The Louisiana Department of Environmental Quality requires industrial solid waste generators to assume accountability for their waste with transparent and accurate annual reporting, a responsibility encapsulated in the SW FSD 1 form. This essential document, serving as an Industrial Solid Waste Generator Annual Report, outlines a comprehensive stocktake of the waste generated from July 1 through June 30 of any given year, mandating its submission by the following August 1. It features several critical sections including site identification, agency interest number, the generator's name and address, contact information, and a detailed summary of the waste generated, including its code numbers, quantities (reported in wet-weight tons), and the identifiers of both collectors/transporters and disposers. Generators must certify the completeness and truthfulness of their reports, fully aware that misrepresentation could lead to severe penalties, including fines or imprisonment. This certification underscores the form's role in bolstering accountability and transparency in environmental stewardship. The reporting requirement aims to foster a more sustainable approach to industrial waste management by ensuring that the Office of Environmental Services, within specified deadlines, receives accurate data. Such vigilance supports the Louisiana Environmental Quality Act’s objectives, highlighting both the regulatory and enforcement capabilities of the Department to maintain environmental integrity. The form, therefore, stands as a crucial tool in the state's environmental regulatory framework, ensuring that industrial solid waste is tracked, managed, and disposed of responsibly.
| Question | Answer |
|---|---|
| Form Name | Form Sw Fsd 1 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | VII, seq, sw fsd 1, false |
July 1, _____ thru June 30, _______ |
Page______ of ______ |
LOUISIANA DEPARTMENT OF ENVIRONMENTAL QUALITY
INDUSTRIAL SOLID WASTE GENERATOR ANNUAL REPORT
(To Complete Please Refer to the Detailed Instructions)
1.Site Identification No. ___________________________________________
2.Agency Interest Number____________________________
3.Name of Generator __________________________________________________________________________
4.Mailing Address____________________________________________ Parish_________________________________
Physical Address
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5.Contact _________________________________________________ Telephone (_______) ______________________
6.SUMMARY OF INDUSTRIAL SOLID WASTE GENERATED THIS YEAR:
(If additional sheets are required, please provide your identification number and the date on each sheet)
INDUSTRIAL WASTE CODE
NUMBER
QUANTITY
COLLECTOR/
TRANSPORTER IDENTIFICATION NUMBER
DISPOSER
IDENTIFICATION NUMBER
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Total Amount |
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Generated |
7. |
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 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 fine and imprisonment.
Signature__________________________________________________________Date __________________________________
Name and Title___________________________________________________________________________________________
Print or type the name and title of the person signing the form
This report is to be submitted to the Office of Environmental Services (address below) no later than August 1 following the end of each reporting year. Failure to submit this report on or before August 1 following the end of each reporting year is a violation of LAC 33:VII.Subpart 1, and may result in enforcement action by the Department under the authority granted by the Louisiana Environmental Quality Act (the Act), La. R.S. 30:2001, et seq., and particularly by La. R.S. 30:2025(C), 30:2050.2 and 30:2050.3(B). The Department reserves the right to seek civil penalties in any manner allowed by law for each violation.
Waste Permits Division
Attn: SW Reports
P. O. Box 4313
Baton Rouge, LA
11/2011 |
July 1, _____ thru June 30, _______ |
Page______ of ______ |
INDUSTRIAL SOLID WASTE GENERATOR ANNUAL REPORT
Detailed instructions
The Solid Waste Generator Annual Report covers generation of waste for the period beginning July 1 and ending June 30 of each year. This is to be submitted by August 1 following the end of each year. Questions regarding the form may be directed to the Waste Permits Division at
1.Identification number: Indicate the facility identification number that has been assigned to the generator by the Administrative Authority. Also, enter the year in which the report applies.
2.Agency Interest Number: Indicate the facility identification number that has been assigned to the generator by the Administrative Authority.
3.Name of Generator: Enter the name of the entity reporting the industrial solid waste generated this year.
4.Mailing Address: Enter the mailing address for the facility, the parish location, the latitude (in degrees, minutes, seconds), the longitude (in degrees, minutes, seconds), and the datum used to obtain the latitude and longitude.
5.Contact: Enter the name of the person knowledgeable about the information submitted on the form and his/her telephone number.
6.Summary of Industrial Solid Waste Generated this Year: For each individual solid waste generated, list the Industrial waste code number (the number assigned to the waste by the Office of Environmental Services, Waste Permits Division), indicate the total amount of waste generated (in
Add up the amounts reported and enter the total in the Total Amount Generated box.
If additional sheets are required, please put your identification number and the date on each sheet. Also, add up the amounts reported on all pages and put the total in the Total Amount Generated box on the FIRST PAGE ONLY.
7. Certifi atio y sig ature: The legally authorized represe tative of the site’s operatio should sig
the form. Print or type the date, the name and the title of the person signing the form.
11/2011 |