Form 26R – Fill Out and Use This PDF

The Form 26R, officially known as the Chemical Analysis of Residual Waste Annual Report by the Generator, is a requisite document mandated by the Commonwealth of Pennsylvania Department of Environmental Protection Bureau of Waste Management. This document must be filled out comprehensively and accurately, detailing the chemical properties of the residual waste produced by a company within a year, alongside descriptions of the waste production and disposal processes. It serves a critical role in regulating waste management practices, ensuring environmental protection measures are strictly followed. To streamline the completion of your annual waste reporting duties, click on the button below for a simplified Form 26R submission process.

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Form 26R PDF Details

Focused on promoting environmental responsibility and compliance, the Commonwealth of Pennsylvania leverages the Form 26R for a comprehensive peek into the management of residual waste. At its core, this form is an annual report mandated for generators of residual waste, put forth by the Department of Environmental Protection's Bureau of Waste Management. Not only does it require detailed client information, including company and contact specifics, but it also dives deep into the waste's characteristics, its generation, and subsequent storage locations. The form spans various sections, requiring a fine-grained description of the waste itself, including its physical state, appearance, and a meticulous chemical analysis. Beyond the surface-level details, it delves into the processes that produce the waste, coupled with schematics and descriptions, ensuring a robust understanding of its origin. Importantly, the Form 26R also navigates through the waste's lifecycle post-generation - detailing the processing or disposal facilities involved and exploring opportunities for beneficial reuse. Certification at the document's conclusion underscores the importance of accuracy and truthfulness, highlighting the legal implications tied to the report. This measure not only underscores the state's commitment to environmental stewardship but also ensures that waste generators are held accountable for the comprehensive tracking and responsible management of residual waste.

Question	Answer
Form Name	Form 26R
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	26r form padep, form 26r dep, pa dep 26r, form 26r padep fillable form

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2540-PM-BWM0347

Rev. 1/2011

COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

BUREAU OF WASTE MANAGEMENT

FORM 26R

CHEMICAL ANALYSIS OF RESIDUAL WASTE

ANNUAL REPORT BY THE GENERATOR

This form must be fully and accurately completed. All required information must be

DEP USE ONLY

typed or legibly printed in the spaces provided. If additional space is necessary, identify

Date Received & General Notes

each attached sheet as Form 26R, reference the item number and identify the date

prepared. The date on attached sheets needs to match the date noted below.

General Reference 287.54

Date Prepared/Revised

SECTION A. CLIENT (GENERATOR OF THE WASTE) INFORMATION

Company Name

If a Subsidiary, Name of Parent Company

EPA Generator ID#

Company Mailing Address Line 1

Company Mailing Address Line 2

Company Address Last Line – City

State

Zip+4

Phone

Ext

Company Contact Last Name

First Name

Suffix

Municipality

County

Contact Phone

Ext

Contact Email Address

Is the waste generated at the Company Mailing Address (noted above)?

Yes

If ‘No’, describe location of waste generation and storage.

Municipality

County

State

SECTION B. WASTE DESCRIPTION

Residual

Residual Waste

Unit of

Time

Waste Code

Code Description

Amount

Measure

Frame

cu yd

gal

ton

One Time

1. GENERAL PROPERTIES

pH Range

(based on analyses or knowledge)

Physical State

Liquid Waste (EPA Method 9095)

Solid (EPA Method 9095)

Gas (ambient temperature & pressure)

Physical Appearance

Color

Odor

Number of Solid or Liquid Phases of Separation

Describe each phase of separation.

2. CHEMICAL ANALYSIS ATTACHMENTS

The results of a detailed chemical characterization of the waste, as described in the

Yes

instructions, is attached.

A detailed description of the waste sampling method is attached.

Yes

The quality assurance/quality control procedures employed by the laboratory(ies) is

Yes

attached.

The results of the hazardous waste determination is attached.

Yes

If applicable, a detailed explanation supporting use of generator knowledge in

Yes

N/A

lieu of actual chemical analysis is attached.

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2540-PM-BWM0347 Rev. 1/2011

3. PROCESS DESCRIPTION & SCHEMATIC ATTACHMENTS

a.	A detailed description of the manufacturing and/or pollution control processes producing						Yes	No
	the waste, as specified in the instructions, is attached.

b.	A schematic of the manufacturing and/or pollution control processes producing the waste,						Yes	No
	as specified in the instructions, is attached.

c.	If portions of the information submitted are confidential, the substantiation for					Yes	No	N/A
	a confidentiality claim, as described in the instructions, is attached.

	SECTION C. MANAGEMENT OF RESIDUAL WASTE
		1. PROCESSING OR DISPOSAL FACILITY(IES)
The area below (a.-d.) will accommodate the identification of two facilities. Attach additional sheets if necessary.

a.	Solid waste permit number(s) for processing or disposal facility being utilized.

b.	Facility Name

	Address Line 1

	Address Line 1

	Address City State ZIP

	Municipality			County

c.	Facility Contact Name

	Title

	Phone			Email Address

d.	Volume of waste shipped to processing or disposal facility in the previous year.
		cu yd	gal	lb	ton	(check one)

a.	Solid waste permit number(s) for processing or disposal facility being utilized.

b.	Facility Name

	Address Line 1

	Address Line 1

	Address City State ZIP

	Municipality			County

c.	Facility Contact Name

	Title

	Phone			Email Address

d.	Volume of waste shipped to processing or disposal facility in the previous year.
		cu yd	gal	lb	ton	(check one)

			2. BENEFICIAL USE
a.	Has the waste been approved for beneficial use?						Yes	No
	If “Yes”, list the general permit number or approval number.

b.	Volume of waste beneficially used in the previous year.
		cu yd	gal	lb	ton	(check one)

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2540-PM-BWM0347 Rev. 1/2011

SECTION D. CERTIFICATION

I certify, under penalty of law, that I have personally examined and am familiar with the information submitted in this Annual Report and all attached documents and that based upon my inquiry of those individuals immediately responsible for obtaining the information, I verify that the submitted information is true, accurate and complete to the best of my knowledge. I understand that the submission of false information herein is made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities, which include fine and imprisonment.

Check the following, if applicable:

I certify the information required in Section B-1, General Properties was supplied to the Department for the year and has not changed.

Form Submitted:

Date Submitted:

Form 26R

Other (specify)

I certify the information required in Section B-2, Chemical Analysis was supplied to the Department for the year and has not changed.

Form Submitted:

Date Submitted:

Form 26R

Other (specify)

I certify the information required in Section B-3, Process Description and Schematic, was supplied to the Department

for the year

and has not changed.

Form Submitted:

Date Submitted:

Form 26R

Other (specify)

Name of Responsible Official		Title

Signature		Date

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Form 26R – Fill Out and Use This PDF

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