Canada Gazette, Part I, Volume 149, Number 16: SUPPLEMENT

April 18, 2015

DEPARTMENT OF THE ENVIRONMENT

CANADIAN ENVIRONMENTAL PROTECTION ACT, 1999

Proposed notice requiring the preparation and implementation of pollution prevention plans in respect of hydrazine related to the electricity sector

Pursuant to section 56 of the Canadian Environmental Protection Act, 1999 (hereinafter referred to as the “Act”), the Minister of the Environment proposes to publish the annexed Notice. The proposed Notice (“Notice”) will initiate a 60-day comment period. Following the comment period and after review of the comments received, the Minister intends to publish a final Notice requiring the preparation and implementation of pollution prevention plans in the Canada Gazette, Part I.

The Final Notice will require the preparation and implementation of a pollution prevention plan in respect of hydrazine, which is specified on the List of Toxic Substances in Schedule 1 of the Act. The Final Notice will apply to any person or class of persons within the electricity sector (excluding non-thermal generation) who operates a facility that uses hydrazine at a concentration of greater than 10% (% by weight) and as a result of this use, the facility releases effluent at the final discharge point of the facility that contains hydrazine.

More information on pollution prevention planning can be found in the Pollution Prevention Planning Provisions of Part 4 of the Canadian Environmental Protection Act, 1999: Guidelines for Implementation. These guidelines and other information related to pollution prevention and pollution prevention planning can be found in the “Pollution Prevention Planning” section of Environment Canada's Web site, at www.ec.gc.ca/planp2-p2plan.

HELEN RYAN
Director General
Energy and Transportation Directorate

On behalf of the Minister of the Environment

PROPOSED NOTICE REQUIRING THE PREPARATION AND IMPLEMENTATION OF POLLUTION PREVENTION PLANS IN RESPECT OF HYDRAZINE RELATED TO THE ELECTRICITY SECTOR

Notice is hereby given that, pursuant to the provisions of subsection 56(1) of Part 4 of the Act, the Minister of the Environment requires any person or class of persons described in section 2 of this Notice to prepare and implement a pollution prevention plan in respect of hydrazine, which is specified on the List of Toxic Substances in Schedule 1 of the Act.

1. Definitions

The definitions in this section apply to this Notice.

“Act” means the Canadian Environmental Protection Act, 1999 (CEPA 1999).

“Effluent” means a process stream released at any final discharge point of the facility.

“Electricity sector” means a group of companies engaged in the generation and transmission of electricity, and whose primary purpose is the generation of electricity for distribution or commercial sale.

“Facility” includes any industrial site that

and excludes facilities where electricity is generated with a non-thermal process.

“Final discharge point” means an identifiable release point, prior to any dilution by receiving water, beyond which the facility operator no longer exercises control over quality of the effluent.

“Hydrazine” means the substance with the Chemical Abstracts Service Registry Number (CAS RN (see footnote 1) 302-01-2, and the Domestic Substances List name “Hydrazine”.

“Minister” means the Minister of the Environment.

“Normal operating conditions” means representative of regular or typical operating conditions related to the use of hydrazine which results in an effluent containing hydrazine at the final discharge point. This would include any regularly scheduled events other than startup and shutdown.

“Notice” means the proposed Notice requiring the preparation and implementation of pollution prevention plans in respect of hydrazine related to the electricity sector.

“Operator” means the person who operates or has charge, management or control of a facility.

“Plan” means a pollution prevention plan (as described in subsection 56(1) of the Act).

“Pollution prevention,” as defined in section 3 of the Act, means the use of processes, practices, materials, products, substances or energy that avoid or minimize the creation of pollutants and waste and reduce the overall risk to the environment or human health.

“Techniques” includes both the facility equipment used in the process and how the process is operated. It includes, but is not limited to, matters such as the number of employees, their qualifications and experience, working methods, training, supervision and the manner in which the process is performed. It also includes the design, construction, lay-out and maintenance of the facility.

2. Person or class of persons required to prepare and implement a plan

The person or class of persons can show proof of this by submitting to the Minister the supporting monitoring and sampling data.

3. Activities in relation to which the plan is to be prepared

The Minister requires any person or class of persons identified in section 2 of the Notice to prepare and implement a plan in relation to the storage, use or release of hydrazine.

