Form TCEQ-0757 "One-Time Shipment Request for Texas Waste Code (Ots) (For Shipments of Hazardous and/or Class 1 Waste From a Nonregistered or Inactive Generator)" - Texas

What Is Form TCEQ-0757?

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

Form Details:

  • Released on January 1, 2014;
  • The latest edition provided by the Texas Commission on Environmental Quality;
  • 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 Form TCEQ-0757 by clicking the link below or browse more documents and templates provided by the Texas Commission on Environmental Quality.

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Download Form TCEQ-0757 "One-Time Shipment Request for Texas Waste Code (Ots) (For Shipments of Hazardous and/or Class 1 Waste From a Nonregistered or Inactive Generator)" - Texas

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IHW GE/_______________________/CO/
/OTS
Texas Commission on Environmental Quality
One-Time Shipment Request for Texas Waste Code (OTS)
(For Shipments of Hazardous and/or Class 1 Waste from a Nonregistered or Inactive Generator)
Part 1: Owner of Waste and Generating Site Information
Reason for Request: (Check one)
New One-Time Texas Waste Code Request
Update One-Time Texas Waste Code
Current Registration Information: (If your facility is registered with any TCEQ program,
provide the CN and RN numbers below. If your facility has an inactive SWR Number, provide the
numbers below. If your facility has an active SWR you cannot use this form; complete Form 00002,
Part II, to update your Notice of Registration.)
Solid Waste Registration Number (SWR):
EPA Identification Number:
Customer Reference Number CN:
Regulated Entity Number RN:
OTS Site Information: (Physical address of the location where the waste was generated)
Site Name:
Site Address:
City:
State:
Zip:
Zip+4:
County:
Site Land Type: (Check one)
Private
Tribal
County
Municipal
District
State
Federal
Other:
TCEQ-0757 (Rev. 01/01/2014)
IHW GE/_______________________/CO/
/OTS
Texas Commission on Environmental Quality
One-Time Shipment Request for Texas Waste Code (OTS)
(For Shipments of Hazardous and/or Class 1 Waste from a Nonregistered or Inactive Generator)
Part 1: Owner of Waste and Generating Site Information
Reason for Request: (Check one)
New One-Time Texas Waste Code Request
Update One-Time Texas Waste Code
Current Registration Information: (If your facility is registered with any TCEQ program,
provide the CN and RN numbers below. If your facility has an inactive SWR Number, provide the
numbers below. If your facility has an active SWR you cannot use this form; complete Form 00002,
Part II, to update your Notice of Registration.)
Solid Waste Registration Number (SWR):
EPA Identification Number:
Customer Reference Number CN:
Regulated Entity Number RN:
OTS Site Information: (Physical address of the location where the waste was generated)
Site Name:
Site Address:
City:
State:
Zip:
Zip+4:
County:
Site Land Type: (Check one)
Private
Tribal
County
Municipal
District
State
Federal
Other:
TCEQ-0757 (Rev. 01/01/2014)
OTS Owner Information: (Owner or Generator of the one-time waste)
Owner Type: (Check one)
City Government
General Partnership
Corporation
Individual
County Government
Limited Partnership
Federal Government
State Government
Other:
Owner Legal Name: (If owner is an individual, print first name, last name, i.e., John Smith)
Owner Tax Information:
TX State Franchise Tax ID (11-digits):
Federal Tax ID (9-digits):
TX SOS Filing Number:
Primary NAICS Code: (5 0r 6 digits)
(North American Industrial Classification System. For a list of NAICS codes go to:
www.census.gov/epcd/www/naicscod.htm )
OTS Owner or Generator Contact Information:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip:
Zip+4:
Telephone:
Ext:
Fax:
Email:
Broker or Environmental Consultant Information: (If there is no broker or consultant, leave
blank.)
Company Name:
Contact Person’s First Name:
Contact Person’s Last Name:
Mailing Address:
City:
State:
Zip:
Zip+4:
Telephone:
Ext:
Fax:
Email:
Part 2: Waste Stream Information
TWC:
Official use only
Answer questions 1-4 for each nonhazardous waste code requested and questions 1-8 for each
hazardous waste code requested. The information needed to complete questions 1, 4, 5, and 7 can
be found in Part 3: Instructions. Copy this page as needed to request additional waste codes.
1. Form Code (3-digits):
2. Class Code: (Check one)
Hazardous
Class 1
3. Waste Description: (What the waste is and how it was generated. Example: Spent solvent
