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Form Mo 780 1164 – Fill Out and Use This PDF

Form Mo 780 1164 is an essential document for conducting complicated financial transactions and proceedings in the State of Missouri. It serves as a reliable and legally binding agreement that allows parties involved in an organized transaction such as real estate, lending and borrowing money, or other commercial activities to prepare appropriately for legal proceedings. This document outlines important details pertaining to the agreed upon transaction including personal information protecting the parties involved, the designated transaction types, approved punishments if defaults occur, solvency stipulations, interest payments on principal investments, agreements to pay various fees associated with the transfer of funds or property rights, and many other particulars. This ensures both transactions operate fair and clear while preventing any legal reassessment that may be initiated ever after they take place. Form Mo 780 1164 provides many key elements allowing both transactioness to securely retreat into strong agreements thereby eliminating any fears or confusion that would otherwise cause opposition to organizing deals properly.

Form Mo 780 1164 PDF Details

In order to ensure that you are getting the most out of your solar energy investment, it is important to periodically have your system inspected and serviced by a professional. Form Mo 780 1164 is an inspection form used by the Missouri Department of Energy that solar energy system owners can use to schedule an inspection with their local MO Department of Energy approved contractor. In this post, we'll provide an overview of what's covered in Form Mo 780 1164 and how you can use it to keep your solar energy system running at its best.

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Form Name	Form Mo 780 1164
Form Length	8 pages
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Avg. time to fill out	2 min
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MISSOURI DEPARTMENT OF NATURAL RESOURCES

HAZARDOUS WASTE PROGRAM

NOTIFICATION OF REGULATED WASTE ACTIVITY

All new and reactivating registrations require a $100 initial fee. Registrations without this fee will not be processed. The fee is not required if only updating information to an existing and active registration. Form must be completed in its entirety, or it will be returned. Instructions are at the end of this form. Completed form should be sent to:

Hazardous Waste Program	or	Hazardous Waste Program
P.O. Box 176		1730 East Elm Street
Jefferson City, MO 65102 - 0176		Jefferson City, MO 65101-4130
573-751-3176
I. TYPE OF NOTIFICATION

A. NEW NOTIFICATION

B. SUBSEQUENT NOTIFICATION

EPA ID NUMBER

MISSOURI ID NUMBER

II. NAME OF INSTALLATION (BUSINESS NAME, SITE NAME OR D.B.A)

III. LOCATION OF INSTALLATION (PHYSICAL ADDRESS)

STREET

CITY

STATE

ZIP CODE + 4

COUNTY NAME

IV. INSTALLATION MAILING ADDRESS

STREET

CITY

STATE

ZIP CODE + 4

A. Billing Address (Fill this section out for a separate billing address. If left blank, fee invoices will be sent to mailing address)

STREET

CITY

STATE

ZIP CODE + 4

V. INSTALLATION CONTACT

FIRST NAME

E-MAIL ADDRESS

LAST NAME		TITLE

	TELEPHONE NUMBER WITH AREA CODE		EXTENSION

VI. OWNERSHIP

Note: Make copies of this section for multiple ownerships.

A. NAME OF INSTALLATION’S LEGAL OWNER

STREET, P.O. BOX OR ROUTE NUMBER

CITY		STATE		ZIP CODE + 4

TELEPHONE NUMBER WITH AREA CODE	EXTENSION	E. CHANGE OF INSTALLATION OWNER INDICATOR
		YES	NO DATE OF CHANGE:

C. INSTALLATION OWNER TYPE - MARK ONE

PRIVATE COUNTY

DISTRICT

FEDERAL

TRIBAL

MUNICIPAL

STATE

HOSPITAL

OTHER

D. NAME OF PROPERTY’S LEGAL OWNER

STREET, P.O. BOX OR ROUTE NUMBER

F. PROPERTY OWNER TYPE (MARK ONE)

PRIVATE

COUNTY

DISTRICT

FEDERAL

TRIBAL

MUNICIPAL

STATE

HOSPITAL

OTHER

MO 780-1164 (11-12)