4. Factors to consider in preparing the plan

The Minister requires any person or class of persons identified in section 2 of the Notice to consider the following factors when preparing the plan:

5. Period within which the plan is to be prepared

6. Period within which the plan is to be implemented

7. Content of the plan

A person or class of persons identified in section 2 of the Notice is to determine the appropriate content of that person's plan; however, the plan must meet all the requirements of the Notice. The plan must also contain the information required to file the Declaration of Preparation referred to in section 9 of the Notice and be able to generate the information required to file the Declaration of Implementation referred to in section 10 and the Interim Progress Report referred to in section 12 of the Notice.

8. Requirement to keep the plan and record keeping

Under section 59 of the Act, any person or class of persons identified in section 2 of the Notice must keep a copy of the plan at the location in Canada in relation to which the plan is prepared. Where a single plan is prepared for more than one facility, a copy of that plan must be kept at each location.

Any person or class of persons identified in section 2 of the Notice must keep the plan and any records pertaining to the plan for a minimum of five years following the period referred to in section 6 of the Notice.

9. Declaration of Preparation

Under subsection 58(1) of the Act, any person or class of persons identified in section 2 of the Notice must file, within 30 days after the end of the period within which the plan is to be prepared as specified in section 5 or within 30 days after the period extended under section 14, a written “Declaration that a Pollution Prevention Plan Has Been Prepared and Is Being Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999).” This Declaration must be submitted to the Minister, using the form that the Minister provides that contains the information set out in Schedule 1 of the Notice. Where a person or class of persons has prepared a single plan for several facilities, a separate Declaration of Preparation must be filed for each facility.

10. Declaration of Implementation

Under subsection 58(2) of the Act, any person or class of persons identified in section 2 of the Notice must file within 30 days after the end of the period within which the plan is to be implemented as specified in section 6 or within 30 days after the end of the period extended under section 14, a written “Declaration that a Pollution Prevention Plan Has Been Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(2) of CEPA 1999).” This Declaration must be submitted to the Minister, using the form that the Minister provides that contains the information set out in Schedule 5 of the Notice. Where a person or class of persons has prepared a single plan for several facilities, a separate Declaration of Implementation must be filed for each facility.

11. Filing of amended Declarations

Under subsection 58(3) of the Act, where a person or class of persons specified in section 2 of the Notice has filed a Declaration of Preparation or a Declaration of Implementation, referred to in sections 9 and 10 of the Notice, and the Declaration contains information that, at any time after the filing, has become false or misleading, that person or class of persons must file an amended Declaration to the Minister within 30 days after the time that the information became false or misleading, using the appropriate form referred to in section 9 or 10 of the Notice.

12. Interim Progress Reports

A person or class of persons identified in section 2 of the Notice must file with the Minister, no later than the dates indicated below, a written “Interim Progress Report — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999),” using the form that the Minister provides and that contains the information set out in Schedule 4 of the Notice. If a Declaration of Implementation is submitted before an Interim Progress Report is due, the obligation to submit the Interim Progress Report is no longer required.

The Interim Progress Report will report data pertaining to the previous calendar year. Where a person or class of persons has prepared a single plan for several facilities, a separate Interim Progress Report must be filed for each facility.

13. Use of a plan prepared or implemented for another purpose

Under subsection 57(1) of the Act, a person or class of persons may use a pollution prevention plan prepared or implemented for another purpose to satisfy the requirements of sections 2 to 12 of the Notice. Under subsection 57(2) of the Act, where a person or class of persons uses a plan that does not meet all the requirements of the Notice, the person or class of persons must either amend the plan so that it meets all of those requirements or prepare an additional plan that meets the remainder of those requirements. A person or class of persons using existing plans must still file the Declaration of Preparation referred to in section 9 of the Notice, the Declaration of Implementation referred to in section 10 of the Notice, and, where applicable, any amended Declarations referred to in section 11 of the Notice and any Interim Progress Reports required under section 12 of the Notice.

14. Extension of time

Under subsection 56(3) of the Act, where the Minister is of the opinion that further time beyond the period referred to in section 5 is needed to prepare the plan, or that further time beyond the period referred to in section 6 is needed to implement the plan, the Minister may extend the period for a person or class of persons who submits a written “Request for Time Extension — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 56(3) of CEPA 1999).” The written request must be submitted using the form that the Minister provides, contain the information set out in Schedule 3 of the Notice, and be made before the expiry of the date referred to in section 5 or section 6 or before the expiry of any extended period.

