Form DTSC1430 "Certified Appliance Recycler Waste Management Certification" - California

What Is Form DTSC1430?

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 December 14, 2016;
  • 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;

Download a printable version of Form DTSC1430 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 Form DTSC1430 "Certified Appliance Recycler Waste Management Certification" - California

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State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Form DTSC 1430 - Certified Appliance Recycler Waste Management Certification
According to AB 2277 (2004), a Certified Appliance Recycler (CAR) must remove and properly manage ‘materials that
require special handling’ from discarded major appliances. (HSC §25211)
To document that the ‘materials that require special handling’ were removed from major appliances prior to the appliance
being crushed, baled, shredded, sawed, sheared apart or otherwise processed in a manner that could result in the release
of these materials; scrap metal recycling facilities receiving appliances that have had ‘materials that require special
handling’ removed, must collect form DTSC 1430 at the time of transaction. Form DTSC 1430 is to be completed by the
CAR that removed the materials that require special handling, not by the transporter. Form DTSC 1430 is a written
certification signed by the CAR that ‘materials that require special handling’ have been removed from the appliances listed
below, in a manner that maintained compliance with subdivision (a) of Section 25212 of the Health and Safety Code.
.
For appliance recycling information contact: (916) 322-4819
1.) DTSC Certified Appliance Recycler (CAR) Number:
Please confirm CAR contact information, associated with above CAR #
Name:
Phone #
(
)
Address:
2.) EPA Hazardous Waste Generator Identification Number:
(To obtain an EPA ID # complete form DTSC 1358)
3.) List the number of appliances next to the correct type for this shipment:
Washer:
Space Heater:
Microwave:
Dryer:
Boiler:
Oven:
Refrigerator:
Furnace:
Stove:
Freezer:
Water Heater:
Other: (please specify)
Trash Compactor:
Air Conditioner:
4.) List all facilities that the ‘materials that require special handling’ removed from the above listed appliances
were sent to, or the facilities where the materials will be sent:
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or Material will be sent to
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or Material will be sent to
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or
Material will be sent to
CAR Name / Signature
Date
Transporter (if not CAR) / Signature
Date
Signature of Person Accepting Shipment
Date
DTSC 1430 (12/14/16)
State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Form DTSC 1430 - Certified Appliance Recycler Waste Management Certification
According to AB 2277 (2004), a Certified Appliance Recycler (CAR) must remove and properly manage ‘materials that
require special handling’ from discarded major appliances. (HSC §25211)
To document that the ‘materials that require special handling’ were removed from major appliances prior to the appliance
being crushed, baled, shredded, sawed, sheared apart or otherwise processed in a manner that could result in the release
of these materials; scrap metal recycling facilities receiving appliances that have had ‘materials that require special
handling’ removed, must collect form DTSC 1430 at the time of transaction. Form DTSC 1430 is to be completed by the
CAR that removed the materials that require special handling, not by the transporter. Form DTSC 1430 is a written
certification signed by the CAR that ‘materials that require special handling’ have been removed from the appliances listed
below, in a manner that maintained compliance with subdivision (a) of Section 25212 of the Health and Safety Code.
.
For appliance recycling information contact: (916) 322-4819
1.) DTSC Certified Appliance Recycler (CAR) Number:
Please confirm CAR contact information, associated with above CAR #
Name:
Phone #
(
)
Address:
2.) EPA Hazardous Waste Generator Identification Number:
(To obtain an EPA ID # complete form DTSC 1358)
3.) List the number of appliances next to the correct type for this shipment:
Washer:
Space Heater:
Microwave:
Dryer:
Boiler:
Oven:
Refrigerator:
Furnace:
Stove:
Freezer:
Water Heater:
Other: (please specify)
Trash Compactor:
Air Conditioner:
4.) List all facilities that the ‘materials that require special handling’ removed from the above listed appliances
were sent to, or the facilities where the materials will be sent:
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or Material will be sent to
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or Material will be sent to
Type of material:
Facility information:
Please circle the appropriate:
Materials have been sent
or
Material will be sent to
CAR Name / Signature
Date
Transporter (if not CAR) / Signature
Date
Signature of Person Accepting Shipment
Date
DTSC 1430 (12/14/16)