"Commercial Hauler & Special Waste Hauler Registration Form" - New Mexico

Commercial Hauler & Special Waste Hauler Registration Form is a legal document that was released by the New Mexico Environment Department - a government authority operating within New Mexico.

Form Details:

  • Released on March 15, 2019;
  • The latest edition currently provided by the New Mexico Environment Department;
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Download "Commercial Hauler & Special Waste Hauler Registration Form" - New Mexico

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NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
MICHELLE LUJAN GRISHAM
JAMES C. KENNEY
P.O. Box 5469
Cabinet Secretary
Governor
Santa Fe, New Mexico 87502-5469
JENNIFER J. PRUETT
HOWIE C. MORALES
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
Deputy Secretary
Lt. Governor
www.env.nm.gov/swb
COMMERCIAL HAULER & SPECIAL WASTE HAULER
REGISTRATION FORM
In accordance with the Solid Waste Act (NMSA 1978, § 74-9-8.H) and the New Mexico Solid Waste Rules (20.9.3.31 NMAC),
commercial haulers and haulers of special waste shall register with the Department thirty (30) days prior to operations and every
five years thereafter. To register as a commercial hauler or hauler of special waste, complete this form providing all required
information. Assistance may be obtained by contacting the Solid Waste Bureau’s Permit Section at (505) 827-2328.
I .
GENERAL INFORMATION:
A .
LEGAL NAME OF TRANSPORTER:
NAME
NAME OF OWNER (
)
If different
DRIVER’S LICENSE NUMBER & STATE OF ISSUE (
)
If business is a proprietorship or partnership
MAILING ADDRESS: __________________________________________________
B.
C .
PHYSICAL STREET ADDRESS (
):
If different from the mailing address
D .
BUSINESS TELEPHONE:
E .
LOCAL REPRESENTATIVE AND TELEPHONE:
NAME
TELEPHONE
ADDRESS
CITY/STATE/ZIP CODE
Revised 3/15/2019
Page 1 of 6
NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
MICHELLE LUJAN GRISHAM
JAMES C. KENNEY
P.O. Box 5469
Cabinet Secretary
Governor
Santa Fe, New Mexico 87502-5469
JENNIFER J. PRUETT
HOWIE C. MORALES
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
Deputy Secretary
Lt. Governor
www.env.nm.gov/swb
COMMERCIAL HAULER & SPECIAL WASTE HAULER
REGISTRATION FORM
In accordance with the Solid Waste Act (NMSA 1978, § 74-9-8.H) and the New Mexico Solid Waste Rules (20.9.3.31 NMAC),
commercial haulers and haulers of special waste shall register with the Department thirty (30) days prior to operations and every
five years thereafter. To register as a commercial hauler or hauler of special waste, complete this form providing all required
information. Assistance may be obtained by contacting the Solid Waste Bureau’s Permit Section at (505) 827-2328.
I .
GENERAL INFORMATION:
A .
LEGAL NAME OF TRANSPORTER:
NAME
NAME OF OWNER (
)
If different
DRIVER’S LICENSE NUMBER & STATE OF ISSUE (
)
If business is a proprietorship or partnership
MAILING ADDRESS: __________________________________________________
B.
C .
PHYSICAL STREET ADDRESS (
):
If different from the mailing address
D .
BUSINESS TELEPHONE:
E .
LOCAL REPRESENTATIVE AND TELEPHONE:
NAME
TELEPHONE
ADDRESS
CITY/STATE/ZIP CODE
Revised 3/15/2019
Page 1 of 6
F .
HAS HAULER EVER TRANSPORTED WASTE UNDER ANOTHER NAME?
IF SO, GIVE PREVIOUS NAME(S), ADDRESS(ES), AND LENGTH OF TIME
DOING BUSINESS UNDER THAT NAME:
NAME
ADDRESS
LENGTH OF TIME
CONTACT PERSON, ADDRESS AND TELEPHONE NUMBER
(Complete if a
G .
person other than the local contact person should be NMED’s primary contact):
NAME
TELEPHONE
ADDRESS
CITY/STATE/ZIP CODE
H .