15. Application for waiver of factors to consider

Under subsection 56(5) of the Act, the Minister may waive the requirement for a person or class of persons to consider a factor in preparing the plan specified in section 4 where the Minister is of the opinion that it is neither reasonable nor practicable to consider a factor on the basis of reasons provided by that person or class of persons when submitting a written “Request for Waiver of the Requirement to Consider a Factor or Factors — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 56(5) of CEPA 1999).” This written request must be submitted using the form that the Minister provides and must contain the information set out in Schedule 2 of the Notice. Such a request must be made before the expiry of the period within which the plan is to be prepared as referred to in section 5 of the Notice or before the expiry of any extended period.

16. Performance measurement and evaluation of the Notice

Performance measurement of the Notice will be conducted after every reporting cycle in order to evaluate the effectiveness of the Notice in meeting its intended objectives. Performance reports summarizing the overall results to date will be posted online.

The Minister will evaluate the effectiveness of the Notice with respect to the risk management objective set out in section 4 of the Notice.

The Minister will determine whether other measures, including regulations, are needed to further prevent or reduce negative impacts of hydrazine on the environment and human health.

17. Resources

Guidance on preparing pollution prevention plans may be obtained from

Additional information and guidance on pollution prevention can be found on

18. Notice Reference Code: P2Hydrazine

For administrative purposes, all communication with Environment Canada concerning the Notice should refer to the following Notice Reference Code: P2Hydrazine.

19. Public disclosure of information and forms

The Minister of the Environment intends to publish information submitted in response to the Notice in Schedules 1, 4 and 5 in the Pollution Prevention Planning section of Environment Canada's Web site.

Under section 313 of the Act, all persons or classes of persons submitting information to the Minister may submit with the information a written request that specific information be treated as confidential. Persons or classes of persons submitting such a request should also include the reasons for the request.

The Notice includes the following forms:

Forms referred to in the Notice (Schedules 1 to 5) are published as part of the Notice and may be filled out electronically using the Pollution Prevention Planning Online Reporting Tool found at www.ec.gc.ca/planp2-p2plan.

20. Environment Canada contact information

For technical questions about the proposed Notice, please contact or send queries to

Dan Roumbanis, P.Eng.
Electricity and Combustion Division
Environment Canada
4905 Dufferin Street
Toronto, Ontario
M3H 5T4
Email: ecd-dec@ec.gc.ca

For more information about pollution prevention planning or reporting online, please contact

Innovative Measures Section
Regulatory Innovation and Management Systems
Environment Canada
351 Saint-Joseph Boulevard, 20th Floor
Gatineau, Quebec
K1A 0H3
Telephone: 819-420-7796
Fax: 819-420-7386
Email: LCPEPlansP2-CEPAP2Plans@ec.gc.ca

EXPLANATORY NOTE

(This note is not part of the Notice.)

Compliance with the Canadian Environmental Protection Act, 1999 (hereinafter referred to as the “Act”) is mandatory pursuant to subsections 272(1) and 272.1(1) of the Act. Subsections 272(2), (3) and (4) and 272.1(2), (3) and (4) of the Act set the penalties for persons who commit an offence under the Act. Offences include the offence of failing to comply with an obligation arising from the Act and the offence of providing false or misleading information. Penalties for offences can result, upon conviction (either summary conviction or indictment), in fines of not more than $12 million, imprisonment for a term of not more than three years, or both.

The current text of the Act, including the most recent amendments, is available on the Department of Justice Canada Web site at http://laws-lois.justice.gc.ca/eng/acts/C-15.31.

The Act is enforced in accordance with the Compliance and Enforcement Policy for the Canadian Environmental Protection Act, 1999, available at www.ec.gc.ca/lcpe-cepa/default.asp?lang=En&n=5082BFBE-1. Suspected violations under the Act can be reported to the Enforcement Branch by email at environmental.enforcement@ec.gc.ca.

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 18 and 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only.

Schedule 1: Declaration That a Pollution Prevention Plan Has Been Prepared and Is Being Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999)

Notice Reference Code: P2Hydrazine

For guidance on how to complete this Declaration, please refer to the Instructions for Completing the Schedules.

Is this an amendment to a Declaration previously submitted? check box Yes check box No

If yes, please specify the amended parts and reasons below. In addition, please complete Parts 1.0 and 9.0 and any other parts of this Declaration for which previously reported information has become false or misleading. Previously reported information that is unchanged need not be resubmitted.

If no, please proceed to Part 1.0 of this Declaration.

Amendment Part(s)

Please specify the part(s) of the Declaration that you would like to amend.

 

Amendment Reason(s)

Please specify the reason(s) for each of the amendments that you would like to make.

