Form MO780-1521 "Used Oil Processors and Re-refiners Inspection and Record Checklist" - Missouri

What Is Form MO780-1521?

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

Form Details:

  • Released on June 1, 2004;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • 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 printable version of Form MO780-1521 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
HAZARDOUS WASTE PROGRAM
USED OIL PROCESSORS AND RE-REFINERS
INSPECTION RECORD AND CHECKLIST
S
NAME
DATE
EPA I.D. NUMBER
ADDRESS
RR NO.
MO I.D. NUMBER
CITY
NUMBER OF EMPLOYEES
YEARS AT SITE
TELEPHONE NUMBER
FACILITY REPRESENTATIVE(S), TITLE(S)
DESCRIPTION OF THE FACILITY’S OPERATIONS AND PLANT
A. GENERAL REQUIREMENTS
1.
Registered and obtained EPA identification number - 10 CSR 25-11.279(1)
COMMENTS
incorporating 40 CFR 279.51(a).
2.
Facility has determined that the used oil being stored at the site is not
hazardous waste - 10 CSR 25-11.279(1) incorporating 40 CFR 279.53.
3.
Follow and keep a written analysis plan at the facility - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.55.
4.
Maintained and operated to minimize the possibility of fire, explosion or any
unplanned release of used oil - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(1).
5.
Equipped with internal communication/alarm system, device capable of
summoning emergency assistance, fire control equipment and water at
adequate volume and pressure - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(2).
6.
Equipment tested and maintained - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(3).
7.
Access to communications or alarm system - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.52(a)(4).
8.
Facility has made attempts for arrangements with emergency response
agencies - 10 CSR 25-11.279(1) incorporating 40 CFR 279.52(a)(6).
9.
Facility has emergency coordinator on the facility premises or on call - 10 CSR
25-11.279(1) incorporating 40 CFR 279.52(b)(5).
MO 780-1521 (6-04)
MISSOURI DEPARTMENT OF NATURAL RESOURCES
HAZARDOUS WASTE PROGRAM
USED OIL PROCESSORS AND RE-REFINERS
INSPECTION RECORD AND CHECKLIST
S
NAME
DATE
EPA I.D. NUMBER
ADDRESS
RR NO.
MO I.D. NUMBER
CITY
NUMBER OF EMPLOYEES
YEARS AT SITE
TELEPHONE NUMBER
FACILITY REPRESENTATIVE(S), TITLE(S)
DESCRIPTION OF THE FACILITY’S OPERATIONS AND PLANT
A. GENERAL REQUIREMENTS
1.
Registered and obtained EPA identification number - 10 CSR 25-11.279(1)
COMMENTS
incorporating 40 CFR 279.51(a).
2.
Facility has determined that the used oil being stored at the site is not
hazardous waste - 10 CSR 25-11.279(1) incorporating 40 CFR 279.53.
3.
Follow and keep a written analysis plan at the facility - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.55.
4.
Maintained and operated to minimize the possibility of fire, explosion or any
unplanned release of used oil - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(1).
5.
Equipped with internal communication/alarm system, device capable of
summoning emergency assistance, fire control equipment and water at
adequate volume and pressure - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(2).
6.
Equipment tested and maintained - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(3).
7.
Access to communications or alarm system - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.52(a)(4).
8.
Facility has made attempts for arrangements with emergency response
agencies - 10 CSR 25-11.279(1) incorporating 40 CFR 279.52(a)(6).
9.
Facility has emergency coordinator on the facility premises or on call - 10 CSR
25-11.279(1) incorporating 40 CFR 279.52(b)(5).
MO 780-1521 (6-04)
B. USED OIL STORAGE
COMMENTS
1.
Tanks/containers exposed to precipitation closed - 10 CSR 25-11.279(2)(F)(5).
2.
Adequate aisle space is available - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(a)(5).
3.
Storage containers in good condition - 10 CSR 25-11.279(1) incorporating 40
CFR 279.54(b).
4.
Secondary containment for containers - 10 CSR 25-11.279(1) incorporating 40
CFR 279.54(c).
5.
Secondary containment system contains dike, berm or retaining wall and a
floor - 10 CSR 25-11.279(1) incorporating 40 CFR 279.54(c)(1)(i)(ii).
6.
Secondary containment system is sufficiently impervious to used oil - 10 CSR
25-11.279(1) incorporating 40 CFR 279.54(c)(2).
7.
Secondary containment system has capacity equal to or greater than 10
percent of the containerized waste volume or the volume of the largest
