close print view
Hazardous Waste Program Forms and License ApplicationsAgency: Environmental Quality
Please Note: The forms on this web site require the Adobe Acrobat Reader and may require the most recent version. Adobe Acrobat is free software for viewing and printing Adobe Portable Document Format (pdf) files on all major hardware and operating system platforms. Download Adobe Reader.
Notification of Hazardous Waste or Liquid Industrial Waste activity for this site.
The Michigan Site Identification Form (Revised 12/2007) must be submitted for certain facilities regulated under Part 111, Hazardous Waste Management or Part 121, Liquid Industrial Waste of Michigan's Natural Resources and Environmental Protection Act, 1994 PA 451 (Act 451), as amended, and Subtitle C of the Federal Resource Conservation and Recovery Act, RCRA), and the rules there under, to obtain a Site Identification Number (initial notification).
You must also submit the completed form as a component of a Part A, as a component of the Hazardous Waste Report (biennial report), or you may choose to submit the form as a subsequent notification or as part of the Annual User Fee Charge required for certain types of hazardous waste generators.
You may search our database at http://www.deq.state.mi.us/wdspi/ to determine if the site location already exists (even if under a different facility name). If the physical location does exist in the data system you may request a pre-populated Site Identification Verification Form (EQP5150-v) by contacting the closest DEQ district office and asking for staff in the hazardous or liquid industrial waste program in the Office of Waste Management and Radiological Protection (OWMRP) or you can call OWMRP in Lansing (517.335.2690) and ask for staff in the Waste Tracking and Data Management Unit. If you find that the site you are notifying about does not exist in the data system, you will need to download the blank form.
EQP5150 - Michigan Site Identification Form (directions not included) Revised 5/2010
EQP5150 - Michigan Site Identification Form Directions (form not included) Revised 7/2005
This is the replacement form for:
and it is used in conjunction with the Michigan Hazardous Waste Operating License Form EQP5111.
The $50 User Charge Fee
Requests for the issuance of a Site Identification Number for hazardous waste or liquid industrial waste activities are subject to a user charge of $50.00. The DEQ will not issue a site identification number until the $50.00 user charge has been paid and the payment has cleared. If you are required to pay the $50 user fee charge, you may pay by credit card (Master Card, VISA, or Discover Card) by going to the secure site https://www.thepayplace.com/mi/deq/siteid
If you choose to pay by credit card, you must submit your receipt with the Site Identification Form. Either mail to:
DEQ, Office of Waste Management and Radiological Protection
Or the payment may be made by check if the application is submitted with the $50.00 check made payable to "State of Michigan " and mailed to:
DEQ Office of Financial Management
To help ensure proper credit, please indicate on the check "Site ID User Charge".
The following are some examples of when the Office of Waste Management and Radiological Protection considers the facility to be "new" and the $50 user charge fee must be submitted with the Site Identification Form (EQP5150):
Emergency Site Identification Numbers:
An Emergency Site Identification Number is assigned to any situation where there is an unexpected incident and the cleanup waste can not be accumulated on site because that would further threaten human health and the environment. Reasons why the waste can not be accumulated on site vary greatly but common reasons are there isn't any room to accumulate the waste (e.g., on the side of the road with minimal shoulder), the waste is too dangerous to be left (e.g., flammable and it is a hot and humid summer day), or there are other hazards in the area that means the waste could not be protected. When issued, the emergency Site Identification Number is valid until the immediate threat has been addressed and is provisional upon payment of the requisite $50 user charge. The numbers are site specific and cannot be transferred between locations. Any long term clean up requires the generator to file a Site Identification Form (EQP5150-v).
To obtain an Emergency Site Identification Number during normal business hours contact the DEQ and ask for the Waste Tracking and Data Management Unit at 517-335-2690. During evenings, weekends, and holidays contact the Pollution Emergency Alerting System (PEAS) at 1-800-292-4706. You will receive a copy of EQP5150-v generated from the information received over the telephone regarding your emergency cleanup site. You are required to fill in all of the additional information that is missing, such as the Federal Identification Number. After you have completed the form, write a check payable to the "State of Michigan" in the amount of $50.00 to pay for the issuance of the ID number and mail the check and completed form to:
The federal RCRA Hazardous Waste Part A Permit Application Form: The EQP5111 form plus the EQP5150 form together are Michigan's complete replacement of the EPA Part A form.
The completed and signed forms must be mailed to:
Department of Environmental Quality
The following are the Forms, Instructions, and Microsoft Word Templates for the attachments to the Michigan Hazardous Waste Operating License Application Form (EQP5111).
Applicants are advised to consult Part 111, Hazardous Waste Management, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, and Part 5 of the administrative rules promulgated pursuant thereto for further information regarding the requirements for hazardous waste management facility license applications. Not all of the requirements are embodied in the above listed forms and templates.
Copyright © 2001-2014 State of Michigan