1987 Hazardous Waste Generation and Shipment Report (Package A) Forms v.5


                                    OMB #: 2050-0024 Expires 12-31-88
                      United States
            Environmental Protection Agency
      1987 Hazardous Waste Generation
               and Shipment Report
                  (PACKAGE A)


                      FORMS
One report package must be completed for every site receiving this mailing:

Complete Package A   1987 Hazardous Waste Generation and Shipment
                   Report - if, in 1987, hazardous wastes were not
                   managed at this site, as defined in the box on page 1 of
                   the instructions booklet.

Complete Package B - 1987 Hazardous Waste Generation and Management
                   Report - if, in 1987, hazardous wastes were managed
                   at this site, as defined in the box on page 1 of the
                   instructions booklet.
          Submission of the appropriate Report package fulfills
          1987 RCRA Annual/Biennial Report requirements.
 Form 8700-13A (5-80) (Rev. 11-85) Revised (12-87)

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OMB#: 2050-0024 Expires 12-31-88
BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL
OR ENTER:

SITE NAME
EPA ID NO.
I I I I
FORM
1C
U.S. ENVIRONMENTAL
PROTECTION AGENCY

1987 Hazardous Waste Generation
and Shipment Report

IDENTIFICATION AND
CERTIFICATION
WHO MUST COMPLETE THIS FORM? Form 1C must be completed by every site that received this package.
INSTRUCTIONS: Please read the detailed instructions beginning on page 8 of the 1987 Hazardous Waste Generation
and Shipment Report Instructions booklet before completing this form.
Complete Sections I through IV and Sections VI through IX immediately. Complete Section V,
certification, after you have finished the full report package.
SEC.
I.
Site name and physical location which may differ from the mailing address. Complete items A through G.
Mark [X] for items A, B, C, D, F, and G if same as label; if different, enter corrections, if label is absent, enter information.
A. Site/company name
Same as label fj
B. EPA ID No.
Same as label fj
C. Address number and street name of physical location - if not known, enter Industrial park, building name or other physical location description
Same as label F
3. City, town, village, etc.
Same as label fj
E. County
F. State
Same as label
G. Zip Code
Same as label fj
I I I
SEC.
Mailing address of site.
Mark [X] for A, B, C, and D if same as label; if different, enter corrections.
A. Number and street name of mailing address
Same as label [H
B. City, town, village, elc.
Same as label Q
C. State
Same as label
D. Zip Code
Same as label
I I I I—I
SEC. Ill,I Name, title, and telephone number of the person who should be contacted if questions arise regarding this report.
A. Please print: Last name
First name
M.I.
B. Title
C. Telephone
Extension I
I I I
SEC.
IV.
Enter the Standard Industrial Classification (SIC) Code that describes the principal products, group of products, produced or distributed, or the
services rendered at the site's physical location. Enter more than one SIC Code only if no one industry description includes the combined activities
of the site. SIC codes are listed beginning on page 1 of the 1987 Hazardous Waste Generation, Shipment and Management Report Codebook.
I I I
I I I
I I I
I I I
I I I
SEC
V.
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents,
and that based on my inquiry of those individuals immediately responsible for obtaining the information, I bejieve that the submitted information
is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine
and imprisonment.
A. Please print: Last name
First name
M.I.
Title
B. Signature
Date of signature
Mo. Day Yr.
Page 1 of.
EPA Form 8700 - 13A (5-80) (Rev. 11-85) Revised (12-87)
OVER --->

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                                                                                                          FORM  1C