Page 1 of 8

VII. TYPE OF REGULATED WASTE ACTIVITY (ONLY MARK THE FOLLOWING SECTIONS THAT APPLY)

A. Hazardous Waste Activities	B. Universal Waste Activities
1. Generator of hazardous waste (Choose only one of the following	1. Large quantity handler of universal waste (accumulate 5,000kg
four categories.)		or more). [Refer to Missouri regulations to determine what is
a. LQG: Greater than 1,000kg (2,220 lbs.) of non-acute		regulated.] Indicate types of universal waste managed or
hazardous waste or 1kg (2.2 lbs.) of acute hazardous waste		accumulated at your site. Check all boxes that apply.
in a calendar month.			MANAGE
b. SQG: Generate 100 to 1,000kg (220-2,220 lbs.) of non-		a.	Batteries
acute hazardous waste at any one time.		b.	Lamps
c. CESQG: Generate less than 100kg (220 lbs.) of hazardous		c.	Pesticides
waste in a calendar month and never accumulate 100kg		d.	Thermostats
(220 lbs.) or more of hazardous waste at any one time.		d.	Thermostats
(220 lbs.) or more of hazardous waste at any one time.		2. Destination facility for universal waste. Note: A hazardous
d. Not a generator. Generate no hazardous waste at any time.
	waste permit may be required for this activity.
	waste permit may be required for this activity.

In addition, indicate other generator activities.	C. Used Oil Activities (Check all boxes that apply)
e. United States importer of hazardous waste.	1.	Used oil transporter – Indicate types of activities.
e. United States importer of hazardous waste.
f. Mixed waste (hazardous and radioactive) generator.			a. Transporter
f. Mixed waste (hazardous and radioactive) generator.
			b. Transfer facility
For items 2 through 8, check all boxes that apply.
2. Transporter of hazardous waste.	2. Used oil processor or re-refiner – Indicate types of activities.
a. Transporter.			a. Processor
b. Transfer Facility (at your site).			b. Re-refiner
3. Treater, storer or disposer of hazardous waste (at your
site).	3.	Off-specification used oil burner
Note: A hazardous waste permit is required for this activity.
4. Recycler of hazardous waste (at your site).	4. Used oil fuel marketer – Indicate types of activities.
Note: A hazardous waste permit may be required for this			a. Marketer who directs shipment of off-specification used oil
activity.			to off-specification used oil burner.
5. Exempt boiler or industrial furnace.			b. Marketer who first claims the used oil meets the
a. Small quantity on-site burner exemption.			specifications.
b. Smelting, melting and refining furnace exemption.
6. Underground injection control.	D. E-Scrap Recycling Activities
7. Receives hazardous waste from off-site.	1.	E-Scrap Recycling
	1.	E-Scrap Recycling
8. Precious metals reclamation.

VIII. DESCRIPTION OF REGULATED WASTE ACTIVITY (USE ADDITIONAL SHEETS IF NECESSARY)

A. Waste Codes for Federally Regulated Hazardous Wastes. Please list the waste codes of the Federal hazardous wastes handled at your site. List them in the order they are presented in the regulations (e.g., D001, D003, F007, U112). For waste codes see 40 CFR 261.20 - 261.24 or 40 CFR 261.31 - 261.33. Use additional page if more spaces are needed for waste codes.

B. Waste Code for State-Regulated (e.g., non-Federal) Hazardous Waste. List the waste codes of the State-regulated hazardous wastes handled at your site. List them in the order they are presented in the regulations. Use additional page if more spaces are needed for waste codes.

IX. NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM (NAICS CODE(S)

Visit www.census.gov/eos/www/naics for NAICS code list.

DESCRIBE PRINCIPAL BUSINESS ACTIVITY

X. COMMENTS

XI. CERTIFICATION

I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment.

