"Registration Form for Outdoor Used Tire Storage Site/Waste Tire Collection Site" - Arizona

This "Registration Form for Outdoor Used Tire Storage Site/Waste Tire Collection Site" is a Arizona-specific form released by the Arizona Department of Environmental Quality on July 1, 2017.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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Download "Registration Form for Outdoor Used Tire Storage Site/Waste Tire Collection Site" - Arizona

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INSTRUCTIONS FOR REGISTRATION OF:
 OUTDOOR USED TIRE SITES
(100 OR MORE USED TIRES)
 WASTE TIRE COLLECTION SITES
(OVER 500 WASTE TIRES)
I
NSTRUCTIONS
New rules that are effective July 1, 2012, require the owner or operator of a site that stores 100 or more used tires
outdoors or a site that stores over 500 but less than 5,000 waste tires to register with the Arizona Department of
Environmental Quality (ADEQ) and submit to the Department specific information about the site. Additionally,
the rules require the payment of a registration fee and certification that the site complies with state statutes and
1
rules governing that type of site
.
Outdoor used tire sites storing 100 or more used tires on any day and waste tire collection sites that store over 500 but less
than 5,000 waste tires on any day are required to comply with registration requirements. The attached registration form
must be submitted for review and approval by ADEQ.
The registration form requires the following:
Applicant and site identification,
Key contact information,
Tire storage information, and
A signed certification statement that states the site is in compliance with items as required by Arizona state law.
Note Regarding Waste and Used Tires: This application form is for the registration of an outdoor used tire site storing 100
or more used tires or the registration of a waste tire collection site (WTCS) storing greater than 500 but less than 5,000
waste tires on-site on any day. Authorization for a facility to store 5,000 or more waste tires on any day, if not required to
obtain plan approval, must be obtained by completing a Registration for Solid Waste Facilities Requiring Self-
Certification form and paying the appropriate fee. A tire site/facility that must register under more than one program is
2
only subject to one fee, which will be the greater of the two fees.
A “used tire” is any tire that has been used for more than one day on a motor vehicle.
3
“Outdoors” means other than inside a building with a weatherproof roof.
4
A “waste tire” means a motor vehicle tire that is no longer suitable for its original intended purpose because of
wear, damage, improper repair or manufacturer’s recall.
5
“Damage” means any cracking, bubbling, cutting, chunking or separation of the tire sidewall or tread,
6
including exposed body ply or belt material, or any visible deterioration of the tire bead or inner liner.
“Improper repair" means any puncture repair of damage larger than one-fourth of an inch, any puncture
repair to a tire sidewall, the tread shoulder or belt edge area, or a puncture repair that has not been both
7
sealed or patched on the inside and repaired with a cured rubber stem through to the outside.
“Wear” means the reduction of the major groove depth of the tire to two thirty-seconds of an inch.
8
A “waste tire collection site” means a site where waste tires are collected before being offered for recycling or
9
reuse and where more than 500 tires are kept on-site on any day.
1
Arizona Administrative Code (A.A.C.) R-18-13-1211 & 1212, Arizona Revised Statutes (A.R.S.) §44-1304.01
2
A.A.C. R18-13-1213
3
A.A.C. R18-13-1212(C)(1)
4
A.A.C. R18-13-1212(C)(2)
5
A.R.S. § 44-1301(6)
6
A.R.S. § 44-1301(1)
7
A.R.S. § 44-1301(2)
8
A.R.S. § 44-1301(8)
9
A.R.S. § 44-1301(7)
SWU (R
2017)
P
i
EVISED JULY
AGE
1110 W
W
S
, P
, AZ 85007
EST
ASHINGTON
TREET
HOENIX
www.azdeq.gov
INSTRUCTIONS FOR REGISTRATION OF:
 OUTDOOR USED TIRE SITES
(100 OR MORE USED TIRES)
 WASTE TIRE COLLECTION SITES
(OVER 500 WASTE TIRES)
I
NSTRUCTIONS
New rules that are effective July 1, 2012, require the owner or operator of a site that stores 100 or more used tires
outdoors or a site that stores over 500 but less than 5,000 waste tires to register with the Arizona Department of
Environmental Quality (ADEQ) and submit to the Department specific information about the site. Additionally,
the rules require the payment of a registration fee and certification that the site complies with state statutes and
1
rules governing that type of site
.
Outdoor used tire sites storing 100 or more used tires on any day and waste tire collection sites that store over 500 but less
than 5,000 waste tires on any day are required to comply with registration requirements. The attached registration form
must be submitted for review and approval by ADEQ.
The registration form requires the following:
Applicant and site identification,
Key contact information,
Tire storage information, and
A signed certification statement that states the site is in compliance with items as required by Arizona state law.