       Does this site's EPA ID authorize hazardous waste generation?
  j—|    NO  	» SKIP TO SECTION VII.
  j~]    YES 	• Did this site generate any hazardous waste during 1987?
        r—i  YES	. READ DETAILED INSTRUCTION ON PAGE 9 OF THE 1987 HAZARDOUS WASTE GENERATION AND SHIPMENT REPORT
                     INSTRUCTIONS BOOKLET FOR ACUTE AND ACCUMULATION LIMITS. MARK {£] NEXT TO THE HAZARDOUS WASTE
                     GENERATION QUANTITY CATEGORY THAT APPLIED TO THIS SITE DURING 1987.
              fj  Category 1:  More than 10OOkg (2,200 Ib) in one or more months
              Q  Category 2:  More than 100 kg (220 Ib) but no more than 1000 kg (2,200 Ib) in any single month
              Q  Category 3:  No more than 100 kg (220 Ib) in any single month
                  Q  Mark El if this site changed from Category 1 to Category 2 or 3 due to waste minimization activity conducted during 1986
                      or 1987.
        Q  NO 	. CONTINUE  BELOW. MARK CB NEXT TO ALL THAT APPLY.
              Q  Generated, excluded or delisted wastes
              Q  Generated hazardous waste prior to 1987 but do not expect to generate in the future - MARKS] FOR REASON IN ONE BOX BELOW

                  fj  Waste was from one-time event(s) (e.g. spills, remedial actions, etc.)
                  Q]  Waste minimization activity undertaken during 1986 or 1987
                  Q  Out of business
              [3  Generated hazardous waste prior to 1987 and expect to generate in the future
              Q  Never generated  before but expect to generate in the future
              fj  Never generated and do rot expect to generate in the future - MARK [XJ FOR REASON IN ONE BOX BELOW
                  L~]  Protective notifier only
                  fj  Misunderstood the requirements
                  Q  Notified to secure transportation services
                  rj  Other EXPLAIN REASON FOR GENERATOR NOTIFICATION IN COMMENTS
 SuiP' IDoes tnis site have RCRA Interim Status or a RCRA permit to treat, store, or dispose hazardous waste?
  r—]   NO	 SKIP TO SECTION VIII
  r—•|   YES	 Did the site treat, store, or dispose (T/S/D) hazardous waste in RCRA-regulated units during 1987?
        Q YES 	> SKIP TO SECTION VIII
        Q NO  	. CONTINUE BELOW, MARK Kl NEXT TO ALL THAT APPLY
             f~)  T/S/D excluded waste during 1987
             Q  T/S/D hazardous waste in exempt units during 1987
             Q  T/S/D hazardous waste prior to 1987 but did not T/S/D waste during 1987. MARK Kl IN ONE BOX BELOW
                  []  T/S/D will resume in the future
                  fj  Have notified of planned closure
                  Q  Site is in closure or post closure
              fj Never T/S/D hazardous waste prior to 1987 but: MARK Kl IN ONE BOX BELOW
                  fj  Expect to T/S/D hazardous waste in the future
                  fj  Do not expect to T/S/D hazardous waste in trie future - EXPLAIN REASON FOR INTERIM STATUS OR PERMIT IN COMMENTS
  VIII.
       Do you wish to withdraw this site's generator notification or EPA Part A permit application?
       Withdraw generator notification      Q Yes  fj No
       Withdraw Part A permit application   Q yes  D No
 SEC.
  IX.
Does this site have an area not requiring a RCRA Part A or Part B permit that is used exclusively for the short term
accumulation of hazardous waste?
       CD NO
       r~I YES 	DOES THE AREA HAVE:
                     Containers     r~I No    r~I Yes    ENTER THE NUMBER OF TANKS AND THEIR TOTAL CAPACITY IN GALLONS.
                     Tanks         i—i No    i—i Yes 	.  i  ,   ,   i            I   ,,,,,,,,   I
                                  L—'        "—'         I  I   I   I Number    I   I   I   [  I   I   I  !   I   I Gallon capacity
Comments:
                                                                                               Page 2 of

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL jg& •*)*,
ORENTER: § ** \
SITE NAME I t*W*7 *

EPAIDNO. 1 i i i i ...

