2017FormRHolloman_LEAD_waste_materials_transferred_offsite.pdf

*** Draft Form Only: Do Not Submit to EPA *** Form Approved OMB Number:2025-0009 Approval Expires: 2018-06-30

EPA FORM R

United States Environmental Protection Agency

Section 313 of the Emergency Planning and Community Right-to-know Act of 1986, also known as Title III of the Superfund Amendments and Reauthorization Act.

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead

WHERE TO SEND

COMPLETED FORMS:

1. TRI Data Processing Center P.O. Box 10163 Fairfax, VA 22038 *** Draft Form Only: Do Not Submit to EPA ***

2. APPROPRIATE STATE OFFICE

(See instructions in Appendix F)

This section only applies if you are revising or withdrawing a previously submitted form, otherwise leave blank:

Revision (Enter up to two code(s))

Withdrawal (Enter up to two code(s))

Important: See Instructions to determine when "Not Applicable (NA)" boxes should be checked.

Part I. FACILITY IDENTIFICATION INFORMATION

SECTION 1. REPORTING YEAR : 2017

SECTION 2. TRADE SECRET INFORMATION

2.1 Are you claiming the toxic chemical identified on page 2 trade secret?

[ ] Yes (Answer question 2.2; attach substantiation forms) [ X ] NO (Do not answer 2.2; go to Section 3)

2.2 Is this copy

[ ] Sanitized [ ] Unsanitized (Answer only if "Yes" in 2.1)

SECTION 3. CERTIFICATION (Important: Read and sign after completing all form sections.)

I hereby certify that I have reviewed the attached documents and that, to the best of my knowledge and belief, the submitted information is true and complete and that the amounts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report.

Name and official title of owner/operator or senior management official: Signature: Date Signed:

Draft Form Only: Do Not Submit to EPA Draft Form Only: Do Not Submit to EPA XX/XX/XXXX

SECTION 4. FACILITY IDENTIFICATION

4.1 TRI Facility ID Number 88330HLLMNHWY70

Facility or Establishment Name

US DOD USAF HOLLOMAN AFB

Facility or Establishment Name

US DOD USAF HOLLOMAN AFB

Facility or Establishment Name or Mailing Address(if dif ferent f rom street address)

Street

HWY 70 10 MILES W OF ALAMOGORDO

Mailing Address (if dif ferent f rom physical street address) 550 Tabosa Avenue

City/County/Tribe/State/ZIP Code HOLLOMAN AFB / Otero / BIA Code: / NM / 88330

City/State/ZIP Code

HOLLOMAN AFB NEW MEXICO / NM / 88330

Country (Non-US)

4.2 This report contains information for :

( Important: check a or b; check c or d if applicable) a. [ ] An Entire facility b. [ X ] Part of a facility c. [ X ] A Federal facility d. [ ] GOCO

4.3 Technical Contact name ISAMAR NIEVES-CANCEL

Email Address

ISAMAR.NIEVES-CANCEL@US.AF.MIL

Telephone Number (include area code and ext.)

575-572-3931

4.4 Public Contact name 49TH WING PUBLIC

AFFAIRS

Email Address

49WG.PAOFFICE@US.AF.MIL

Telephone Number (include area code and ext.)

575-572-7575

4.5 NAICS Code(s) (6 digits) a. 928110

(Primary) b. c. d. e. f.

4.6 Dun and Bradstreet

Number(s) (9 digits)

a. NA b.

SECTION 5. PARENT COMPANY INFORMATION

5.1 Name of U.S. Parent Company (for TRI Reporting

purposes) US DEPARTMENT OF DEFENSE No U.S. Parent Company (for TRI

Reporting purposes) [ ]

5.2 Parent Company's Dun & Bradstreet Number NA [ X ]

EPA Form 9350-1 (Rev. 06/2014) - Previous editions are obsolete. Printed using TRIMEweb

EPA FORM R

PART II. CHEMICAL - SPECIFIC INFORMATION

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead SECTION 1. TOXIC CHEMICAL IDENTITY (Important: DO NOT complete this section if you are reporting a mixture component in Section 2 below.)

