE SYSTEMS

The evaluations of existing systems in the office buildings under study, as reported in
Volume II, indicate these systems are operated with reasonable economy and with
relatively minor deficiencies.

These investigations found that these systems are operated largely without specialized
equipment by custodial work forces as they perform daily routine cleaning and
maintenance functions.  This work is generally performed when buildings are
unoccupied, thereby permitting effective supervision and control of these activities.

Composition of wastes generated in the office  buildings studied were neither hazardous
nor objectionable when  related to handling or disposal. Largely consisting of paper
with an intermix of small quantities of food wastes and non-combustibles, these
materials are generated  in relatively low volumes.

The numerical rating, reflecting the environmental aspects of these evaluations,
identified that  the major deficiencies exist in  storage functions and the off-site
system. These  deficiencies are relatively minor by comparison  to those found in
the hospital waste systems0  Upgrading of these systems as in the case of hospitals
requires adopting higher standards of operation.  The motivation for adopting such
standards is multipurpose; to improve building  safety and safety of occupants through
elimination of fire hazards and conservation of space through minimizing storage.
Based upon the equipment research undertaken in this study, there are limited
mechanical  devices that can be employed to help achieve such improvements.
Such improvements for these buildings will require additional capital investments
and likely result in higher annual costs than presently experienced.
System Criteria:

Minimum modifications that may be considered,  limited to such installations as
gravity chutes and/or stationary compactors or balers, will require only nominal
investments and accomplish  the basic objective of improving on-site storage deficiencies.

Major modifications,  eliminating in-building storage entirely, may be feasible in
major building  complexes.   Such systems, employing pneumatic conveyor systems,
could evacuate materials deposited in gravity chutes in  each building and convey

-------
VOL.   I	
CHAP. VI                                                                   VI-14
these materials to a central storage or processing point.  Such processes, including
compaction or baling, pulping or grinding and incineration, may be considered as
the final on-site treatment of wastes.  However, due to the seventy of air pollution
in the Los Angeles Basin,  the latter has not been considered suitable for the Civic
Center buildings under study.
Identification of Considered System Modifications:

Reference to the identification of those modified systems considered in the evaluations
will be limited to the ID numbers established as follows:

    1  - Manual Fed Stationary  Compactor (System serves single building),
       Continued Transport to  Sanitary Landfill

    2  - Gravity Chutes,  Pneumatic Conveyor System, Central Stationary Compactor
       (System serves several buildings),  Continued Transport to  Sanitary Landfill

    3  - Gravity Chutes,  Pneumatic Conveyor System, Central Wet Grinding  Station,
       Discharge to Sewers and/or Reclamation of Pulp (System serves several
       buildings)

    4 - Gravity Chute,  Stationary Compactor (System serves single building),
       Continued Transport to  Sanitary Landfill
Evaluation of Modified Systems:

The procedures in evaluation of office building systems follow the same procedures
as outlined earlier for hospitals.  The following evaluations of the modified systems
include tabular and graphic illustrations of the numerical  ratings, estimated project
costs,  estimated daily labor costs and the  economic analysis of such modifications
considered at the four office buildings under study.  The above described systems
are considered at each of these buildings  except the Engineers Building, wherein,
due to the remote location from the tunnel system connecting the Civic Center
buildings, only systems 1 and 4 may be feasible.

-------
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'< i 1
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'£ J! o •£.
O O O "
CO CO tO UJ
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                                                                              TABLE VI-4
                                                                              PAGE VI-17

-------
VOL.   I
CHAP. VI
                                                  VI-18
                TABLE VI-5
COMPARISON OF OFFICE BUILDING PROJECT COSTS
BUILDING


HALL OF
ADMI NISTRATION



COUNTY
COURTHOUSE



HALL OF
RECORDS



ENGINEERS
BUILDING
SYSTEM
1
2

3
4

1
2
3
4

1
2
3

4
1
4
SYSTEM COMPONENTS
Compactor
Vacuum Tube
Gravity Chute
Compactors
Building
Total
Vacuum Tube
Gravi ty Chute
Grinders
Bui Iding
Total
Gravity Chute
Compactor
Total
Compactor
Vacuum Tube
Gravity Chute
Compactors
Building
Total
Vacuum Tube
Gravity Chute
Grinders
Building
Total
Gravity Chute
Compactor
Total
Compactor
Vacuum Tube
Gravity Chute
Compactors
Building
Total
Vacuum Tube
Gravity Chute
Grinders
Building
Total
Gravity Chute
Compactor
Total
Compactor
Gravity Chute
Compactor
Total
INSTALLED
COSTS
$ 12,000
$102,200
4,050
6,250
25,000
$137,500
$102,200
4,050
18,750
25,000
$150,000
$ 4,050
15,000
$ 19,050
$ 12,000
$102,200
4,050
6,250
25,000
$102,200
4,050
18,750
25,000
$ 4,050
15,000
$ 19,050
$ 12,000
$102,200
7,650
6,250
25,000
$141,100
$102,200
7,650
18,750
25,000
$153,600
$ 7,650
15,000
$ 22,650
$ 12,000
$ 4,050
15,000
$ 19,050
ESTIMATED
LIFE (YEARS)
10
25
25
10
25

25
25
10
25
25
10

10
25
25
10
25
25
25
10
25
25
10

10
25
25
10
25
25
25
10
25

25
10
10
25
10
DEPRECIATION
$1,200
$4,088
162
625
1,000
$5,875
$4,088
162
1,875
1,000
$7,125
$ 162
1,500
$ 1 . 660
$1,200
$4,088
162
625
1,000
$4,088
162
1,875
1,000
$ 162
1,500
$1,660
$1,200
$4,088
306
625
1,000
$4,088
306
1,875
1,000
$7,270
$ 306
1,500
$1,810
$1,200
$ 162
1,500
$1,660

-------
VOL.  I
CHAP. VI
VI-19
            TABLE VI-6     ESTIMATED DAILY LABOR REQUIREMENTS
                           AND COSTS OF SYSTEMS 2 AND 3


REQUIREMENTS OF WASTE SYSTEM:
Unit System (Man Mrs.)
Inter-Unit System (Man Hrs.)
Total System (Man Hrs.)
ESTIMATED LABOR COSTS:
Unit System
Inter-Unit System
Total System Cost
Cost/Ton
Cost/Pound
Hal! of
Records

52.9
1.0
53.9

$ 196
$ 5
$ 201
$ 402
$0.201
Hall of
Administration

85.0
1.0
86.0

$ 315
$ 5
$ 320
$ 250
$0.125
County
Courthouse

56.6
1.0
57.6

$ 210
$ 5
$ 215
$ 246
$0.123
   Note:  Above cost summary does not include off-site system costs, which
          are expected to remain generally constant.
   Note:  Present labor costs are not expected to be affected in System 1.

-------
VOL.  I
CHAP. VI
VI-20
           TABLE VI-7     ESTIMATED DAILY LABOR REQUIREMENTS
                          AND COSTS OF SYSTEM 4


REQUIREMENTS OF WASTE SYSTEM:
Unit System (Man Mrs.)
Inter-Unit System (Man Mrs.)
Total System (Man Hrs.)
ESTIMATED LABOR COSTS:
Unit System
Inter-Unit System
Total System Cost
Cost/Ton
Cost/Pound
Hall of
Records

52.9
2.0
54.9

$ 196
$ 7
$ 203
$ 406
$0.203
Hall of
Administration

85.0
2.0
87.0

$ 315
$ 7
$ 322
$ 252
$0.126
County
Courthouse

56.6
2.0
58.6

$ 210
$ 7
$ 217
$ 248
$0.124
County
Engineers

37.6
1.0
38.6

$ 139
$ 4
$ 143
$ 340
$0.170
Note:  Above cost summary does not include off-site system costs, which are
       expected to remain generally constant.
Note:  Present labor costs are not expected to be affected in System 1.

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VOL.  I
CHAP. V!
VI-21
          TABLE VI-8    ECONOMIC EVALUATION OF SOLID WASTE
                                SYSTEM MODIFICATIONS
OFFICE BUILDING







HALL OF
ADMINISTRATION













COUNTY
COURTHOUSE

HALL OF
RECORDS



ENGINEERS
BUILDING




1 INVESTMENT
Installed Cost of Project
Investment Released or Avoided by Ptoiecf
Net Investment Required
II OPERATING ADVANTAGE
DIRECT EFFECT OF PROJECT
Labor
Maintenance
Materials and Supplies
Power
Floor Space
Net Increase or Decrease in Operating Costs
HI COMPUTATION OF DESIRABILITY RATING
Total Advantage
Depreciation
Return on Investment
Definability Ratina
1 INVESTMENT
rnstolled Cost of Pro|ect
Investment Released or Avoided by Project
Net Investment Required
II OPERATING ADVANTAGE
DIRECT EFFECT OF PROJECT
Labor
Maintenance
Materials and Supplies
Power
Floor Space
Net Increase or Decrease in Operating Costs
11 COMPUTATION OF DESIRABILITY RATING
Total Advantage
Depreciation

D-«robilitv Ratina
1 1 NVESTMENT
Installed Cost of Project
Investment Released or Avoided by Project
Net Investment Required
11 OPERATING ADVANTAGE
DIRECT EFFECT OF PROJECT
Labor
Maintenance
Materials and Supplies
Power
Floor Space
Net Increase or Decrease in Operating Costs
Ml COMPUTATION OF DFSIRABU ITY RATJNC,

Depreciation
Return on Investment
Of jirabi.ilv Ratina
1 INVESTMENT
Installed Cost of Project
Investment Released or Avoided by Proiect
Net Investment Required
11 OPERATING ADVANTAGE
DIRECT EFFECT OF PROJECT
Labor
Maintenance
Materials and Supplies
Power
Floor Sooce
Net Increase or Decrease in Operotirw Costs
Ml COMPUTATION OF DESIRABILITY HATING
Total Advantage
Depreciation
keturn on Investment
Desirability Rating
SYSTEM
1

$ 12,000

S 12,000

Increase

J 60
90
1.090

J- 640
Decrease
$ 0



1 600


$- 640
1,200
$-1,840
-15

S 1? 000

i 12,000

Increase

$ 60
90
1,090

$- 640
Decrease
$ 0



S 600


J- MO
1.200
$- .840
-15

i 12.000

$ 12,000

Increase

S 60
90
1,090

$- MO
Decrease
J 0



$ 600


$- 640
1.200
S-1,840
-15

5 12 000

$ 12,000

Increase

S 60
90
1,090

S- 640
Decrease
s o



$ 600


S- 640
1,200
$- ,8*
-15
2

$137,500

J137.500

Increase

S 690
1.030
1.000


Decrease
$6 350



$ 600
$4,230

J 4,230
5,875
$-l,M5
-1

«i.i7 son

$137,500

Increase

S 690
1.030
1.000


Decrease
$4.350



$ 600
$4,230

S 4,2X
5.875
$-1.645
-1

1141.100

$141,100

Increase

4 690
1.030
1,000


Decrease
$6.350



$ 600
$4.230

$ 4,230
6,020
$-1.790
-1





Increase






Decrease











3

$150,000

$150,000

Increase

$ 750
1.125
1.550


Decrease
$6.350



$ 600
$3,525

$ 3,525
7,125
$-3.600
-2

$150.000

$150,000

Increase

$ 750
1,125
1.550


Decrease
$6.350



$ 600
$3,525

$ 3,525
7,125
$-3600
-2

$153.600

$153,600

Increase

$ 750
1.125
1,550


Decrease
$6.350



$ 600
$3.525

$ 3,525
7,270
$-3,745
-2





Increase






Decrease











4

$ 19,050

$ 19,050

Increase

$ 100
150
1.245


Decrease
$5.385



i 600
$4,490

$4,490
1,660
$2,830
15

$ 19.050

$ 19.050

Increase

$ 100
150
1.245


Decrease
15.385



$ 600
$4,490

$4.490
1,660
$2.830
15

$ 22 650

$ 22,650

Increase

$ 100
150
1,245


Decrease
VS.3B5



$ 600
$4,490

$4,490
1,810
$2.680
12

$ 19,050

S 19,050

Increase

$ 100
150
1,245


Decrease
$5.385



$ 600
$4,490

$4.490
1,660
$2,830
15
   Note: Term "Desirability Rating" is synonymous with percent of return on investment.

-------
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                                                                                  PAGE VI-22

-------
VOL.   I	
CHAP. VI                                                                    VI-23
Summary:

In review of the foregoing evaluations of system modifications, Table VI-9 was prepared
in summary of these findings, showing comparisons of system deficiencies, investment
requirements and the increase or decrease in annual costs.

Based on investment requirements and the  effect on annual costs of operation,  basic
interim improvements in these types of building systems could be accomplished most
practically through the installation of stationary packers at slight additional annual
cost.  Installation of gravity chutes in existing buildings should be considered  in
future building modification plans.

It is likely that a pneumatic collection system and central processing station serving
a number of buildings such as exist in the  Civic Center complex could prove economi-
cally  feasible, providing broad participation could be achieved.  In the  case of the
Civic Center complex, this would likely require joint participation of Federal, State,
County and City agencies occupying the numerous governmental buildings in the area
and perhaps participation of private enterprise buildings on the perimeter of this
complex.  It is beyond the scope  of this project to investigate such  potentials further,
but this concept is recommended for consideration in planned expansions  of the
Civic Center and in the planning stage of similar new complexes.

-------









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TABLE VI -9
PAGE Vl-24

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VOL.   I      SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP. VII     REVIEW OF STUDY                                Page No.
             HOSPITAL WASTE SYSTEMS                           VII-1

             DETENTION FACILITY WASTE SYSTEMS                 VI1-3

             OFFICE BUILDING WASTE SYSTEMS                    VII-4

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-------
VOL.    I      SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
CHAP.  VII     REVIEW OF STUDY                                             Vll-l
The findings of this study have confirmed general inadequacies that prevail, both in
(1) the operation of conventional solid waste systems and (2) the development and/or
use of hardware that can upgrade operating standards.
HOSPITAL WASTE SYSTEMS

In the hospitals inspected, both locally and throughout the country, significant
deficiencies exist in the in-plant system as well as off-site disposal.  Based on the
detailed investigations of local institutions, those deficiencies, relating to the
environmental aspects of in-plant handling and storage of wastes, are tolerated
daily,  while generally incurring high costs of operation.  Mechanized and automated
handling systems currently exist and are being tested and improved. Although rela-
tively high in capital costs, these systems will likely provide overall economy in
annual operating costs for many small and large institutions.  Pneumatic conveyor
systems  for handling soiled linens and disposable wastes have  the greatest potential
for adaptation in existing buildings.   The pneumatic system and conveyor systems
for sealed container transfer both hold merit for use in buildings in the planning
stage.   The latter has the added flexibility of handling the distribution  of  clean
supplies as well as soiled materials and wastes. However, it  is also likely that
economically the latter could  not be justified unless it is in fact designed  to handle
all types of these materials. Both types of systems will afford similar improvements
in operating standards in  that material movements are accomplished in a closed
transport system, minimizing exposure within  the plant as well as minimizing interim
storage  requirements.

The deficiencies existing in on-site processing and disposal are largely  due to lack
of investment in proper equipment and/or operating personnel.  However,  types of
equipment that can provide satisfactory processing are limited. Incineration is the
only proven method of on-site  disposal that is widely used. In many cases, on-site
incinerators with reasonable capabilities are improperly operated.  Similarly, many
on-site  installations exist that  are not capable of  handling the loads imposed on
them or being operated to meet local  standards, even if there were qualified oper-
ators.  Both incinerator design and operation  are highly complex. Although the
importance of design engineering  is now generally recognized, specialized training
of operators is not.  The industry is capable of designing incinerators to meet the

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VOL.    I	
CHAP. VII                                                                 VI1-2
most stringent standards.  In the larger metropolitan areas where air pollution conditions
are severe, the more sophisticated control devices will likely be required in  order to
meet local standards.  However,  it presently appears economically and/or technologically
infeasible that such devices can be adapted to the smaller on-site  incinerators based on
lack of such equipment in this waiting market.  Further,  in view of the severity of air
pollution conditions that exist in such areas as the Los Angeles Basin, where  progressively
restrictions are necessarily being strengthened on air pollution, incineration  cannot
be recommended.  Except in such extreme cases, a properly designed incinerator with
qualified operators is the only currently proven method of on-site disposal that could
be recommended, whereby materials can be reduced and converted to an innocuous
state, microbiologically safe for off-site transfer and disposal.

Alternative methods of on-site processing investigated that would properly condition
waste materials were all centered around pulping or wet grinding.  It was concluded
that such processing,  followed by sterilization and dewatering, would provide adequate
conditioning  for off-site transfer and disposal.  Similarly, it was considered  that the
environment would not be further exposed to contamination  if,  following the pulping
process, the material  were discharged to the sewers, utilizing an already contaminated
channel for transport.  Various types of wet grinding and pulping equipment  of various
capacities are presently available and being improved.   Such equipment can be sized
for small and large installations.  Sterilization processes and equipment specifically
designed for handling of unselected solid v/astes are non-existent.  However, certain
processes may be adapted for this need.  Capabilities of the sewers for pipeline
transport of additional non-settlcable solids appear to be adequate if the materials
are property introduced„  Chief concern with this method, employing sewer transport,
is the ultimate effect of solid loadings on conventional sewage treatment plants, water
reclamation and modifications in treatment processes that may be required.

Considering the local conditions of the  Lo> Angeles Basin area, and the dilemma
facing the hundreds of hospitals, nursing homes,  clinics, etc,,, all generating similar
wastes and having similar problems in the control of processing and disposal of these
materials, the need for detailed studies of pulping and wet grinding was considered
warranted.  This study appeared fully justified when considering that improving
standards  of handling and disposal of hospital wastes is a growing national problem.

Further development of this concept suggested that a pilot project be developed

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VOL.    I	
CHAP. VII                                                                   VI1-3
of sufficient scale to prove meaningful under a wide range of conditions.  Inasmuch as
successful experimentations have been carried out on small scale projects, it is vital
that this project be of sufficient scope to test the full  range of disposal methods
connected with the wet grinding or pulping process.

Based on these qualifications and the  total findings  of this study, the project concept
was further developed, and the LAC-USC Medical Center was recommended as the site
for this project.   Complete details of  the development of this concept, together with
schematic plans, and the environmental and economic evaluation of the modified
system for the Medical Center, were carried out in  Volume IV and are appended
(Appendix G) in their entirety in this volume for the reader's convenience.

The proposed project includes the design, construction and operation of the proposed
waste system, together with an extensive program of observations,  analysis,  and  testing
(as noted in the  appended study).

The proposed system for this project involves pneumatic transport of disposable wastes
and reusable linens employing a single tube pneumatic conveyor system.  This  proposed
system also will  contain a central pulping station for disposable materials, a wet
oxidation process and an  experimental sewage treatment plant.  Optional disposal
methods available include discharge of raw or sterilized pulped wastes to sewers,
transport of dewatered  raw or sterilized pulped wastes to  landfills, nearly complete
oxidation of pulped wastes with discharge of residue to sewers or dewatered residue
to landfills or emergency bypassing of all processes  with direct discharge of bulk
wastes to a compactor for disposal  at landfills.

Based upon the foregoing study, this project is recommended as a solution to the
more critical problems  of the current solid waste system at LAC-USC Medical Center.
It is a solution with qualifying economic  and  environmental benefits.  In summation,
the proposed project would meet local needs while also providing a laboratory for
study and experimentation on a number of optional disposal methods for institutional
application.
DETENTION FACILITY WASTE SYSTEMS

The observation and evaluation of existing solid waste systems in local detention

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VOL.    I	
CHAP. VII                                                                   VII-4
facilities indicated that principal in-plant deficiencies occur in central storage.  Manual
in-plant housekeeping functions, including the collection and transfer of solid wastes to
central  storage, are generally performed by inmate work details.  Changes in the manner
of performance of these  internal  functions are not considered feasible and  quality of
such performance is subject to the enforcement of standards by staff and supervisors.

