COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

Recyclable Materials Biennial Report Page 1 Complete this report if you recycle more than 100 kilograms per month of recyclable material under a claim that the material qualifies for an exclusion or exemption pursuant to HSC 325143.2. Facilities that recycle at the same location at which the material was generated (onsite recyclers) and facilities that recycle materials generated at an offsite location (offsite recyclers) must complete a report. Persons who send materials to another location to be recycled, and who do not recycle material onsite under a claim to an exclusion or exemption provided in HSC 3 25143.2, need not complete a report. Offsite recyclers must complete one report for each generator from whom they receive recyclable materials. Complete a separate Page 2 of the Report for each recyclable material. When this report is submitted, provide a copy of the completed report to the generator of the material recycled. Refer to HSC 325143.10 for reporting requirements for recyclers. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR,Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the COPA. This is the unique number that identifies your facility. 2. EPA ID NUMBER- Enter your facility--s 12-character U.S. Environmental Protection Agency(U.S. EPA) or California Identification number. For facilities in California, the number usually starts with the letters ACA-. If you do not have a number contact the DTSC Telephone Information Center at(916) 324-1781, (800) -61-TOXIC or (800)61-86942, to obtain one. 3. BUSINESS NAME- Enter the full legal name of the business. 500. BEGINNING DATE OF REPORTING PERIOD - Enter the beginning date of the reporting period for this report. This report is for two calendar years and is due on July 1 of every even-numbered year. 501. ENDING DATE OF REPORTING PERIOD - Enter the ending date of the reporting period for this report. 502. ONSITE RECYCLING -Check AYes= if the recycling facility recycles more than 100 kilograms per month of recyclable material generated onsite under a claim that the material qualifies for an exclusion or exemption pursuant to HSC 325143.2. Check ANo= if the recycling facility does not recycle onsite. 503. OFFSITE RECYCLING -Check AYes= if the recycling facility recycles more than 100 kilograms per month of recyclable material under a claim that the material qualifies for an exclusion, or exemption pursuant to HSC 325143.2, and that material was received from one or more offsite locations. Check ANo= if the recycling facility does not recycle material generated offsite. 504. OFFSITE GENERATOR NAME - If the generator is different from the recycler, enter the name of the person that generated the recyclable material. Complete a separate report for each generator. 505. OFFSITE GENERATOR EPA ID NUMBER- Enter the generator=s 12-character U.S. Environmental Protection Agency(EPA) identification number. If the generator needs but does not yet have an identification number, the owner oroperator can contact the Tele hone Information Center at 916 324-1781. 506. OFFSITE GENERATOR STREET ADDRESS Complete items 506—510 for each generator of recyclable 507. OFFSITE GENERATOR PHONE NUMBER material. 508. OFFSITE GENERATOR CITY 509. OFFSITE GENERATOR STATE 510. OFFSITE GENERATOR ZIP CODE 511. OFFSITE GENERATOR MAILING ADDRESS Complete items 511 —514 if the mailing address for the offsite 512. CITY FOR MAILING ADDRESS generator is different from the street address. 513. STATE FOR MAILING ADDRESS 514: ZIP CODE FOR-MAILING ADDRESS SIGNATURE OF CERTIFIER -The business owner/operator of the recycling facility shall sign in the space provided. This signature certifies that the signer believes that the information submitted is true, accurate, and complete. 515. DATE CERTIFIED - Enter the date that the certification was signed. 516. NAME OF DOCUMENT PREPARER - Enter the name of the person who prepared the report. 517. CERTIFIER NAME - Enter the full printed name of the certifier. 518. CERTIFIER TITLE - Enter the title of the person signing the report. UPCF(12/99 revised)