from degreasing operation in tool production. Waste is a mixture of mineral spirits and metal
shavings.)
4. Origin Code: (Check one)
1- Generated on site from product or
4- Received from off site and not recycled or
service activity
treated on site
2- Spill cleanup, equipment
5- Residual from onsite treatment, disposal or
decommissioning, or emergency
recycling of hazardous waste
removal by company
6- State, federal or locally funded cleanup
3- Derived from the onsite
7- Corrective action or closure
management of a nonhazardous
waste
5. Source Code (2-digits): G
(See Appendix B)
6. System Type Code (3-digits): H
(Only fill out System Type Code if you selected
Source Code G25 or Origin Code 5.) (See Appendix C)
7. NAICS Code (6-digits):
8. EPA Hazardous Waste Number (EHWN): (Provide all EHWNs that apply in the order of
greatest constituent first) (For a list of EPA EHWNs see 40 (CFR) Code of Federal Regulations,
Part 261, Subpart C at www.epa.gov/)
Part 3: Certification
I certify that the information submitted herein is complete and accurate to the best of my
knowledge.
Preparer’s Name (print)
Telephone Number
Preparer’s Company Name (print)
Preparer’s Signature
Date of Signature
,
If you have an additional waste stream
click the additional page button:
Additional Page
TCEQ-0757 (Rev. 01/01/2014)
Please do not fax these pages!
Part 4: Instructions and Appendices
You may mail or fax this form. If the form is faxed, do not mail a copy. Due to the U.S. EPA Cromerr
Rule, this form may not be submitted using email.
Fax: 512-239-6410 Phone: 512-239-6413
Mailing Address: Texas Commission on Environmental Quality
Permitting and Remediation Support Division
Registration and Reporting Section
PO Box 13087 MC 129
Austin TX 78711-3087
Reasons for expediting One-Time Shipment (OTS) forms:
All requests for expediting must be submitted in writing with the waste code request form.
1. Endangerment to human health or the environment.
2. Under a governmental order (i.e., Federal, State, County, etc.); copy of the order is required.
3. Financial duress: If results are not received within a specific time, the company will suffer
temporary/permanent close of business, bankruptcy, layoff of personnel, etc.
Do not use this form for the follow purposes:
This form cannot be used to add a waste stream to an ACTIVE generator’s Notice of Registration
(NOR).
Nonindustrial, nonhazardous waste generators should not use this form.
CESQG: a nonindustrial generator who generates less than 100 kilograms (26 ½ gal. or 220 lbs.)
of hazardous waste and less than 1 kilogram (about 1 quart) of acutely hazardous waste in any
calendar month (30 Texas Administrative Code (TAC) 335.78).
CESQG generators do not have a notification or reporting requirement and should manifest their
waste using the following information:
Solid Waste Registration Number = CESQG
EPA Identification Number = TXCESQG
Sequence Number of waste stream = CESQ + form code + class code (H or 1)
Example of 8-digit Texas Waste Code for CESQG = CESQ203H
APPENDIX A – FORM CODE LIST: This list has been modified for OTS. For a complete list, see
Appendix A of Form No. 00002, Instructions for Notification for Industrial or Hazardous Waste
Management form.
LAB PACKS—Lab packs of mixed wastes, chemicals, lab wastes
Code
Waste Description
001
Lab pack of old chemicals only
002
Lab pack of debris only
003
Mixed lab packs
004
Lab pack containing acute hazardous wastes
009
Other lab pack (Specify in Comments)
LIQUIDS—Inorganic and organic liquids
Inorganic Liquids: Waste that is primarily inorganic and highly fluid (e.g., aqueous), with low
suspended inorganic solids and low organic content
Code
Waste Description
101
Aqueous waste with low solvents
102
Aqueous waste with low other toxic organic
103
Spent acid with metals
104
Spent acid without metals
105
Acidic aqueous waste
106
Caustic solution with metals but no cyanides
107
Caustic solution with metals and cyanides
108
Caustic solution with cyanides but no metals
109
Spent caustic
110
Caustic aqueous waste
111
Aqueous waste with reactive sulfides
112
Aqueous waste with other reactive (e.g., explosives)
113
Other aqueous waste with high dissolved solids
114
Other aqueous waste with low dissolved solids
115
Scrubber water
116
Leachate
117
Waste liquid mercury
119
Other inorganic liquids (Specify in Comments)
198
Nonhazardous photographic chemical wastes
(inorganic)
199
Brine solution that could also bear the form code 113