Mechanization of any portion of the solid waste system, subject to abuse by  inmate
operators, should be avoided.  Although mechanical  processing devices such as
stationary compactors would improve central storage  conditions, reliable functioning
could be expected only  if operated and maintained by a qualified employee. As a
practical matter, improvements in detention facility  waste systems can be  expected
only through enforcement of standards by :,taff and supervisors.,
OFFICE BUILDING WASTE SYSTEMS

In those office buildings investigated in the Civic Center, only minor deficiencies
were found in the elements of storage and off-site disposal.  Generally, in-plant
supervision is effective in maintaining good operating standards.  In-plant defi-
ciencies that occur are primarily due to lack of equipment for confinement and
reduction of collected waste materials.

Interim improvements in these systems wil1 require adoption of higher standards of
operation with accompanying increase in annual costs.  Basic improvements can
be accomplished with the installation of manually fed stationary compactor units.
Further improvements can be accomplished with chute installations directly feeding
the compactor units.

Long range improvements, involving chute installations  in each building connected
with a central pneumatic conveyor system and processing station, should be
considered in planned expansions in the Civic Center complex in the initial design
stages of similar projects.

The proposed project recommended for the LAC-USC Medical Center will determine
the feasibility of such systems and the results  should also be evaluated from the
viewpoint of application to office building complexes.

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VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
                                                                Page No.
                                APPENDICES

     A        LAC-USC MEDICAL CENTER
              (Existing Solid Waste System)                            a-1

     B        DETENTION FACILITIES
              (Description of Existing Solid Waste Systems)               b-1

     C        DETENTION FACILITIES
              (Evaluation of Existing Solid Waste Systems)                c-1

     D        OFFICE BUILDINGS
              (Description of Existing Solid Waste Systems)               d-1

     E        OFFICE BUILDINGS
              (Evaluation of Existing Solid Waste Systems)                e-1

     F        LAC-USC MEDICAL CENTER
              (Considered Improvements to Solid Waste System)           f-1

     G        LAC-USC MEDICAL CENTER
              (Recommended Solid Waste System Improvements)           g-1

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VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX A                                                               a-1
              The study and evaluation of the existing solid waste system
              operation at the LAC-USC  Medical Center, as  reported in
              Chapter II, Volume II, is appended in its entirety.  This
              study illustrates the depth of investigations undertaken
              and supports the continuing studies of this institution
              leading to recommended system modifications.

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VOL.  II      OBSERVATIONS OF LOCAL PRACTICES
CHAP. II      LAC-USC MEDICAL CENTER                               Page No,
              DESCRIPTION OF EXISTING PLANT                         ||-1
                  Range of Medical Functions and Specialties                ||-1
                  Plant Services and Population                             ||-2
                  Location, Buildings and Land                             ||-4

              CHARACTERISTICS OF THE SOLID WASTE SYSTEM             ||-7
                  Types of Waste Materials Generated                       ||-7
                  Brief Description of the Total System                       ||-8
                  Responsibility of Solid Waste Management                  ||-9
                  Organization of Manpower                               11-11

              OBSERVATIONS OF THE INTER-BUILDING AND
                  OFF-SITE SYSTEM                                      ||-13
                  The Inter-Building Materials Handling System               11-13
                  Handling and Storage of Disposable Waste Materials         11-17
                  Waste Disposal Practices                                 11-19
                  Handling and Storage of Reusable Waste Materials           11-20
                  Quantities and Types of Disposable Waste Materials         11-21
                  Quantities and Types of Reusable Waste Materials           11-26
                  Summary of Total Waste Production                        11-28
                  Equipment and Building Areas Used in  System Operation      11-28
                  Subcontract Services and Disposal Fees                    11-31
                  Personnel Requirements                                  11-31

              OBSERVATIONS OF THE IN-BUILDING SYSTEM               ||-32
                  General                                                ||-32
                  Handling of Disposable Waste Materials                    11-33
                  Handling of Reusable Waste Materials                      11-34
                  Personnel Requirements                                  11-34
                  Equipment and Building Area Requirements                 11-38

              ESTIMATED OPERATING COST OF THE TOTAL SYSTEM        ||-39

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VOL.  II       OBSERVATIONS OF LOCAL PRACTICES
CHAP. II       LAC-USC MEDICAL CENTER                             Page No.
               OBSERVATIONS ON AEROSOL CONTAMINATION         11-46
                  Equipment and Procedures Used                         11-46
                  Observations at Selected Sampling Stations              11-47
                  Results of the Sampling Program                         11-48

               EVALUATION OF EXISTING SYSTEM OPERATION          11-50
                  The Developed Rating                                  11-52
                                LIST OF TABLES

       ll-l     Shift Population and Waste Production                      11-3
       11-2     General Services Personnel                                11-12
       11-3     Inter-Building Disposable Waste Collection                  11-22
       11-4     Production of Disposable Wastes by Buildings                11-23
       11-5     Load Record 8-Day Period                                 11-24
       11-6     Soiled Linen Processing - October 1968                     11-27
       11-7     Summary of Daily Waste Production                         11-29
       11-8     Costs of Building and Equipment in Inter-Building
               and Off-Site System                                      11-30
       11-9     Daily Requirements for In-Building Waste Handling           11-36
       11-10   Labor Requirements of In-Eiuilding Waste System              11-37
       11-11   Building Areas and  Equipment of the In-Building System       11-38
       11-12   Estimated Annual Equipment Operating Cost                 11-40
       11-13   Estimated Daily  Labor Costs of Hospital  Solid Waste Systems   11-41
       11-14   Distribution of Estimated Annual Costs to Waste
               System  Components                                       11-43
       11-15   Cost Comparison of Disposable and Reusable Wastes          11-44
       11-16   Summary of Air  Sampling Data                             11-48
       11-17   Description of Hospital Solid Waste Systems                 11-51
       11-18   Numerical Rating of Hospital Solid Waste Systems            11-53

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VOL.  II      OBSERVATIONS OF LOCAL PRACTICES
CHAP. II      LAC-USC MEDICAL CENTER                            Page No.
                              LIST OF FIGURES

       11-1    Site Plan                                              11-5
       11-2    Aerial Photograph of LAC-USC Medical Center             11-6
       11-3    Observations of Daily Cart Movement                      11-15
       11-4    Detail of Clean and Soiled Cart Movements                11-16
       11-5    Schematic of Inter-Building Solid Waste System             11-18
       11-6    Air Sampling Procedures in Soiled Linen Room               11-48

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VOL.  II       OBSERVATIONS OF LOCAL PRACTICES
CHAP. II       LOS ANGELES COUNTY-USC MEDICAL CENTER             ll-l
DESCRIPTION OF EXISTING PLANT

Los Angeles County-University of Southern California Medical  Center,  until  1968
known as Los Angeles County General Hospital, is the largest facility of the  eight
hospitals presently operated by the Los Angeles County Department of Hospitals
and one of the largest facilities in the United States. Through  its affiliation  with
USC Medical School, it is also one of the largest  teaching hospitals in the country.
The Medical  Center, along with the other County hospitals, is  administered by the
Board of Supervisors through the  Director of the Department of  Hospitals.  However,
at plant management level, each of these hospital facilities may be considered
autonomous or semi-autonomous in the adoption and implementation of administrative
policies and plant operating procedures.
Range of Medical Functions and Specialties:

The Medical Center is operated to provide hospitalization, out-patient care and
convalescent care as well as home care for qualifying patients within certain
geographic limits of Los Angeles County and the maximum capacity limits of its
facilities.  It offers specialized diagnostic, medical and surgical procedures as
well as emergency care  for the critically ill and accident victims.  It provides
teaching and training programs for medical specialties,  nursing and allied health
professions,  including clinical teaching to USC students and post-graduate training
for health personnel through its affiliation with the University, as well as inservice
training for both health  and supportive personnel.   It actively supports research
efforts to advance medical knowledge,  treatment techniques, health services and
management functions, all in  cooperation with the University„

Types of care offered include  preventive, diagnostic and therapeutic functions.
Plant facilities provide for inpatient, outpatient and emergency services. A
comprehensive range of  medical care specialties, or special categories, are

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VOL.  II	
CHAP. II                                                                   11-2
provided including:

    Internal Medicine       Pediatrics                   Burns
    Chest Medicine         Communicable Diseases      Neurosurgical
    Dermatology            Psychiatry                   Orthopedics
    Metabolic Unit         Jail Medicine               Otolaryngology
    Renal                  General  Surgery             Ophthalmology
    Dentistry               Chest Surgery               Urology
    Neuromedicine         Tumor                      Premature Center
                       Obstetrics/Gynecology
Plant Services and Population Related to Solid Waste Production:

Present plant services maintained at this facility and  staffed by hospital personnel
include the Dietary Department, which prepares some 10,000 meals daily, the
Laundry, which processes some 56,500 pounds of soiled linen daily with a working
staff of 200,  General Services (Housekeeping and Custodial Services) with a staff
of 600,  the Transportation Department, Maintenance Shops,  Security, Pharmacy.

The Business Office, Medical Records, Personnel, Communications and the Computer
Center provide those business services required in  further support of the plant
activitieSo A nursing staff of 1,466 and 3,181 nurses aides (attendants) are
involved in the various aspects of patient care functions.

Total population in the Medical Center Complex is comparable to  that of a substantial
communityo   Including  patients, paid and non-compensated personnel, there is a
gross population of approximately 21,000 persons scheduled over a seven-day week,
24-hour day basis.  Non-compensated personnel include students, trainees,
volunteer workers and personnel that may be paid  by  other agencies.

The breakdown of the total  population based on daily census records and ordinance
personnel lists consists of about 2,000 bee  patients per day (avg, seven-day basis),
2,800 outpatients per day (avg. five-day basis), 10,800 paid personnel and 5,600
non-compensated personnel.

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VOL.   II
CHAP. II
1-3
 Each person in this total population of 21,000 is a direct creator of solid waste,
 and quantities of wastes each generates varies with his classification, daily
 activities and hours present0

 Table ll-l illustrates probable variations in plant population that may occur over
 the weekly period and relates the corresponding rate (percentage) of waste
 production by shifts that may be expected daily.
           TABLE ll-l    SHIFT POPULATION AND WASTE PRODUCTION

Bed Patients (constant)
Outpatients
Paid Personnel
Non-Comp. Personnel
Total Est. Population/Shift
Avg, Shift & Daily Pop.
Rate of Waste Production:
% of Dally Production
Monday - Friday
1st Shift
2,000
2,800
5,400
3,200
13,400
2nd Shift
2,000
1,500
1,600
5,100
3rd Shift
2,000
1,500
800
4,300
*7,100
54%
25%
21%
Saturday and Sunday
1st Shift
2,000
3,000
5,000
2nd Shift
2,000
1,500
3,500
3rd Shift
2,000
1,500
3,500
4,000
42%
29%
29%
•"Includes outpatients weighted at 1/2 value due to limited time in hospital
Although the above estimate and observations indicate that waste production is a
continuing process, the major handling of accumulated wastes is primarily confined
to services provided during the first shift operation.

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VOL.  II	
CHAP. II                                                                      ||-4
Location, Buildings and Land:

The Medical  Center is located in the Central District of Los Angeles about one mile
northeast of the downtown Civic Center.  Eiounded by Mission Street, Marengo Avenue,
Cummings Street and Zonal Avenue, it occupies a site of some 68 acres bisected by
State Street meandering on a north-south axis through this property.  The proportions
of the property range  from about 1200 feet wide on the north-south axis to an average
length of some 2500 feet.  Grade differential is considerable, ranging from the
highest elevation on the  east boundary (Cummings Street) at 430' MSL,  falling
about 125' in grade to the west with its lowest elevation at about 305' in the
southwest portion of the property.

Basically,  the total site consists of three building plateaus.   Nominal differences
in grade will be found in that portion of the property developed as building sites
and parking areas lying west of State Street  with grades ranging from the low of
305' to 337'.  The developed building areas generally lying in the southeast
quarter of the property, east of State Street, range from a low of 330" to a high
of 350'.  In the northeast quarter, also  lying east of State Street, grades range
from a nominal low of 360' to 400', with abrupt changes of grade occurring along
the west and south borders of this parcel.

This complex is comprised of 28 buildings, varying from 1  to 20 stories in height.
Nineteen of these buildings are classified as permanent structures.  The remaining
nine buildings, though classified as obsolete, are currently in use.

The Site Plan of the existing plant, Figure ll-l, identifies all buildings by number,
function,  number of stories, etc. The aerial photograph,  Figure 11-2, further
illustrates the relationship of buildings and emphasizes the magnitude of this
complex.   Future development by the addition of major new buildings will
likely be confined to  the general area presently occupied  by these obsolete
structures. Buildings  in this complex, ranging from 5 to 40 years in age,
together with  land, equipment and vehicles, are estimated to have a
replacement value of  approximately $150,000,000.  Collectively, the existing
buildings provide about 3,000,000 square feet of useable floor area, of which
some 2,800,000 square feet is represented in permanent structures.

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Aerial Photograph of LAC-USC Medical Center
FIGURE 11-2
  PAGE 11-6

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VOL.   II	
CHAP.  II                                                                    11-7
CHARACTERISTICS OF THE SOLID WASTE SYSTEM

The foregoing description of the existing facilities at the Medical Center has
indicated the complexities of this 68-acre plant layout.  The complexities of
the total solid waste system, both in variety of materials generated and methods
of handling,  processing and disposal of these materials, are equally as great.
Types of Waste Materials Generated:

Types of conventional solid wastes generated in this plant present similar varieties
and quantities as will be found in a municipality of similar size, including:

        1.  Garbage              6.  Bulky Wastes (furnishings, auto parts, tires, etc.)

        2.  Rubbish               7.  Expended Vehicles

        3.  Ashes                 8.  Street and Landscaping Refuse

        4.  Dead Animals         9.  Construction and Demolition Wastes

        5.  Special Wastes        10.  Industrial  Wastes (shops)

In addition, reusable materials and equipment, such as linens, food service items,
patient care items, etc. requiring  reprocessing, will be found in quantities that
far exceed the amounts of these conventional solid wastes.  These reusables have
all the handling and transport problems of conventional  waste materials, and
dependent on future changes  in operating policy, single-use (disposable) items
may replace certain of these  materials, substantially increasing the problem of
disposal.

Generally, bulky wastes, worn-out vehicles, street and landscaping refuse, con-
struction and demolition wastes are handled in separate  channels apart from the
main flow of waste materials  generated daily within the plant buildings.  Daily
quantities of these materials generated fluctuate considerably.  Dependent on the
nature and quality of these materials, they may be salvaged for in-plant reuse or

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VOL.   II
CHAP.  II
11-8
deposited at landfills.  By and  large, the methods of disposal selected appear to be
satisfactory and are limited by  the characteristics of the individual waste materials.
Detailed studies of these types  of wastes will not be considered further in this study,
except as they  may be found  within the building waste handling system.   Similarly,
those radiological wastes which are generated in varying quantities and handled
in compliance with State and Federal regulations will not be investigated in depth
except as they  may affect the waste  handling system in  this building complex.

In summary, the identification  of kinds of wastes that may  be found in the main
stream of the solid waste system include garbage, rubbish,  ashes, dead animals,
special wastes and reusables.  From observations of the  different characteristics
of certain waste materials and their respective handling  requirements within the
total system, eight categories of waste materials have been established for detailed
study. These categories are identified as follows:

       1.  Sharps - needles, blades, etc.                  (Disposable)

       2.  Surgical,  pathological and animals             (Disposable)

       3.  Soiled linen                                   (Reusable)

       4.  Rubbish or mixed  refuse                        (Disposable)

       5o  Patient care items                             (Reusable)

       6.  Non-combustible - glass,  metals and ashes    (Disposable)

       7.  Garbage (Non-grindable)                      (Disposable)

       8»  Food service items                             (Reusable)
Brief Description of the Total System:

Policies of operation of the solid waste system specify relatively direct and simple

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VOL.  II	
CHAP. II                                                                      11-9
procedures to be followed.  Certain special purpose equipment has been provided for
disposal of wastes.  Pathologic incinerators provide facilities for disposal of tissue
wastes.  Grinder installations provide facilities for disposal of food preparation wastes
and selected pathologic wastes.  Central on-site incineration has generally prevailed
over the years for the disposal of other infectious wastes.  The balance of disposable
wastes are hauled by hospital packer trucks to landfill for final disposal.

An inter-building transfer system, employing  tram trains, collects loaded carts at
intermediate storage points, transports them via surface,  tunnel and corridor routes
to central storage points.  Infectious wastes are discharged at the central incinerator
for disposal. Other disposable wastes are discharged and loaded into a compactor
truck for transport to a landfill.  Reusable wastes are directed to their respective
reprocessing points. The compactor truck also provides collection service from a
number of outlying  buildings not serviced by the tram train.   Direct haul to the
landfill is made after each load is collected.

Various methods of waste collection and transport exist within the 28  buildings in
this complex.  However, generally hand cart collection of materials on each floor
prevails.  Eight of the multistory buildings have chutes for vertical transport of
soiled linens and mixed refuse.  The balance  of waste materials, both reusables
and disposables, are transported by elevators  where available or manually via
stairs in some of the two and three story  buildings to intermediate storage points
to await the inter-building pickup.
Responsibility of Solid Waste Management:

General  Services (Housekeeping and Custodial Services) is charged with the
responsibility of solid waste management along with other plant services.  In
performance of the functions in  solid waste management,  this department must
observe those general regulations dealing with building safety, fire prevention,
air pollution,  sanitation, as well as the applicable requirements of the Hospital
Licensing Act.

Operational policies have been adopted by plant administration which provide

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VOL.  II	
CHAP. II                                                                   M-10
a means of coordinating all supportive services with the medical activities within the
plant. Coordination between the Medical  Department, charged with the primary
function of patient care services, and the Non-Medical Departments'  function of
providing  all other required support service:; is accomplished through a  system which
subdivides the total plant operation into administrative or service areas.  Each area
is assigned an administrator to provide liaison between Medical and Non-Medical
personnel  in performance of their respective functions.

As related to management of the solid waste system by Housekeeping and Custodial
Services,  these service areas may be physically defined as follows:

    Area 1 - The Outpatient and Admitting Room Administrative Area,
              consisting of the Outpatient Building (Bldg0 No. 3) and the
              basement and 1st floor of Unit I (Bldg0 No.  1).

    Area 2 - The Laboratory-Radiology  ard Surgical Specialties Adminis-
              trative Areas, consisting of floors 2, 3, 4 and 5 of Unit  I
              (Bldg. No.  1).

    Area 3 - The General Medicine Administrative Area, consisting  of
              floors 6, 7 and  8 of Unit I (Bldg. No,  1).

    Area 4 - The Medico I-Surgical Administrative Area, consisting of
              floors 9 through 19 of Unit I (Bldg0 No. 1).

    Area 5 - Psychiatry and Children's Division Administrative Areas,
              consisting of the Psychiatric Building (Bldg» No. 5) and
              the Children's Division Building (Bldg0  No. 4).

    Area 6 - The Obstetrics-Gynecology Administrative Area, consisting
              of Unit II  (Bldg. No. 2).

Two other service areas generally non-medical in function are defined  as follows:

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VOL.   II	
CHAP.  II                                                                    11-11
    Area 7  - The Special Services Area, consisting of all outlying buildings
              (Bldgs. No. 9 through 28), grounds, service yards and tunnels.

    Area 8  - The Resident Hall Area,  consisting of the Interns and Nurses
              Buildings (Bldgs. Nos. 6, 7 and 8).
Organization of Manpower:

The housekeeping and custodial labor force is subdivided into teams serving the total
plant.  These teams provide all services for the specified service areas, including
on-floor refuse collection activities and transport of segregated waste material
to intermediate storage  points.

A special service team  (for Area 7) provides all custodial services to the group of
outlying buildings, as well as operation of tram trains, elevators and refuse trucks
for transfer of waste materials from intermediate storage areas in all buildings to
central  storage, processing and disposal points.

