DTSC Form 1294 "Transportation Regulatory Exemption Application/Variance" - California

What Is DTSC Form 1294?

This is a legal form that was released by the California Department of Toxic Substances Control - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2020;
  • The latest edition provided by the California Department of Toxic Substances Control;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DTSC Form 1294 by clicking the link below or browse more documents and templates provided by the California Department of Toxic Substances Control.

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Download DTSC Form 1294 "Transportation Regulatory Exemption Application/Variance" - California

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California Environmental Protection Agency
Department of Toxic Substances Control
Transporter Unit
1001 I Street MS 11A, Sacramento, CA 95814
Phone: (800) 618-6942 Fax: (916) 323-3500
Transportation Regulatory Exemption Application/Variance
DTSC Form 1294 (Revision 04/2020)
The California Code of Regulations (Cal. Code Regs.), title 22, division 4.5, chapter 13, article 4
establishes four categories of transportation variances. Each variance category corresponds to a
specific type of hazardous waste transportation operation, which if conducted in accordance with the
provisions of article 4, poses an insignificant risk to human health or to the environment. When signed
in Part E by an authorized representative of the Department of Toxic Substances Control (DTSC) this
document becomes the issued variance as applied for. Prior to operating pursuant to this variance, a
transporter shall send a copy of this variance to each hazardous waste generator serviced under its
provisions. Complete Parts A through D as indicated.
Part A. Transporter (Applicant) Identification
Business Name: ___________________________________________________________________
EPA Identification Number (12 characters): _____________ Transporter Registration Number: _____
Business Address:__________________________________________________________________
Street Number and Name
________________________________________________________________________________
PO Box
________________________________________________________________________________
City
State
ZIP Code
Mailing Address:___________________________________________________________________
Street Number and Name
________________________________________________________________________________
PO Box
________________________________________________________________________________
City
State
ZIP Code
Contact Person:____________________________________________________________________
Telephone Number:______________________ Fax Number: _______________________________
Email Address: ____________________________________________________________________
Variance Serial Number (DTSC Use Only):_______________
California Environmental Protection Agency
Department of Toxic Substances Control
Transporter Unit
1001 I Street MS 11A, Sacramento, CA 95814
Phone: (800) 618-6942 Fax: (916) 323-3500
Transportation Regulatory Exemption Application/Variance
DTSC Form 1294 (Revision 04/2020)
The California Code of Regulations (Cal. Code Regs.), title 22, division 4.5, chapter 13, article 4
establishes four categories of transportation variances. Each variance category corresponds to a
specific type of hazardous waste transportation operation, which if conducted in accordance with the
provisions of article 4, poses an insignificant risk to human health or to the environment. When signed
in Part E by an authorized representative of the Department of Toxic Substances Control (DTSC) this
document becomes the issued variance as applied for. Prior to operating pursuant to this variance, a
transporter shall send a copy of this variance to each hazardous waste generator serviced under its
provisions. Complete Parts A through D as indicated.
Part A. Transporter (Applicant) Identification
Business Name: ___________________________________________________________________
EPA Identification Number (12 characters): _____________ Transporter Registration Number: _____
Business Address:__________________________________________________________________
Street Number and Name
________________________________________________________________________________
PO Box
________________________________________________________________________________
City
State
ZIP Code
Mailing Address:___________________________________________________________________
Street Number and Name
________________________________________________________________________________
PO Box
________________________________________________________________________________
City
State
ZIP Code
Contact Person:____________________________________________________________________
Telephone Number:______________________ Fax Number: _______________________________
Email Address: ____________________________________________________________________
Variance Serial Number (DTSC Use Only):_______________
Part B. Specific Variance Exemption(s): Check the box next to the Transportation Regulatory
Exemption(s) you are requesting. For each variance exemption category requested, list and describe
each hazardous waste. Provide the Department of Transportation shipping description or the generic
or commonly used industrial name and the estimated frequency and quantity transported per month.
Use a separate page if necessary. A summary of each variance exemption category is provided
below as guidance only. The actual regulations should be consulted prior to making any decision that
may impact regulatory compliance.
Emergency Response Incident Operations (Cal. Code Regs, title 22, section 66263.43).
Allows a State, local or county governmental emergency response incident unit to transport up to five
85-gallon drums of hazardous waste from an incident site to a central collection facility using a
shipping paper instead of a hazardous waste manifest. The waste may be accumulated for up to 90
days and must then be manifested to an authorized facility.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Polychlorinated Biphenyl (PCB) Waste Operations (Cal. Code Regs., title 22, section
66263.44).
Allows a governmental agency or public utility to transport its own PCB waste to a central collection
facility using a shipping paper instead of a hazardous waste manifest. Handling and storage time for
the waste shall meet the provisions of Cal. Code Regs., title 22, section 66263.18, and must then be
manifested to an authorized facility.
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Consolidation Operations (Cal. Code Regs., title 22, section 66263.45).
Allows a transporter who owns/operates multiple small, RCRA-exempt generation sites to transport
up to 100 kilograms of hazardous waste per load from those sites to a temporary hazardous waste
storage facility using a shipping paper instead of a hazardous waste manifest. Handling and storage
time for the waste shall meet the provisions of Cal. Code Regs., title 22, section 66263.18, and must
then be manifested to an authorized facility.
________________________________________________________________________________
________________________________________________________________________________
Small Load Operations (Cal. Code Regs., title 22, section 66263.46).
Allows a transporter to transport up to 100 kilograms of RCRA-exempt hazardous waste per load, and
no greater than 1000 kilograms per calendar month, directly to an authorized facility using a shipping
paper instead of a hazardous waste manifest.
________________________________________________________________________________
________________________________________________________________________________
Variance Serial Number (DTSC Use Only):_______________
Part C. Address of Central Collection Facility or Temporary Hazardous Waste Facility
________________________________________________________________________________
________________________________________________________________________________
Part D. Certification of Applicant
I, the undersigned have read, understood and will comply with the provisions of Cal. Code Regs, title
22, division 4.5, chapter 13, article 4. I declare under penalty of perjury under the laws of California
that the information and statements provided in this application are true and correct to the best of my
knowledge. I understand that there are significant penalties, including monetary fines and
imprisonment, for knowingly submitting false information. I understand that I am obligated to
immediately notify DTSC of any noncompliance with the terms of this variance. I understand that I am
not exempt from any requirement of law except as specified above, and that the exemption(s) granted
by this variance is/are not transferable to another party.
________________________________________________________________________________
Signature of Authorized Representative
Date
________________________________________________________________________________
Name and Title of Authorized Representative (print or type)
Part E. Determination of Completeness (DTSC Use Only)
DTSC finds this variance application to be complete, and that based on the information provided
above, the applicant meets the requirements of Cal. Code Regs, title 22, division 4.5, chapter 13,
article 4 for the transportation regulatory exemption(s) requested. DTSC hereby issues to the
applicant this variance for the specified exemptions identified in Section B. This variance is effective
from the issue date through the expiration date as indicated below. This variance is valid only with a
current State of California Hazardous Waste Transporter Registration. This variance is subject to
review at the discretion of DTSC and may be revoked at any time.
________________________________________________________________________________
Signature of Authorized Representative
Date
________________________________________________________________________________
Name and Title of Authorized Representative (print or type)
________________________________________________________________________________
Variance Expiration Date
Variance Serial Number (DTSC Use Only):_______________
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