C.M.R. 06, 096, ch. 402, app 096-402-B
Annual Report Form
for PROCESSING FACILITIES, and
TRANSFER STATIONS and/or STORAGE SITES
LICENSEE: _____________________________________________________________
CONTACT PERSON: ____________________________ PHONE NO: _____________
DEP LICENSE NUMBER: _________________________________________________
1. Summary of activity during past year (including factors which affected the operation, design, or environmental monitoring program).
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2. Operations
A. Submit copies of reports prepared in accordance with the transfer station or storage facility's Hazardous and Special Waste Handling and Exclusion Plan.
B. Report on deviations from approved operations manual and proposed changes in operations and/or operations manual.
Past Year Deviations
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Proposed Changes
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3. Summary of staff training provided on operation or maintenance of the transfer station.
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4. Summary of all spills, fires and/or accidents on-site.
Spills
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Fires
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Accidents
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5. Provide verification of 2 feet till soil between waste, and seasonal high water and bedrock if one or more base pads for storage of non-containerized waste is used. (Required for transfer station or storage facility only.)
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6. Design
If any aspect of design was changed, please submit as-built plans and a narrative on these changes (proposed design changes for current year may be described).
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7. Monitoring (if facility has a monitoring plan).
Evaluation of past year's monitoring results, monitoring program and equipment; recommended changes may be submitted. Attach additional sheets or provide a separate attachment if additional space is needed.
Monitoring Results
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Monitoring Program
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Equipment
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Recommended Changes
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8. Provide a summary of universal waste handling activities at the transfer station.
C.M.R. 06, 096, ch. 402, app 096-402-B