"Annual Status Report" - New York

Annual Status Report is a legal document that was released by the New York State Department of Environmental Conservation - a government authority operating within New York.

Form Details:

  • The latest edition currently provided by the New York State Department of Environmental Conservation;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New York State Department of Environmental Conservation.

ADVERTISEMENT
ADVERTISEMENT

Download "Annual Status Report" - New York

Download PDF

Fill PDF online

Rate (4.7 / 5) 76 votes
Annual Status Report
Please refer to Part B of the Guidance for more details: 
http://www.dec.ny.gov/chemical/8769.html 
Facility Name –
EPA ID –
Contact Name at Facility -
Title of Contact –
Phone Number(s) –
Email Address –
Fax Number (optional) –
Date of Submission -
Check if your mailing address changed. If so, provide new address is comments box below.
Check if you hold a Part 373 permit for Treatment, Storage and Disposal.
Check if you are a generator of acute hazardous wastes.
Additional Comments (optional) ‐
Annual Status Report
Please refer to Part B of the Guidance for more details: 
http://www.dec.ny.gov/chemical/8769.html 
Facility Name –
EPA ID –
Contact Name at Facility -
Title of Contact –
Phone Number(s) –
Email Address –
Fax Number (optional) –
Date of Submission -
Check if your mailing address changed. If so, provide new address is comments box below.
Check if you hold a Part 373 permit for Treatment, Storage and Disposal.
Check if you are a generator of acute hazardous wastes.
Additional Comments (optional) ‐
Describe your progress in achieving your time schedule for implementing
technically feasible and economically practicable waste reduction
alternatives. If waste reduction alternatives are not implemented as
scheduled in your plan, please identify the reason an activity was not
implemented and include a reasonable revised time schedule for
implementing the waste reduction alternatives.
If your facility determines that any method of waste reduction chosen and
implemented is not achieving the degree of waste reduction anticipated,
notwithstanding commitments made in the original Hazardous Waste
Reduction Plan or Biennial Update, your facility may choose and
implement another waste reduction alternative more likely to achieve
waste reduction. Please explain such action below and account for such
action in your next Biennial Update.
REQUIRED TABLES
An excel document for tables 1 and 2 can be found to the left of
this page as an attachment. You may use this document, or attach
your own tables to this pdf while in "edit pdf" mode. Please click the
paperclip icon (or use the shortcut button below). Your excel tables
will save directly to this pdf.
Shortcut
Please check the boxes below once you have completed each table.
Table 1
Table 2
CERTIFICATION
This page should be signed and dated by at least one responsible official or senior staff
member. An additional signatory is optional.
“I am a senior facility manager or authorized facility signatory, and am fully authorized to commit 
financial and/or staff resources to implementing this HWRP. In addition, I am familiar with the 
requirements of Article 27, Section 0908 of the Environmental Conservation Law. Further, I have 
personally examined and am familiar with the information contained in this HWRP. The information 
contained in this HWRP is, to the best of my knowledge and based on reasonable inquiry, true, 
accurate, and complete." 
Optional: You may provide an additional signatory below.
Page of 4