Personnel of other departments are involved in certain aspects of handling soiled
linen and used food service items.  The nursing staff and aides are  largely responsible
for on-floor handling up to the point of depositing linens in the laundry chutes and
placing used food service items on the carts for return.  Laundry personnel are
assigned to clean out the soiled linen chute rooms, including bagging and placing
on soiled linen carts.  Dietary personnel, of course,  handle cleanup of food carts
on the return to the kitchen.

Each of the eight service areas are staffed to furnish services as required on a
seven-day week basis.   Table 11-2 indicates General Services manpower classi-
fications and assignments in each  of these areas.

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VOL.  II
CHAP. II
1-12
               TABLE 11-2   GENERAL. SERVICES PERSONNEL
Personnel
Classification
Sfo Foreman
Cusr. Foreman
Cust0 Working Foreman
Institutional Laborers
Custodians
Truck Driver
Tram Operator
Elev. Operator
Chief Hskpr.
Sr. Hskpr.
Housekeepers
Misc.
Total
Personnel Assigned by Service Areas
1
1
2
3
7
74
-
-
-
-
-
-
-
87
2
1
2
3
-
51
-
-
-
-
-
-
-
57
3
1
2
3
-
44
-
-
-
-
-
-
-
50
4
1
2
4
-
61
-
-
-
-
-
-
-
68
5
1
2
3
3
64
-
-
-
-
-
-
-
73
6
1
3
4
2
80
-
-
-
-
-
-
-
90
7
1
2
-
9
43
3
6
36
-
-
-
18
118
8
.
-
-
-
10
-
-
-
1
2
•48
-
61
Total
7
15
20
21
427
3
6
36
1
2
48
18
604

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VOL.   II	
CHAP. II                                                                   H-13
 OBSERVATIONS OF THE INTER-BUILDING AND OFF-SITE SYSTEM

 Comprehensive field observations were conducted during October, November and
 December,  1968, at the Medical Center to determine (1) daily quantities of solid
 wastes produced, (2)  distribution of generated wastes by principal buildings
 and/or accumulation points, (3) manpower, and equipment used in the handling
 and disposal of these materials, and (4) actual methods  and practices employed.

 Initial inspections at the Medical Center were made to  identify the characteristics
 and functions of the inter-building solid waste system.  Upon inspection of the
 complexities of the inter-building material  handling system in which solid wastes
 were transported, it appeared that extended observations were warranted in this
 area,
 The  Inter-Building Materials Handling System:

 Ten  major buildings of the plant are connected by a combination of elevated
 corridors, tunnels, basement corridors and surface lanes providing the basic
 traffic network for inter-building movement of pedestrians and materials.  The
 remaining 18 buildings are served primarily by surface routes (streets and sidewalks)

 The  tunnel-corridor network serving the major buildings is the  common transport
 route for the movement of pedestrian traffic (employees and patients), clean
 materials and dirty materials. Various types of small vehicles  (combustion engines
 and  electric powered vehicles) are utilized in this activity.  Peak activities in
 movement of materials and people generally occur at different time  intervals;
 however,  overlapping of these functions is common in a routine day.  Peak
 pedestrian movements occur  with changes of shifts.  Peak activities  in movement
 of clean materials occur with the dispatch of  pharmacy supplies, clean linen
 supplies, food cart movement prior to meal  service, and distribution and collection
 of medical records. Peak activities in movement of dirty materials occur with
 refuse and soiled  linen collection, return of food carts following meal service,
 and  return of reusable equipment associated with patient care.  During these
peak periods, moderate traffic congestion is noticeable at the  terminal
 (distribution and collection)  points in  each of the buildings along the tunnel-
corridor network.

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VOL.   II	
CHAP.  II                                                                   11-14
The center of material handling activity and the major area of congestion exists in the
corridors of Unit 1 wherein trains of food carts, medical records and general supplies
are assembled  for dispatch and disassembled on return.  Through traffic of clean and
dirty materials routed to and from the Interns'  Residence and Outpatient Clinic
must pass through the main corridor„  Cleanout of soiled linen and trash rooms
adjacent to this corridor and makeup of the carts and trains handling this material
generated in Unit I  also occurs here.  Nearly  all general supplies for upper floors
of Unit I must  be dispatched from this corridor level.  Patients being transferred
for treatment to Unit 1 or the Outpatient Clinic must also be moved through the
main corridor.  The interchange of plant personnel between buildings and working
personnel in various departments on the service level of Unit  I is a continuing process
as required by the daily routine.  Due  to inadequate warehousing space, corridors
are used as an area  for overflow storage of new supplies and equipment until
permanent storage space becomes available!.  Substantial congestion is the prevailing
condition in the main corridor of Unit I from 6:00 a.m.  to 2:00 p.m., when pedestrian
and material movements slack off.

Extreme congestion  of cart traffic at variable intervals also occurs at both the laundry
receiving area and the central storage  area for refuse (former incinerator) with carts
often backed up into the adjacent  areas of the tunnel-corridor awaiting unloading
or return.

To measure the magnitude of the inter-building materials handling system, observa-
tions of the tram train activity over a two  day period were recorded.  Average daily
activity of the three tram  trains used in the system was calculated at a combined
total of 193 stops for pickup and/or discharge  of carts, with a total of 493 cart
movements occurring daily. These observations were confined to a ten-hour period
during  the day and did not include activity after 3:00 p.m^,  which principally
consists of food cart movements for the evening meal and other limited activity.
These observations also excluded the tram  train assigned exclusively for the
movement of pharmacy supplies and other  /chicles used in material  and people
movement.  Figures 11-3 and 4 were prepared to illustrate hourly activity during
the ten hour period  and the percentage of activity related to  the movement of
clean and dirty materials.  Including the return movement of  food carts,  together
with soiled linen cart and refuse cart movements, 63% of pickups, 68% of cart
movements and 63% of daily time were allocated to solid waste handling„

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VOL.  II

CHAP. II
11-15
 c
 D
u
 o
z
     80
     70 -
     60 -
     50 ~
     40 -
     30 ~
     20-
     10 -
                               Hourly Intervals
          FIGURE 11-3    OBSERVATIONS OF DAILY CART MOVEMENT

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VOL.  II
CHAP. II
1-16

30-
25

X
4- on
Percent of Activi
_. N
Oi C
1 ._l
10-
5-
n






_c
Irt
IS
_c
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c
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o
 :'
: c ::
; HJ ::
'• "a :.
flJ ;.
•'5:-:-
:LO...-:


•.• */)• •
• • -^-x :
. . l_.f. .
:: a-x
;;• u;----
:•: "D: : :
• o-' '•
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. : u_-': .

o
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^

% of Carts Moved
Clean 32%
Soiled 68%








: ;, Rubbish Ux:x:xx' ::::';T;


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 ''.

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in
il

% of Daily Time
Clean 37%
Soiled 63%


     FIGURE 11-4   DETAIL OF CLEAN AND SOILED CART MOVEMENTS

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VOL.   II	
CHAP.  II                                                                    11-17
Handling and Storage of Disposable Waste Materials:

Figure 11-5 illustrates the building layout of this plant and shows the  location of the
connecting tunnel-corridor network, intermediate and central solid waste storage
points, as well as collection stations serving the minor buildings.  It  will be noted
that nine buildings in this complex, varying from 3 to 20 stories in height,
collectively contain 18 intermediate trash and soiled linen storage rooms, each
being chute fed from the floors above.  Other intermediate storage points include
the  "can room" and "tank carts" in the kitchen area in Unit I.  In addition to these
principal waste storage points, some 30 refuse collection stations (cans and  bins) are
located on surface routes throughout the complex.

In each of the trash rooms, a portable bin (cart) of about 2 to 2  1/2 cubic yard
capacity with hinged top is positioned to receive the direct discharge from  the trash
chuteSo  It is intended that as these carts are filled to capacity, an empty cart will
be manually moved into position.  Often  in practice, this cart movement does not
occur until the loaded cart is overflowing and/or the chute is backed up. When
these circumstances develop, manual clearing of the chute and cleanup of spilled
litter is required., Observations indicate the majority of this mixed refuse is plastic
bagged before deposit in the chutes.  However, rupturing of bags occurs along with
occasional deposits of loose material directly into the chutes. An intermix  of reusable
equipment items, such as soiled linen, patient care utensils, etc. is commonplace.
These salvageable pieces are normally separated when observed and re-channeled
into their proper route for reprocessing.  As carts are filled during the day,  they are
moved out of the trash rooms into the adjoining corridors to await pickup by the
tram train and transport to the central storage  area.,   Here the carts are uncoupled
to await discharge of contents, and are returned to assigned or needed locations on
subsequent trips.

Segregated non-combustibles, disposable syringes and needles, and all pathologic
wastes are collected in covered containers, then transported via hand cart and
elevator to the  "can room" located on a branch of the main service level corridor
in Unit I.  Here materials are assembled for later disposition.  The intended systems
direct that all materials other than segregated pathologic wastes be loaded on flat
bed carts for transport  to the central storage area to  await disposal.  Pathologic
wastes are either directed to the pathologic incinerator in Unit I or in Unit  II.

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Schematic of Inter-Building Solid Waste System
                                                             PAGE 11-18

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VOL.   II	
CHAP.  II                                                                    11-19
Non-grindable wastes from the kitchen are deposited in "tank carts".  These carts are
transferred from the ground floor kitchen to the basement level by elevator to await
pickup by the tram train and transport to the  central storage area.
Waste Disposal Practices:

At the beginning of the observation period, on-site disposal of the majority of mixed
refuse was accomplished by incineration„   However, during this period,  the incinerator
installation,due to violation of air pollution regulations,was forced to shut down, and
all waste materials formerly handled by this method were routed to a privately operated
landfill via  the hospital's compactor truck. During the time incineration was practiced,
the carts containing mixed refuse, kitchen wastes, etc, were emptied directly on the
upper level  charging floor of the incinerator,  then scooped (charged) into the furnace
in a  continuous manner until the capacity of the furnace was reached.  Segregated
non-combustible materials and accumulations of disposable syringes and needles in
cans were stored for later transfer to the landfill.

After incineration was discontinued,  an improvised plywood chute was constructed
to convey all waste materials from the upper level charging floor to a rear end
loader compactor truck on a parking lot grade some 14 feet below. Generally an
attempt was made to discharge the carts directly into the chute or in its vicinity.
Problems of  area littering and sanitation on the charging floor level were similar
for both the incineration operation and the truck loading operation; however, the
latter method also created additional  problems in the area of the truck at ground
level o This system was later modified when a  new top  loading (forklift) truck was
acquired. Present methods provide direct chute discharge to the topside receiving
hopper of the truck.  Spillage has been minimized in the loading operation but
windblown littering as  well as occasional  overcharging of the chute remains a
sanitation problem. A second rear loading compactor truck utilized in the plant
system is normally stationed at the loading dock at the service level on  the north
side  of Unit I.  This loading dock is also utilized as a principal  receiving point
for incoming supplies.   All bulky packaging materials from the warehousing
operation and  miscellaneous other wastes are loaded directly into this truck during

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VOL.   II	
CHAP.  II                                                                    ]]-20
the day.  This truck is also employed on a building to building collection system
servicing the balance of the outlying buildings in this complex.  Due to the nature
of this collection system, this truck proceeds to a private landfill for disposal of all
materials as loads are collected.  Currently (since October,  1968),  all wastes
formerly incinerated are also hauled to the same landfill for disposal.  Observations
at this landfill indicate substantial salvage activities occur on a continuing basis at
the working faces of the fill.  Hospital wastes are routinely handled at discharge
points common to all refuse haulers.

At the time of observations, the pathologic: incinerator  in Unit II was partially
disassembled  for repairs and the incinerator in Unit I was not used due to malfunction,
After the central incinerator was shut down,  no alternate method of on-site disposal
existed  for this material „  Due to apparent lack of communications or lack of an
awareness of the problem, these materials were inadvertently  channeled into the
off-site disposal channel by operating personnel „  It may be pointed out at this
time that the location of the pathologic incinerator in Unit I is at an intermediate
level between the basement and the ground floor level.  All wastes intended to be
handled by this incinerator must be transported to the basement level by hand cart
and elevator, and then  hand carried up two flights of stairs to the incinerator
cubicle.  Similarly all residue must be hand carried  to the basement level.
Handling and  Storage of Reusable Waste Materials:

The routine in handling soiled linen is simi lar to the methods of handling mixed
refuse.  The majority of linen gathered on floors is either bagged (cloth) or
bundled before deposit in the chutes.  Observations  at the chute rooms indicate
a substantial quantity of the bagged material loosens and scatters on impact and
that a sizeable quantity, principally surgical  linen, is placed in the chutes in a
loose  fonrio As in the case of the trash rooms, a miscellaneous intermix of other
reusable materials, as well as rubbish, may be found in the soiled linen rooms.
Cleaning out linen rooms involves separation of the  extraneous items,  rebagging
and loading the linen on flatbed soiled linen carts,,  These are  placed  in the
adjoining  corridor to await pickup by the tram train  and transport to the receiving

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VOL.   II	
CHAP.  II                                                                    11-21
area adjacent to the laundry.  These materials are either taken directly from the cart
to a conveyor belt for manual sorting or unloaded on the nearby soiled stockpile to
await the sorting process.  At peak activities, soiled linen carts are backed up well
into the elevated corridor awaiting handling.  At times, assembled clean linen supply
carts awaiting tram train distribution further congest this area.

The major reusable material other than  linen at this facility generally consists of
patient care and food service items, etc»  After use, those materials leaving the
floors above are transported via cart and elevator to intermediate collection points
on the service level  to await pickup by the tram trains for transport to  their respective
stations for reprocessing.  However, in the case of patient care utensils, the cleaning
process may occur on the floor or at central sterilization stations within the building,
not requiring tram train handling.  Reusable food service items are, of course,
returned on the food carts to the central kitchen cleaning area in Unit I.
Quantities and Types of Disposable Waste Materials:

After identification of methods and practices characteristic of the systems operation,
a quantity survey was made to determine daily volume of solid wastes produced in
the total plant.

Initially observations were limited to that portion of wastes transported via the
tram train to the incinerator which at that time was in operation.,  Portable scales
were located in the vicinity of the incinerator, and a record was prepared identifying
all  carts by number, tare weight and locations (building, trash room, etc0) where
specific carts were assigned,,  Similarly all accumulation or  intermediate storage
points were identified by building location„  Actual weighing of loaded carts was
recorded for a period of eight days to acquire a reasonable cross section of daily
activity and to establish a  "typical" day's production as delivered  to the incinerator.
Considerable variations in  quantities collected were observed during this period.,
Observers' comments indicate this was likely due  to the variable productivity
of labor and/or mechanical problems rather than extreme variations in waste

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VOL.  II
CHAP. II
11-22
production during the normal week day.  However,  with limited activity of admin-
istrative, outpatient, laboratory and other supportive functions during the week-
end, it is obvious that waste production would also be substantially lower during
the weekend period.

Tables 11-3 and 11-4 illustrate typical daily activity occurring during this eight day
period in refuse cart movements, distribution of wastes by accumulation points and
buildings within the plant, and the breakdown of segregated non-combustible and
mixed refuse as delivered to the incinerator area.  These summaries do not include
the quantities of wastes collected by the compactor truck for landfill disposal.
        TABLE 11-3    INTER-BUILDING DISPOSABLE WASTE COLLECTION

Date

10-16 (W)
10-17 (Th)
10-18 (F)
10-21 (M)
10-22 (T)
10-23 (W)
10-24 (Th)
10-25 (F)
TOTAL
TYP. DAY
Disposable Solid Wastes Transferred
Combustible
Lbs.
10,673
9,828
9,833
7,905
10,698
10,673
8,848
8,535
76,993
9,624
% Tot.
93.3
94.3
94.8
94.3
88.9
93.4
88.6
96.8

92.9
Non-Comb „
Lbs.
750
590
535
480
1,360
750
1,135
285
5,885
735
% Tot.
6.7
5.7
5.2
5.7
11.1
6.6
11.4
3.2

7.1
Total
(Lbs.)
11,423
10,418
10,368
8,385
12,058
1 1 ,423
9,983
8,820
82,878
10,359
Cart Movement
No ./Day

84
81
79
64
91
83
82
80
644
80
Avg. NetWt.
Lbs. /Cart
136
128
132
131
132
137
121
110

129

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VOL.  II
CHAP. II
11-23
        TABLE \\-4    PRODUCTION OF DISPOSABLE WASTES BY BUILDINGS
Building
No.

1
2
3
4
5
6
7
9
10
16
-
Function

Unit 1 - Acute
Unit II - OB/Gyn.
Outpatients
Ped./CD
Psychiatric
Interns
Nurses
Pharmacy
Gen'l. Lab
Laundry
Misc.
TOTAL
Avg. Lbs.
Collected
Daily
5,510
1,570
930
640
570
400
150
80
60
220
170
10,300
Shortly after this eight-day period of observations, the incinerator was closed down
and a new system was improvised by  General Services to haul all wastes to the
landfill with the addition of one compactor truck. To complete the quantity
survey, including all wastes now handled by both trucks, it was necessary to
ride both vehicles and obtain weight records at the landfill.  Observers on
the trucks after obtaining tare weights,  recorded refuse  weights for a period
of four days and the truck operators continued to provide scale records for an
additional four day period.  Table 11-5 illustrates the truck weight records for
this additional period of time, including the combined quantities of wastes
which  were  formerly incinerated with those previously collected and hauled to
the landfill. Total daily activity during this eight day period indicated
4.4 trips averaging 4,600 pounds (2.3 tons)  or 20,550 pounds (10.25 tons) of
disposable solid waste material were hauled  daily to  the private landfill.
General observations of the truck activity prior to the incinerator shut down

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CHAP, il
11-24
                TABLE 11-5   LOAD RECORD 8-DAY PERIOD
Date
12-3 (Tues.)
12-4 (Wed.)
12-5 (Thurs.)
12-6 (Fri.)
12-7 (Sat.)
12-8 (Sun.)
12-9 (Mon.)
12-10 (Tues.)
No. of Trips:
Avg ./Day
Total Waste
Avg . Day (Lbs.)
Avg . Load (Lbs.)
Truck No. 3363
Tare Wt. 1
Gross Wt.
21,220
20,830
25,000
24,560
23,600
24,120
24,100
24,760
24,870
24,550
24,631
24,515
24,605
24,320
24,610
23,730
24,750
24,300
24,820
24,863

8,660 Lbs.
Net Wt.
2,560
2,170
6,340
5,900
4,940
5,460
5,440
6,100
6,210
5,890
5,971
5,355
5,945
5,660
5,950
5,370
6,090
5,640
6,160
6,203
2.5
13,700
5,500
Truck No. 3369
Tare Wt . 1
Gross Wt.
24,630
24,500
24,740
20,800
21,320
22,412
21,530
21,580
22,630
21,453
22,300
20,650
19,915
21,430
23,410

8,560 Lbs.
Net Wt.
6,070
5,940
6,180
2,240
2,760
3,762
2,970
3,020
4,070
2,893
3,740
2,090
1,355
2,870
4,850
1.9
6,850
3,700
Total Daily
Refuse
Hauled
14,570
27,770
23,522
9,180
24,806
18,238
20,555
25,723
4.4
20,550
4,600

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VOL.   II	
CHAP.  II                                                                    11-25
Indicated it was making about three to four trips a day hauling estimated average
loads of about one and a half tons or about 9,000 to 12,000 pounds daily.
Final observations of the combined activity of both trucks reasonably confirmed
these quantity estimates.

Following the above observations on the principal disposable wastes, there
remained only two basic types of wastes with unknown quantities.  These materials
were food preparation wastes deposited directly in kitchen grinders and patho-
logical wastes for disposal by incineration.

