"Solid Waste Landfill Annual Report" - Utah

Solid Waste Landfill Annual Report is a legal document that was released by the Utah Department of Environmental Quality - a government authority operating within Utah.

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Instructions for Completing Solid Waste Landfill Annual
Report Form
Review and complete each section of the form and respond to all questions. If a question does
not apply to your facility, please enter “NA” on the line for that question. If an email address is
available, please provide it. Closure and post-closure cost estimates must be adjusted to include
the 1.2% inflation factor, by multiplying 2020 cost estimates by 1.012.
Additional copies of the form can be obtained on the Division of Waste Management and
Radiation Control’s web page at
https://deq.utah.gov/waste-management-and-radiation-control/forms-division-of-waste-
management-and-radiation-control
or at
https://documents.deq.utah.gov/waste-management-and-radiation-control/solid-waste/
DSHW-2017-005940.pdf
Upon completion of the Solid Waste Landfill Annual Report, the form must be delivered
electronically, or by the U.S. Postal Service or a commercial carrier. Ensure that copies are
signed, and if delivering electronically, they should be scanned after signing or e-signed using a
secure digital signature application. Persons signing the report should have authority to sign for
the permit holder as designated in UAC R315-310-2(4). Forms that are not signed cannot be
accepted.
If delivering electronically, please email reports to:
dwmrcsubmit@utah.gov
If mailing the report, please send them to:
Ty L. Howard, Director
Division of Waste Management and Radiation Control
P.O. Box 144880
Salt Lake City, Utah 84114-4880
Instructions for Completing Solid Waste Landfill Annual
Report Form
Review and complete each section of the form and respond to all questions. If a question does
not apply to your facility, please enter “NA” on the line for that question. If an email address is
available, please provide it. Closure and post-closure cost estimates must be adjusted to include
the 1.2% inflation factor, by multiplying 2020 cost estimates by 1.012.
Additional copies of the form can be obtained on the Division of Waste Management and
Radiation Control’s web page at
https://deq.utah.gov/waste-management-and-radiation-control/forms-division-of-waste-
management-and-radiation-control
or at
https://documents.deq.utah.gov/waste-management-and-radiation-control/solid-waste/
DSHW-2017-005940.pdf
Upon completion of the Solid Waste Landfill Annual Report, the form must be delivered
electronically, or by the U.S. Postal Service or a commercial carrier. Ensure that copies are
signed, and if delivering electronically, they should be scanned after signing or e-signed using a
secure digital signature application. Persons signing the report should have authority to sign for
the permit holder as designated in UAC R315-310-2(4). Forms that are not signed cannot be
accepted.
If delivering electronically, please email reports to:
dwmrcsubmit@utah.gov
If mailing the report, please send them to:
Ty L. Howard, Director
Division of Waste Management and Radiation Control
P.O. Box 144880
Salt Lake City, Utah 84114-4880
LANDFILL ANNUAL REPORT
For Calendar year 2020
Administrative Information (
Please enter all the information requested below - type or print legibly)
Facility Name:
Facility Mailing Address:
(Number & Street, Box and/or Route)
City:
Zip Code:
County:
Permit No.:
Owner
Name:
Phone No.:(
)
Mailing Address:
(Number & Street, Box and/or Route)
City:
State: Utah
Zip Code:
Contact's Name:
Title:
Contact's Mailing Address:
Phone No.:(
)
Contact's Email Address:
Operator
(Complete this section only if the operator is not an employee of the Owner shown above)
Name:
Phone No.:(
)
Mailing Address:
(Number & Street, Box and/or Route)
City:
State: Utah
Zip Code:
Contact's Name:
Title:
Contact's Mailing Address:
Phone No.:(
)
Contact's Email Address:
Facility Type and Status
Class I
Class IIIb
Class V
Class II
Class IVa
Class VI
Class IIIa
Class IVb
Facility operates separate cells for C/D and municipal waste.
Yes
No
If facility was permanently closed during the year enter date closed:
Annual Disposal
Total tons received at facility for disposal:
Waste Type
Waste Origin
Total
Measurement
In-State
Out-of-State
Tons Cubic
Yards
Municipal
Industrial
1
C&D
1
C&D waste includes all waste going to a Class IV or VI landfill cell
Conversion Factor Used
None
From rules
Site Specific Conversion
:
(please list)
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Recycling
Material Recycled:
Tons
Cubic Yds.
(Material recycled should not be included in disposed tons reported. Report compost on separate form. Circle tons or yards)
Utah Disposal Fee (See Utah Code Annotated 19-6-119(6) and 19-6-119(7))
2020 Annual Disposal Fee Paid to State
Municipal, Industrial and
$
Annual Fee
$
C&D
(Fee for Disposal, Treatment, and Incineration @ $0.21 per ton – Transfer @ $0.11 per ton – Minimum yearly fee @ $500)
Landfill Capacity
Current Landfill Remaining Capacity
Tons:
Cubic Yards:
Years:
Acres:
Acres Currently Open:
Acres Currently Closed:
Financial Assurance
Current Closure Cost Estimate:
Current Post-Closure Cost Estimate:
Current Amount or Balance in Mechanism:
(If facility permit has been renewed if balance does not equal or exceed total for closure and post-closure care please
contact the Division)
Current Financial Assurance Mechanism:
(ie. Bond, Trust Fund, Corporate or government Test etc.)
Mechanism Holder and Account Number:
(ie. Name of Bond Company, Bank etc. Account number)
Financial Assurance: Each facility must recalculate the cost of closure and post-closure
care to account for inflation and design changes each year. The inflation factor can be
found on the Division web page. Facilities that are using a trust account should include a
copy of the most recent account statement.
Note
Facilities using “Local Government Financial Test” or the “Corporate Financial
Test” must provide the information required in R315-309-8(4) or R315-309-9(3)
each year.
Other Reports and Information
Ground Water Monitoring: Class I and V landfills only. Check if exempt
Explosive Gas Monitoring: Class I, II and V landfills only. Check if exempt
Training Report: A report of all training programs or procedures completed by facility
personnel during the year.
Does the facility have a landfill gas collection system Yes
No
If yes please
briefly describe use of gas, e.g., flared or used for electricity generation.
Signature:
Date:
Signature should be by an executive officer, general partner, proprietor, elected official, or a duly authorized representative. A duly authorized
representative must meet the requirements of the solid waste rules (UAC R315-310-2(4)(d)).
Print name:
Title:
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