1.1 CAS Number (Important: Enter only one number exactly as it appears on the Section 313 list. Enter category code if reporting a chemical category.)

7439921

1.2 Toxic Chemical or Chemical Category Name (Important: Enter only one name exactly as it appears on the Section 313 list.)

Lead

1.3 Generic Chemical Name (Important: Complete only if Part I, Section 2.1 is checked "Yes". Generic Name must be structurally descriptive).

NA

SECTION 2. MIXTURE COMPONENT IDENTITY (Important: DO NOT complete this section if you completed Section 1.)

2.1 Generic Chemical Name Provided by Supplier (Important: Maximum of 70 characters, including numbers, spaces, and punctuation.)

NA

SECTION 3. ACTIVITIES AND USES OF THE TOXIC CHEMICAL AT THE FACILITY

(Important: Check all that apply.)

3.1 Manufacture the toxic chemical: 3.2 Process the toxic chemical: 3.3 Otherwise use the toxic chemical:

a. [ ] Produce b. [ ] Import

If produce or import:

c. [ ] For on-site use/processing

d. [ ] For sale/distribution

e. [ ] As a byproduct

f. [ ] As an impurity

a. [ ] As a reactant

b. [ ] As a formulation component

c. [ ] As an article component

d. [ ] Repackaging

e. [ ] As an impurity

a. [ ] As a chemical processing aid

b. [ ] As a manufacturing aid

c. [ X ] Ancillary or other use

SECTION 4. MAXIMUM AMOUNT OF THE TOXIC CHEMICAL ON-SITE AT ANY TIME DURING THE CALENDAR YEAR

4.1 [ 02 ] (Enter two-digit code from instruction package.)

SECTION 5.QUANTITY OF THE TOXIC CHEMICAL ENTERING EACH ENVIRONMENTAL MEDIUM ON-SITE A. Total Release (pounds/year*) (Enter range code or estimate**)

B. Basis of Estimate (Enter code) C. Percent from Stormwater

5.1 Fugitive or non-point

air emissions NA [ ] 0 O

5.2 Stack or point

air emissions NA [ X ]

5.3 Discharges to receiving streams or

water bodies (Enter one name per box) NA [ X ]

Stream or Water Body Name Reach Code (optional)

5.3.1 NA

*For Dioxin and Dioxin-like Compounds, report in grams/year EPA Form 9350-1 (Rev. 06/2014) - Previous editions are obsolete. **Range Codes: A=1-10 pounds; B=11-499 pounds; C=500-999 pounds.

PART II. CHEMICAL - SPECIFIC INFORMATION (CONTINUED)

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead SECTION 5. QUANTITY OF THE TOXIC CHEMICAL ENTERING EACH ENVIRONMENTAL MEDIUM ON-SITE (Continued)

NA A. Total Release (pounds/year*) (Enter range code** or estimate) B. Basis of Estimate (Enter code) 5.4-5.5 Disposal to land on-site

5.4.1 Class I Underground

Injection wells [ X ]

5.4.2 Class II-V Underground

Injection wells [ X ]

5.5.1.A RCRA subtitle C landfills [ X ]

5.5.1.B Other landfills [ X ]

5.5.2 Land treatment/application

farming [ X ]

5.5.3A RCRA Subtitle C surface impoundments [ X ]

5.5.3B Other surface impoundments [ X ]

5.5.4 Other disposal [ X ]

SECTION 6. TRANSFER(S) OF THE TOXIC CHEMICAL IN WASTES TO OFF-SITE LOCATIONS

6.1 DISCHARGES TO PUBLICLY OWNED TREATMENT WORKS (POTWs) NA [ X ]

EPA Form 9350-1 (Rev. 06/2014) - Previous editions are obsolete. **Range Codes: A=1-10 pounds; B=11-499 pounds; C=500-999 pounds.