^zay 198

, , i FORM
GS
U.S. ENVIRONMENTAL
PROTECTION AGENCY
7 Hazardous Waste Generation
and Shipment Report
WASTE GENERATION AND
SHIPMENT
WHO MUST COMPLETE THIS FORM? Form GS must be completed by every site that generated hazardous waste on site or shipped
hazardous waste off site during 1987.
Mark H if you are not required to complete Form GS.
INSTRUCTIONS: Please read the detailed instructions beginning on page 12 of the 1987 Hazardous Waste
Generation and Shipment Report Instructions booklet before completing this form.
Make and complete a photocopy of this form for each hazardous waste generated on site or
shipped off site during 1987.
Complete Sections 1 through IV. Throughout this form enter "DK" if the information requested is not
known or is not available; enter "MA" if the information requested is not applicable.
Sec. 1 A. Waste description
1 1 Instruction Page 12
B. EPA hazardous waste code
Page 12
1 1 1 1 1 1 1 1 1 1 III
C. State hazardous waste code
Page 13
I I 1 I 1 I 1 t 1 1 1 1 1 1 1
i i i i i i i i i i i i

D. SIC code E. Source code F. Waste form code
Page 13 1 1 1 1 1 Page 13 1 1 1 Page 13 1 1 1

Sec. IA. Organics B. Water C. T
II 1 Instruction Page 14 Page 15 P
High | 	 | High | 	 | K
Low | 	 | Low | 	 | L
Test | 	 | Note | 	 | Note | 	 | r.
G. pH H. Flashpoint I. (
• Page 18 Page 18 1
Hiflh 1 1 I.I 1 High 1 1 1 1 °F Hta
Low 1 1 1. ( | Low | | | | °F Lou
Note | 	 | Note | 	 | Tes
Sec. 1 A. 1986 quantity hazardous waste generated
Jj^J Instruction Page 20
1 I 1 t I I 1 I I I

E. Quantity hazardous waste on site on January 1, 1987
Page 21
1 1 1 1 1 1 1 1 1 I

Dial Solids D. Suspended Solids E. BTU
'age 15 Page 15 Page 18
tah I I High 1 1 High 1 1 1 1 1 1
owll Low 1 1 Lowllllll
tote | 	 | Note | 	 | UOM | 	 | Note L
Cyanides J. Halogens K. Radioactive
'age 19 Page 20 Page 20
h | 	 | High | 	 | Yes \~\
I [ 	 | Low | 	 | No | 1
t | 	 | Note | 	 | Note | 	 | Note | 	 |

Page 20 Page
1 1 1 1 1 1 1 1 1 1 II

G. Waste minimization results
| Page 13 | 	 |
F. Toxic Metals
Page 18 Note | 	 |
Metal High Low Test
1. 1 1 1 I — 1 1 — 1 1 — 1
J
2. 1 1 1 | 	 | | 	 | | 	 |
_l
3. 1 1 1 | 	 | | 	 | | 	 |
4. 1 1 1 | 	 | | 	 | | 	 |
5.1 1 I LJ LJ LJ
6. 1 1 1 | 	 || 	 || 	 |
D. Density
21 Page 21
' 1 ' • 1 1 '
fj" Ibs/gal rjsg
F. Quantity hazardous waste remaining on site on December 31, 1987
Page2t
1 1 1 1 1 1 1 1 1 1

Sec. 1 A. EPA ID No. of facility to which waste was shipped
IV | Instruction Page 22
1 1 1 1 1 1 1 1 1 1 1 1 1

B. Number of C. Transport D. Off-site T/S/D/H code
shipments mode Page 22
Page 22 Page 72.
1 1 1 1 II 1 1 1 1 1 1 1 1

E. Total quantity shipped
Page 22
1 1 1 1 1 1 1 1 1 1

Comments:
Page
of

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  BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL
  OR ENTER:

  SITE NAME
  EPA ID NO.
                             FORM

                              Ol
     U.S. ENVIRONMENTAL
     PROTECTION AGENCY

1987 Hazardous Waste Generation
      and Shipment Report

   OFF-SITE IDENTIFICATION
WHO MUST COMPLETE THIS FORM?