Note Regarding Waste and Used Tires: This application form is for the registration of an outdoor used tire site storing 100
or more used tires or the registration of a waste tire collection site (WTCS) storing greater than 500 but less than 5,000
waste tires on-site on any day. Authorization for a facility to store 5,000 or more waste tires on any day, if not required to
obtain plan approval, must be obtained by completing a Registration for Solid Waste Facilities Requiring Self-
Certification form and paying the appropriate fee. A tire site/facility that must register under more than one program is
2
only subject to one fee, which will be the greater of the two fees.
A “used tire” is any tire that has been used for more than one day on a motor vehicle.
3
“Outdoors” means other than inside a building with a weatherproof roof.
4
A “waste tire” means a motor vehicle tire that is no longer suitable for its original intended purpose because of
wear, damage, improper repair or manufacturer’s recall.
5
“Damage” means any cracking, bubbling, cutting, chunking or separation of the tire sidewall or tread,
6
including exposed body ply or belt material, or any visible deterioration of the tire bead or inner liner.
“Improper repair" means any puncture repair of damage larger than one-fourth of an inch, any puncture
repair to a tire sidewall, the tread shoulder or belt edge area, or a puncture repair that has not been both
7
sealed or patched on the inside and repaired with a cured rubber stem through to the outside.
“Wear” means the reduction of the major groove depth of the tire to two thirty-seconds of an inch.
8
A “waste tire collection site” means a site where waste tires are collected before being offered for recycling or
9
reuse and where more than 500 tires are kept on-site on any day.
1
Arizona Administrative Code (A.A.C.) R-18-13-1211 & 1212, Arizona Revised Statutes (A.R.S.) §44-1304.01
2
A.A.C. R18-13-1213
3
A.A.C. R18-13-1212(C)(1)
4
A.A.C. R18-13-1212(C)(2)
5
A.R.S. § 44-1301(6)
6
A.R.S. § 44-1301(1)
7
A.R.S. § 44-1301(2)
8
A.R.S. § 44-1301(8)
9
A.R.S. § 44-1301(7)
SWU (R
2017)
P
i
EVISED JULY
AGE
1110 W
W
S
, P
, AZ 85007
EST
ASHINGTON
TREET
HOENIX
www.azdeq.gov
I
F
R
:
NSTRUCTIONS
OR
EGISTRATION OF
O
U
T
S
(100
M
U
T
)
W
T
C
S
(O
500
T
)
UTDOOR
SED
IRE
ITES
OR
ORE
SED
IRES
OR
ASTE
IRE
OLLECTION
ITES
VER
WASTE
IRES
G
ENERAL APPLICATION PROCESS
1) Applicant submits one copy of the registration form and the appropriate registration fee.
Note: The form must be submitted with an original signature.
2) ADEQ reviews the form for completeness and informs the applicant of any deficiencies in writing.
3) Applicant addresses any deficiencies.
4) ADEQ notifies the applicant that the registration process is complete.
F
EES
7
An initial fee is required along with your registration form.
Fees for registration are:
 An outdoor used tire site (OUTS) storing 100 or more used tires on any day:
$500 for initial registration
$75 for annual registration thereafter
 A waste tire collection site (WTCS) that stores over 500 but less than 5,000 waste tires on any day:
$500 for initial registration
$75 for annual registration thereafter
 A site registering as both an OUTS and WTCS.
$500 for initial registration
$75 for annual registration thereafter
W
?
HERE DO I SUBMIT MY APPLICATION
Submit your application to:
Arizona Department of Environmental Quality
Solid Waste Unit
1110 West Washington Street
Phoenix, AZ 85007
For assistance or inquiries regarding the application process, please contact the ADEQ Solid Waste Unit at (602) 771-4123
or toll-free in Arizona at (800) 234-5677, ext. 771-4123.
7
A.A.C. R18-13-1212
SWU (R
2017)
P
ii
EVISED JULY
AGE
1110 W
W
S
, P
, AZ 85007
EST
ASHINGTON
TREET
HOENIX
www.azdeq.gov
REGISTRATION FORM FOR:
 OUTDOOR USED TIRE SITES
(100 OR MORE USED TIRES)
 WASTE TIRE COLLECTION SITES
(OVER 500 WASTE TIRES)
G
I
ENERAL
NFORMATION
Indicate which type of site you are registering:
Outdoors Used Tire Site (100 or more used tires)
Waste Tire Collection Site (over 500 waste tires)
Both
1
1.
Applicant
Identify who is requesting this registration. Provide the name and title of the highest-ranking local official responsible for day-
to-day operation and compliance. Include the name of the company, as it should appear on the registration, and its mailing and
street address. Include one phone number for the identified company official (a) and a business phone number for the
company (b).
Owner
Operator
Owner and Operator
Other:
Name and Title
Company
Street Address
City
State
Zip
Mailing Address
City
State
Zip
Telephone Numbers: (a)
(b)
E-mail
Registered to do business in Arizona?