Hospital personnel in Dietary and Pathology assisted in determination of quantities
of these materials in order to minimize disruption in these very active departments.
The  Chief Dietitian selected a day with menu requirements of foods with  high volume
of preparation wastes,  which are the principal materials  handled by the grinder
installations.  Personnel in the various preparation areas segregated this material
and  weighed the accumulated wastes prior to charging the grinders.  Results of
this  activity presented  a combined daily total of all food preparation wastes of
2,600 pounds.  At the  time  of this survey, about 10,000 meals per day were
prepared or it can be related that up to 0.26 pounds of waste per meal  may
be expected o

Surgery, autopsy and the laboratories generate the major quantities of segregated
pathologic wastes.  Technicians in these services over a  three day period estimated
volumes of wastes accumulated each day for disposal by the pathologic incinerator
at approximately 187 gallons. Using a density factor of 5»2 Ibs./gal.  based on
an allowed 70% moisture factor  for this type  of material, it is indicated that a
total production of about 1000 Ibs./day may  be expected from these combined
sources.  Distribution of this material generated  by the major producers for
disposal by incineration is as follows:

     Unit I   - Basement -  Lab  Services                30 gallons per day
               2nd  Floor - Autopsy and Lab  Areas       80 gallons per day
               2nd  Floor-  Laboratories                 45 gallons per day
                16th Floor- Pathology Lab              30 gallons per day

     Unit II  - 4th Floor -  Surgical-Delivery             2 gallons per day

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VOL.   II	
CHAP.  II                                                                    11-26
The prevailing handling practice at the time of observations involved storage of
materials in closed containers with plastic liners, with deliver/ once daily via
cart and/or elevator to the Can Room in Unit I for intermediate storage prior
to disposal.  Interviews with various personnel involved in handling and dispatch
of these materials indicated differences of opinion as to routing and storage
procedures..
Quantities and Types of Reusable Waste Materials:

To complete the quantity survey, data on reusable supplies and equipment
classified as solid waste material in this study had to be developed. The
principal  identifiable materials in quantity in this classification are soiled
linens, patient care and food service items.

Laundry records were found to be quite comprehensive, and daily weight records
of soiled linen processed were readily available.  Utilizing the most current
month's records that were typical (October,  1968), an average calendar day
production of some  45,500 pounds was calculated opposed to an average of
56,500 pounds processed daily.   Table 11-6 itemizes daily activity by  shifts
for the total number of days worked in the month of October.

Reusable food service items collected  from the wards was calculated on the basis
of number of patient meals served daily.  Some variations occur with type of food
service for various meals; however, an average of 1  1/2 Ibs./patient meal was
estimated,, Based on 6,000 patient meals served  per day, a daily quantity of
some 9,000 pounds  may be expected for return from  the wards in  food  carts to
the kitchen for reprocessing.

Patient care items presented greater difficulty in identifying a consistent
handling system and basis for estimating quantities.  In the case of patient
care utensils, in most buildings cleaning or sterilizing facilities are available
on each ward or within the building, and these materials are seldom seen in
the inter-building system.  The major  reusable supplies circulated within the
inter-building are reusable bottles from Pharmacy.  These are generally
transferred exclusively in racks or cartons by the Pharmacy tram train  on the

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VOL.   II
CHAP.  II
                                                                   11-27
         TABLE 11-6    SOILED LINEN PROCESSING  -  OCTOBER 1968
                        Processing  by Shifts  (Lbs./Day)
Date
1
2
3
4
5
7
8
9
10
11
14
15
16
17
18
19
21
22
23
24
25
28
29
30
31
TOTAL
1st Shift
21,970
29,970
29,135
29,530
19,845
29,760
28,813
27,640
22,885
27,865
26,500
30,290
28,360
31,410
32,525
18,675
31,730
27,700
30,775
32,220
28,995
31,980
31,085
33,295
33,925
716,878
2nd Shift
19,085
24,890
30,545
29,307
—
26,290
28,500
29,880
30,340
30,370
29,690
31,250
30,525
30,930
30,905
—
30,885
33,845
32,950
31,890
29,215
31,930
31,350
32,293
32,790
689,655
Total
41,055
54,860
59,680
58,837
19,845
56,050
57,313
57,520
53,225
58,235
56,190
61,540
58,885
62,340
63,430
18,675
62,615
61,545
63,725
64,110
58,210
63,910
62,435
65,588
66,715
1,406,533
                      Average Lbs. Per Working Day

                      Average Lbs. Per Calendar Day
56,500

45,500

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VOL.   II
CHAP.  II
return of carts to this department and then reprocessed in the bottle washing section.
Observations during  the entire period at this plant indicate that total patient care
items expected to be handled daily in the inter-building system will be represented
in trace amounts only.
Summary of Total Waste Production:

In summary, Table 11-7 presents the types and quantities of wastes that may be
expected to be generated daily at the Medical  Center under its present level of
service, and relates these quantities to the number of bed patients, number of
employees and  combined plant population, as well as total floor area of this
building complex.  The closing chapter of '-his volume will summarize our
findings on all  hospitals under study and attempt to establish patterns in the
relationship of population or plant size to total waste production.
Equipment and Building Areas Used in System Operation:

For later economic analysis of the solid waste system, identification of all
elements which contribute to its function is necessary.  Included in these
elements are building areas and equipment used exclusively in waste handling,
storage,  processing and disposal, and equipment shared with other services,,

Excluding the numerous trash and soiled linen chute rooms considered as cost
elements of the in-building system, building areas used in the inter-building
waste system are limited to (1) the abandoned incinerator presently used as a
central storage and loading area for disposable wastes, (2)  the covered storage
area for soiled linen, and (3) the two rooms housing pathologic incinerators.
Collectively, the replacement costs of present covered storage area requirements
for disposable wastes and soiled linens (about 2,000 square feet) should not exceed
a nominal $20,000.00 investment.  The pathologic incinerator rooms (about
250 square feet of building area) based on a nominal $25.00 per square foot
building  cost allowance would represent an investment of about $6,000.00.
The balance of areas in the inter-building system used for storage and
processing as well as transfer routes are of mixed  use and cannot be directly

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VOL.   II
CHAP. II
11-29
             TABLE 11-7    SUMMARY OF DAILY WASTE PRODUCTION

Type of Waste
Sharps, Needles, Etc.
Path. & Surgical
Soiled Linen
Rubbish
Reusable Patient Items
Non-Combustibles
Garbage (Non-Gri ridable)
Food Service Items
Ash & Residue
Animal Carcasses
Food Waste (Grindable)
TOTAL WASTES
Total Disposable
Total Reusable
Avg. Wt.
Lbs./Day
75
1,000
45,500
16,200
TR
1,500
1,800
9,000
TR
25
2,600
77,700
23,200
54,500
%of
Total
.1
1.3
58.6
20.9
TR
1.8
2.3
11.6
TR
TR
3.4
100.0
29.9
70.1
* Daily Production Factors
Lbs./Bed Patient
TR
.5
22.8
8.1
TR
.7
.9
4.5
TR
TR
1.3
38.8
11.6
27.2
Lbs. /Capita
TR
TR
2.2
.8
TR
TR
.1
.4
TR
TR
.1
3.7
1.1
2.6
*Based Avg. Census of 2,000 Bed Patients Daily and Gross Population of 21,000

Note - Total Production Related to Gross Bldg. Area of 3,000,000 SF:
       Disposables @ 7.5 Lbs./MSF, Reusables (q> 18.1 Lbs./MSF
       or Total of 25.6  Lbs./MSF Daily.

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VOL.  II
CHAP. II
                                            11-30
allocated to the waste system •

The principal equipment acquired for exclusive use in the inter-building waste system
includes the pathologic incinerators, all soiled linen carts, trash carts and portable
bins.  The equivalent of two tram train power units are also used in transporting
reusable and disposable waste materials.  The balance of carts used for transport
of clean supplies and return of reusables or disposable materials should be allocated
to the movement of clean supplies and not to the waste system.

Equipment utilized in the off-site system is limited to the  13 cubic yard compactor
truck providing the building to building collection service and the new 33 cubic yard
compactor truck which handles the majority of materials formerly incinerated.

A summary of these elements in the inter-building and off-site systems is presented
in Table 11-8,  which shows the inventory and cost allowance of each item. This
estimate based on approximate replacement costs indicates a capital investment
of about $68,250.00 required to duplicate building areas and equipment  used in
the inter-building system, and $52,000.00 for equipment  used in the off-site system.
               TABLE 11-8    COSTS OF BUILDING AND EQUIPMENT
                            IN INTER-BUILDING AND OFF-SITE SYSTEM
Inter-Building System:
   Building Areas (Incinerator rooms & covered storage areas)
                                         Est. Value
                                         $  26,000
   Equipment:
      2 - Tram Train Tractors
     10 - Flatbed Trash Carts
     35 - Portable Trash Bins
     30 - Soiled Linen Carts
      8 - Tank Carts
      2 - Patho. Incinerators
@
$3000 = $ 6,000
  200 =   2,000
         12,250
          6,000
          6,000
 350-
 200-
 750 =
5000 =
           10,000
         ESTIMATED EQUIPMENT COST
                                            42,250
Off-Site System:
      1-13 CY Compactor Truck
      1-33 CY Compactor Truck
         ESTIMATED EQUIPMENT COST
            15,000
            37,000
                                            52,000
EST. REPLACEMENT COST OF BUILDINGS AND EQUIPMENT
                                           120,250

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VOL.  II	
CHAP. II                                                                   11-31
Subcontract Services and Disposal Fees:

A disposal fee for those materials hauled to the private landfill has been established
at $4.00 per ton, plus $1.00 per load for special handling of hospital wastes.  In
practice, loads are not generally weighed and charges are made on a truck load
basis.  However, based on the daily production of about 10 tons and using the above
rates, charges should be in the range of $45 to $50 per day for off-site disposal,
dependent on the number of loads required. With the larger compactor truck
recently added to the system, the minimum rate will probably be achieved.

One contract not specifically related to  the economic analysis of the inter-building
and off-site system  has been issued to a private contractor for collection, transpor-
tation and disposal  of radioactive waste material  in accordance with State and  Federal
regulations.  This contract provides for removal of special 55 gallon containers at a
cost of $27.55 per container. Current experience indicates about eight drums per
year are handled.
Personnel Requirements:

From field records of the entire period of observations, it is estimated that average
daily activity of the inter-building and off-site systems involves an equivalent of
about sixteen men. About one third of this manpower is represented by truck and
tram operators, with the  remainder consisting of laundry workers, institutional
laborers, custodians, etc. performing loading, unloading or other handlings of the
various types of waste materials.  Further detail  on the labor force, including
cost data, is shown later in this chapter.

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VOL.  II	
CHAP. II                                                                      11-32
OBSERVATIONS OF THE  IN-BUILDING SYSTEM

Continuing observations at the Medical  Center were carried out to determine the
detailed functions of the in-building operation (Unit and Inter-Unit Systems).
Cursory inspection of the major buildings in the plant was accomplished with the
assistance of area supervisors of Housekeeping and Custodial Services.  The purpose
of this inspection was primarily to compare methods and practices employed in the
various departments and buildings and to select "typical" wards and stations for
in-depth observations.
General:

These cursory inspections revealed or confirmed the complexity and confusion that
usually exists within the waste handling operations of hospitals.  These complexities
are "built-in" through the multitude of different materials and supplies that are
distributed and used throughout the hospital  daily.  Emphasis is placed on the
importance of distribution of new materials with little direction given in handling
the residual waste materials.

Detailed studies by staff members of the University of Minnesota^ '  have been made
previously in the field of hospital wastes, cataloging and itemizing typical components
of mixed refuse to be found  in various hospitals.  These materials can be broadly
categorized into (1) wood and paper products, (2) cloth or fiber, (3) plastics and
rubber,  (4) plants and miscellaneous foods, (5) miscellaneous non-combustibles,
(6) medications, and (7) reusables.

In addition to these categories of wastes that are generated throughout the hospital,
additional concentrations of wastes requiring special handling are occasionally passed
into the general waste system, bypassing intended channels.  Similarly, in many  cases,
mixed refuse of the above material categories, dependent on point of generation, such
as isolation  wards,  etc., are also intended for special  handling but are inadvertently
channeled into the general waste system.  Confusion in proper handling methods may be
introduced by high turnover of personnel, difficulty in identifying the material after it
passes through the first hands, language difficulty, morale,  and improper equipment.

(1) Bacterial Contamination From Hospital Solid Waste, Re  G.  Bond and
   G. S. Michaelsen, Research Grant  EF-00007-04 National Institute of Health,  1964.

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VOL.   II	
CHAP.  II                                                                    11-33
First observations confirmed the general  kinds and intermix of materials prevailing in
the system. Rather than devote extensive field time to cataloging the components of
the mixed waste materials, observations were directed to the mechanics of handling,
handling techniques associated with all types of wastes, equipment used, and time
devoted by personnel classifications in various aspects of waste handling in an
effort to establish operating standards, efficiencies, and a basis of determining
costs of the present waste system operation.

Initial inspections were confined to the Acute Unit (Building 1), O.B./Gyn.
(Building 2), Outpatients (Building 3),  Communicable Disease (Building 4),
Psychiatric (Building 5), and various laboratories and kitchen areas. Observations,
together with interviews with custodial  personnel and supervisors, as well  as floor
nurses and  nurses' supervisors, assisted in providing a basis of labor estimates.
Handling of Disposable Waste Materials:

It was generally observed, as may be expected, that disposable wastes are created
and/or handled by all  personnel, patients and visitors in a continuing daily flow.
However, upon deposit in the initial  container, handling of disposable wastes
immediately becomes limited to the Housekeeping and Custodial staff.

Wastebaskets in patients' rooms and other initial containers are usually wiped out
with disinfectants and  lined with plastic bags after use.  Floor workers, along with
general cleaning  duties, empty these containers by removing the filled plastic bags
and placing them into  a plastic lined cloth bag suspended on the custodial cart.
When the plastic  liner is filled, a custodian  wheels the cart to the nearest trash
chute, ties the bag closed, and deposits it in the chute.

Though a relatively simple system, breakdowns occur due to innumerable reasons,
including shortages of plastic bags, monotony of the routine, etc.  Plastic liners
are on occasion omitted from containers or from the cloth bag on the custodial cart.
Occasionally, the plastic liners of the  cloth bag are filled  to excess and cannot
be tied or are too large to enter the  chute door.  These circumstances then create
additional time, effort and risk in handling. Typical alternative handling
methods may include (1) dumping of  loose material  in chutes, (2) hand carried

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VOL.   II	
CHAP.  II                                                                     Th3?
or stretcher borne bags of trash transported by elevator to the intermediate storage
rooms, (3)  Improper storage on  the floor, and (4) rebagging of materials for deposit
in chutes,  all of which give greater exposure of the environment to the material
and increase  handling costs.

Miscellaneous segregated waste materials on each floor, including non-combustible
items, syringes and needles, and  double-bagged medical wastes, as well as surgical
and pathological wastes from limited locations,  are collected separately in cans,
which are manually transported by custodial personnel via elevator or stairs to
service level  intermediate storage locations for later  retransfer to selected disposal
stations.
Handling of Reusable Waste Materials:

Custodial personnel are not as greatly involved in the initial handling of reusable
waste materials.  The nursing staff and nurses aides (attendants) are the primary
handlers of this material prior to use and after its conversion from clean to dirty
classification.  They remove soiled linen, bag (cloth) or bundle the material and
hand carry it to the nearest chute for deposit in same.  Highly contaminated
linens from certain areas may be double-bagged or plastic-bagged prior to deposit
within the chute system.  Similarly, they also collect used food service items
from patient rooms after meals, bag disposable food wastes, and assemble all
implements on food carts to await pickup by custodial personnel.  These carts
are then escorted via elevator transport, and grouped at intermediate collection
points at service level  to await the inter-building transfer to the main kitchen.
Patient  care items are also collected by nurses or attendants and hand  carried to
on-floor cleaning and/or sterilizing facilities for reprocessing.  Reusable bottles,
largely  from the pharmacy department, are collected as required,  placed in racks
or cartons and stored in utility rooms or corridors until picked up by pharmacy
personnel  for return via elevator and tram train for reprocessing.
Personnel Requirements:

Minor variations occur in the on-floor unit system of handling solid wastes.  However,

-------
VOL.   II  	
CHAP.  II                                                                     11-35
the previously described methods prevail in the major waste-producing areas.  To
relate personnel requirements to this operation,  various departments and typical
wards were observed.  Four wards were selected for detailed observations of
personnel involved in the daily routines of housekeeping functions.  Observations
of shift  routines at each of these  wards were made over a period of four days,
recording time devoted to handling of the principal solid waste material,
including sharps, soiled linen, patient care and food service items, rubbish and
non-combustibles.

The observed time devoted to waste handling as  recorded was consistently less than
estimated by the various supervisory personnel in each classification.  It also
appeared more reasonable as a basis for this estimate and determination of unit
factors that could be used in projecting total estimated manpower requirements.
Similar  observations were made in other areas of the in-building  system and
composite time factors of all personnel involved in waste handling were
developed.  These factors were related to the major types of wastes and were
resolved to minutes per day per bed patient in handling each material.  Projections
of total  manhour and equivalent manday requirements for the in-building system,
shown in Table 11-9, indicate an equivalent of 180 mandays are required daily in
these waste handling activities.  Table 11-9 also relates this labor force to personnel
classifications and shows the composite time factor (minutes/bed) utilized in these
projections.

As noted earlier in  this report,  estimated labor is specifically limited to (1) the
handling of disposable waste materials from the point of initial deposit through
the point of disposal and (2) the handling of reusable materials after use up  to
the point of storage or accumulation preceding reprocessing.  Estimated labor as
shown does not include general cleaning duties of custodians or handling of clean
supplies that may later be converted to wastes.

-------
VOL.  II
CHAP. II
M-36
   TABLE 11-9    DAILY REQUIREMENTS FOR IN-BUILDING WASTE HANDLING
Type of Waste
Sharps
Soiled Linen
Reusable Patient Items
Food Service Items
Rubbish
Non-Comb .
Other ^ '
TOTAL
Equivalent Man Days
Manhours by Persoinel Classifications
Nurses
—
94
16
142
—
—
—
252
31
Aides
—
94
66
142
—
—
—
302
37
Cust,
92
67
—
—
559
95
—
813
102
.ndry.
Wrkr.
—
34
—
—
—
—
—
34
4
(1)
Other
—
—
—
7
—
—
44
51
6
Total
92
289
82
291
559
95
44
1452
—
Equiv.
Man
Days
11
36
10
36
70
12
5
180
180
Min.
Per
Bed
2.8
8.7
2.5
8.7
16,7
2,9
1.3
43.6
—
 (1) Lab. Tech., Food Service Worker, Ellev. Operator, Institutional Laborer

 (2) Pathological, Garbage (Non-GrindabIe), Radiological

-------
VOL.  II
CHAP. II
11-37
Table 11-10 was prepared to illustrate the manpower load requirements on major
personnel classifications involved in the in-building solid waste system.  It shows
average daily personnel available (7 day basis) and the number and percent required
for handling of solid wastes,, Further detail on personnel requirements, including
cost estimates, in handling of solid  wastes within the various components of the
system will  be presented at the close of this chapter.
    TABLE 11-10   LABOR REQUIREMENTS OF IN-BUILDING WASTE, SYSTEM
                                   Man  Day  Distribution
Personnel
Classifications
Nurses
Nurses Aides
Custodians
(1) Total
Available
1,047
2,272
327
Required for Waste Handling
Man Days
31
37
102
% of Tot.
2.9%
1.6%
31.2%
    (1)  7-Day Basis (5/7 of Ordinance Positions)

-------
VOL.  II
CHAP. II
           11-38
Equipment and Building Area Requirements:

Principal building areas and equipment utilized in the in-building waste system are
limited to the soiled linen and trash rooms, shaftways housing chutes and the fixed
equipment (chutes and access doors).  Col Actively, the 18 pairs of soiled linen
and trash rooms, together with shaftways, chutes and hardware, represent an
investment estimated at about $345,000 in building and equipment exclusively
used by the in-building solid waste system.  Table 11-11 shows the breakdown of
these costs based on nominal allowances of $25.00 per square foot for building
area and $3.00 per cubic foot for shaftways;.
 TABLE 11-11    BUILDING AREAS AND EQUIPMENT OF THE IN-BUILDING SYSTEM
Building Areas and Volumes:

1 Can Storage Room                  500 SF @ $25/SF

18 Trash Rooms @ Avg. 155 SF Area =2800 SF @ $25/SF

18 Soiled Linen Rooms @ Avg. 275 SF Area = 5000 SF@ $25/SF

3620 LF Chute-Shafts @ 6 CFAF = 21,720 CF @ $3/CF
Est. Value
$ 12,500

  70,000

 125,000

  65,160
                             Total Building Value Allowance
$272,660
Fixed Equipment:

3620 LF Trash and Linen Chutes @ $20AF Installed
$ 72,400
        TOTAL BLDG. & FIXED EQUIPMENT
$345,060

-------
VOL.  II	
CHAP. II                                                                    11-39
ESTIMATED OPERATING COST OF THE TOTAL SYSTEM

Building, equipment and labor involved in the system operation have been explored
in detail in the preceding sections of this chapter.  An investment of some $370,000
has been calculated for those portions of the physical plant and fixed equipment that
are exclusively used in solid waste handling functions.  Projecting the estimated
value of buildings and fixed equipment on a thirty-five year basis with a nominal
interest rate of 5% (average annual amortization rate at  6.107%) results in an
average expense of about $23,000 per year,  or $63.00 per calendar day.  A
reasonable budget allowance for maintenance and  repairs of these types of
facilities should be equal to about 2% of building  costs,  or some $7,400 a year,
or $20 per day.