TYPE/CLASSIFICATION OF WASTE TO BE HAULED:
MSW
CONSTRUCTION & DEMOLITION ONLY
SPECIAL WASTE
(If checked, applicant must complete Section IV)
II.
INSURANCE
(Information in this section pertains only to vehicle liability insurance):
A.
NAME OF INSURANCE COMPANY:
B.
ADDRESS:______________________________________________________________
C .
POLICY NUMBER, AMOUNT OF LIABILITY INSURANCE & EFFECTIVE DATE:
III .
OPERATIONS:
A .
ANTICIPATED START DATE OF OPERATION
HOURS OF
,
(for new operators)
OPERATION AND DAYS OF COLLECTION:
ANTICIPATED START DATE
HOURS OF COLLECTION
DAYS OF COLLECTION
B .
MEANS OF CONTROLLING ODORS
(Describe methods to be used or attach a written plan):
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C .
NUMBER AND TYPE OF STORAGE CONTAINERS TO BE USED FOR
RESIDENCES, COMMERCIAL, INSTITUTIONAL AND INDUSTRIAL
ESTABLISHMENTS TO BE SERVED:
NUMBER
TYPE & SIZE OF CONTAINER(S)
D .
PHYSICAL LOCATION OF ALL EQUIPMENT, EMPTY CONTAINER OR
VEHICLE STORAGE YARDS IN NEW MEXICO:
E .
TRANSPORT DISTANCE FROM THE NEAREST AND FARTHEST POINTS OF
COLLECTION TO THE PRIMARY SOLID WASTE FACILITY:
F .
IDENTITY OF EACH SOLID WASTE FACILITY, COLLECTION CENTER OR
OTHER REGISTERED OPERATION RECEIVING SOLID WASTE FOR DISPOSAL
(Must include the facility’s permitted name, physical address, telephone, and state-
OR TRANSFER
issued permit or registration number – if necessary, attach an additional sheet):
STORAGE FACILITIES OPERATED AS PART OF THE APPLICANT’S
G.
COMMERCIAL OR SPECIAL WASTE HAULING OPERATIONS
(Commercial haulers
or haulers of special waste are not required to separately register storage or collection facilities that are part
of the hauler’s operations as long as the operational rate of the collection facility does not exceed 240 cubic
yards per day monthly average (including recyclable material); the collection facility does not serve the
general public, meaning that only waste collected by the applicant’s hauling operations may be stored at the
facility and the facility shall not be open to the public; and the facility’s operations are described and included
as part of the commercial hauler or hauler of special waste registration).
IF A STORAGE FACILITY IS PROPOSED, THE APPLICANT SHALL ATTACH
AN OPERATIONS PLAN AND A SITE MAP ADDRESSING THE FOLLOWING:
1 .
The Operations Plan shall, at a minimum, describe the exact physical location of
the storage area(s), the types of waste to be stored, on-site equipment (if any),
the method of storage and containment of the waste, the maximum length of
time such waste shall remain in temporary storage, and methods or procedures
that will be undertaken to preclude creation of a public nuisance, mitigate odors,
prevent litter and ensure that the operational limit of 240 cubic yards per day is
maintained. Haulers of special waste shall describe in detail how the special
Page 3 of 6
waste will be managed, containerized, labeled, manifested and reloaded (if
applicable) for disposal or treatment to ensure sufficient protection of public
health and the environment.
Operations Plan Attached
2 .
The Site Map does not have to be drawn to scale, but it shall, at a minimum,
indicate the zoning of the facility and the surrounding area, all storage, loading
and unloading areas, fencing and gates, signage (if any), entrances/exits and
roadways, buildings and the specific location of all solid waste, special waste or
recyclables storage areas.
Site Map Attached
COLLECTION VEHICLES AND TRAILERS:
H .
