DEP Form 62-730.900(3) "Application for a Hazardous Waste Emergency EPA/DEP Identification Number" - Florida

What Is DEP Form 62-730.900(3)?

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

Form Details:

  • Released on April 23, 2013;
  • The latest edition provided by the Florida Department of Environmental Protection;
  • 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 fillable version of DEP Form 62-730.900(3) by clicking the link below or browse more documents and templates provided by the Florida Department of Environmental Protection.

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Download DEP Form 62-730.900(3) "Application for a Hazardous Waste Emergency EPA/DEP Identification Number" - Florida

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FACILITY NAME _____________________________ FL
_______________ ISSUE DATE_____________
ISSUED BY_____________
FDEP USE ONLY
DATE RECEIVED_____________
NOT VALID AFTER_____________
PROCESSED BY_____________
COUNTY_____________
APPLICATION FOR A HAZARDOUS WASTE EMERGENCY EPA/DEP
IDENTIFICATION NUMBER
Complete the following information, make sure the form is signed by the generator, and send the original form to the
Hazardous Waste Compliance/Enforcement Section at the appropriate Florida Department of Environmental
Protection (FDEP) district office. Type or legibly write the information in ink.
Emergency I.D. numbers are generally issued only in the following circumstances, pursuant to Rule 62-730.161,
Florida Administrative Code (F.A.C.):
1. Emergency situations (e.g. spills);
2. Cleanup of an abandoned site;
3. One-time cleanup of a site that does not normally generate hazardous waste and will not foreseeably
generate hazardous waste in the future.
If the Department issues an emergency EPA/DEP I.D. number, you must submit legible copies of all signed and
returned manifests to the Hazardous Waste Compliance Section of the FDEP District office that issued the number
within 45 days of the last shipment of hazardous waste. If you generate more than 1000 kilograms of hazardous
waste in a calendar month, you must submit a biennial report as described in Rule 62730.160(5), F.A.C.
If you need an emergency EPA/DEP I.D. number for an emergency response situation, call the FDEP district office
with the information requested on this form and a number will be issued as quickly as possible
IMPORTANT: THE EMERGENCY EPA/DEP I.D. NUMBER IS NOT VALID BEYOND 60 DAYS OF THE
ISSUE DATE. [62-730.161(4)(d), F.A.C.]
A. Situation:
Person Requesting I.D.
Number:_____________________________________________________________________________________
Briefly describe the situation and state why you need an emergency EPA/DEP I.D. number:
B. Hazardous Waste Information:
(1) Waste
Description:___________________________________________________________________________________
(2) Fill in the table with the waste code(s) and amount(s), including the unit of measurement
EPA Waste Codes
Manifested Amount
UOM
Page 1 of 2
DEP Form 62-730.900(3), incorporated in Rule 62-730.161(2)(a), F.A.C., Effective Date 4-23-13
FACILITY NAME _____________________________ FL
_______________ ISSUE DATE_____________
ISSUED BY_____________
FDEP USE ONLY
DATE RECEIVED_____________
NOT VALID AFTER_____________
PROCESSED BY_____________
COUNTY_____________
APPLICATION FOR A HAZARDOUS WASTE EMERGENCY EPA/DEP
IDENTIFICATION NUMBER
Complete the following information, make sure the form is signed by the generator, and send the original form to the
Hazardous Waste Compliance/Enforcement Section at the appropriate Florida Department of Environmental
Protection (FDEP) district office. Type or legibly write the information in ink.
Emergency I.D. numbers are generally issued only in the following circumstances, pursuant to Rule 62-730.161,
Florida Administrative Code (F.A.C.):
1. Emergency situations (e.g. spills);
2. Cleanup of an abandoned site;
3. One-time cleanup of a site that does not normally generate hazardous waste and will not foreseeably
generate hazardous waste in the future.
If the Department issues an emergency EPA/DEP I.D. number, you must submit legible copies of all signed and
returned manifests to the Hazardous Waste Compliance Section of the FDEP District office that issued the number
within 45 days of the last shipment of hazardous waste. If you generate more than 1000 kilograms of hazardous
waste in a calendar month, you must submit a biennial report as described in Rule 62730.160(5), F.A.C.
If you need an emergency EPA/DEP I.D. number for an emergency response situation, call the FDEP district office
with the information requested on this form and a number will be issued as quickly as possible
IMPORTANT: THE EMERGENCY EPA/DEP I.D. NUMBER IS NOT VALID BEYOND 60 DAYS OF THE
ISSUE DATE. [62-730.161(4)(d), F.A.C.]
A. Situation:
Person Requesting I.D.
Number:_____________________________________________________________________________________
Briefly describe the situation and state why you need an emergency EPA/DEP I.D. number:
B. Hazardous Waste Information:
(1) Waste
Description:___________________________________________________________________________________
(2) Fill in the table with the waste code(s) and amount(s), including the unit of measurement
EPA Waste Codes
Manifested Amount
UOM
Page 1 of 2
DEP Form 62-730.900(3), incorporated in Rule 62-730.161(2)(a), F.A.C., Effective Date 4-23-13
FACILITY NAME _____________________________ FL
_______________ ISSUE DATE_____________
ISSUED BY_____________
FDEP USE ONLY
DATE RECEIVED_____________
NOT VALID AFTER_____________
PROCESSED BY_____________
COUNTY_____________
C. Generator Information:
(1) Facility for which I.D. number is requested (must be generation point):
(a) Facility Name: ________________________________________________________________
(b) Physical Address:
_______________________________________________________
City: _____________
________ State: _______________ Zip: _______________
(c) Phone Number: ______________________
(d) Contact Person: ____________ __________ E-Mail________
___________________
(2) Mailing Address (if different from above):
(a) Name: __________
_______________________________________________________
(b) Address:
_______________________________________________________________
City:
____________________ State: _______________ Zip: _________________
D. Shipment Information:
(1) Transporter Name:
______________________________________________________________
Transporter EPA I.D.
_____________________________________________________________
(2) Designated TSD Facility:
________________________________________________________
TSDF EPA I.D.:
________________________________________________________________
CERTIFICATION
I hereby certify that I am an authorized employee of the generator, and that the information in this application is
correct and complete to the best of my knowledge. I further certify that the emergency EPA/DEP I.D. number shall
be used only for the above hazardous wastes and their shipment unless I obtain prior FDEP approval to do
otherwise. I shall send a copy of the manifest to FDEP within 45 days of the last shipment of hazardous wastes. I
certify that the situation described in Section A is true. I understand that submission of false or incorrect information
or use of the emergency EPA/DEP I.D. number beyond 60 days from the date of issuance may result in enforcement
action.
_________________________________________________ ________________________________
Signature
Date
_________________________________________________ (_____)________________
Name (please print or type)
Telephone
Page 2 of 2
DEP Form 62-730.900(3), incorporated in Rule 62-730.161(2)(a), F.A.C., Effective Date 4-23-13
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