62-730.900. Forms


Effective on Wednesday, November 13, 2019
  • 1Forms are listed here by form number. Copies of all forms can be obtained on the internet 18at 19https://floridadep.gov/waste/permitting-compliance-assistance/content/forms-chapter-62-730-hazardous-waste 20or by contacting the 24Permitting and Compliance Assistance Program, 29MS 4500, Division of Waste Management, Department of Environmental Protection, 2600 Blair Stone Road, Tallahassee, Florida 32399-2400. In order to facilitate the initial submission of a complete application, applicants for hazardous waste permits are encouraged to use the Hazardous Waste Facility Permit Application Instructions, which provide guidance to the forms and assistance in assuring that the application complies with the provisions of 9140 C.F.R. Part 270 95and this chapter.

    98(1) Notification Forms.

    101(a) Application for Transfer of a Permit, January 29, 2006. [Form number 11362-730.900(1)(a)114]

    115(b) 8700-12FL – Florida Notification of Regulated Waste Activity, 12-2019 [Form number 12762-730.900(1)(b)128], which is adopted and incorporated by reference in paragraph 13862-730.150(2)(a), 139F.A.C.

    140(2) Application for a Hazardous Waste Facility Permit, which is adopted and incorporated by reference in paragraph 15762-730.220(2)(a), 158F.A.C.

    159(a) Application for a Hazardous Waste Permit Part I – General, 12-2019. [Form number 17362-730.900(2)(a)174]

    175(b) [reserved]

    177(c) Information Regarding Potential Releases from Solid Waste Management Units, 12-2019. [Form number 19062-730.900(2)(c)191]

    192(d) Application for a Hazardous Waste Facility Permit Certification, 12-2019. [Form number 20462-730.900(2)(d)205]

    206(3) Application for a Hazardous Waste Emergency EPA/DEP Identification Number, 4-23-13 [Form number 21962-730.900(3)220], which is adopted and incorporated by reference in paragraph 23062-730.161(2)(a), 231F.A.C.

    232(4) Hazardous Waste Financial Responsibility Forms, which are adopted and incorporated by reference in subsection 24762-730.180(6), 248F.A.C.

    249(a) Hazardous Waste Facility Letter from Chief Financial Officer to Demonstrate Financial Assurance, 4-23-13. [Form number 26562-730.900(4)(a)266]

    267(b) Hazardous Waste Facility Letter from Chief Financial Officer to Demonstrate Financial Responsibility, 4-23-13. [Form number 28362-730.900(4)(b)284]

    285(c) Hazardous Waste Facility Corporate Guarantee to Demonstrate Financial Assurance, January 5, 1995. [Form number 30062-730.900(4)(c)301]

    302(d) Hazardous Waste Facility Corporate Guarantee for Liability Coverage, January 5, 1995. [Form number 31662-730.900(4)(d)317]

    318(e) Hazardous Waste Facility Trust Fund Agreement to Demonstrate Financial Assurance, January 5, 1995. [Form number 33462-730.900(4)(e)335]

    336(f) Hazardous Waste Facility Standby Trust Fund Agreement to Demonstrate Financial Assurance, January 5, 1995. [Form number 35362-730.900(4)(f)354]

    355(g) Hazardous Waste Facility Irrevocable Letter of Credit to Demonstrate Financial Assurance, January 5, 1995. [Form number 37262-730.900(4)(g)373]

    374(h) Hazardous Waste Facility Financial Guarantee Bond to Demonstrate Financial Assurance, January 5, 1995. [Form number 39062-730.900(4)(h)391]

    392(i) Hazardous Waste Facility Performance Bond to Demonstrate Financial Assurance, January 5, 1995. [Form number 40762-730.900(4)(i)408]

    409(j) Hazardous Waste Facility Insurance Certificate to Demonstrate Financial Assurance, January 5, 1995. [Form number 42462-730.900(4)(j)425]

    426(k) Hazardous Waste Facility Certificate of Liability Insurance (Primary Policy), January 5, 1995. [Form number 44162-730.900(4)(k)442]

    443(l) Hazardous Waste Facility Certificate of Liability Insurance (Excess/Surplus Policy), January 5, 1995. [Form number 45862-730.900(4)(l)459]

    460(m) Hazardous Waste Facility Endorsement (Primary Policy), January 5, 1995. [Form number 47262-730.900(4)(m)473]

    474(n) Hazardous Waste Facility Endorsement (Excess/Surplus Policy), January 5, 1995. [Form number 48662-730.900(4)(n)487]

    488(o) Hazardous Waste Facility Irrevocable Letter of Credit To Demonstrate Liability Coverage, January 29, 2006. [Form number 50562-730.900(4)(o)506]

    507(p) Hazardous Waste Facility Surety Bond To Demonstrate Liability Coverage, January 29, 2006. [Form number 52262-730.900(4)(p)523]

    524(q) Hazardous Waste Facility Trust Fund To Demonstrate Liability Coverage, January 29, 2006. [Form number 53962-730.900(4)(q)540]

    541(r) Hazardous Waste Facility Standby Trust Fund To Demonstrate Liability Coverage, January 29, 2006. [Form number 55762-730.900(4)(r)558]

    559(5) Hazardous Waste Transporter Financial Responsibility Forms, which are adopted and incorporated by reference in subsection 57562-730.170(2), 576F.A.C.

    577(a) Certificate of Liability Insurance Hazardous Waste Transporter and Used Oil Handler, 4-23-13. [Form number 59262-730.900(5)(a)593]

    594(b) Hazardous Waste Transporter Liability Endorsement, 4-23-13. [Form number 60362-730.900(5)(b)604]

    605(c) Hazardous Waste Transporter Liability Surety Bond, 4-23-13. [Form number 61562-730.900(5)(c)616]

    617(6) [reserved]

    619(7) [reserved]

    621(8) 622RCRA Subtitle C Site Identification and Hazardous Waste Report, 6316-18-18 [Form number 63462-730.900(8)635], which is adopted and incorporated by reference in subsection 64562-730.150(3), 646F.A.C.

    647Rulemaking Authority 649120.53, 650403.061, 651403.0611 FS. 653Law Implemented 655120.52, 656120.53, 657120.55, 658403.0611, 659403.0875, 660403.7234 FS. 662History–New 11-30-82, Amended 4-1-83, 5-5-83, 8-21-83, 3-1-84, 5-31-84, 9-17-84, 10-29-84, 2-11-85, Formerly 17-1.207(1), (3)-(6), Amended 2-6-86, 4-8-86, 9-23-87, Formerly 17-30.401, Amended 6-28-88, 12-12-88, Formerly 17-30.900, Amended 7-3-89, 8-13-90, 9-10-91, 10-14-92, 10-7-93, Formerly 17-730.900, Amended 1-5-95, 10-10-02, 1-29-06, 4-22-07, 10-28-08, 1-4-09, 4-23-13, 6-18-18, 11-13-19.