Instructions for Completing the Hazardous Waste Generator Reporting Form
Please read these instructions carefully before completing the reporting form. If you have questions
regarding the form, contact the Hazardous Materials Programs Office at (925) 335-3200.
The Hazardous Waste Generator Reporting Form is due to the Hazardous Materials Programs on or
before March 2, 2015. Forms postmarked after March 2, 2015, may be subject to a 50% late
fee. Do not send payments at this time. Retain a copy for your records. Businesses will receive a
single invoice for all applicable CUPA program fees.
Hazardous waste is defined as any waste that is listed or meets the criteria of toxicity, corrosivity,
ignitability, or reactivity as defined by the California Code of Regulations, Title 22, Chapter 11.
1. Determine the amount of hazardous waste shipped offsite at your business during the 2014
calendar year. Each site must complete a separate reporting form. Hazardous waste manifests,
consolidated manifests, receipts and bills of lading will provide you this information.
2. These guideline conversion factors may be used when calculating tonnage:
a) Number of gallons
b) Number of cubic yards
c) Number of pounds
X
X
÷
0.00417 tons / gallon
1.35 tons / cubic yard
2000 pounds
=
=
=
Number of tons
Number of tons
Number of tons
3. Enter the total tonnage of hazardous waste generated and shipped offsite.
4. Businesses producing any amount of hazardous waste must submit the Hazardous Waste
Generator Reporting Form. For example: A facility producing five gallons of hazardous waste in
calendar year 2012 must complete the reporting form.
5. Used oil is a hazardous waste in California. Used oil generated by your business is no longer
exempt from inclusion in the total tonnage of waste generated.
Businesses that collect used oil from the public under the CalRecycle Program have special
reporting rules. Please call CCHSHMP and speak with a Hazardous Materials Specialist for more
information.
6. Used oil filters and used fuel filters that are confirmed to be recycled, are exempt from fees.
Please call CCHSHMP and speak with a Hazardous Materials Specialist if you have questions.
7. By March 2, 2014 send the completed Hazardous Waste Generator Reporting Form, along with
your business’ other CUPA forms (Business Activity, Owner/Operator Information, etc.) to:
CONTRA COSTA HEALTH SERVICES-HAZARDOUS MATERIALS PROGRAMS
4585 PACHECO BOULEVARD. - SUITE 100
MARTINEZ, CA 94553
Please contact the Hazardous Materials Programs if you have questions at (925) 335-3200