Operating costs for vehicular equipment will include such items as maintenance
and repairs, tires,  fuel, service, licenses, etc. For the  most part,  though all
power vehicles are operated on relatively low mileage basis, most of the equipment
is operated at least at idling speed during active work shifts.  Therefore, an average
of 8 hours per day on a 7 day week basis or about 3,000  operating hours per year
has been allowed in the following calculations of total annual and average daily
equipment costs.  Table 11-12 summarizes the equipment  referred to earlier in this
report, together with capital and operating expenses they represent.

-------
VOL.  II
CHAP. II
11-40
       TABLE 11-12    ESTIMATED ANNUAL EQUIPMENT OPERATING COST
Equipment Item
l-33CYComp. Truck
1-13 CY Comp. Truck
Cost
Allowance
$37,000
15,000
TOTAL OFF-SITE EQUIPMENT
2-Tram Train Tractors
10-Flatbed Trash Carts
35-Portable Trash Bins
30-Flatbed Linen Carts
8 -Tank Carts
2-Pathol . Incin.
$ 3,000
200
350
200
750
5,000
Oper. &
Maint,, Cost
$3.5C/Hr.
2.50/Hr.

$1.25/Hr.
10% of Vol.
10% of Vol.
10% of Val .
10% of Val .
--
TOTAL INTER-BUILDING EQUIPMENT
TOTAL EQUIPMENT
Annual
Oper. &
Maint. Cost
$ 10,500
7,500
$ 18,000
$ 7,500
200
1,225
600
600
1,000
$11,125
$29,125
Annual
Depre-
ciation
$ 3,700
1,500
$ 5,200
$ 600
200
1,225
600
600
1,000
$ 4,225
$9,425
Total Annual
Cost
$14,200
9,000
$23,200
$ 8,100
400
2,450
1,200
1,200
2,000
$15,350
$38,550
In addition to the foregoing costs, labor for the total system, including payroll taxes
and insurance and social benefits, has been calculated at about $2,275,000 annually
or $6,232 per calendar day. Table 11-13 relates types of employees involved in waste
handling and the distribution of estimated labor costs to the various types of wastes
(reusables and disposables) and components of the total waste system „

-------

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PAGE 1
-41

-------
VOL.  II	
CHAP. II                                                                    11-42
Certain other operating costs lie in the area of the miscellaneous expendable
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throughout the plant.  A nominal allowance of $100.00 per day has been
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of the system based on the foregoing data is shown  in Table 11-14, which also
relates these costs to the various components of the waste system.

-------
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                                                                                PAGE 11-43

-------
 VOL.  II
 CHAP. II
1-44
 Collectively all costs of equipment, buildings, etc., exclusive of labor, are slightly
 more than 5% of the total annual costs of the waste system.  It is of interest to note
 that total annual costs of the waste system are equivalent to 2.6% of the total annual
 operating budget of the Medical Center, which in 1969 was $79,826,000.

 Table 11-15 provides a comparison of the respective costs of handling disposable and
 reusable wastes, excluding only the costs of reprocessing the reusable materials.
   TABLE 11-15    COST COMPARISON OF DISPOSABLE AND REUSABLE WASTES
Type of Waste
Disposables:
Rubbish
Other
Total
Reusables:
Soiled Linen
Food Service Items
Other
Total
Total All Materials
Avg, Wt.
Lbso/Day
16,200
7,000
23,200
45,500
9,000
TR
54,500
77,700
Daily Costs of Handling & Disposal
Labor
$2,235
1,027
$3,262
$1,255
1,403
312
$2,970"
$6,232
Bldg, &
Equip.
$104
40
$144
$ 45
f~45
$189
*Other
$ 85
60
$145
—
$145
Total
$2,424
1,127
$3,551
$1,300
1,403
312
$3,015
$6,566
Avg0 Cost
Per
Ton
$300
322
$305
$ 57
312
$110
$170
Per
Bed
$1.22
.56
$1.78
$0.65
.70
.15
$1.50
$3.28
*Miscellaneous expendable supplies and dumping fees

-------
VOL.   II	
CHAP.  II                                                                   11-45
The cost estimates as presented herein are based upon observations and judgments,
generally without benefit of record data or statistics,.  Costs of building areas and
equipment as well as hourly rates of labor are based on nominal average unit cost
allowances,.  Waste quantities and manhour estimates, of course,  are based on
actual observations. Certain extrapolations have been made which by analysis
of time (minutes per bed) and costs per bed appear to be reasonable.

The final chapter of this volume will provide cost comparison of solid waste  systems
in all hospitals under study and the cost "yardstick" to assist in the evaluation of
systems.

Alternative methods of waste handling and disposal to be explored in Volume IV
of this study will also provide cost comparisons  of considered alternatives for the
Medical Center system „

-------
VOL.  II	
CHAP. II                                                                   11-46
OBSERVATIONS ON AEROSOL CONTAMINATION

Previous research through air and surface sampling has been performed in various
hospitals in the country, relating the effects of waste handling activities on the
environment and the resulting contamination which may likely occur. Specific
investigations by Bond and Michaelsen (Bacterial  Contamination from Hospital
Solid Wastes  - 1964) had given insight into expected effects of waste handling
practices on airborne microflora. They had indicated, for instance,  that soiled
laundry handling was by far the most significant influence on increased airborne
bacteria.  They also indicated general levels of airborne bacteria associated
with various hospital areas and  had suggested that such factors as activity levels
and ventilation patterns could greatly affect sampling results..

As part of the waste handling evaluation at the Medical Center, it was decided
to obtain a limited quantity of data concerning microbiological aerosolization
by actually monitoring procedures in several locations specifically selected for
their proximity to waste handling activities.  The main objective was to demon-
strate similar effects to those previously reported, actually occurring in  the
hospital being studied and to emphasize the potential hazards that exist  in
these less obvious sources of contamination.  Local field experimentation was
conducted at the Medical Center in March,  1969.  This program was limited
to air sampling for quantitative estimates of airborne bacteria at selected
locations in the plant.  Field testing and lab analysis were performed by
personnel of the Los Angeles County Health Department in collaboration with
special consultants from the Division of Environmental Health and Safety,
School of Public Health, University of Minnesota.
Equipment and Procedures Used:

The air samplers chosen for the study were Elliot Slit Samplers.  These samplers
were connected to vacuum pumps and equipped with gauges to regulate airflow
to one cubic foot per minute.  The samplers operate on the slit impaction
principle.  Air sampling plates are placed on a turntable adjusted to a distance
of 2 mm between the bottom of the slit and the agar surface.  Two samplers

-------
VOL.  II	
CHAP. II                                                                  11-47
were employed„  One was set for one revolution of the turntable in two minutes
(two cubic feet)  while the other made one revolution in six minutes (six cubic feet),
Prepoured plates containing Trypticase Soy Agar were obtained for the program.
Plates were incubated at 37° C for 20-24 hours after sampling, then counted.
When plates were too heavily contaminated for accurate counting,  results were
recorded as TNTC and arbitrarily assigned a value of 200 col/cu ft.
Observations at Selected Sampling Stations:

The areas selected for sampling included the following:

1.  Trash chute rooms and the adjacent corridor in the service level of the
    Acute Unit (Bldg. No. 1)  at the Medical Center,,

2.  Laundry chute rooms and adjacent corridor areas at the same level.

3.  The soiled linen sorting area at the laundry.

4.  One soiled utility room on an upper story nursing station,,

Each of the selected areas was sampled on several occasions.  On those days when
the chute rooms and adjacent corridors were being sampled, one sampler was set
up in the room while the other was located in the corridor near the door, which
was kept closed except when entry was necessary.  A sample was run on each
machine approximately every 15 minutes, starting between 6:30 and 7:30 a.m.
and continuing for some 6 to 8 hours.  A detailed record of activity associated
with each sample was kept.  Additional samples were sometimes run directly
associated with a specific waste handling activity, such as loading of trash or
laundry into carts. Figure 11-6 shows the typical arrangement of air sampling
equipment during sampling procedures.

-------
VOL.  II
CHAP. II
11-48
          Figure 11-6   Air Sampling Procedures in Soiled Linen Room
In the soiled linen sorting area, one machine was set up near the start of the belt
operation and the other near the endo  Again sequential samples were taken every
15 minutes or so for 4 or 5 hours.  On the nursing station the two machines were
located on opposite sides of the soiled  utility room.
Results of the Sampling Program:

The overall results of the air sampling program are summarized in Table 11-16.


               TABLE  11-16   SUMMARY OF AIR SAMPLING DATA
Station
Trash Chute Room

Laundry Chute Room

Soiled Linen Sorting
Station Utility Room
- Inside
Outside
- Inside
- Outside
Area

* Observations
99
96
58
57
54
55
Mean col/
cu. ft.
14.1
8.8
38.3
31.4
71.0
5.0
# of TNTC
Plates
2
0
2
5
7
0

-------
VOL.  II	
CHAP. II                                                                   11-49
It is obvious that the laundry handling operation does generate considerably greater
aerosols than does the trash handling.  This is consistent with the conclusions of
Bond and Michaelsen.  Also of considerable interest is the finding that colony counts
in the corridor adjacent to the soiled  linen chute rooms were almost as high as in
the storage room itself.  Thus, it appears that the soiled linen handling operation
as currently practiced might actually  result in exposing the great number of persons
utilizing the adjacent corridor to increased airborne contamination.

It is somewhat surprising that the corridor outside of the soiled linen chute rooms
should be significantly more contaminated than the same corridor outside of trash
chute rooms, as the trash and soiled linen  storage rooms are  often in close proximity
to each other.  One possible explanation might be that the pattern of air movement
in the tunnel is from the trash rooms toward the soiled linen  rooms.

In summary, the air sampling program  has demonstrated, in agreement with previously
published reports, that soiled linen handling  is a significant source of airborne
contaminants and that even when the  activity is confined  to a storage room with
the door closed most of the time, the  effect can be demonstrated in adjacent areas.

-------
VOL.   II	
CHAP.  II                                                                   11-50
EVALUATION OF EXISTING SYSTEM OPERATION

The evaluation of the performance capabilities of the existing solid waste system at the
Medical Center has been based upon observations of  the plant,  equipment and oper-
ating techniques employed in its operation.  As an aid for evaluation of the system,
a summary description of the total  solid waste system, Table 11-17, was prepared,
showing typical daily production of the various types of wastes and the prevailing
methods of performing the various function within each of the system components
(Unit, Inter-Unit, Inter-Building and Off-Site System) for each type of waste.

As indicated in the Table, the task of the movement  of waste materials at the
Medical Center is largely manual in nature.  Although equipment presently
employed provides mechanical means of vertical and horizontal transportation
over substantial distances for those wastes of the greatest quantities (soiled linen
and rubbish, etc.), movement of each of these wastes generally involves a minimum
of four different modes of transport, and four to five  physical rehandlings or
transfers of the loose or contained materials, between the points of initial
deposit and  their ultimate resting place.  An extreme contrast to these methods
may  be observed in the direct closed system afforded food preparation wastes,
which are generally limited to a single handling as they are deposited directly
in the kitchen grinders soon after creation.

It is  evident that evaluation of the existing systems for handling the various types
of waste materials within the complex will,  in the majority of cases, depend upon
methods of preparation of waste materials and  reflect the performance of  labor
handling this material, working generally without benefit of specialized  equipment.
Malfunctions of any of the limited equipment in the system will tend to handicap
labor further in satisfactorily performing its functions and affect standards
throughout the respective waste system.

-------
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-------
VOL.  II
CHAP. II
The Developed Rating:

In the development and application of evaluation methods adopted for this study,
general guidelines were established for rating the various types of equipment and
methods employed in each function of the system for handling the respective types
of waste.  Evaluation of the total system  was based  on observations over a period
of some sixty days, during which various  malfunctions in the system occurred.
However, the evaluation was based on what appeared to be prevailing practices
and conditions during this period.  Table 11-18 presents  the composite deficiency
rating as developed by the project staff,  and follows the format established in
the introductory section in Volume I. Proper interpretation of the rating of
individual waste systems will indicate those areas of the system where remedial
measures should be considered, It would appear that minimizing rehandling
and exposure of all waste materials within the plant by means of a closed
transport system,  with no interruption between the initial points of dispatch
and processing or disposal  stations would  provide the optimum in solid waste
system.

Discussions on remedial measures to be considered as suggested by the deficiency
rating of the individual waste systems at the Medical Center are presented in
Volume IV.

-------
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                                                         PAGE M-53

-------

-------
VOL  I	   SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
APPENDIX B
              The tabular descriptions of the existing solid waste
              systems In detention facilities, as reported in
              Chapter IX,  Volume II, are appended in support
              of the summary contained in Chapter IV of this
              volume.

-------

-------
VOL.  II
CHAP. VIM
                                         VI11-23
     TABLE VI11-9
DESCRIPTION OF SOLID WASTE SYSTEM - MIRA LOMA
REHABILITATION CENTER AND SHERIFF'S FACILITY
System Components
Inter-Unit or Inter-Building:
Internal Transfer
Central Storage
Central Processing or Disposal
Off- Site:
External Transfer
Final Processing and/or Disposal
TOTAL WASTES PRODUCED
Avg. Daily Weight
% of Total
Types of Waste
Soiled Linen

Hand Cart
Laundry Sorting
Area
Laundry

	
	

2,174
52.7
Garbage

Sheriff's Truck
Commercial
Bins
	

Private Packer
Truck
Private Landfill

1,140
27.7
Rubbish

Sheriff's Truck
Commercial
Bins
	

Private Packer
Truck
Private Landfill

810
19.6

-------
VOL.  II
CHAP. IX
IX-6
     TABLE 1X-2   DESCRIPTION OF SOLID WASTE SYSTEM - CENTRAL JAIL
System Components
Inter-Unit or Inter-Building:
Internal Transfer
Central Storage
Central Processing or Disposal
Off-Site:
External Transfer
Final Processing and/or Disposal
TOTAL WASTES PRODUCED
Avg. Daily Weight
% of Total
Types of Waste
Soiled Linen

Hand Cart
Soiled Linen
Room
	

Sheriff's Truck
Mira Loma
Laundry

12,000
50.8
Garbage

Hand Cart
Refrigerated
Storage Room


Private Truck
Hog Feeding

7,420
31.5
Rubbish

Hand Cart
Commercial
Bins
	

Private Packer
Truck
Private Landfill

4,200
17.7

-------
VOL.  II
CHAP. IX
1X-12
 TABLE IX-4   DESCRIPTION OF SOLID WASTE SYSTEM - SYBIL BRAND INSTITUTE
System Components
Inter-Unit or Inter-Building:
Internal Transfer
Central Storage
Central Processing or Disposal
Off-Site:
External Transfer
Final Processing and/or Disposal
TOTAL WASTES PRODUCED
Avg. Daily Weight
% of Total
Types of Waste
Soiled Linen

Hand Carl-
Laundry Sorting
Area
Laundry

	
	

1,756
40.5
Garbage

Hand Cart
Commercial
Bins
	

Private Truck
Hog Feeding

1,367
31.5
Rubbish

Hand Cart
Commercial
Bins
	

Private Packer
Truck
Private
Landfill

1,217
28.0

-------
VOL.  II
CHAP. IX
1X-18
           TABLE 1X-6   DESCRIPTION OF SOLID WASTE, SYSTEM -
                       SAN FERNANDO VALLEY JUVENILE HALL
System Components
Inter-Unit or Inter-Bui Iding:
Internal Transfer
Central Storage
Central Processing or Disposal
Off-Site:
External Transfer
Final Processing and/or Disposal
TOTAL WASTES PRODUCED
Avg. Daily Weight
% of Total
Types of Waste
Soiled Linen

Hand Cart
Soiled Linen
Room
	

Institution
Truck
Olivs View
Laundry

895
25.2
Garbage

Hand Cart
Area Near
Loading Dock
	

Sheriff's Truck
Hog Feeding

1,300
36.5
Rubbish

Hand Cart
Loading Dock
	

Institution
Truck
Private Landfill

1,360
38.3

-------
VOL.  II
CHAP. IX
IX-23
   TABLE IX-8   DESCRIPTION OF SOLID WASTE SYSTEM - HALL OF JUSTICE
System Components
Inter-Unit or Inter-Building:
Internal Transfer
Central Storage
Central Processing or Disposal
Off-Site:
External Transfer
Final Processing and/or Disposal
TOTAL WASTES PRODUCED
Avg. Daily Weight
% of Total
Types of Waste
Soiled Linen

Elevator
Soiled Linen
Room
	

Sheriff's Truck
Mira Loma
Laundry

7,000
49.9
Garbage

Elevator
Open Storage
Room
	

Private Truck
Hog reeding

4,000
28.5
Rubbish

Elevator
Commercial
Bins
	

Private Packer
Truck
Private Landfill

3,036
21.6

-------

-------
VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX C                                                             c-1
              The tabular evaluations of the existing solid waste
              systems in detention facilities, as reported in
              Chapter IX, Volume II, are appended in support
              of the summary contained in Chapter IV of this
              volume.

-------

-------
    VOL.  II
    CHAP. VIII
VI11-24
TABLE VIII-10              MIRA LOMA REHABILITATION CENTER AND SHERIFF'S FACILITY

              NUMERICAL RATING OF DETENTION FACILITY SOLID WASTE SYSTEMS

i
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System
Components
nternal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
Final Processing
and/or Disposal
Total
TOTAL
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
5
2
2
3
5
2
5
10
3
2
3
7
13
6
10
20












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Def.
Value
2
3
2
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3
10
19




5
6
12
21
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15
22
10
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27
15
8
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48
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Value
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80
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Rubbish
Def.
Value
5
11
7
7
2
19
30
22




7
30
37
29
1
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25
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51
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Total
Def.
Value
12
16
11
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10
24
45
51
3
2
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25
42
59
70
6
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41
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49
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59
99
119
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Value
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Def.
Value
51
130
15
196
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106
120
316
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MO
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2(5^.