SIGNATURE (ORIGINAL INK REQUIRED)

NAME AND OFFICIAL TITLE (TYPE OR PRINT)

DATE SIGNED

MO 780-1164 (11-12)

Page 2 of 8

NAME OF INSTALLATION

EPA ID

XII. DESCRIPTION OF REGULATED WASTE CONTINUED (ADDITIONAL SHEET)

B. Listed Hazardous Waste. (See 40 CFR 261.31 - 33. Use this page only if you need to list more waste codes.)

SIGNATURE (ORIGINAL INK REQUIRED)

NAME AND OFFICIAL TITLE (TYPE OR PRINT)

DATE SIGNED

MO 780-1164 (11-12)

Page 3 of 8

Notification of Regulated Waste Activity Instructions

Note: All new registrations and reactivations require a $100 initial fee as stated in 260.380.1 (1), Revised Statutes of Missouri, or RSMO. Registrations without this fee will not be processed. The fee is not required if you are only updating information to an existing, active registration.

ITEM I. - TYPE OF NOTIFICATION

A. New Notification: Check this box if this is the first notification for the installation named in Section II of the form.

B. Subsequent Notification: If you are filing a subsequent notification enter your EPA ID number and MO ID number in the space provided.

Note: When the owner of a facility changes, the new owner must notify the department of the change, even if the previous owner already received an EPA ID number. Because the EPA ID number is 'site-specific,' the new owner will keep the existing ID number. If the facility moves to another location, the owner/operator must notify the department of this change. In this instance a new EPA ID number will be assigned, since the facility has changed locations. The same is true of a Missouri Generator ID number as for an EPA ID number.

ITEMS II. AND III. - NAME AND LOCATION OF INSTALLATION

Complete Items II and III. Note: The address you give for Item III, "Location of the Installation," must be a physical address, or

directional description (example: number of miles from a known junction, not a post office box or route number.)

County Name: Enter the county name for the site. If the county name is unknown, contact the local post office.

ITEM IV. - INSTALLATION MAILING ADDRESS

Enter the installation mailing address. This is the address all correspondence will be sent to. If the mailing address and the location of the installation (Item III) are the same, you can print "SAME" in the box for Item IV.

A. Billing Address: This section is only for those facilities that would like bills sent to a different address. If this section is left blank, all fee invoices will be sent to the Installation Mailing Address.

ITEM V. - INSTALLATION CONTACT

Enter the name, title, email address and business telephone number with area code of the person who should be contacted regarding information submitted on this form.

ITEM VI. – OWNERSHIP

A. Name of Installation's Legal Owner (Business Owner):

Enter the name of the legal owner(s) of the installation. Also enter the address and phone number where this individual can be reached. Make copies of this section for multiple ownerships.

B. Change of Installation Owner Indicator: If the owner of the installation (business) has changed since the facility's original notification, check the box marked "Yes" and enter the date that the owner changed.

C. Installation Owner Type: Check the box that best describes the legal status of the current business owner of the facility.

Note: The Ownership code for Hospitals may only be used if a facility is licensed under Chapter 197 of the RSMO.

D. Name of the Property's Legal Owner: Enter the name of the legal owner(s) of the property. Also enter the address and phone number where this individual can be reached. Make copies of this section for multiple ownerships. If the property owner and the installation's legal owner (Item VI.A.) are the same, you can print "SAME" in the box for item VI.D.

E. Change of Property Owner Indicator: If the owner of the property has changed since the facility's original notification, check the box marked "Yes" and enter the date that the owner changed.

F. Property Owner Type: Check the box that best describes the legal status of the current owner of the property.

ITEM VII. - TYPE OF REGULATED WASTE ACTIVITY

A. Hazardous Waste Activities: Check the boxes to show the hazardous waste activities at this installation.

1.a.-c. Generator: If you generate a hazardous waste that is identified by characteristic or listed in 40 CFR Part 261check the appropriate box for the quantity of nonacutely hazardous waste that would indicate the highest generation per month or accumulation at any one time. If you generate acutely hazardous waste, please refer to 40 CFR Part 262 and 10 CSR 25-5 for further information.

d. Not a Generator: Mark only if a.-c. do not apply but you are completing the form for another reason.

