"Scrap Tire Facility Registration Application" - Ohio

Scrap Tire Facility Registration Application is a legal document that was released by the Ohio Environmental Protection Agency - a government authority operating within Ohio.

Form Details:

  • The latest edition currently provided by the Ohio Environmental Protection Agency;
  • 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 printable version of the form by clicking the link below or browse more documents and templates provided by the Ohio Environmental Protection Agency.

ADVERTISEMENT
ADVERTISEMENT

Download "Scrap Tire Facility Registration Application" - Ohio

Download PDF

Fill PDF online

Rate (4.4 / 5) 22 votes
Scrap Tire Facility Registration Application
Application Type
Check One:
New Facility
Amendment
If an amendment:
Registration Number: __ __ - __ __ __ - __ __ __ __ __
Section(s) Being Amended:
Facility Information
Emergency Contact(s)
Fire Contingency Plan
Facility Operator
Property Owner
Financial Assurance
Plan View Drawings
Closure Information
Applicant Information
This must be the Facility Owner or Operator and person who is completing the registration form.
Applicant Type:
Facility Owner
Facility Operator
Facility Owner/Operator
Name:
Phone Number:
Mailing Address:
City:
State/Province:
Zip:
Email:
Facility Type
Please check one
Scrap Tire Collection
Scrap Tire Storage – Class 2
Scrap Tire Recovery – Class 2
Mobile Scrap Tire Recovery
Facility Information
Name:
Phone Number:
Address:
City:
Zip:
County:
Latitude:
___ ___
___ ___ ___ ___ ___ ___
Longitude:
___ ___
___ ___ ___ ___ ___ ___
Local Health Department:
Note: If you do not know your local health department, you can look it up on line at www.odh.ohio.gov and then select Local Health
Dept. Alternately, you may also call the Ohio Department of Health at 614-466-3543.
Facility Operator Information
Name:
Phone Number:
Address:
City:
State/Province:
Zip:
Email:
1
Scrap Tire Facility Registration Application
Application Type
Check One:
New Facility
Amendment
If an amendment:
Registration Number: __ __ - __ __ __ - __ __ __ __ __
Section(s) Being Amended:
Facility Information
Emergency Contact(s)
Fire Contingency Plan
Facility Operator
Property Owner
Financial Assurance
Plan View Drawings
Closure Information
Applicant Information
This must be the Facility Owner or Operator and person who is completing the registration form.
Applicant Type:
Facility Owner
Facility Operator
Facility Owner/Operator
Name:
Phone Number:
Mailing Address:
City:
State/Province:
Zip:
Email:
Facility Type
Please check one
Scrap Tire Collection
Scrap Tire Storage – Class 2
Scrap Tire Recovery – Class 2
Mobile Scrap Tire Recovery
Facility Information
Name:
Phone Number:
Address:
City:
Zip:
County:
Latitude:
___ ___
___ ___ ___ ___ ___ ___
Longitude:
___ ___
___ ___ ___ ___ ___ ___
Local Health Department:
Note: If you do not know your local health department, you can look it up on line at www.odh.ohio.gov and then select Local Health
Dept. Alternately, you may also call the Ohio Department of Health at 614-466-3543.
Facility Operator Information
Name:
Phone Number:
Address:
City:
State/Province:
Zip:
Email:
1
Emergency Contact
Person(s) authorized to commit resources necessary for emergency response, equipment, material, and services for the facility.
Name:
Phone Number:
Address:
City:
State/Province:
Zip:
E-mail:
Note: If there is more than one Emergency Contact, please attach an additional sheet listing those contacts with the above information.
Property Owner Information
Name:
Phone Number:
Address:
City:
State/Province:
Zip:
Parcel Number(s):
All Property Owners must be included on this application. Please make additional entries for each Property Owner where the facility
is located. Please attach additional entries on a separate piece of paper if needed.
A certified copy of the title (i.e. a copy of the recorded deed with county, volume, and pages clearly identified) to the property on
which the facility is located must be enclosed with initial registrations or amendments where the business location has moved.
Notifications
Have notifications of the new facility been sent to the following Ohio EPA Divisions:
Division of Air Pollution Control
Division of Surface Water
Yes
No
Yes
No
If you answered no, you may want to contact Ohio EPA’s Office of Compliance Assistance and Pollution Prevention (OCAPP) to help
you determine if you need an air permit or a storm water permit. OCAPP provides free and confidential services to businesses that
need help with Ohio EPA compliance requirements. For more information, call (800) 329-7518 or visit http://epa.ohio.gov/ocapp.
Licensed Motor Vehicle Salvage Dealer
If you are a licensed motor vehicle salvage dealer (MVSD) under ORC Chapter 4738, please provide the following information:
MVSD License Number:
MVSD License Issue Date:
__ __ /__ __ / __ __ __ __
Name of MVSD License:
If an applicant is a MVSD under ORC Chapter 4738, then No Application Fee is required in accordance with ORC Section 3734.83.
Scrap Tire Collection Only
Describe any portable containers in which scrap tires shall be stored including the number and types of containers and capacity of each
container.
2
Security Measures and Vector Control
For all Scrap Tire Facilities
Please provide a narrative description of the security measures that will be used at the facility.
Please check this box if answers are attached on a separate piece of paper.
Please provide a narrative description of the method(s) used at the facility to control mosquitoes.
Please check this box if answers are attached on a separate piece of paper.
Scrap Tire Storage Class 2 & Scrap Tire Recovery Class 2
Maximum number of whole tires to be stored on site:
Maximum surface area to be used for the tire storage on site (in square feet):
Note: Plan view drawings are required; please see the Plan View Drawing section below for requirements.
a) Describe the equipment and methods to be used in the operation and maintenance of the facility. Include: performance
capabilities, scrap tire processing rates and specifications of each piece of powered equipment to be used for loading, unloading,
handling or processing scrap tires.