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10130

-------
VOL.  II
CHAP. IX
IX-8
        TABLE IX-3   NUMERICAL RATING OF SOLID WASTE SYSTEM - CENTRAL JAIL

Inter-Unit or Inter-Building System
I
£
to
£
O

System
Components
Internal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
•inal Processing
and/or Disposal
Total
TOTAL
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
13
5
2
3
2
0
5
5




15
5
7
8
5
3
3
5
15
3
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15
20
6
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35
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28
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7
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14
8
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27
Max.
Value
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Def.
Value
5
3
3
3
1
5
15
15




6
8
18
18
1
5
0
3
3
15
25
19
4
20
25
22
10
28
43
40
Max.
Value
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Def.
Value
20
11
7
8
5
6
25
25




25
17
32
33
11
11
6
13
23
19
33
49
34
30
,3? ..
62
59
47
71
95
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Value
SB
40"
30
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•'»•
40
'&'
75
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50
40..
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530
130
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220
240
300
TOTAL
Def.
Value
46
61

107
41
124
165
272
Max.
Value
. W
17S
)85
540
W
'26$
*&>'•
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-------
VOL.  II
CHAP. IX
IX-14
    TABLE IX-5   NUMERICAL RATING OF SOLID WASTE SYSTEM - SYBIL BRAND INSTITUTE

j
?
fo
4
3
5
'c
5
_c
I
£
O

System
Components
Internal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
:inal Processing
and/or Disposal
Total
TOTAL
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
5
2
2
3
2
2
5
10
3
2
7
3
10
6
14
16












10
6
14
16
Max.
Value
: 25
JO
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15
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5
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13
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7
16
22
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19
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38
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26
43
49
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-------
   VOL.  II
   CHAP. IX
1X-20
TABLE IX-7   NUMERICAL RATING OF SOLID WASTE SYSTEM - SAN FERNANDO VALLEY JUVENILE HALL

Inter-Unit or Inter-Building System
Off-Site System

System
Components

nternal Transfer


Central Storage
Central Processing
or Disposal
Total
External Transfer
:inal Processing
and/or Disposal
Total
TOTAL


Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
5
2
2
3
2
2
5
5




7
4
7
8
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4
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14
9
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35
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Value
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7
16
18
33
2
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12
36
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17
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18
25
32
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12
11
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19
33
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66
53
55
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122
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35
96

131
46
124
170
301
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54Q
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2(55
460 i
•JOJ30

-------
VOL.  II
CHAP. IX
1X-25
      TABLE IX-9   NUMERICAL RATING OF SOLID WASTE SYSTEM - HALL OF JUSTICE

Inter-Unit or Inter-But Idtna System '
Off-Site System

System
Components
Internal Transfer
Central Storage
Central Processing
or Disposal
Total
External Transfer
Final Processing
and/or Disposal
Total
TOTAL
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Sanitation
Safety
Security
Esthetics
Soiled Linen
Def.
Value
13
5
2
3
5
2
10
10




18
7
12
13
5
3
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5
15
3
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15
20
6
8
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38
13
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33
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54
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7
16
33
26
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19
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58
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8
12
17
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32
28
57
66
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73
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108
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-------

-------
VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX D                                                            d-1
              The tabular descriptions of the existing solid waste
              systems in office buildings, as reported in
              Chapter X, Volume II, are appended in support
              of the summary contained in Chapter IV of this
              volume.

-------

-------
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                                                                        TABLE X-3
                                                                        PAGE X-6

-------

-------
VOL. 1	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX E                                                             e-1
              The tabular evaluations of the existing solid waste
              systems in office buildings, as reported in
              Chapter X, Volume II, are appended in support
              of the summary contained in Chapter IV of this
              volume.

-------

-------
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                                                        j
Central Processing
or Disposal
                                                                                   u. o
                                                                                                  _
                           UNIT SYSTEM
                                                     INTER-UNIT SYSTEM
                                                                              OFF-SITE SYSTEM
                                                                                            TABLE X-7
                                                                                            PAGEX-12

-------

-------
VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX F                                                               M
              The evaluation of considered improvements to the solid waste
              system at the LAC-USC Medical Center, as reported in
              Chapter III, Volume IV, is appended in its entirety. Based
              upon evaluation methods and system requirements established
              in earlier stages of this study, considered modifications to
              the existing system were all centered around a central
              pneumatic collection system with various processing and
              disposal options.  The following comparisons of these
              systems further support the selected modifications
              proposed as the basis for the demonstration  project.

-------

-------
VOL.   IV	
CHAP.  Ill                                                                   111-11
LAC-USC MEDICAL CENTER

The evaluation of those system modifications described in the foregoing, and the overall
effect of those modifications on the solid waste system operation at the  LAC-USC Medical
Center are summarized in the following group  of illustrations:

    Table Ill-l          Percentage  Deficiencies of Sub-System Functions

    Figure Ill-l          Comparison of System Deficiencies

    Table 111-2          Comparison of Project Costs

    Table 111-3          Economic Evaluation  of Solid Waste System Modifications

    Figure III-2         Comparison of Economic Desirability of Systems

Table Ill-l shows percentage deficiencies of sub-system functions within each modified
system and the comparison to deficiencies of the existing system.  Figure Ill-l graphically
illustrates these comparisons.  These illustrations are summarized from the detailed
numerical ratings of each modified system included as Appendix B  (pages b-1 and b-2).
It will be noted that variations in deficiencies of the modified systems occur only in
the functions of on-site central processing or disposal  and the off-site system.
Substantial decreases of present deficiencies in the handling system operation are
expected to be accomplished with the pneumatic conveyor system.  The remaining
deficiencies are largely associated with those  reusables (patient and food service
items) not entering the modified  system, as well as the initial handling  of nearly all
items in the unit system prior to entering the modified portions of the system.  In the
case of the latter, further reduction of deficiencies in operation are likely to come
about only through enforcement of policies and closer supervision and not through
mechanization in the foreseeable future.

Estimated costs of the various systems are illustrated in Table 111-2.  It will be noted
that approximate  costs  of the pneumatic system are constant in all  systems with
variations occurring only in the processing and disposal elements.   Estimated daily
labor costs for each of  the modified systems  shown  in Appendix  B (pages b-3, b-4
and b-5) provide  detail on classifications of labor  distributed to various categories

-------
VOL.  IV	
CHAP. Ill                                                                   111-12
of wastes within the sub-systems. These may be compared to estimated daily labor costs
of the existing system (Table 11-13,  Page 11-41, Volume II).  Principal economies,
occurring  in the Unit,  Inter-Unit and Inter-Building systems as a direct result of the
pneumatic system, are  constant in the labor estimates of each modified system.
Variations in labor between the modified systems occur only with the differing
requirements of processing and disposal methods.

Economic evaluation of the various modified systems is summarized in  Table  111-3,
showing net investment requirements, direct annual operating advantages (gross savings)
and indirect or non-operating annual advantages (savings accruing from elimination of
certain parts of the existing system).  Calculations of the annual return on the investment
after depreciation is shown in dollars and the percentage return is expressed as the
"desirability rating".  Figure 111-2 graphically illustrates the comparison of desirability
ratings.  In  comparison between systems, the higher the return, the greater the
"economic desirability" of the investment.  It is emphasized that this  analysis does
not consider the cost of funding such improvements and the rate of return (desirability
rating) shown should be compared to existing interest  rates available and average
annual interest rate applicable to the respective investments.

Investment requirements of the four systems considered (systems  1-4) with processing and
disposal methods which meet the established criteria range from $1,932,000 to
$2,317,000.  The indicated annual  return on required investments range  from 16% to
22%.  The range in system improvements indicates the deficiencies of the existing
system may be decreased by 58% - 65% with major improvements at nearly  all levels
of operation.

-------
VOL.  IV
CHAP. Ill
    TABLE 111-1
Comparison of Hospital Solid Waste Systems

       LAC-USC Medical Center

PERCENTAGE DEFICIENCIES OF SUB-SYSTEM FUNCTIONS

Sob-System and Function

UNIT SYSTEM:
Initial Deposit
Initial Transfer
Initial Storage
Weighted Average
INTER-UNIT SYSTEM:
Vertical Transfer
Intermediate Storage
Weighted Average
INTER-BUILDING SYSTEM:
Internal Transfer
Central Storage
Central Proc. or Disp.
Weighted Average
OFF-SITE SYSTEM:
External Transfer
Final Proc . or Disp.
Weighted Average
TOTAL SYSTEM
% DECREASE OF DEFICIENCIES

Existing
System

52.3
50.5
62.1
55.0

41.2
62.2
52.0

54.9
74.8
67.4
68.0

23.3
71.8
60.0
58.0
—
Improved Systems
System
1

34.0
34.3
25.3
31.1

16.6
21.3
19.1

8.3
31.4
34.8
24.8

1.5
7,1
5.7
20.6
64.7
System
2

34.0
34.3
25.3
31.1

16.6
21.3
19.1

8.3
31.4
47.1
29.1

1.8
2.6
2.4
20.8
64.3
System
3

34.0
34.3
25.3
31.1

16.6
21.3
19.1

8.3
31.4
34.8
24.8

3.3
20.0
15.9
23.2
60.2
System
4

34.0
34.3
25.3
31.1

16.6
21.3
19.1

8.3
31.4
34.8
24.8

9.1
24.3
20.5
24.4
58.1

-------
VOL.  IV
CHAP. Ill
FTT
            SYSTEM I
                                                     SYSTEM 2
         SYSTEM 3
                                                     SYSTEM 4
                                 LEGEND









.•v
"\~
N— *

-EXBTNG
-PROPOSED
           FIGURE Ill-l    COMPARISON OF SYSTEM DEFICIENCIES

                         LAC-USC Medical Center

-------
VOL.   IV
CHAP.  Ill
1-15
                      TABLE 111-2    COMPARISON OF PROJECT COSTS

                               LAC-USC Medical Center
SYSTEM
1

2

3

4

5

6

7

8

9

SYSTEM COMPONENT
Vacuum Tube
Grinders
Building
Wet Oxidation
Total
Vacuum Tube
1 ncinerator
Total
Vacuum Tube
Grinders
Building
Wet Oxidation
Truck
Total
Vacuum Tube
Grinder
Building
Total
Vacuum Tube
Grinders
Building
Extruders
Truck
Total
Vacuum Tube
Shred
Building
Truck
Total
Vacuum Tube
Grinders
Dewater
Building
Truck
Total
Vacuum Tube
Compactor
Containers
Building
Equipment
Total
Vacuum Tube
Trucks
Building
Equipment
Total
INSTALLED
COSTS
$1,600,000
200,000
210,000
360,000
$2,370,000
$1,600,000
750,000
$2,350,000
$1,600,000
200,000
210,000
360,000
25,000
$2,395,000
$1,600,000
200,000
210,000
$2,010,000
$1,600,000
200,000
210,000
90,000
25,000
$2,125,000
$1,600,000
220,000
210,000
25,000
$2,035,000
$1,600,000
200,000
55,000
210,000
25,000
$2,090,000
$1,600,000
30,000
24,000
150,000
75,000
$1,879,000
$1,600,000
80,000
150,000
75,000
$1,905,000
ESTIMATED
LIFE (YEARS)
25
10
25
25

25
25

25
10
25
25
10

25
10
25

25
10
25
10
10

25
10
25
10

25
10
10
25
10

25
10
25
25
25

25
10
25
25

DEPRECIATION
$ 64,000
20,000
8,400
14,400
$106,800
$ 64,000
30,000
$ 94,000
$ 64,000
20,000
8,400
14,400
2,500
$109,300
$ 64,000
20,000
8,400
$ 92,400
$ 64,000
20,000
8,400
9,000
2,500
$103,900
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VOL. I	SUMMARY, CONCLUSIONS AND RECOMMENDATIONS	
APPENDIX G                                                                g-1
              The continuing study of proposed solid waste system
              improvements at the LAC-USC Medical Center, as
              reported in Chapter VI, Volume IV, is appended in
              its entirety.  This study covers the development of
              the design concept, schematic plans, estimated costs
              of construction and operation, benefits of the system
              and a proposed testing  and observation program after
              installation of the system„

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VOL .  IV     SELECTION AND DESIGN OF SOLID WASTE SYSTEMS	
CHAP. VI     PROPOSED PILOT PROJECT                         Page No.
             SCOPE OF PROJECT                                VI-1

             PROJECT OBJECTIVES                              VI-3

             CONSTRUCTION PROGRAM                         VI-4

             IMPLEMENTATION SCHEDULE                        VI-5

             DESIGN CONCEPT                                 VI-7

             PRELIMINARY PLANS                               VI-8

             DESCRIPTION OF THE SYSTEM OPERATION             VI-12

             OPERATING CHARACTERISTICS - Wet Pulping System      VI-16

             OPERATING CHARACTERISTICS - Mechanical Conveyors   VI-18

             OPERATING CHARACTERISTICS - Wet Air Oxidation System VI-19

             OPERATING CHARACTERISTICS - Experimental Sewage
                Treatment Plant                                  VI-20
                Design Criteria                                  VI-20

             ESTIMATED ANNUAL OPERATING COSTS               VI-22

             ESTIMATED CONSTRUCTION COSTS                   VI-24

             BENEFITS OF THE SYSTEM                           VI-27

             RECOMMENDATIONS FOR IMPLEMENTATION           VI-33

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VOL .  IV      SELECTION AND DESIGN OF SOLID WASTE SYSTEMS	
CHAP. VI      PROPOSED PILOT PROJECT                              Page No.
                               LIST OF TABLES

       VI-1    Solid Waste Classification                                 VI-17
       VI-2    Annual  Operating Costs of Project Facilities                 VI-22
       VI-3    Estimated Daily Labor Costs of the Modified Waste System
                  LAC-USC Medical Center                              VI-23
       VI-4    Estimated Construction Costs                                VI-25
       Vl-5    Tangible Economic Benefits                                Vl-28
       VI-6    Numerical Rating of Proposed Solid Waste System
                  LAC-USC Medical Center                              VI-29
       VI-7    Percentage Deficiencies of Sub-System Functions             VI-31
                               LIST OF FIGURES

       VI-1    Estimated Schedule of the Continuing Program                VI-6
       VI-2    Schematic of Inter-Building Solid Waste System (Existing)     VI-9
       VI-3    Proposed Refuse Processing Plant - LAC-USC Medical Center  VI-10
       VI-4    Proposed Refuse Processing Plant - LAC-USC Medical Center  Vl-ll
       Vl-5    Diagrammatic Chart - Refuse Processing Plant                VI-14
       VI-6    Comparison of Percentage Deficiencies of Sub-System
                  Functions - LAC-USC Medical Center                   VI-32

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VOL.  IV      SELECTION AND DESIGN OF SOLID WASTE SYSTEMS	
CHAP. VI      PROPOSED PILOT PROJECT                                   Vl-l
The earlier volumes of this study have provided a summary of the total study, a detailed
study and evaluation of existing waste systems in selected building complexes and an
investigation of available equipment for system improvements.  In the preceding
section of this volume, an evaluation of considered system improvements was made
at each of the selected building complexes.  Upon review of these evaluations, one
of these complexes, the LAC-USC Medical Center, was selected for  continuing study
and as the site for construction of the recommended system to be tested.

The proposed waste system for this project  involves pneumatic transport of disposable
wastes and reusable linens employing a single tube pneumatic conveyor system.  This
proposed system also will contain a central pulping station for disposable materials,
a wet oxidation process and an experimental sewage treatment plant.  Optional
processes and disposal methods available include discharge of raw or  sterilized  pulped
wastes to sewers,  transport of dewatered raw or sterilized pulped wastes to landfills,
nearly complete oxidation of pulped wastes with discharge of residue to sewers  or
dewatered residue to landfills or emergency bypassing of all processes with direct
discharge of bulk  wastes to a compactor for disposal at landfills.

The Medical Center project permits a full  range of observations  and tests on sterili-
zation of pulped wastes, effects of raw or  sterilized pulped wastes on various sewage
treatment processes, recovery of cellulose  by the wet oxidation  process and numerous
other activities noted  in the scope and objectives of the project.
SCOPE OF PROJECT

The project includes the design, construction and operation of the proposed solid waste
system, together with an extensive program of observations, sampling, analysis, and
testing,,  This program will determine the adequacy of each item of equipment to
fulfill its function properly and any modifications that may be needed to improve
its operation.  Careful  records of operating and maintenance cost will be maintained
and any improvements in related services will be observed to evaluate properly the
economic impact resulting from the installation.

Tests will be conducted and observations made to determine the improvement in environ-
mental conditions as related  to the handling of waste materials and the disposal of
refuse.  Microbiological air samples will  be taken in the vicinity of laundry and refuse
chutes, in service tunnels  and at the  inlet of the conveying system  to determine

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VOL.  IV	
CHAP. VI                                                                     VI-2
improvement' achieved through the installation of the system.  Similar tests will be
made on the discharge of the exhaust filters from the conveying system, at the pulping
units to determine the level  of aerosol contamination at these points, and the need, if
any, of modifying these installations. Evaluations will be made on the effectiveness
of a single tube pneumatic conveying system for transport of disposable wastes and
reusable linen„

Physical inspections will be  made of the sewers into which pulped refuse is discharged
to determine the condition of the sewers, quantities and type  of deposits, septic
conditions,  etc. both above and at intervals below the point of discharge of pulped
waste before commencing such discharge and at intervals during the program.

Measurements will be made of sewage flows above and at intervals below the point of
discharge  of the pulped  waste, together with the quantities of pulped waste discharged
into the sewers.   Measurements will also be made of the quantities of refuse  delivered
to the waste processing plant, the volume and  weight of non-pulpable wastes removed,
the amounts of electric power or other fuel consumed, and the quantities of water
requi red.

Physical,  chemical and  bacterial analyses will be made periodically on samples of the
pulped refuse and sewage samples taken above and at intervals below the point of
discharge  into the sewer to determine the effect of such discharge on the characteristics
of the sewage and to the effect on water reclamation.

Tests, including chemical and bacterial analyses, will be conducted on the wet
oxidation  process to determine the temperature-pressure-time  relationship required to
sterilize,  to oxidize completely or to oxidize sufficiently to permit the recovery of
cellulose  fiber from varying  concentrations of pulped refuse or from varying mixtures
of pulped  refuse and sewage sludge as would be encountered in a municipal sewerage
system if pulped solid waste  were admitted on a general  or restricted basis.

Tests will  be conducted  on the stability of the  dewatered cake from the wet oxidation
process, extent of the reduction of solids and upon the feasibility of recovery of a
useable cellulose fiber. Tests will also be conducted on the amenability of the
filtrate to conventional  sewage treatment processes, either alone or mixed with
varying amounts of domestic sewage and on the amenability of various mixtures
of pulped  refuse and sewage to treatment by conventional or other means.

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VOL.   IV	
CHAP.  VI                                                                    VI-3
PROJECT OBJECTIVES

Broadly, the objectives of this program are to develop operating procedures and
performance standards and determine operational reliability of the designed system,
together with an evaluation of the environmental improvements and economic benefits
that may be derived from such projects.  These  objectives are further expanded as
follows:

1.      To demonstrate the savings in cost and improvement in environmental conditions
        in a hospital- complex through the installation of a pneumatic conveying
        system for handling soiled and contaminated materials from hospital floors.

2.      To demonstrate the practicality of using sewage  as the fluid for pulping and
        transportation of pulped hospital  wastes, and to  determine what preconditioning
        of the sewage, if any, is needed before use in the pulper.

3.      To demonstrate the practicality and costs of disposing of pulped hospital wastes
        in a sanitary sewerage system and the savings  in cost thereby„
                                                                  *
4.      To determine the extent of wet oxidation required and the costs of such
        processes to sterilize effectively  a pulped contaminated hospital waste.

5.      To determine the effect of wet oxidation of pulped hospital wastes and the
        effect of residue discharged into  sanitary sewerage systems.

6.      To determine the extent of wet oxidation necessary to produce a stable  and
        sterile dewatered pulp and to determine the costs of such processes.

70      To determine the extent of wet oxidation necessary to recover a useable
        cellulose pulp from pulped hospital waste and the costs of such processes,
        as well  as the practicality of recovering a commercially valuable cellulose
        pulp from a mixed sewage sludge and pulped waste as might be obtained
        from the general discharge of pulped solid wastes into the sanitary sewerage
        system.