In addition to the above, check the following appropriate boxes to indicate other generator activities occurring at this site. (Mark all boxes that apply.)

MO 780-1164 (11-12)

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Notification of Regulated Waste Activity Instructions continued

d. United States Importer of Hazardous Waste: Check this box if you import hazardous waste from a foreign country into the United States. Refer to 40 CFR 262.260 for additional information.

e. Mixed Waste Generator: Check this box if you are a generator of mixed waste (waste that is both hazardous and radioactive). RCRA defines 'mixed waste' as waste that contains both hazardous waste and source, special nuclear, or by- product material subject to the Atomic Energy Act, or AEA, RCRA section 1004(41), 42 U.S.C 6903 (63 FR 17414; April 9, 1998).

2.Transporter of Hazardous Waste: Check this box if you transport hazardous waste within the United States and mark all that apply.

a.Transport: Mark if you transport hazardous waste within the United States. The federal regulations for hazardous waste transporters are found in 40 CFR Part 263.

b.Transfer facility: Mark if you hold manifested hazardous waste(s) at your site for a period of 10 days or less while the waste is in transit. The federal regulations for hazardous waste transfer facilities are found in 40 CFR Part 263.12.

3.Treater/Storer/Disposer: If you treat, store or dispose of regulated hazardous waste, check this box. You are reminded to contact your state to request Part A of the RCRA permit application. The federal regulations for hazardous waste facility owners/operators are found in 40 CFR Part 264 and 265; the State regulations are found in 10 CSR 25-7.

4.Recycler of Hazardous Waste: If you recycle regulated waste (recyclable materials), check this box. The federal regulations for owners or operators of sites that recycle hazardous waste are found in 40 CFR 261.6. A hazardous waste permit may be required for this activity. You may also be subject to other federal and state regulations.

5.Exempt Boiler or Industrial Furnace:

a.If you burn small quantities of hazardous waste in an on-site boiler or industrial furnace in accordance with the conditions in 40 CFR 266.108, check the box to indicate that you qualify for the small quantity on-site burner exception.

b.If you process hazardous wastes in a smelting, melting or refining furnace solely for metals recovery, as described in 40 CFR 266.100(d), or to recover economically significant amounts of precious metals, as described in 40 CFR 266.100(g), or if you process hazardous wastes in a lead recovery furnace to recover lead, as described in 40 CFR 266.100(h), check the box to indicate that you qualify for the smelting, melting and refining furnace exception.

6.Underground Injection Control: If you generate, treat, store, or dispose of hazardous waste and there is an underground injection well located at your site, check the box. The federal regulations for owners or operators of underground injections wells are found in 40 CFR Part 148.

7.Receives Hazardous Waste From Off-site: Check this box if you received hazardous waste from another site, whether this waste was received as a commercial transaction or waste received from a restricted group of off-site generators.

8.Precious Metals Reclamation: Check this box if you will be performing precious metals reclamation at your site.

B.Universal Waste Activities: Refer to 10 CSR 25-16.273 requirements and definitions for universal waste. Also refer to 40 CFR 261.9 and 40 CFR Part 273 for the Federal Regulations covering universal waste.

1.Large Quantity Handler of Universal Waste, or LQHUW: You are a large quantity handler if you accumulate a total of 5,000 kg or more of any universal wastes (calculated collectively) at any time. Check the appropriate boxes to indicate the types of universal wastes you generate and/or accumulate at your site. If your state has additional universal wastes, indicate what they are and check the corresponding boxes.

2.Destination Facility: Check this box if you treat, dispose of, or recycle universal wastes on site. A hazardous waste permit is required if you treat or dispose of universal wastes; a permit may be required if you recycle universal waste.