NUMBER
TYPE OF VEHICLE & TRAILER
(Include the year, make, model, size or
maximum cubic yards per vehicle/trailer, and indicate the type of cover system – if
necessary, attach an additional sheet):
I.
STREET ADDRESS & ZONING OF VEHICLE MAINTENANCE YARD:
J.
TRANSPORT/TRANSFER REQUIREMENTS FOR SPECIAL WASTE HAULERS
(Indicate necessary special handling, transportation and disposal requirements for the special waste):
K .
IDENTIFY TRAINING PROVIDED FOR DRIVERS AND CREW FOR
DIFFERENTIATING BETWEEN HAZARDOUS WASTE, SPECIAL WASTE AND
OTHER SOLID WASTE
(Attach a copy of your training manual or outline, which must be signed
& dated by the hauler’s owner or authorized representative).
Training Attached
CERTIFICATION OF LICENSE AND REGISTRATION REQUIREMENTS FOR
L .
DRIVERS, VEHICLES AND TRAILERS
(Attach copies of current driver’s licenses, vehicle
registrations, and trailer registrations OR attach a signed, dated letter identifying the drivers/vehicles/
trailers and certifying that they are, and will continue to be, properly licensed or registered).
Certification Attached
Page 4 of 6
IV.
SPECIAL WASTE HAULERS:
A CONTINGENCY PLAN, INCLUDING A LIST OF THE CLEAN UP KIT
A.
CONTENTS,MUST BE SUBMITTED AT THE TIME OF APPLICATION. A COPY
OF THE APPROVED CONTINGENCY PLAN AND THE ACTUAL CLEAN UP
KIT MUST BE KEPT WITHIN EACH COLLECTION VEHICLE DURING
HAULING OPERATIONS.
ALL SPECIAL WASTE HAULERS MUST COMPLETE THE FOLLOWING
(Please
B.
check the types of special waste to be transported):
1.
Treated Formerly Characteristic Hazardous Wastes (TFCH)
2.
Packing House and Killing Plant Offal
3.
Regulated Asbestos Waste
4.
Ash
5.
Infectious Waste
6 .
Sludge
7 .
Industrial Solid Waste
8 .
[ Reserved ]
9 .
Spill of a Chemical Substance or Commercial Product
10 .
Petroleum Contaminated Soils
11 .
Oil Conservation Division (OCD) Wastes
12 .
Other (
):
Specify
V.
CERTIFICATIONS :
A .
I CERTIFY THAT THE APPROVED WASTE IDENTIFICATION TRAINING
PROGRAM WILL BE IMPLEMENTED
(Section III-K):
INITIALS
NOT
IF APPLICANT IS
A PUBLIC ENTITY OR A PUBLICLY HELD
B.
CORPORATION, HAVE ANY OF THE OWNER(S) OR OPERATOR(S) EVER
BEEN FINED FOR VIOLATION OF ANY ENVIRONMENTAL LAWS OF ANY
YES
NO
STATE OR THE UNTIED STATES?
INITIALS
INITIALS
IS
IF APPLICANT
A PUBLIC ENTITY OR A PUBLICLY HELD CORPORATION,
C.
HAVE ANY OF THE OWNER(S) OR OPERATOR(S) BEEN FINED FOR
VIOLATION OF ANY ENVIRONMENTAL LAWS WITHIN THE STATE OF NEW
MEXICO WITHIN THE LAST FIVE (5) YEARS? YES
NO
INITIALS
INITIALS
NOT
IF APPLICANT IS
A PUBLIC ENTITY OR A PUBLICLY HELD
D.
CORPORATION, HAVE ANY OF THE OWNER(S) OR OPERATOR(S) EVER HAD
ANY PERMIT OR REGISTRATION REVOKED OR PERMANENTLY
SUSPENDED FOR CAUSE UNDER ENVIRONMENTAL LAWS OF ANY STATE
OR THE UNITED STATES? YES
NO
INITIALS
INITIALS
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