PART II. CHEMICAL - SPECIFIC INFORMATION (CONTINUED)

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead

SECTION 6.2 TRANSFERS TO OTHER OFF-SITE LOCATIONS NA [ ]

6.2.1 Off-Site EPA Identification Number (RCRA ID No.) ALD981020894

Off-Site Location Name: Clean Earth of Alabama Off-Site Address: 402 WEBSTER CHAPEL ROAD

City GLENCOE County Etowah State AL ZIP 35905 Country (Non-US)

Is location under control of reporting facility or parent company? [ ] Yes [ X ] No

A. Total Transfer (pounds/year*) (Enter range code** or estimate)

B. Basis of Estimate (Enter code)

C. Type of Waste Treatment/Disposal/ Recycling/Energy Recovery (Enter code)

1 . 43.7 1 . O 1 . M64

SECTION 7A. ONSITE WASTE TREATMENT METHODS AND EFFICIENCY

[ X ] Not Applicable (NA) - Check here if no on-site waste treatment is applied to any waste stream containing the toxic chemical or chemical category.

a. General Waste Stream (enter code)

b. Waste Treatment Method(s) Sequence [enter 3-character code(s)]

c. Waste Treatment Efficiency Estimate

EPA Form 9350-1 (Rev. 06/2014) - Previous editions are obsolete. **Range Codes: A=1-10 pounds; B=11-499 pounds; C=500-999 pounds.

PART II. CHEMICAL - SPECIFIC INFORMATION (CONTINUED)

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead

SECTION 7B. ON-SITE ENERGY RECOVERY PROCESSES

[ X ] NA - Check here if no on-site energy recovery is applied to any waste stream containing the toxic chemical or chemical category.

Energy Recovery Methods [Enter 3-character code(s)]

SECTION 7C. ON-SITE RECYCLING PROCESSES

[ X ] NA - Check here if no on-site recycling is applied to any waste stream containing the toxic chemical or chemical category.

Recycling Methods [Enter 3-character code(s)]

SECTION 8. SOURCE REDUCTION AND WASTE MANAGEMENT

Column A Prior Year

(pounds/year*)

Column B Current Reporting

Year (pounds/year*)

Column C Following Year (pounds/year*)

Column D Second Following

Year (pounds/year*)

8.1 - 8.7 Production-Related Waste Managed

8.1a Total on-site disposal to Class I Underground Injection Wells, RCRA Subtitle C landfills, and other landfills

NA NA NA NA

8.1b Total other on-site disposal or other releases 0 0 0 0

8.1c Total off-site disposal to Class I Underground Injection Wells, RCRA Subtitle C landfills, and other landfills

46.7 43.7 40 40

8.1d Total other off-site disposal or other releases NA NA NA NA

8.2 Quantity used for energy recovery

on-site NA NA NA NA

8.3 Quantity used for energy recovery

off-site NA NA NA NA

8.4 Quantity recycled on-site NA NA NA NA

8.5 Quantity recycled off-site NA NA NA NA

8.6 Quantity treated on-site NA NA NA NA

8.7 Quantity treated off-site NA NA NA NA

8.8 Non-production-related waste managed** NA

8.9 [ ] Production ratio or [X] Activity ratio (select one and enter value to right) 1

8.10 Did your facility engage in any newly implemented source reduction activities for this chemical during the reporting year?

If so, complete the following section; if not, check NA.

NA [X]

Source Reduction Activities (Enter code(s)) Methods to Identify Activity (Enter code(s)) Estimated annual reduction

(Enter code(s)) (optional)

8.10.1 NA

EPA Form 9350-1 (Rev. 06/2014) - Previous editions are obsolete.

*For Dioxin and Dioxin-like Compounds, report in grams/year

** Includes quantities released to the environment or transferred off-site as a result of remedial actions, catastrophic events, or other one-time events not associated with production processes

TRI Facility ID Number

88330HLLMNHWY70

Toxic Chemical, Category, or Generic Name

Lead

Additional optional information on source reduction, recycling, or pollution control activities.

Section 8.11: If you wish to submit additional optional information on source reduction, recycling, or pollution control activities, provide it here.

Topic Comment

Section 9.1: If you wish to submit any miscellaneous, additional, or optional information regarding your Form R submission, provide it here.

Topic Comment