DTSC Form 1199 "Transportable Treatment Unit Permit-By-Rule/Conditional Exemption Unit-Specific Notification" - California

What Is DTSC Form 1199?

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 August 1, 2015;
  • 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 1199 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 1199 "Transportable Treatment Unit Permit-By-Rule/Conditional Exemption Unit-Specific Notification" - California

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State of California - California Environmental Protection Agency
Department of Toxic Substances Control
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
Initial
For Use By Transportable Treatment Unit (TTU) Treating Hazardous Waste
Amended
Under Conditional Exemption and Permit-By-Rule.
Renewal
(Pursuant to Health and Safety Code 25201.5 and
Title 22, California Code of Regulations, Chapter 45)
Please refer to the attached instructions before completing this form. This form is to be used by all Permit-By-Rule
and Conditionally Exempt Transportable Treatment Units (TTUs) only. The TTU Permit-by-Rule/Conditional Exemption Unit-
Specific Notification Form supersedes DTSC Form 8429. You may notify for more than one permitting tier by using this
notification form, DTSC Form 1199. You must attach a separate TTU Site-Specific Notification Form for each TTU you
operated. There are different site-specific notification forms for each of the three categories. You only have to submit forms
for the tier(s) that cover your unit(s). Please recycle the other unused forms. Put your EPA ID Number on each page.
Please provide all of the information requested; all fields must be completed except those that state `if different' or `if
available'. Please type the information provided on this form and any attachments. Please submit four sets of the
completed notification package with original signatures to the Department.
I.
NOTIFICATION CATEGORIES
Indicate the tiers(s) that your TTU will operate in.
Conditionally Exempt Small Quantity Treatment (CESQT) operators
may not operate units under any other tier.
A. ____ Conditionally Exempt-Small Quantity Treatment
(CESQT)
B. ____ Conditionally Exempt-Specified Wastestream
(CESW)
C. ____ Permit by Rule (PBR)
II.
GENERAL TTU INFORMATION
COMPANY EPA ID NUMBER CA__ __ __ __ __ __ __ __ __ __
BOE NUMBER (if available) H __ HQ__ __ __ __ __ __ __ __
TTU SERIAL NO. __ __ __ __ __ __ __ __
COMPANY NAME (DBA-Doing Business As) _________________________________________________
DTSC Form 1199 (8/15)
Page 1
(Previously DTSC 8429)
State of California - California Environmental Protection Agency
Department of Toxic Substances Control
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
Initial
For Use By Transportable Treatment Unit (TTU) Treating Hazardous Waste
Amended
Under Conditional Exemption and Permit-By-Rule.
Renewal
(Pursuant to Health and Safety Code 25201.5 and
Title 22, California Code of Regulations, Chapter 45)
Please refer to the attached instructions before completing this form. This form is to be used by all Permit-By-Rule
and Conditionally Exempt Transportable Treatment Units (TTUs) only. The TTU Permit-by-Rule/Conditional Exemption Unit-
Specific Notification Form supersedes DTSC Form 8429. You may notify for more than one permitting tier by using this
notification form, DTSC Form 1199. You must attach a separate TTU Site-Specific Notification Form for each TTU you
operated. There are different site-specific notification forms for each of the three categories. You only have to submit forms
for the tier(s) that cover your unit(s). Please recycle the other unused forms. Put your EPA ID Number on each page.
Please provide all of the information requested; all fields must be completed except those that state `if different' or `if
available'. Please type the information provided on this form and any attachments. Please submit four sets of the
completed notification package with original signatures to the Department.
I.
NOTIFICATION CATEGORIES
Indicate the tiers(s) that your TTU will operate in.
Conditionally Exempt Small Quantity Treatment (CESQT) operators
may not operate units under any other tier.
A. ____ Conditionally Exempt-Small Quantity Treatment
(CESQT)
B. ____ Conditionally Exempt-Specified Wastestream
(CESW)
C. ____ Permit by Rule (PBR)
II.
GENERAL TTU INFORMATION
COMPANY EPA ID NUMBER CA__ __ __ __ __ __ __ __ __ __
BOE NUMBER (if available) H __ HQ__ __ __ __ __ __ __ __
TTU SERIAL NO. __ __ __ __ __ __ __ __
COMPANY NAME (DBA-Doing Business As) _________________________________________________
DTSC Form 1199 (8/15)
Page 1
(Previously DTSC 8429)
EPA ID NUMBER _____________________________________