                                    D
                      INSTRUCTIONS:
Form Ol must be completed by every site that shipped hazardous waste off site and every site that
received hazardous waste from off site during 1987.
Mark [X] if you are not required to complete Form Ol.

Please read the detailed instructions beginning on  page  23 of the 1987 Hazardous Waste
Generation and Shipment Report Instructions booklet before completing this form.
Complete A through E for each off-site installation to which you shipped waste or from which you
received waste during 1987.
Complete A through Dfor every transporter you used during the reporting year.
Throughout this form enter "DK" if the information requested is not known or is not available; enter
"NA" if the information requested is not applicable. Make and complete additional copies of this
form if you need to identify more than four off-site installations or transporters.
Site A. EPA ID No. of off-site installation or transporter
•j Instruction page 23
ill!
C. Site type code
Page 24
u
I I I I f I !
D. Site relationship code
Page 24
U
Site A. EPA ID No. of off-site installation or transporter
2 Instruction page 23
I I
C. Site type code
Page 24
U
I I I I I I
D. Site relationship code
Page 24
U
Site I A. EPA ID No. of off-site installation or transporter
3 I Instruction page 23
I II I ! I I I I
C. Site type code
Page 24
LJ
D. Site relationship code
Page 24
LJ
Site A. EPA ID No. of off-site installation or transporter
4 Instruction page 23
I I
C. Site type code
Page 24
U

I I I I I 1
D. Site relationship code
Page 24
U

3. Name of off-site installation or transporter
Page 23
E. Address of off-site installation
Page 24
Street
Zip
nay State I | I Code I | | I I — I I I I I
B. Name of off-site installation or transporter
Page 23
E. Address of off-site installation
Page 24
Street
. . Zip
rity Slate I | I Code I I I I - I ! I ! I
B- Name of off-site installation or transporter
Page 23
E. Address of off-site installation
Page 24
Street
. i Zip
ray State I I I Code f 1 I I — I I I I I

B. Name of off-site installation or transporter
Page 23
E. Address, of off-site installation
Page 24
Street
1 Zip
nty State ! 1 1 Code | | | | j - | III


Comments:
                                                                                                 Page.
                                                                     of

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL
OR ENTER:

SITE NAME      	
EPA ID NO.
                  I   I  I   I   I  I   I  I
                            FORM

                          WM
                     U.S. ENVIRONMENTAL
                     PROTECTION AGENCY


                1987 Hazardous Waste Generation
                      and Shipment Report


                     WASTE MINIMIZATION

                             PARTI
WHO MUST COMPLETE THIS FORM?
                    INSTRUCTIONS:
Form WM Part I, describing efforts undertaken to implement waste minimization programs, must
be completed by all generators required to file an Annual/Biennial Report. This requirement was
established  in response to  statutory  provisions  included in  the Hazardous  and  Solid  Waste
Amendments of 1984 (HSWA).

NOTE:  Generators shipping hazardous waste off site are required to certify, on Item 16 of the
Uniform Hazardous Waste Manifest, that they have a program in place to reduce, to the degree
determined  economically practicable, the volume and toxicity  of hazardous waste generated. A
similar certification must also  be  made by  generators who have obtained a RCRA treatment,
storage, or  disposal  permit.  Consistent with these certification requirements, generators must
report, on Form WM Part I, the efforts undertaken to implement waste minimization programs.

Please read the detailed instructions on page 25 of the 1987  Hazardous Waste Generation and
Shipment Report Instructions booklet before completing this form.

