Tompkins County Solid Waste Management Division

122 Commercial Ave., Ithaca, NY 14850

Telephone # 273-6632 or Email pcowles@tompkins-co.org

UNIVERSAL WASTE APPLICATION

for conditionally Exempt small quantity generators (CESQG)

To use Tompkins County’s Household Hazardous Waste Management Facility (DEPOT)

Please read first: State and federal laws exempt some commercial hazardous waste generators from strict waste management regulations, based on the amount of hazardous waste generated and stored. To be considered a conditionally exempt small quantity generator (CESQG), you must:

Produce less than 220 pounds or 28 gallons (100 kilograms) – approximately ½ of a 55-gallon drum of hazardous waste (“hazwaste”) in any given month; or no more than and about 2.2 pounds or 1 kilogram, of acutely hazardous waste in any calendar month.

You must also never accumulate more than 2,200 pounds (1,000 kilograms) – approximately 5 drums of hazwaste on your property.

For assistance in determining your eligibility as an exempt generator, please call either the New York State Department of Environmental Conservation at 800-452-1925 or the Tompkins County Solid Waste Management Division (TCSWMD) at 273-6632.

Once CESQG status is established, complete the application below and send it to: ATTENTION: HHWMF, 122 Commercial Ave., Ithaca, NY 14850, or email it to: pcowles@tompkins-co.org

Generator /Company /Organization Name	Business Type

Address	City	State	Zip

Contact Person	Phone #	Fax #

E-mail Address	EPA ID #	Permit Number

I certify that the materials offered for disposal originated from a business, institution or farm classified as a conditionally exempt small quantity generator, as defined above and by 6NYCRR Part 372.1(e)(1)(I), from within Tompkins County, and are not from any residence or source other than defined above.

Print Name	Date

Signature	Title

4-2016