b) List proposed hours of operation.
c)
Describe inspection procedures to prevent any material other than scrap tires from being accepted at the facility. Include
descriptions of how tires mounted on wheel rims and the associated lead weights shall be segregated, stored, and managed for
recycling or proper disposal.
d) Describe all activities to be performed on the site, including but not limited to, receiving, unloading, handling, storing, compacting,
bailing, shredding, processing rates, order of operations, operational methods used to handle bulky and dusty materials, and any
other processing operations.
3
e) Describe measures used to control dust and erosion at the facility.
Scrap Tire Recovery Class 2 Only: Facilities must calculate their Daily Designed Input Capacity (DDIC), in Tons
and provide narrative describing the basis for the DDIC calculation:
The initial DDIC shall be calculated as an estimated average of the total daily processing amount for all operating days in each month,
expressed in weight. This amount shall be updated for each new licensing year to determine the need for an amendment. Updated
calculations shall be based on the amounts recorded in the facility’s operating log, expressed either by weight (for the facilities using
scales), number count, or volume per day. Use the conversion factors table between weight and volume or number in Appendix I of OAC
Rule 3745-27-61.
Financial Assurance
Scrap Tire Storage Class 2 & Scrap Tire Recovery Class 2
Calculations of the amount of financial assurance must be based on the cost of a third party to complete closure of the facility.
The financial assurance calculation shall be based on the maximum number of scrap tires and the maximum amount of scrap
tire material to be stored at the facility. Please use passenger tire equivalents to calculate the maximum number of scrap tires.
Total number of whole scrap tires (including
baled tires and rough tire shreds) currently
X
=
$1.00
stored plus those tires to be stored at the facility
or planned to be stored at the facility.
Total number of processed scrap tires
The cost for transportation and
X
=
(excluding baled tires and rough tire shreds
disposal at a scrap tire monocell
captured above) to be stored at the facility.
or monofill facility
All other processed scrap tires, manufacturing
by-products, and manufacturing residuals from
The cost of removal from the
X
=
scrap tires (including all component parts,
facility to a recycling or disposal
partially assembled, and fully assembled
facility
products made from scrap tires).
Financial Assurance required for Closure Costs. (sum of all boxes on the right)
$
For initial applications, an unexecuted draft of the financial assurance instrument must be submitted in this the application.
Financial Assurance
Mobile Scrap Tire Recovery
All mobile scrap tire recovery facilities shall submit to Ohio EPA – Division of Materials and Waste Management (DMWM) an executed
and funded financial assurance instrument(s) in the amount of no less than Fifty Thousand Dollars ($50,000) before issuance of the
initial registration certificate(s).
General
guidelines
for
all
financial
assurance
mechanisms
can
be
found
in
OAC
Rule
3745-25-15
(http://epa.ohio.gov/portals/34/document/currentrule/3745-27-15_current.pdf) The wording required for all financial assurance
forms
for
“instruments”
can
be
found
in
each
relevant
section
of
OAC
3745-27-17
(http://epa.ohio.gov/portals/34/document/currentrule/3745-27-17_current.pdf).
For renewal applications, ensure financial assurance is maintained an on file with the Ohio EPA – DMWM. The financial assurance
instrument(s) must be in the name of the business as stated above on this application.
4
Mobile Scrap Tire Recovery
Describe portable equipment to be used:
Describe processing methods to be used:
Calculate the Daily Designed Input Capacity (DDIC), in Tons and provide narrative describing the basis for the DDIC calculation:
The initial DDIC shall be calculated as an estimated average of the total daily processing amount for all operating days in each month,
expressed in weight. This amount shall be updated for each new licensing year to determine the need for an amendment. Updated
calculations shall be based on the amounts recorded in the facility’s operating log, expressed either by weight (for the facilities using
scales), number count, or volume per day. Use the conversion factors table between weight and volume or number in Appendix I of
OAC Rule 3745-27-61.
Plan View Drawing
For Scrap Tire Storage and Recovery only
The Plan View Drawing defines where material can be placed at the facility. Any changes to the location of the materials placement
area or boundary lines of the facility must be documented by submission of an amended scrap tire facility registration and a revised
Plan View Drawing.
Plan view drawings and detailed engineering plans must be submitted showing the following items inside the facility boundaries and
within 500 feet of the proposed processing facility:
Location of the property lines where the facility is to be located
Location and size limits of proposed portable scrap tire containers including maximum height of all scrap tire storage piles
Location and with of all fire breaks
Location and dimensions of all buildings, fencing, gates or structures, including the location and dimension of all domiciles in
the facility’s boundaries and within 500 feet of the facility’s boundaries
Location of all access roadways
Existing direction of flow and points of concentration of all surface water
Any berms and/or other structures that are required by OAC Rule 3745-27-62(C)(2-3), or to control run-off from the facility
in accordance with OAC Rule 3745-27-65(I)(2)(d)
Location of bridges, elevated trestles, elevated roadways, elevated railroads or electric power lines having voltage in excess
of 750 volts or that supply power to fire emergency systems
Limits of the regulatory floodplain
Plan view drawings must meet the following criteria:
a.
Minimum dimension of 24 inches by 36 inches
b. Scale with one inch equaling a maximum of 200 feet
c.
North arrow included
Letter(s) of Intent
5