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
PHYSICAL LOCATION ___________________________________________________________________
CITY_______________________________
CA
ZIP ___________-__________
COUNTY_______________________________
COMPANY MAILING ADDRESS, IF DIFFERENT:
STREET ____________________________________________________________________
CITY _____________________________________ STATE ____ ZIP ________-_______
OWNER NAME __________________________________________________________________________
OWNER TELEPHONE NUMBER (______)_______-__________
TTU CONTACT PERSON ___________________ ____________PHONE NUMBER (_____)_____- __________
(first name)
(last name)
DTSC Form 1199 (8/15)
Page 2
(Previously DTSC 8429)
EPA ID NUMBER _____________________________________
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
TTU OPERATOR(S) INFORMATION, ONLY IF DIFFERENT FROM OWNER
List all Operators that will be operating this unit. If more than 3 operators, please attach list of the additional
operators.
OPERATOR #1 NAME __________________________________________________________________
STREET _______________________________________________________________________________
_______________________________________________________________________________________
CITY __________________________________________________ STATE ____ ZIP ________-_____
CONTACT PERSON _______________________________________ TELEPHONE # (____) ____-______
(First)
(Last)
OPERATOR #2 NAME __________________________________________________________________
STREET _______________________________________________________________________________
_______________________________________________________________________________________
CITY __________________________________________________ STATE ____ ZIP ________-______
CONTACT PERSON ______________________________________ TELEPHONE # (____) ____-_______
(First)
(Last)
OPERATOR #3 NAME __________________________________________________________________
STREET _______________________________________________________________________________
_______________________________________________________________________________________
CITY __________________________________________________ STATE ____ ZIP ________-______
DTSC Form 1199 (8/15)
Page 3
(Previously DTSC 8429)
EPA ID NUMBER _____________________________________
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
CONTACT PERSON _____________________________________ TELEPHONE # (____) ____-________
(First)
(Last)
OPERATOR #4 NAME __________________________________________________________________
STREET _______________________________________________________________________________
_______________________________________________________________________________________
CITY __________________________________________________ STATE ____ ZIP ________-______
CONTACT PERSON _____________________________________ TELEPHONE # (____) ____-________
(First)
(Last)
DTSC Form 1199 (8/15)
Page 4
(Previously DTSC 8429)
EPA ID NUMBER _____________________________________
TRANSPORTABLE TREATMENT UNIT PERMIT-BY-RULE/CONDITIONAL EXEMPTION
UNIT-SPECIFIC NOTIFICATION
III.
WASTESTREAMS AND TREATMENT PROCESSES:
A.
CONDITIONAL EXEMPTION - SMALL QUANTITY TREATMENT (CESQT):
Estimated Monthly Total Volume Treated:__________pounds and/or _________ gallons
The following are the eligible wastestreams and treatment processes. To be eligible to treat under Conditional
Exemption - Small Quantity Treatment (CESQT), the TTU can have no other authorization from DTSC, including
Conditional Exemption - Specified Wastestream (CESW). Please check all applicable boxes:
1.
Aqueous wastes containing hexavalent chromium may be treated by the following process:
a.
Reduction of hexavalent chromium to trivalent chromium with sodium bisulfite, sodium metabisulfite, sodium
thiosulfate, ferrous sulfate, ferrous sulfide, or sulfur dioxide provided both pH and addition of the reducing
agent are automatically controlled.
2.
Aqueous wastes containing metals listed in Title 22, CCR, section 66261.24 (a)(2) and/or fluoride salts may be
treated by the following technologies:
a.
pH adjustment or neutralization.
b.
Precipitation or crystallization.
c.
Phase separation by filtration, centrifugation, or gravity settling.
d.
Ion exchange.
e.
Reverse osmosis.
f.
Metallic replacement.
g.
Plating the metal onto an electrode.
h.
Electrodialysis.
i.
Electrowinning or electrolytic recovery.
j.
Chemical stabilization using silicates and/or cementitious types of reactions.
k.
Evaporation.
l.
Adsorption.
DTSC Form 1199 (8/15)
Page 5
(Previously DTSC 8429)
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