MO 780-1164 (11-12)

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Notification of Regulated Waste Activity Instructions continued

C. Used Oil Management Activities: Check the appropriate boxes to indicate which used oil fuel activities are taking place at this installation. The Federal regulations for used oil management are found in 40 CFR Part 279; the State regulations are found in 10 CSR 25-11.

1.Used Oil Transporter/Transfer Facility: If you transport used oil, or if the site you are registering is a used oil transfer facility, check the appropriate boxes to indicate your activity.

2.Used Oil Processor/Re-refiner: If you are processing or re-refining used oil at the facility which you are registering for, check the appropriate boxes to indicate your activity.

3.Off-Specification Used Oil Burner: If you burn used oil fuel, check the appropriate box.

4.Used Oil Marketer: If you market used oil fuel, check the appropriate boxes.

Note: Used oil generators are required to notify only if they are marketing directly to a burner.

D. E-Scrap Recycling Activities: Check this box if you are handling E-scrap at your site.

ITEM VIII. - DESCRIPTION OF REGULATED WASTE ACTIVITY

Only persons involved in hazardous waste activity (Item VII.A.1 & Item VII.A.8) need to complete this item.

Transporters requesting an EPA Identification number do not need to complete this item, but must mark A.2 and sign the 'Certification' in Item XI. You will need to refer to 40 CFR Part 261 and 10 CSR 25-4 in order to complete this section. Part 261 identifies those wastes EPA defines as hazardous. If you need help in completing this section, please contact the Hazardous Waste Program.

A.Federally Regulated Hazardous Wastes: If you handle hazardous wastes described in 40 CFR Part 261, enter the appropriate 4-digit code(s) in the boxes provided.

B.State-Regulated Hazardous Wastes: If you manage hazardous wastes that have a Missouri waste code, enter the appropriate codes in the boxes provided.

ITEM IX. - NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM, or NAICS, CODE(S)

Box A. Provide the North American Industry Classification System code that best describes your site's primary business production process for your products or services. Use the six digit code (most specific description) if available for your business; if not, use the five digit code; do not enter any codes with four or fewer digits.

Box B.-D. List other North American Industry Classification System codes that describe the primary business production process for your site. Use the most specific five or six digit codes available.

You can obtain North American Industry Classification System codes from the following sources:

North American Industry Classification System Online at www.census.gov/eos/www/naics and at some libraries.

Principal Business Activity - Enter a description of the activity that best typifies your business, (e.g., manufacture steel chairs and related products.)

ITEM X. – COMMENTS

Use this section as needed to provide additional information. You may attach additional sheets if needed.

ITEM XI. – CERTIFICATION

This certification must be signed by the owner, operator, or an authorized representative of your installation. An

'authorized representative' is a person responsible for the overall operation of the facility (e.g., a plant manager or superintendent or a person of equal responsibility). All notifications must include the certification to be complete.

Mail completed forms and $100 fee, if applicable, to:

Missouri Department of Natural Resources	or	Missouri Department of Natural Resources
Hazardous Waste Program		Hazardous Waste Program
1730 E. Elm		P.O. Box 176
Jefferson City, MO 65101-4130		Jefferson City, MO 65101

MO 780-1164 (11-12)

Page 6 of 8

Notification of Regulated Waste Activity Instructions continued

DEFINITIONS

The following definitions are included to help you to understand and complete the Notification Form:

ACT or RCRA means the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act of 1976, as amended by the Hazardous and Solid Waste Amendments of 1984, 42 U.S.C. Section 6901 et seq.

Authorized Representative means the person responsible for the overall operation of an installation or an operational unit (i.e., part of a facility). An authorized representative could be a superintendent or plant manager, or person of equivalent responsibility.

Boiler means an enclosed device using controlled flame combustion and having the following characteristics:

1.The unit has physical provisions for recovering and exporting energy in the form of steam, heated fluids or heated gases.

2.The unit's combustion chamber and primary energy recovery section(s) are of integral design (e.g., they are physically formed into one manufactured or assembled unit).