container - 10 CSR 25-11.279(2)(F)(2).
C. CONTINGENCY PLAN
1.
Contingency plan maintained for the facility - 10 CSR 25-11.279(1)
COMMENTS
incorporating 40 CFR 279.52(b)(1).
2.
Contingency plan describes actions facility personnel must take in response
to emergencies, such as fires, explosions - 10 CSR 25-11.279(1) incorporating
40 CFR 279.52(b)(2)(i).
3.
Contingency plan describes arrangements agreed to by emergency response
agencies - 10 CSR 25-11.279(1) incorporating 40 CFR 279.52(b)(2)(iii).
4.
Contingency plan list names, addresses and phone numbers of all people
qualified to act as emergency coordinator - 10 CSR 25-11.279(1) incorporating
40 CFR 279.52(b)(2)(iv).
5.
Contingency plan includes a list of all emergency equipment and
decontamination equipment - 10 CSR 25-11.279(1) incorporating 40 CFR
279.52(b)(2)(v).
6.
Contingency plan includes an evacuation plan - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.52(b)(2)(vi).
7.
Copy of contingency plan maintained at the facility and submitted to
local/state emergency response agencies - 10 CSR 25-11.279(1) incorporating
40 CFR 279.52(b)(3).
D. TRACKING (SHIPMENTS/ACCEPTANCE)
1.
Facility keeps records of each oil shipment accepted for processing/re-
COMMENTS
refining - 10 CSR 25-11.279(1) incorporating 40 CFR 279.56(a).
2.
Records include name and address of the transporter that delivered the used
oil to the refiner - 10 CSR 25-11.279(1) incorporating 40 CFR 279.56(a)(1).
3.
Records include the name and address of the generator/processor/refiner that
sent the used oil - 10 CSR 25-11.279(1) incorporating 40 CFR 279.56(a)(2).
4.
Records include the EPA identification number of the transporter that
delivered the used oil - 10 CSR 25-11.279(1) incorporating 40 CFR 279.56(a)(3).
5.
Records include the EPA number of the generator/processor/refiner that sent
the used oil - 10 CSR 25-11.279(1) incorporating 40 CFR 279.56(a)(4).
6.
Records include the quantity of used oil accepted - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.56(a)(5).
7.
Records include the date of acceptance - 10 CSR 25-11.279(1) incorporating 40
CFR 279.56(a)(6).
E. TRACKING (SHIPMENTS/DELIVERY)
COMMENTS
1.
Facility keeps records of each shipment of used oil from the facility to a used
oil burner, processor/re-refiner, or disposal facility - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.56(b).
2.
Records include name and address of transporter - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.56(b)(1).
3.
Records include name and address of the facility receiving the used oil - 10
CSR 25-11.279(1) incorporating 40 CFR 279.56(b)(2).
4.
Records include EPA identification number of transporter - 10 CSR 25-
11.279(1) incorporating 40 CFR 279.56(b)(3).
MO 780-1521 (6-04)
5.
Records include EPA identification number of facility receiving the used oil -
COMMENTS
10 CSR 25-11.279(1) incorporating 40 CFR 279.56(b)(4).
6.
Records include the quantity of used oil shipped - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.56(b)(5).
7.
Records include the date of shipment - 10 CSR 25-11.279(1) incorporating 40
CFR 279.56(b)(6).
8.
On and off-site shipment records maintained for at least three years - 10 CSR
25-11.279(1) incorporating 40 CFR 279.56(b)(7).
9.
Facility uses transporter that has obtained an EPA identification number - 10
CSR 25-11.279(1) incorporating 40 CFR 279.58.
F. OPERATING RECORD
1.
Written operating record at the facility - 10 CSR 25-11.279(1) incorporating 40
COMMENTS
CFR 279.57(a)(1).
2.
Operating record includes records and results of used oil analysis - 10 CSR
25-11.279(1) incorporating 40 CFR 279.57(a)(2)(i).
3.
Operating record includes summary reports and details of all incidents that
required the implementation of the contingency plan - 10 CSR 25-11.279(1)
incorporating 40 CFR 279.57(a)(2)(ii).
4.
Used oil processor/refiner report submitted on a biennial basis (March 1 of
each even numbered year) to the DNR - 10 CSR 25-11.279(1) incorporating 40
CFR 279.57(b).
CHECKLIST KEY

Check the
if in compliance.
Circle the
if not in compliance and provide comment.
N/A = Not Applicable.
A shaded item is a serious deviation from the requirements (Class I violation).
An unshaded item is a significant deviation from the requirements (Class II violation unless conditions warrant Class I).
COMMENTS
INSPECTOR’S SIGNATURE
DATE
MO 780-1521 (6-04)
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