Answer questions 1 through 10. Throughout this form enter "DK" if the information requested is not
known or is not available; enter "MA" if the information requested is not applicable.
        Did this site create or expand a source reduction and recycling program?
                                                 1987                   1986
                                            Yes      No          Yes      No
                            Create

                            Expand
     D
     D
  D
  D
  Prior Years
 Yes      No
 D      D
 D      D
        Did this site have a written policy or statement that outlined goals, objectives and methods for source reduction and
        recycling of hazardous waste?
                                                 1987                   1986                Prior Years
                            Yes

                            No
         D
      D
      D
      D
      D
        What was the dollar amount of capital expenditures (plant and equipment) and operating costs devoted to source
        reduction and recycling of hazardous waste? ENTER ZERO (0) IF NONE.
                                                 1987                   1986                PriorYears
                Capital expenditures        $	        $	        $	
                    Operating costs
   $.
$.
$.
        Did this site have an employee training program or provide incentives (bonuses, awards, personal recognition, etc.)
        to identify and implement source reduction and recycling opportunities and activities?
                                                 1987                   1986                PriorYears
                                            Yes      No           Yes      No           Yes      No
Training
Incentives
D
D
D D
D D
D D
                                                                                                  Page
                                                                      of
                                                                                                          OVER—>

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FORM WM - PART I
5. Did this site conduct a source reduction and/or recycling opportunity assessment or audit? Note: an opportunity
assessment or audit is a procedure that identifies practices that can be implemented to reduce the generation of
hazardous waste or the quantity which must subsequently be treated, stored or disposed.

1987 1986 Prior Years
Yes No Yes No Yes No
Site-Wide D D D D

Process-Specific EH EH EH EH
6. Did this site identify or implement new SOURCE REDUCTION opportunities to reduce the volume and/or toxicity
of hazardous waste generated at this site?

1987 1986 Prior Years
Yes No Yes No Yes No

identify D D EH EH EH EH

Implement EH D D EH D EH

7. What factors have delayed or prevented implementation of SOURCE REDUCTION opportunities. MARK [X] NEXT
TO ALL THAT APPLY.

Q] a. Insufficient capital to install new source reduction equipment or implement new source reduction
practices.
Q b. Lack of technical information on source reduction techniques, applicable to my specific production
processes.
I I c. Source reduction is not economically feasible: cost savings in waste management or production
will not recover the capital investment.
Q] d. Concern that product quality may decline as a result of source reduction.

Q] e. Technical limitations of the production processes.

[~| f. Permitting burdens.

O 9- Other (SPECIFY)
8. Did this site identify or implement new RECYCLING opportunities to reduce the volume and/or toxicity of hazardous
waste generated at this site or subsequently treated, stored, or disposed of on site or off site?

1987 1986 Prior Years
Yes No Yes No Yes No

identify D D EH EH EH EH

Implement EH EH EH EH EH EH
Page of

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FORM WM - PART I
EPA ID NO.
I I
I l I
I
9.
10.
What factors have delayed or prevented implementation of on-site or off-site RECYCLING opportunities. MARK |
NEXT TO ALL THAT APPLY.
D
a
a
a
a
a
a
a
a.

g-
h.
k.

I.
Insufficient capital to install new recycling equipment or implement new recycling practices.

Lack of technical information on recycling techniques applicable to this site's specific production
processes.
Recycling is not economically feasible: cost savings in waste management or production
will not recover the capital investment.
Concern that product quality may decline as a result of recycling.

Requirements to manifest wastes inhibit shipments off site for recycling.

Financial liability provisions inhibit shipments off site for recycling.

Technical limitations of product processes inhibit shipments off site for recycling.

Technical limitations of production processes inhibit on-site recycling.

Permitting burdens inhibit recycling.

Lack of permitted off-site recycling facilities.

Unable to identify a market for recyclable materials.