3.The unit continuously maintains an energy recovery efficiency of at least 60 percent, calculated in terms of the recovered energy compared with the thermal value of the fuel.

4.The unit exports and utilizes at least 75 percent of the recovered energy, calculated on an annual basis (excluding recovered heat used internally in the same unit, for example, to preheat fuel or combustion air or drive fans or feedwater pumps).

5.The unit is one which the Regional Administrator has determined on a case-by-case basis, to be a boiler after considering the standards in 40 CFR 260.32.

Burner means the owner or operator of any boiler or industrial furnace that burns hazardous waste fuel for energy recovery and that is not regulated as a RCRA hazardous waste incinerator.

Disposal means the discharge, deposit, injection, dumping, spilling, leaking or placing of any solid waste or hazardous waste into or on any land or water so that such solid waste or hazardous waste or any constituent thereof may enter the environment or be emitted into the air or discharged into any waters, including ground waters.

EPA Identification (ID) Number means the number assigned by EPA to each hazardous waste generator, hazardous waste transporter, and treatment, storage or disposal installation; large quantity handler of universal wastes; used oil transporter, used oil processor/re-refiner, off-specification used oil fuel burner and used oil fuel marketer.

E-Scrap Recycler means a person or group that engages in recycling of end-of-life electronic equipment; including but not limited to, computer equipment such as central processing units, laptop computers, computer monitors, and other cathode ray tubes.

Generator means any person, by site, whose act or process produces hazardous waste identified or listed in 40 CFR Part 261.

Hazardous Waste means a hazardous waste as defined in 40 CFR 261.3.

Industrial Furnace means any of the following enclosed devices that are integral components of manufacturing processes and that use controlled flame combustion to accomplish recovery of materials or energy: cement kilns, lime kilns, aggregate kilns (including asphalt kilns), phosphate kilns, coke ovens, blast furnaces, smelting, melting

and refining furnaces, titanium dioxide chloride process oxidation reactors, methane reforming furnaces, pulping liquor recovery furnaces, combustion devices used in the recovery of sulfur values from spent sulfuric acid and other devices as the Administrator may add to this list.

Installation means all contiguous land, structures, other appurtenances and improvements on the land, used for treating, storing or disposing of hazardous waste. An installation may consist of several treatment, storage or disposal operational units. (For entities that only transport regulated wastes, the term installation refers to the headquarters of that entity's operations.)

Large Quantity Universal Waste Handler means a universal waste handler who accumulates 5,000 kilograms or more of universal waste (batteries, pesticides, or thermostats, calculated collectively) at any time.

Municipality means a city, village, town, borough, county, parish, district, association, Indian tribe or authorized Indian tribal organization, designated and approved management agency under Section 208 of the Clean Water Act, or any other public body created by or under state law and having jurisdiction over disposal of sewage, industrial wastes or other wastes.

Off-Specification Used Oil Fuel means used oil fuel that does not meet the specification provided under 40 CFR 279.11.

On-Specification Used Oil Fuel means used oil fuel that meets the specification provided under 40 CFR 279.11.

Operator means the person responsible for the overall operation of an installation.

MO 780-1164 (11-12)

Page 7 of 8

Notification of Regulated Waste Activity Instructions continued

Owner means a person who owns an installation or part of an installation, including the property owner.

Precious Metals Reclamation means recycling and recovery of precious metals (i.e., gold, silver, platinum, palladium, iridium, osmium, rhodium, and ruthenium) from hazardous waste.

Storage means the holding of hazardous waste for a temporary period, at the end of which the hazardous waste is treated, disposed of, or stored elsewhere.

Transportation means the movement of hazardous waste by air, rail, highway or water.

Transporter means a person engaged in the off-site transportation of hazardous waste by air, rail, highway or water.