8.      To determine the quantities and characteristics of non-pulpable hospital wastes
        and processing required for their  safe and proper disposal, as well as the cost.

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VOL.  IV	
CHAP. VI                                                                   VI-4
 9o    To determine the effect of adding various quantities of pulped solid waste
       to sanitary sewage on both the primary and secondary units of conventional
       sewage treatment plants, including those employing both trickling  filters and
       activated sludge or some of its more recent modifications.

10.    To determine the effect of adding various quantities of pulped solid waste to
       sanitary sewage on sludge characteristics, including  dewaterability and
       degradability under both mesophilic and thermophilic anaerobic conditions,
       as well as under aerobic conditions.

11.    To determine the practicability of aerobic decomposition of dewatered pulped
       waste and sewage sludge through composting.

12.    To determine what process or series of processes may  be required to treat effec-
       tively  the mixtures of sanitary sewage and pulped solid waste which might be
       anticipated in municipal sewerage systems should pulping of such wastes be
       generally adopted.

13.    To evaluate the overall economic and environmental  effects on a municipality
       from the general adoption of pulping as a method of solid waste disposal or of
       limiting it to contaminated hospital  wastes.

14.    To continue research on systems and equipment available for materials handling
       and solid waste disposal to take advantage of development work currently in
       progress,

15.    To continue research on regulator/ codes and restrictions and develop code
       modifications or guidelines for system design as may be required.

16.    To provide documentation of project for educational  purposes,  such as
       photographic coverage, movies, other visual  aids.
CONSTRUCTION PROGRAM

The construction program required for development of this solid waste system is esti-
mated to be completed within the first year's period.  Proposed construction of the
basic components in this system that is necessary to carry out the project objectives

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VOL.  IV	
CHAP. VI                                                                   VI-5
is identified as follows:

1.     A single tube pneumatic conveyor system for the collection of both soiled
       linens and refuse from the various treatment, service and housing units.

2.     A central pulping station with discharge to sewers and optional disposal
       processes.

3.     A wet oxidation plant for the oxidation and sterilization of the pulped
       contaminated waste.

4.     A sewage pumping station to supply sewage to  the pulpers.

5.     A centrifuge or vacuum filter for dewatering oxidized pulp.

6.     Experimental sewage treatment plant with capacity of 40,000 - gpd
       and capable of treating various mixtures of pulped waste and sewage
       by both conventional and non-conventional means.

7.     Laboratory and auxiliary equipment required for the operation of the
       system and carrying out the project  objectives.


IMPLEMENTATION SCHEDULE

The proposed program  is planned over a three-year period.  Progress made
during preliminary planning indicates it is entirely feasible  to expect final design
plans and specifications on these projects to be completed during the first six-month
period and construction  to be accomplished during the remaining portion of the first
year.  It is also feasible  that certain phases of mechanical design of special equipment
components can be accelerated in order that their production and delivery for instal-
lation will coincide with the construction schedule.

It is anticipated that a period of three  to  four months during 'the second year should
be allowed for equipment testing and a transition  period at the Medical Center
project,  before full operation should be expected. Within the proposed .three-year

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VOL.   IV
CHAP.  VI
VI-6
program,  an estimated period of approximately the final twenty months will be
available for detailed observations, testing and systems evaluation under full operating
conditions.  This would appear as a reasonable period in which to accomplish the
ultimate objectives of the proposed project.

This proposed  implementation schedule is graphically illustrated in Figure Vl-l,  which
details principal items occurring during the program  period.
      FIGURE VI-1     ESTIMATED SCHEDULE OF THE CONTINUING PROGRAM
                              first 12 Mos. Period
                                                   Second 12 Mos. Period
                                                                            Third 12 Mos. Period
         Description
                           1  2
                              3456789 10 II 12
                                                 13 14 15 16 17 18 1920 21 22 23 24
                                                                       25 26 27 28 29 30 31 32 33 34 35 36
   pinal Design Plans and Specifications
   'u re hose Special Equipment
   Equipment Shop Drowingi
   Jid and Award Construction Contract
   'reduction of Equipment
  Construction
   Equipment Installation
    Pneumatic System
    Pulping Station
    Wet Oxidation
   Equipment Testing
   Observation of System Operation
   Interim and Final Project Reports
    "Division of first period into separate Design and Construction Pho-ei will likely extend these activities by approximately 90 days.

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VOL.  IV	
CHAP. VI                                                                    VI-7
DESIGN CONCEPT

During the course of this study, from the evaluation of existing solid waste systems
and considered improvements to these systems, the broad concept of a closed mechan-
ical system, fully automated, capable of transporting all disposable and reusable
waste materials and providing on-site disposal, appeared to be the optimum system.
With the preceding studies,  it also became apparent that varying limitations in each
of the building complexes investigated would require certain  compromises on system
selection due to space limitations and existing area functions.

Combined evaluation of the economic and environmental aspects of various combina-
tions of equipment indicated the optimum system for the LAC-USC  Medical Center
should be designed around a pneumatic transport system for the transport of soiled
linens and disposable wastes, together with a central pulping station for processing
disposable materials. These new system components or sub-systems would fully
replace the present inter-building system and off-site system.  Modifications of
certain methods and  equipment in the inter-unit system would also  be required and
collectively, these modifications would have a limited effect on methods and practices
used in the unit system (patient care and service areas).

Personnel  requirements of the improved system would generally be  limited to the
unit system, where emphasis on handling techniques and supervision could be
confined to those initial  handling functions prior to deposit of wastes in chutes.
Those personnel involved in the mechanical system would be limited to qualified
maintenance mechanics and operator classifications.

Local authorities in various County  and  City agencies concerned with environmental
control approved of the basic concept.  However, as design criteria were developed
and the potential loading and characteristics of solids ,in the sewerage system became
more apparent, concern was expressed about these factors and their ultimate effect on
sewage treatment processes.  It was recommended that the proposed basic waste system
project be expanded  to include an experimental sewage treatment plant and sludge
processing (wet oxidation) unit, to provide facilities for on-site  experimentation in
order to evaluate fully the total disposal process.

Preliminary plans were developed around this total concept.  Although a substantial

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VOL.  IV	
CHAP. VI                                                                      VI-8
investment will be required for the basic solid waste system, anticipated annual savings
in the operation of the improved new system would return the investment in a period
of five to seven years excluding costs of the experimental sewage treatment plant.  If
depreciated over a nominal 25-year  period, an annual direct savings or operating
surplus (over present costs) of about $354,000 would be available for redistribution
to patient-care functions or other needed improvementSo  In addition to these direct
savings,  it is estimated that substantial indirect benefits though difficult to estimate
would likely accrue  as a result of improved health and safety standards, both in the
hospital plant and  the community at  large,,
PRELIMINARY PLANS

The above briefly summarizes certain of the background material preceding the
preliminary design phase of the proposed system.  To reorient the readers to the
physical plant at LAC-USC Medical Center, Figure VI-2 illustrates the existing
building layout and relates certain features of the existing solid waste system.  The
schematic routing of the proposed pneumatic conveyor system has been superimposed
on this plan showing the approximate piping network that would be situated on the
main hospital parcel.  The extension of this pipeline across Zonal Avenue terminates
at the proposed location of the waste processing plant.  This site was selected as the
most suitable location for the plant by  hospital  representatives and their master
planning consultant.  Figure VI-4 suggests configuration of the plant facilities.

Implementation of the proposed solid waste system will involve  construction of a
permanent new building to accommodate equipment installations, the control room,
office and laboratory services  which comprise the central waste processing plant
and accessory structures and assemblies.  Structures of the experimental sewage plant
will be located adjacent to the waste processing pi ant.

This basic plant as proposed and illustrated in Figures VI-3 and VI-4 will accommodate
the pneumatic system discharge hoppers, exhausters and bacteriological filters, a
twin pulper installation with provisions for the addition  of a third unit, the wet
oxidation equipment, conveying equipment and other accessories to these various
processes.  In addition, a control room for the pneumatic system, conveying equipment,
pulping process and wet oxidation process, together with an office, laboratory and
employee facilities are  located on the  upper floor level with access provided by
both elevator and stairs.  Contaminated areas within the plant are confined to the

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VOL.  IV	
CHAP. VI                                                                     VI-12
central storage and pulping process areas located on the lower level.  Dense and inert
materials removed by the dejunkers during the pulping process and grit removed by the
hydraulic cyclones after pulping are washed and disinfected as they are conveyed to
an exterior storage hopper in a screened enclosure.  A second hopper in this same
area provides storage of the sterile sludge cake after dewatering, or in emergencies
(processing breakdown), unprocessed bulk wastes can be directly bypassed to the
hopper for evacuation from the plant by compactor trucks.
DESCRIPTION OF THE  SYSTEM OPERATION

The pneumatic conveyor system will provide transport service for accumulations of
disposable wastes and soiled linen from forty-four loading stations on service levels.
These stations include all  existing gravity chutes and selected new loading stations.

The piping network required for connection of these stations to the laundry and
disposal plant involves about 8,300 linea'l feet of 20" diameter 1/4" steel pipe
with flanged joints and  epoxy lining.  In addition to this basic transmission line,
special discharge valves and valved air intake piping will serve each loading
station.

The system will operate on a time and/or demand basis, cycling disposable wastes
and soiled linens alternately or as required.  Exhaust air will be moved at a rate
of about 10,000 cfm or  60 mph by 2-100  HP exhausters with a third 100 HP unit
as standby. Evacuated  materials will be  deposited in collection hoppers at the
waste processing plant and the laundry.

Each of the existing  chutes will be under induced negative pressure by exhausting
air at the rate of about  300 cfm.  It is proposed to bleed off this volume continuously
into the main  transmission line and ultimately through the bacteriological  filters at
the waste processing plant.

Operation of the waste  system (pneumatic conveyors and waste processing  plant) will
be  largely automated.   Monitoring devices and required manual override controls
for all mechanical elements of the system will be housed in the central control room
at the processing plant.  A remote monitoring panel with alarm signal systems should

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VOL.  IV	
CHAP. VI                                                                    VI-13
be located by plant management as a supplementary control station to insure prompt
and proper attention is given to operational malfunctions of the system.

Figure VI-5, a schematic flow diagram, illustrates the various processing functions
and sequence of processes that are available in the proposed waste processing plant
and identifies the principal equipment components contained therein or adjacent to
the structure.  This chart shows the flow of refuse through the various units from the
pneumatic hopper No. 1,  where it is weighed to storage hopper No.  16, where the
material  is transferred to trucks for disposal at landfills.  Refuse material is discharged
from receiving hopper No. 1 into storage hopper No. 2, where storage up to a full
day's capacity is provided.  This central storage  hopper is equipped with a live
bottom slat conveyor which feeds the waste material to conveyor No. 3.  Oscillating
conveyor No. 3 is provided  to even out the load and the rate of feed to conveyor
No. 4, which in turn delivers  the refuse to puiper feed bins  No. 5. The rate of
feed from these bins can be adjusted to the rate at which the materials are being
pulped in unit No.  7.  Pulped material with about a 3% concentration of solids
is delivered by gravity to sump No. 14, from which it in turn is pumped to the
degritting unit No. 10, where ground glass, grit and bits of metal are separated
from the pulp.  The pulp then continues to concentrator No. 13, where sufficient
water is removed to give an  8 to 10% consistency of pulp.   This pulp is then
delivered to storage tank No.  21. From tank No.  21, the pulp enters the wet
oxidation system through sludge pump No. 30 and high pressure pump No. 31.
It first passes through the heat  exchanger No. 24, where it is heated by previously
processed pulp before entering the reactor No. 23.  In reactor No. 23, it is mixed
with steam and compressed air  and the material oxidized.  From here it returns
through the heat exchanger, where much of the heat is given up to the incoming
material  after which it passes to storage tank No. 22. From storage tank No. 22,
the material is dewatered on vacuum filter No.  17 and then delivered via conveyors
No. 18 and 6 to the storage hopper No.  16 for truck loading.  Unpulpable material
is removed from the pulping  machine by junker No. 8 and from degritter and fed
through conveyors  No. 11 and 12 to the grit storage hopper No.  15.  Here the
material, after disinfection, will  be loaded into  trucks for disposal at landfills.

The layout of the plant will  permit discharging a mixture of either sterilized or
unsterilized pulp with sewage to the sewer system or to the experimental sewage
treatment plant for further processing.  Sewage for the operation of the plant and
for the dilution of the pulped material before discharge into the sewerage system

-------
                          DIAGRAMMATIC   CHART  — REFUSE  PROCESSING  PLANT
                                                                 LEGEND
1.    Vacuum system delivery hopper with pneumatically operated disc^rge gate.   24.
2.    Storage bin with  live bottom (pan conveyor).                                25.
2a.   Pneumatically operated bypass gate.                                        26.
3.    Oscillating conveyor to level out load .                                     27.
4.    Belt conveyor.                                                            26,
4a.   Pneumatically operated deflector plate.                                     29
5.    Pulper feed storage bin and conveyor                                       ^Q
6.    Belt conveyor.                                                            3^
7.    60"  pulper.                                                              32.
      Junk separator and elevator.                                               33
9.    Cyclone feed pump.                                                      34.
10.   Hydraulic  cyclone for grit removal.                                        35.
      Screw conveyor for grit and junk transfer.                                   36.
12.   Bucket conveyor  for grit and junk.                                         37.
13.   Single screw thickener.                                                   38.
14.   Pulped refuse sump,                                                       39
15.   Grit and junk storage hopper with bottom gate.                              4Q
16,   Processed refuse storage hopper with bottom gate,                           4]
17.   Vacuum filter.                                                            42.
18.   Beff conveyor.                                                            43>
19,   Mixing chamber.                                                         44.
20.   Sewage storage and settling tank.                                          45,
21.   Pulped waste storage tank.                                                46.
22,   Oxidized waste storage tank.
23.   Reactor.
Heat exchanger.
Level control valves.
Coolers.
Separator.
Solvent pump.
Solvent rank.
Sludge feed pump.
High pressure sludge pump.
Hydraulic pump and storage tank.
Service air compressor and storage tank.
High pressure air compressor.
High pressure steam boiler.
Boiler head I'ank.
Chemical feed for boiler water.
Brine tank.
Water softener.
Vacuum system centrifugal exhausters.
Vacuum purrps for vacuum filter.
Recording scale to weigh  incoming refuse.
Flexible duct connection  to permit weighing incoming refuse
Refuse delivery tube.
Vacuum system exhaust.
Vacuum pump discharge silencer.
                                                                                                            Figure  VI-5
                                                                                                              Page   VI-14

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VOL.  IV	
CHAP. VI                                                                    VI-15
will be taken from the City of Los Angeles sewer system by a small pumping station
and pumped to storage tank No. 20, from which it will be used as needed.  Sewage
from this tank will also be used to feed the experimental  sewage treatment plant.

The refuse storage and processing area has been laid out having in mind that this
material  is contaminated. Operations of this equipment will be controlled from a
console in the control  room on the second floor and it will not be necessary to have
an operator in the refuse or pulping area during its operation.

Accessory equipment, such as flushing and/or steam cleaning devices will be provided
for sanitizing processing, storage and conveyor equipment and work areas after daily
use»  A drainage system will  carry off flushings to a sump  for discharge to sewers.

Exhausters for the vacuum collection system are located on the second floor along
with the vacuum pump required for the operation of the vacuum filtero The discharge
of these exhausters is through filters located on the  roof.  These filters will be of a
type capable of filtering out  bacteria and will be arranged so that they may be
sterilized prior to removal for cleaning.  Air within the refuse storage and pulping
area will be similarly filtered before discharge into the atmosphere.

Design provisions must be made for odor control within the processing plant and to
reduce excessive noise to acceptable  levels within and outside  the plant.

-------
VOL.  IV	
CHAP. VI                                                                  VI-16
OPERATING CHARACTERISTICS -Wet Pulping System

Principal components of the wet pulping system include two pulpers with [unk separators
and elevators, two cyclone feed pumps, two degritters and two concentrators.  The
system shall be capable of pumping the slurry through at least 150 feet of pipe and
elevating the slurry by at least 15 feet.

Each pulper shall be capable of processing 12,000 pounds per day of a mixture
Class I waste, Class IA waste, and Class li waste, as specified in Table Vl-l.  The
pulpers shall accept unselected waste in loose form, bagged, or in cartons, of any
size with the limitation that the longest dimension shall  not exceed 36 inches.

The pulper shall  reduce the major portion of the waste to a slurry.  Pulped particle
dimensions shall  meet provisions of the City of Los Angeles Bureau of Sanitation
Rneness of Grind Specification for Garbage Grinders.  The remainder of the
waste not slurried shall be ejected by the junk separator.

The pulper shall  expel essentially nonpulpables (Class II waste,  some Class IA waste
and Class IV wastes) through the separators.   Such rejects shall initially contain a
maximum of 10% by weight (dry basis) of pulpables, which shall  be flushed out
prior to these rejects being discharged to the conveyor system „  Nonpulpables shall
be removed and conveyed  by the bucket elevator while the pulper is in operation„

Unprocessed waste remaining in the pulper at the end of any given day's operation
shall be processed within 30 minutes.  After pumpdown and cleaning, residue of
non-pulpable materials remaining in the pulper shall not impair the efficiency of
the system when  it is restarted.  It shall not be necessary to remove waste manually
from  the pulper for trouble-free restart.

The water level in the pulper tank shall be automatically controlled.  There shall
also be a provision to meter a disinfectant solution automatically into the system
through the water makeup  line.

Each pulper shall have a rated capacity of processing  12,000 pounds of hospital
waste in a five hour period when fed at a continuous uniform rate a mixture of
90% Class  I waste and  10% Class II waste.   Controls provided shall include
automatic start-stop and manual start-stop.

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  VOL.  IV
  CHAP. VI
                                                                         VI-17
                    TABLE Vl-l    SOLID WASTE CLASSIFICATION
                  PULPABLE
                                                  NONPULPABLE
 00
 Di
 LU
 Q-
 CD
 CO
 LU
 (J
 O
 Cti
 a.
 O
 z
           CLASS I WASTE*

Mixtures, consisting of:

Paper products
Plastic and rubber tubing
Disposable plastic and rubber items
Disposable aluminum cookware, dinner-
  ware and foil
Cloth or  nonwoven fabrics, i.e.
  clothing, bed linen, towels, gowns,
  surgical garments, garbage and bones
  (cooked and uncooked), mop heads,
  rope, string and tape
Wooden vegetable, fruit, poultry and
  meat crates
Plastic casts
                                                      CLASS II WASTE*

                                            Mixtures, consisting of:

                                            Metal cans and caps
                                            Silverware 6nd utensils
                                            Surgical instruments
                                            Nails, screws, bolts, clips and other
                                             fasteners
Animal wastes and bedding

          CLASS 1A WASTE*
Glass, sand,  ceramic, grit
               CLASS III WASTE
-.2
< H-
LO 1/1
00 >.
  00
o>-
z ^
     Autopsy waste**
     Pathogenic waste**
     Isolation area waste**
     Grease, oils and wax
                                                 CLASS IV WASTE

                                       Metal surgical appliances
                                       Pipe and pipe fittings
                                       Metal hardware and other similar objects
                                       Bedpans, urinals, pails, and other stainless
                                        steel wares
                                       Coat hangers, metal wire, and strapping
                                       Building material waste including:
                                        bricks, concrete, blocks, plaster, lumber,
                                        reinforcing rods, roofing material, and
                                        other similar objects
     *Maximum size of object:
      Largest dimension not to exceed tank diameter, less 14 inches
    **Subject to local  regulations

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VOL.  IV	
CHAP. VI                                                                  vi-18
OPERATING CHARACTERISTICS - Mechanical Conveyors

Characteristics of the mechanical conveyor components required in this plant are
described in the following (item numbers refer to keyed numbers on Figure VI-3):
   load 200 Ibs.  per sq. ft
Load-out Conveyor, 1 required (item 2C in bottom of storage bin),  type apron,
   24'L x 8'W, 50 TPH capacity, speed variable 2 to 10 FPM with jog and
   reverse capability, 2 HP motor, maximum load 200 Ibs. per sq. ft., duty
   requires frequent stops and starts, speed changes, jogging and reversing.

Vibrating Conveyor, 1 required (item 3),  \2'l x 4'W x 18"H, 10 TPH capacity,
   1" stroke @ 200 FPM, intermittent duty with frequent starts and  stops.

Tripper Belt Conveyor, 1  required (item 4), 30" belt troughed at 35 for 6" each
   side, 70' o.a.l., 45' horiz. and 25' @ 20° incl., max. load 16 ^PSF,  avg.
   load 4 #PSF, speed 100 FPM,  5 HP motor, 10 TPH capacity, intermittent duty
   with frequent starts and stops.

Tripper, 1 required (item  4a), movable, powered with cable and reel, size and
   cap. to match 4 above, remote control of location and  discharge,  bypass back
   onto belt, intermittent duty with frequent position changes.

Pulper Feed Conveyor, 2 required (item 5), 24" belt troughed @ 35 for 6" each
   side, 20' c. to c., 20° max. incline,  speed variable 10 to 20 FPM, 2 TPH
   capacity, continuous duty.

Bypass Conveyor,  1  required (item 6), 36" belt troughed @ 35° for  6"  each side,
   57' c. to c., 20° incline, 135 FPM, 16 TPH capacity,  continuous duty.

Grit and Junk Conveyor, 1  required (item 11),  type either belt or screw,  size
   12" belt or 9" screw, 28' c, to c., horiz., speed 150 FPM or 15 RPM,  2 TPH
   capacity, continuous duty.

Bucket Elevator, 1  required (item 12), lift 24', incline 70°, 2 TPH capacity,
   continuous duty.

-------
VOL.  IV	
CHAP. VI                                                                    VI-19
OPERATING CHARACTERISTICS - Wet Air Oxidation System

The wet air oxidation system shall include equipment, piping, valves, motor control
center, instrumentation and insulation.  Principal components of the system shall
include two air compressors (400 psig), equipped with 100 HP motors, one hydraulic
pressure pump (25 GPM) equipped with a 15 HP motor, one high pressure hydraulically
operated sludge pump, one sludge feed pump equipped with a 5 HP motor, one solvent
pump (20 GPM) equipped with a 10 HP motor,  one solvent tank constructed of 304
stainless steel or fiber glass, one gas fired boiler (400 psig),  one heat exchanger
with concentric piping of 304 stainless steel tested at 1200 psig, one reactor for
operation at 400 psig and 400°F. tested at 1200 psig, one separator designed for
operation at 400 psig and 400°F. tested at 1200 psig, one gas fired catalytic vapor
oxidation unit, one pulped sludge storage tank (24,000 gallon capacity),  and one
oxidized sludge thickening tank (24,000 gallon capacity).

The system shall be so designed as to produce a sterile and dewaterable oxidized
end product.  Flameless combustion of the pulped sludge shall take place in an
aqueous state.  The oxidized solids shall be dewaterable, without  the addition of
chemical coagulants,  to a moist solid which is  non-putrescible, biologically stable
and free of obnoxious odors.

Based on the calculated 13,000 pounds of pulpable wastes (dry weight) generated
daily at the LAC-USC Medical Center, this low pressure oxidation system shall have
the capability of handling slurries at a digestion rate of 1000 pounds per hour (dry
solid weight) or 24,000 pounds daily under continuous operation.  The capabilities
of the system shall  permit a maximum of 50% reduction of insoluble organic matter
and 90% solubilization and oxidation of polyethylene plastics.

-------
VOL.  IV	
CHAP. VI                                                                  VI-20
OPERATING CHARACTERISTICS - Experimental Sewage Treatment Plant

The purpose of this plant will be to determine the effect on conventional sewage
treatment plants from the addition of various  quantities of pulped refuse to the sewage,
to determine what modifications may be required in sewage treatment plant design
and operation to treat mixtures of pulped refuse and sewage satisfactorily, and to
evaluate the effectiveness of processing pulped refuse at a sewage treatment plant.

The plant will treat a proportioned mix of domestic sewage taken from a sewer in the
vicinity and controlled quantities of pulped refuse taken from the storage  tanks at the
waste processing plant.  The plant will provide a maximum of flexibility within and
between its various elements to  facilitate ihe testing of the various processes and
will have a capacity of 30 gpm  or 43,000 g.p.d.  The design will be based on the
use of steel tanks which  can be  removed a'- the end of the program.

Design Criteria:

1.  Average Flow            43,000 g.p.d.

2.  Population Equivalent     430 persons,

3.  Assume solid loading at 1.2vcap0/day or 500"/day
    Equivalent to 1000 g.p.d. of 6% pulp

4.  Mixing Chamber          Detention rime 15 minutes = 465 gal.
                             Say 4'Dia.  and 5' S.W.D.  with variable speed mixer

5.  Primary Clarifier          Detention 2 1/2 hrs. = 4500 gal.
                             Say 12' Dia. and 6' S.W.D.  with sludge scrapper,
                            central feed and peripheral discharge
                             No skimmeT required

6.  Aeration                 Detention time 24 hrs.  43,000 gal.
                             Say 2-20' Dia. and 9' S.W.D. with variable speed
                            bridge mounted mechanical aerators

-------
VOL.  IV
CHAP. VI
                                                 VI-21
7.  Secondary Clarifier   Detention time 2 hrs. with 25% return 4500 gal.
                         Say 12' Dia. and 6" S.W.D. with sludge scrapper,
                         center feed and peripheral discharge
80  Sludge Processing
Aerobic Digestor for 1/2 capacity at 15 cu.ft./cap -6450 cu.ft.
Say 20'  Dia. and 20' S.W.D. with floating aerator

Anaerobic Digestor for 1/2 capacity at 15 cu0ft./cap =6450 cu.ft.
Say 20'  Dia. and 20' S.W.D. with floating cover

Wet air Oxidation provide sludge thickening  tank
Say 6' Diameter and 7' S.W.D.
1000 gal.  of thickened sludge to be processed at
25 gpm - 40 min. operation daily

Dewatering  Use Vacuum Filter at pulping installation

-------
VOL.  IV
CHAP. VI
VI-22
ESTIMATED ANNUAL OPERATING COSTS

Annual direct operating costs of the total project, excluding capital costs, are estimated
at $202,000.  The breakdown of these costs to the basic elements of the project, i.e.
the waste system, experimental sewage treatment plant and laboratory testing, are
estimated as shown in Table VI-2.
       TABLE VI-2    ANNUAL OPERATING COSTS OF PROJECT FACILITIES

*Payroll
Materials, Equip. & Supplies
Maintenance
Power & Fuels
TOTAL
Solid Waste
System
$ 61,000
5,000
4,000
50,OOC
$120,000
Sewage Tr.
Plant
$32,000
3,000
4,000
2,000
$41,000
Laboratory
$27,000
12,000
2,000
-
$41,000
Total
$120,000
20,000
10,000
52,000
$202,000
*lncludes taxes, insurance and social benefits
The analysis of economic benefits of the project must consider only those costs asso-
ciated with the operation of the waste system and not those involved with research
activities. Implementation of the proposed waste system, although largely limited
in effect to those costs and functions in the existing inter-unit, inter-building and
off-site systems, also will  have some effect on  preparation and handling of certain
disposable wastes in the unit system (patient care and service areas).  Based on these
system modifications,  Table VI-3 was prepared showing the changes in daily payroll
costs  that may be expected.  Comparisons of labor costs by categories of wastes, as
well as costs of operation by system components or sub-systems, can be made with
Table 11-13 (Volume II, Chapter II), the  estimated  daily labor costs of the existing

-------
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-------
VOL.  IV	
CHAP. VI                                                                    VI-24
solid waste system.

It is anticipated that the effect of the proposed system will reduce total daily labor
costs from the present level of $6,232.46 to $4,911072, or a daily savings of $1,320.74.
The largest increment of this savings, an amount of $981.60, is estimated to accrue
from the combined functions of inter-unit, inter-building and off-site systems. Addi-
tional labor savings of $304.92 are estimated to occur in the unit system as a result
of changes of methods, practices and the elimination of separate collection systems,
such as  sharps and needles, made possible by the system modifications.

Increases in certain operational costs, such as materials,  supplies, maintenance,
power and fuels are attributed to the new system.  Collectively, these added costs are
estimated at $60,000 annually, or $164.33 per day.  With these offsetting costs
considered, savings in direct operating costs are reduced to $1,156.36, or a net
reduction in operating costs of about 18.6% in the total system is anticipated,,
ESTIMATED CONSTRUCTION COSTS

Development of the total project previously described,  including the pneumatic
conveyor system,  waste processing plant and the experimental sewage treatment
plant, and based  upon preliminary plans, is estimated to cost $3,180,410, as
shown in Table VI-4, including contingencies and engineering, but excluding
land.

Excluding the costs of the experimental sewage  treatment plant and related contin-
gencies and fees, the net cost of the permanent solid waste system installation as
proposed for the Medical Center is about $3,000,000.

-------
VOL.  IV
CHAP. VI
              TABLE VI-4   ESTIMATED CONSTRUCTION COSTS

A.  Pneumatic Conveyor System                          $            $
    1.  Pipe System, including inlets and controls          1,275,457
    2.  Evacuators, Filters, Hoppers, etc.                   176,000
    3.  Electric Power and Controls                         142,000    1,593,457

B.  Sewage Pump Station
    1.  Structure                                           25,000
    2.  Pumps and Controls                                 21,000
    3.  Piping                                              3,000
    4.  Electrical                                           2,000       51,000

C.  Outside Piping
    1.  Diversion Chamber                                   2,000
    2.  800 If.-12" V.C. Sewer® $12                        9,600
    3.  800 If.-8" C.I. Force Main® $8                      6,400       18,000

D.  Processing Plant
    1.  Building  175,000 cf.  @ $1                         175,000
    2.  Tank  Screening 6,000 sf. @ $6                       36,000      211,000

E.  Fabricated Plate
    1.  Inlet  Hopper                                        2,400
    2.  Storage Bin                                         6,250
    3.  Bypass Hopper                                         750
    4.  Pulper Storage                                       4,270
    5.  Loading Hopper                                     4,700
    6.  Storage Tanks                                      17,400
    7.  Conveyor Supports                                   2,000       37,770

F.  Materials Handling Systems
    1.  Load  in Conveyor 40'L x 8'W 50 T.P.H.               11,000
    2.  Load  out Conveyor 24'L x 8'W 50 T.P.H.               8,000
    3.  Leveling Conveyor Vibratory 12'L x 4'W 10 T.P.H.      4,500
    4.  Tripper Belt Conveyor  70'L x 30" W 10 T.P.H.          9,000
    5.  Tripper                                             5,500
    6.  2 Pulper  Feed Conveyors 20'L x 24"W 2 T.P.H.          6,000

-------
VOL.  IV	
CHAP. VI                                                                VF26
    Materials Handling Systems (continued)
    7.  Bypass Conveyor troughed belt 57'1. x 36"W         $      1,500  $
    8.  Grit & Junk Conveyor screw type 911 x 28'                 4,000
    9.  Grit & Junk Elevator bucket type                         3,000
   10.  Installation (40% x $52,500)                           21,000      73,500
G. Pulping Equipment
    1.  2-60" diam. Pulpers
    2.  2-500 gpm Feed Pumps
102,500
    3.  2-6" Degritters
    4.  2-9" Screw type Thickeners    _
    5.  Installation (40% x $102,500)                          41,000     143,500

Ho  Wet Oxidation Plant
    1.  1  H.P. Air Compressor
    2.  1  H.P. Feed Pump
    3.  1  Bailer Assembly 800 psi
    4,  1  Heat Exchanger 800 psi
    5.  1  Reactor        800 psi
    6.  1  Separator      800 psi
    7.  1  Catalytic Oxidation Unit
    8.  1  Solvent Tank & Pump
    9.  1  Vacuum Filter
   10.  1  Vacuum Pump
   11.  1  Conveyor
   12.  Installation                                                      375,000

I.  Electrical                                                             71,500
J.  Hopper Weighing Scale                                                 7,500
        Total Estimated Cost of Solid Waste System                        $2,582,227
K.  Experimental  Sewage Treatment Plant                                   125,000
        Total Estimated Construction Costs                               $2,707,227
L.  Contingencies 10%                                                   270,723
        Total Construction  Budget                                       $2,977,950
M.  Engineering Fee                                                      202,460
        Total Estimated Cost                                            $3,180,410

 Note: Component Costs Are More Refined Than Those Shown in Table 111-2

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VOL.   IV	
CHAP.  VI                                                                   VI-27
BENEFITS OF THE SYSTEM

It is estimated that the net investment required will produce an annual advantage or
savings of $498,350 before depreciation, or return the initial investment in about six
years. Assuming a straight line depreciation on  the installation, with a 10-year  life
allowed on the pulping station equipment (value about $400,000) and a 25-year life
allowed on the structures, pneumatic system, wet oxidation plant, etc. (value about
$2,600,000), annual depreciation costs can be calculated at about $144,000.  A net
annual surplus of $354,350 available for other improvements or patient care functions,
and representing a return of 12.1% on  the invested capital, is anticipated  after depre-
ciation.

Table VI-5 summarizes Hie tangible economic benefits to be derived from the implemen-
tation of the project, incorporating those direct operating benefits as  noted,  together
with certain indirect benefits that accrue due to elimination of certain parts of the
existing system,,

Certain intangible benefits with monetary value  will also accrue as a  result of operating
the improved solid waste system.  Improvement in sanitation, safety, security and
esthetics may likely have an effect on  the frequency of personal injury, accidents,
illness of personnel,  as well as patients throughout the plant and perhaps the greatest
effect on those being associated with the direct handling of the waste materials.
Similarly, limiting the exposure of wastes in  transport and off-site disposal  would
likely have a beneficial effect to the community at large.   Improvement in systems
operation and these related environmental conditions should also tend to reduce the
general cost of building maintenance and losses due to fire or other casualty.  This
improved system using an isolated and specialized transport method will reduce
congestion in building corridors, allowing more efficient performance of other
service functions.  Economic analysis of annual dollar savings that may accrue from
these  benefits would require a multitude of record statistics of plant operation that
are not available and adequate bases of fact  are not at hand to permit an intelligent
detailed estimate.  However, it is conceivable that collectively the intangible
benefits could equal, if not exceed, the estimated value of tangible benefits.

The improvement in environmental conditions which result from the modified system
are more readily identifiable than the economics of intangible benefits.  Table VI-6
shows the  numerical rating of the improved system by categories of wastes,  sub-systems

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VOL.  IV
CHAP. VI
     VI-28
                TABLE VI-5    TANGIBLE ECONOMIC BENEFITS
Investment Requirement:
 Installed Cost of Project
 Less Salvage Allowance of Existing Waste System Equipment (1)
 Less Avoided Cost of Capital  Improvements to Existing System (2)
NET INVESTMENT REQUIRED
$3,000,000
 -  28,000
 -  50,000
$2,922,000
Direct Operating Benefits (3):
  Operating Labor (4)
  Less Increase in other Operating Costs:
   Maintenance
   Materials and  Supplies
   Power and Fuels
NET  ANNUAL OPERATING ADVANTAGE

Indirect Benefits (Recurring Annual Savings):
  Annual  Decline in  Equipment Salvage Value of Existing System (5)
  Annual  Depreciation on Capital Improvements Avoided (6)
  Annual  Value of Building  Areas Released for Other Use (7)

TOTAL ANNUAL ADVANTAGE OR SAVINGS

Less Annual Depreciation Expense
$  541,650

     4,000
     5,000
-   50,000
$  482,250
$    2,800
     5,000
     8,300

$  498,350

$  144,000
NET ANNUAL RETURN ON INVESTMENT
% Return on Investment
$  354,350
     12.1%
(1)  Approximately 1/3 the estimated cost of present inter-building and off-site equipment
(2)  Allowance for alternate minimum annual improvements to solid waste system
(3)  Savings in annual operating costs
(4)  Net annual savings over present labor costs
(5)  10% of present allowed value or (1) above
(6)  Allow 10-year life on annual improvements (2) above
(7)  Allowance of 1/2 of in-building storage areas or 4,150 SF @ $2.00/SF/Yr.

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VOL.  IV	
CHAP. VI                                                                   VI-30
and sub-system functions within the total system.  Comparison of this rating with
Table 11-18 (page 11-53, Volume II), the numerical  rating of the existing solid waste
system operation, shows the detail  of the decrease in deficiencies accomplished by
the improved system.  The total effect of these improvements can be summarized as
shown in Table VI-7, showing percentage deficiencies by sub-system functions in  the
existing system and the improved system.  Graphically,  these effects are also illus-
trated in Figure VI-6.

It is estimated that a decrease of 64.7% in present deficiencies of system operation
can be accomplished with the proposed improvements.,  The remaining deficiencies
are largely associated with those reusables (patient and food service items) not entering
the modified  system, as well as the initial handling  of nearly all items in the unit system
prior to entering the modified portions of the system.  In the case of the latter, further
reduction of deficiencies in operation are likely to come about only through enforcement
of policies and closer supervision and not  through mechanization in the foreseeable
future.

In summary, marked improvement in environmental conditions (both in-plant and off-
site) can be accomplished through  implementation of the proposed modifications.
Those tangible economic benefits as identified indicate these improvements can be
made  comfortably within the present level of costs; in fact, will  likely provide a
substantial operating surplus.  Intangible benefits, though not of identifiable value,
will in all likelihood provide substantial  economic bonus in the plant operation.

-------
VOL.  IV
CHAP. VI
VI-31
    TABLE VI-7   PERCENTAGE DEFICIENCIES OF SUB-SYSTEM FUNCTIONS
Sub-System and Function
UNIT SYSTEM:
Initial Deposit
Initial Transfer
Initial Storage
Weighted Average
INTER-UNIT SYSTEM:
Vertical Transfer
Intermediate Storage
Weighted Average
INTER-BUILDING SYSTEM:
Internal Transfer
Central Storage
Central Processing or Disposal
Weighted Average
OFF-SITE SYSTEM:
External Transfer
Final Processing or Disposal
Weighted Average
TOTAL SYSTEM
LAC-USC MEDICAL CENTER
Existing
System
52.3
50.5
62.1
55.0
41.2
62.2
52.0
54.9
74.8
67.4
68.0
23.3
71.8
60.0
58.0
% DECREASE OF DEFICIENCIES
Improved
System
34.0
34.3
25.3
31.1
16.6
21.3
19.1
8.3
31.4
34.8
24.8
1.5
7.1
5.7
20.6
64.7

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                                                         FIGURE VI-6
                                                           PAGE VI-32

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VOL.  IV	
CHAP. VI                                                                 VI-33
RECOMMENDATIONS FOR IMPLEMENTATION

Based upon the foregoing study and evaluation of the existing system operation,
considered alternative methods of improvement, the concept of the proposed modifi-
cations and development of this concept through preliminary planning stages,  cost
estimates and the analysis of tangible benefits,  this project is recommended as a
solution to the more critical  problems of the current solid waste system at LAC-USC
Medical Center.  It is a solution with qualifying economic and environmental
benefits.  Through the waste processing and disposal methods employed,  minimal
emissions are contributed to the already critical air pollution conditions  of the
Los Angeles Basin.  A homogeneous residue is also produced by processing for
disposal at landfills or discharge to sewers.

In summation, the proposed project meets local  needs while also providing a labor-
atory for study and experimentation on the pneumatic handling system in combination
with a number of optional disposal methods and  processes that may have potential
application in various size hospital plants throughout the country.
                                                 &US GOVERNMENT PRINTING OFFICE 1972 O-470-307

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Environ'^""-- -
p-otection Agency
•>.,  v
kSo/IIlincis  60606

-------