 

1.0 Information on the Person or Class of Persons Subject to the Notice

Name of the Person or Class of Persons Subject to the Notice:

__________________________________________________________

Facility Name:

__________________________________________________________

Street Number: __________ Street Name: ____________________________

Street Type: __________ Street Direction: ___________________________

Unit/Suite/Building Number: _______ P.O. Box: _________ Rural Route: _________

City: __________ Province/Territory: ____________ Postal Code: _____________

Telephone Number:

__________________________________________________________
(with area code)

Email: _______________________________________________________

Mailing Address of Facility (if different from Street Address)

Street Number: __________ Street Name: ___________________________

Street Type: _______________ Street Direction: __________________

Unit/Suite/Building Number: ________ P.O. Box: __________ Rural Route: __________

City: ______________ Province/Territory: __________ Postal Code: ______________

National Pollutant Release Inventory ID (if no ID, leave blank):

_________________________________________________________

Six-digit North American Industry Classification System (NAICS) code (if no Code, leave blank): _____________________________

Facility Technical Contact:

__________________________________________________________

Email: ___________________________________________

Telephone Number: __________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

Please enter the name of a General Contact for the facility. This contact information will be used by Environment Canada to correspond with your facility on items related to your submission, including your facility registration and password required for login and reporting online.

General Contact Information

First Name: ______________________________________________

Last Name: ______________________________________________

Position/Job Title: _________________________________________

Email: __________________________________________________

Telephone Number: _______________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

2.0 Use of Plans Prepared or Implemented for Another Purpose

Is the Pollution Prevention Plan used to fulfill the obligations of the Notice

If yes, identify the other government requirement(s) or Act of Parliament.

 

3.0 Substance, Activity and/or Class of Persons

Substance, Activity and/or Class of persons for which information is required:

check box Hydrazine (CAS RN (see footnote 2)302-01-2)

4.0 Baseline Information Prior to Implementation of the Pollution Prevention (P2) Plan

Notes:

If you are reporting data for a year other than the above-specified year, select all those that apply:

check box Person or class of persons subject to the Notice has been granted a time extension to prepare a plan that results in a Preparation Year other than 2015

OR

check box Person or class of persons became subject to the Notice after the date of publication that results in a Preparation Year other than 2015

If either of the above is applicable, indicate the new Preparation Year for which you are reporting: ___________.

All references to the Preparation Year 2015 throughout this Declaration will be replaced by this new Preparation Year.

4.1 Nature of Activity

For the activity identified in Part 3.0 of this Declaration, did this facility use the substance on-site in the Preparation Year 2015?
check box Yes check box No

If no, proceed to Part 4.3 of this Declaration.

If yes, for the activity identified in Part 3.0 of this Declaration indicate how the substance was used and the nature of such activity at the facility for the Preparation Year 2015. More than one nature of activity may be identified. Select all that apply:

Use/Process:

check box As a physical or chemical processing aid (e.g. boiler water chemistry control)
check box Other use or process (please specify): ____________________________

4.2 On-site Uses

Report the total quantity of all on-site uses of the substance, in kilograms (kg), for that year, and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below. For hydrazine in an aqueous solution, this total quantity refers only to the weight of hydrazine in the mixture, not the total weight of the mixture.

A1. Total Quantity of all On-site Uses for the Preparation Year (kg) Basis of Estimate Code
   
4.3 On-site Releases

4.3.1 On-site Releases to Air — No data required for this Part

4.3.2 On-site Releases to Underground Injection — No data required for this Part

4.3.3 On-site Releases to Water

For the activity identified in Part 3.0 of this Declaration, did this facility release the substance to water in the Preparation Year 2015?
check box Yes check box No

If no, proceed to Part 4.3.4 of this Declaration.

If yes, report the quantity of all on-site releases of the substance to water, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below for the year in question.

Type of Releases to Waters Quantity Released for the Preparation Year (kg) Basis of Estimate Code
a) Direct discharges — total from all Final Discharge Points    
b) Spills    
c) Leaks    
D. TOTAL D1 n/a

4.3.4 On-site Releases to Land

For the activity identified in Part 3.0 of this Declaration, did this facility release the substance to on-site land in the Preparation Year 2015?
check box Yes check box No

If no, proceed to Part 4.3.5 of this Declaration.

If yes, report the quantity of all on-site releases of the substance to land within the boundaries of the facility, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below.

Type of Releases to Land Quantity Released for the Preparation Year (kg) Basis of Estimate Code
a) Spills    
b) Leaks    
c) Other releases    
E. TOTAL E1 n/a

4.3.5 Total On-site Releases

For the activity identified in Part 3.0 of this Declaration, report the total quantity, in kilograms (kg), for that year, of the substance released on-site.