Treatment means any method, technique or process, including neutralization, designed to change the physical, chemical or biological character or composition of any hazardous waste to neutralize such waste, or to recover energy or material resources from the waste, or to render such waste nonhazardous or less hazardous so it is safer to transport, store or dispose of, or amenable for recovery, amenable for storage or reduced in volume. This includes any activity or processing designed to change the physical form or composition of hazardous waste so as to render it nonhazardous.

Universal Waste means batteries as described in 40 CFR 273.2, pesticides as described in 40 CFR 273.3 as modified by paragraph (2)(A)3. 10 CSR 25-16, mercury switches as described in subparagraph (2)(A)4.A. 10 CSR 25-16, thermostats as described in 40 CFR 273.4, as incorporated in 10 CSR 25-16, mercury containing thermometers and manometers as described in subparagraph (2)(A)4.B. 10 CSR 25-16 and mercury containing lamps as described in subparagraph (2)(A)4.C. 10 CSR 25-16.

Used Oil means any oil that has been refined from crude oil, or any synthetic oil, that has been used and as a result of such use, is contaminated by physical or chemical impurities.

Used Oil Fuel means any used oil burned (or destined to be burned) for energy recovery including any fuel produced from used oil by processing, blending or other treatment and that does not contain hazardous waste (other than that generated by a conditionally exempt small quantity generator and exempt from regulation as hazardous waste under provisions of 40 CFR 261.5). Used oil fuel may itself exhibit a characteristic of hazardous waste and remain subject to regulation as used oil fuel provided it is not mixed with hazardous waste.

Used Oil Processing means chemical or physical operations designed to produce from used oil, or to make used oil more amenable for production of, fuel oils, lubricants or other used oil derived products. Processing includes, but is not limited to: blending used oil with virgin petroleum products, blending used oils to meet the fuel specification, filtration, simple distillation, chemical or physical separation, and re-refining.

Used Oil Processor means an installation that processes on- or off-specification used oil.

Used Oil Re-refiner means an installation that produces lubricating oils and greases, industrial fuel, asphalt extender, gasoline and other products from on- or off-specification used oil.

Utility Boiler means a boiler that is used to produce electricity, steam or heated or cooled air or other gases or fluids for sale.

Waste Fuel means hazardous waste fuel or off-specification used oil fuel.

MO 780-1164 (11-12)

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2. Your next part is to complete these blanks: V INSTALLATION CONTACT FIRST NAME, LAST NAME, TITLE, EMAIL ADDRESS, TELEPHONE NUMBER WITH AREA CODE, EXTENSION, VI OWNERSHIP Note Make copies of, STREET PO BOX OR ROUTE NUMBER, CITY, TELEPHONE NUMBER WITH AREA CODE, EXTENSION, C INSTALLATION OWNER TYPE MARK ONE, STATE, ZIP CODE, and E CHANGE OF INSTALLATION OWNER.

3. The following section is all about VII TYPE OF REGULATED WASTE, B Universal Waste Activities, a LQG Greater than kg lbs of, hazardous waste or kg lbs of, or more Refer to Missouri, b SQG Generate to kg lbs of non, acute hazardous waste at any one, c CESQG Generate less than kg lbs, waste in a calendar month and, d Not a generator Generate no, In addition indicate other, e United States importer of, For items through check all, Transporter of hazardous waste, and Lamps - fill in all of these fields.

Always be really mindful while filling in Lamps and B Universal Waste Activities, since this is where many people make some mistakes.

4. This specific part comes next with the next few empty form fields to focus on: VIII DESCRIPTION OF REGULATED, B Waste Code for StateRegulated eg, IX NORTH AMERICAN INDUSTRY, DESCRIBE PRINCIPAL BUSINESS, X COMMENTS, XI CERTIFICATION, I certify under penalty of law, NAME AND OFFICIAL TITLE TYPE OR, and DATE SIGNED.

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ZIP CODE + 4

TELEPHONE NUMBER WITH AREA CODE

E. CHANGE OF PROPERTY OWNER

DATE OF CHANGE: