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f characteristic wastes are mixed with nonhazardous materials
and the mixture is discharged to the sewer, is the entire mixture
that is discharged still exhibiting the characteristic(s)?
Is the entire mixture actually discharged >15kg per calendar
month? (See 40 CFR 261) (Please list on additional sheets.)
If listed wastes are mixed with non-hazardous materials and then
discharged to the sewer, the entire waste stream is considered
hazardous, and a notification must be submitted. Is there an amt.
discharged > 15 kg? (See 40 CFR 261) (Please list on additional
sheets.)
IU’s who commence discharging after August 23, 1990, must submit the notification no later than 180 days
after the discharge of a hazardous waste.
If there is a subsequent or questionable discharge, you are still required to the one time notification. If any
new regulations under section 3001 of RCRA identifying additional characteristics of hazardous waste or
listing of any additional substance as a hazardous waste, the IU must notify the POTW, the EPA Regional
Waste Management Waste Division Director and the State ED hazardous waste authorities of the discharge
of such substance within 90 days of the effective date of such regulations.
In the case of any notification made under 40 CFR 403, 12 (p):
I, ________________________________ do hereby certify to reduce the volume and toxicity of hazardous
wastes generated to the degree it has been submitted information on this form true, accurate and
complete. I am aware that there is significant penalties for submitting false information, including the
possibility of fine and/or imprisonment.
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_________________ ________________________________________
Date Signature of Official
(Seal, if applicable)