Other (SPECIFY)
Has this site requested or received technical information or financial assistance on source reduction and/or
recycling practices from any of the following sources? MARK B NEXT TO ALL THAT APPLY.
1987
Technical Financial
1986
Technical Financial
Prior Years
Technical Financial
a.

h.
Local government

State government

Federal government

Trade associations

Educational institutions

Suppliers

Other parts of your firm

Other firms/consultants

No request made
D
D
D
D
D
D
D
D
D
D
Other (conferences, literature, [_J
etc.)
D
D
D
D

D
D
D
D

D
D
D
D
D
D
D

D
Comments:
Page
of

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BEFORE COPYING FORM, ATTACH SITE IDENTIFICATION LABEL
OR ENTER:

SITE NAME
EPA ID NO.
FORM
WM
U.S. ENVIRONMENTAL
PROTECTION AGENCY

1987 Hazardous Waste Generation
and Shipment Report

WASTE MINIMIZATION

PART II
WHO MUST COMPLETE THIS FORM? Form WM Part II must be completed only by generators that engaged in an activity during 1987 that
resulted in waste minimization.

Waste minimization means:
(1) reduction in the volume and/or toxicity of hazardous waste generated as a result of source
reduction; and/or,
(2) reduction in the volume and/or toxicity of hazardous waste subsequently treated, stored, or
disposed as a result of on-site or off-site recycling.

Mark E| and do not complete this form if no waste minimization results were achieved during 1987.

INSTRUCTIONS: Please read the detailed instructions beginning on page 26 of the 1987 Hazardous Waste
Generation and Shipment Report Instructions booklet before completing this form.

Make and complete a photocopy of this form for each hazardous waste minimized in 1987.

Complete Sections I through IV. Throughout this form enter "DK" if the information requested is not
known or is not available; enter "NA" if the information requested is not applicable.
Sec.
A. EPA hazardous waste code
Instruction Page 27
1 1 1
III
I 1 1
III
B. State hazardous waste code
Page 27
i i i i i
C. Product or service description
Page 27 '
0. Product or service
SIC code
Page 27
, , I
E. Waste form code
Page 27
F. UOM
Page 28

U
G. Density
Page 28
H. Source description:
Page 28
I. Source code
Page 28
gal
sg
SeC. 1 A. 1986 quantity generated
II 1 Instruction Page 29
I I I I I I
B. 1987 quantity generated
Page 29
I I I I I I I I
C. Production ratio
Page 29
D. Toxicity change code
Page 31
U
E. Waste minimization: recycling
Page 31
Code

1. U
2. U
Quantity recycled

I I I I I I I I I
F. Waste minimization: source reduction
Page 32
Code

1.LJ 2. U 3.IJ
Quantity prevented

I I 1 I I 1 I 1 I I
Sec. 1 A. Narrative description of waste minimization project or activity and results achieved
III 1 Instruction Page 39
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FORM WM - PART II
Sec.
IV.
Instructions: Answer questions 1 through 4. Mark ED next to the effects produced by the source reduction and/or recycling activity
reported on this form in Sections I through III.
1. What effect did this site's source reduction and/or recycling activity have on the quantity of water effluent
produced by hazardous waste generation processes during 1987?
Q a. Increase in the quantity of water effluent
Q] b. Decrease in the quantity of water effluent
Q c. No effect on the quantity of water effluent
| | d. Don't know

2. What effect did this site's source reduction and/or recycling activity have on the toxicity of water effluent produced
by hazardous waste generation processes during 1987?
Q a. Increase in the concentration of hazardous constituents
Q b. Decrease in the concentration of hazardous constituents
Q c. No effect on the concentration of hazardous constituents
Q d. Don't know

3. What effect did this site's source reduction and/or recycling activity have on the quantity of air emissions
produced by hazardous waste generation processes during 1987?
| | a. Increase in the quantity of air emissions
Q b. Decrease in the quantity of air emissions
Q c. No effect on the quantity of air emissions
Q d. Don't know

4. What effect did this site's source reduction and/or recycling activity have on the toxicity of the air emissions
produced by hazardous waste generation processes during 1987?
Q a. Increase in the concentration of hazardous constituents
Q b. Decrease in the concentration of hazardous constituents
Q c. No effect on the concentration of hazardous constituents
I I d. Don't know
Comments:
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