Yes
No
1
2.
Contact Information for the Site Owner
Identify who owns this site. This may be the official identified above, or another individual.
Check this box if the contact information for the site owner is the same as in item 1, above.
Contact Name
Company Name
Mailing Address
City
State
Zip
Telephone
Fax
E-mail
1
3.
Contact Information of Landowner(s)
Check this box if the contact information for the Landowner is the same as in item 1 or 2, above.
Check this box if there are additional owners that are not listed below. Provide contact information for each additional
owner as an attachment to this registration form.
Contact Name
Company Name
Mailing Address
City
State
Zip
Telephone
Fax
E-mail
1
4.
Site Name, Address and Location Information
Provide the name and location information of the site where operations are proposed. If the description is lengthy, please
provide it as an attachment to this application and type “see attachment” in the space provided below.
Site Name
Street Address
City
State
Zip
County
Township
Range
Section(s)
Latitude
º
'
" N
Longitude
º
'
" W
1
A.R.S. § 44-1304.01(A)(8)
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2017)
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EVISED JULY
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1110 W
W
S
, P
, AZ 85007
EST
ASHINGTON
TREET
HOENIX
www.azdeq.gov
R
F
F
:
EGISTRATION
ORM
OR
O
U
T
S
(100
M
U
T
)
W
T
C
S
(O
500
T
)
UTDOOR
SED
IRE
ITES
OR
ORE
SED
IRES
OR
ASTE
IRE
OLLECTION
ITES
VER
WASTE
IRES
2
5.
Quantity and Types of Tires Stored at the Site
Used
Waste
Number of tires stored at this site on a daily basis
Maximum number of tires anticipated for storage at this site
6.
Additional Requirements
I, ________________________, certify that:
3
Initials_____ 1. Any waste tire is not stored on site for more than 90 days.
4
Initial Items 2-8 only if registering as an Outdoor Used Tire Site
Initials_____ 2. The tire piles do not exceed twenty feet in height.
Initials_____ 3. The tire piles are not within three feet of any property line.
Initials_____ 4. The tire piles do not exceed six feet in height if the used tires are stored between three and ten feet of any
property line.
Initials_____ 5. Access routes between and around tire piles are twenty feet wide and maintained free of accumulations or
rubbish, equipment or other materials. Access routes are spaced so that a maximum grid system unit of
fifty feet by one hundred fifty feet is maintained.
Initials_____ 6. The tire piles are not stored within fifty feet of any area in which smoking of tobacco or any other
substance by persons is permitted. “No smoking” signs are posted in appropriate and visible locations.
Initials_____ 7. Used tires are only stored in areas where electrical wiring, fixtures or appliances do comply with the
National Electrical Code.
Initials_____ 8. Used tires are stored with class “2A-10BC” type fire extinguishers at well-marked points throughout the
storage area so that the travel distance from any point in the storage area to a fire extinguisher is not more
than seventy-five feet.
5
7.
Initial Fee of $500
Check this box to indicate fee is attached.
NOTE: ADEQ will not process the registration without the appropriate fee.
5
8.
Certification Statement
I certify under penalty of law that this application and all attachments were prepared under my direction or authorization and
all information is, to the best of my knowledge, true, accurate and complete. I also certify that the site described in this form
is or will be designed, constructed, operated, and/or closed in accordance with the terms and conditions of the applicable
requirements of A.R.S. Title 44 Chapter 9 Article 8 regarding commerce and A.R.S. §49-762.07(F) regarding solid waste
requirements. I am aware that there are significant penalties for submitting false information.
Print Name
Title
Signature
Date
Pursuant to Arizona Revised Statutes (A.R.S. § 41-1030):
(1) ADEQ shall not base a licensing decision, in whole or in part, on a requirement or condition not specifically authorized by statute or rule.
General authority in a statute does not authorize a requirement or condition unless a rule is made pursuant to it that specifically authorizes the
requirement or condition.
(2) Prohibited licensing decisions may be challenged in a private civil action. Relief may be awarded to the prevailing party against ADEQ,
including reasonable attorney fees, damages, and all fees associated with the license application.
(3) ADEQ employees may not intentionally or knowingly violate the requirement for specific licensing authority. Violation is cause for
disciplinary action or dismissal, pursuant to ADEQ’s adopted personnel policy. ADEQ employees are still afforded the immunity in A.R.S. §§
12-821.01 and 12-820.02.
2
A.R.S. § 44-1304.01(A)(8)
3
A.R.S. § 49-701(29)(b)
4
A.R.S. § 44-1304.01(A)(1) through (7)
5
A.A.C. R18-13-1212(A)
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EVISED JULY
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1110 W
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, P
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EST
ASHINGTON
TREET
HOENIX
www.azdeq.gov
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