Total Quantity Released On-site for 2015 (D1 + E1) = __________________ F1

4.4 Off-site Transfers

4.4.1 Off-site Transfers for Distribution — No data required for this Part

4.4.2 Off-site Transfers for Disposal

For the activity identified in Part 3.0 of this Declaration, did this facility transfer the substance off-site for disposal in the Preparation Year 2015? check box Yes check box No

If no, proceed to Part 4.5 of this Declaration.

If yes, report the quantity of all off-site transfers of the substance for disposal, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b), as well as the name and address of the facility that received the off-site transfer for disposal, in the appropriate fields below. Report only the net mass of the substance that was sent off-site, not the total mass of the mixture containing the substance. Report transfers to the first off-site location only and not any subsequent transfers by the waste disposal company.

Type of Transfers for Disposal Quantity Transferred for the Preparation Year (kg) Basis of Estimate Code Facility Name and Address
a) Physical treatment      
b) Chemical treatment      
c) Biological treatment      
d) Incineration/thermal      
e) Containment      
f) Municipal Sewage Treatment Plant (MSTP)      
g) Underground injection      
h) Land treatment      
H. TOTAL H1 n/a n/a

4.4.3 Off-site Transfers for Recycling — No data required for this Part

4.5 Additional Baseline Information

4.5.1 Sampling and Analysis — Concentration of Hydrazine in Effluent at Final Discharge Points

For the activity identified in Part 3.0 of this Declaration, report the concentration of hydrazine in effluent in micrograms per litre (µg/L) determined by laboratory analysis, the dates of sampling and analysis activities, as well as the laboratory name, address and accreditations for analysis of hydrazine at each final discharge point that contains hydrazine, as described in paragraph 4(5)(b) of the Notice for the Preparation Year 2015. In addition, provide the average concentration in the appropriate field below by totalling the column and dividing by the number of samples taken. Names of the final discharge points should be consistent with those identified and labelled in the facility map described in subsection 4(4) of the Notice.

Final discharge point — 1 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

Final discharge point — 2 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

If you need to report more than two final discharge points, you must copy the table above for each additional final discharge point. If you have fewer than four samples in a calendar year, you must provide an explanation in the comment field.

5.0 Anticipated Actions and Results

5.1 Anticipated Action

Parts 5.1.1 through 5.1.6 must be completed separately for each anticipated action in implementing the P2 Plan, i.e., Part 5.1 will be completed as many times as there are anticipated actions to report.

5.1.1 Anticipated Action

What is the name of the action to be taken in implementing the Pollution Prevention Plan?

________________________________________________________

What is the current status of this Action?

check box Planned/To Be Initiated
check box In Progress
check box Completed

Describe the anticipated action to be taken. If the anticipated action includes the use of alternative substances, please include the chemical name or common name, or CAS registry number of the substance. If the anticipated action includes the use of pollution control, please include a description of the method.

 

For the anticipated action reported above, identify whether it represents a pollution prevention method listed in Part 5.1.2 OR an environmental protection method listed in Part 5.1.3.

5.1.2 Types of Pollution Prevention Methods

Select from the list of options provided below one or more pollution prevention methods to describe the anticipated action reported in Part 5.1.1.

check box Material or feedstock substitution

check box Product design or reformulation

check box Equipment or process modifications

check box Spill and leak prevention

check box On-site reuse, recycling or recovery

check box Inventory management or purchasing techniques

check box Good operating practices or training

check box Other: _______________________________________________

5.1.3 Types of Environmental Protection Methods

Select from the list of options provided below one or more environmental protection methods to describe the anticipated action reported in Part 5.1.1.

check box Energy recovery

check box Off-site recycling

check box Incineration with energy recovery

check box Waste treatment

check box Pollution control

check box Disposal

check box Other: _________________________________

In Part 5.1.4, report, where possible, the corresponding change in annual uses, releases or transfers of the substance anticipated to be achieved by implementing that action in kilograms (kg). Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity. Note that estimating a quantitative change for some anticipated actions, such as employee training, may not be possible.

5.1.4 Anticipated Changes: ______________________________________

In Part 5.1.5, select which Baseline Elements are affected by the changes reported in Part 5.1.4 (see below). Note that actions may affect more than one Baseline Element.

5.1.5 Baseline Elements Affected: ____________________________________

In Part 5.1.6, identify the planned completion date for the anticipated action.

5.1.6 Planned Completion Date (YYYY-MM-DD): _____________________________

This ends Parts 5.1.1 through 5.1.6 that must be completed separately for each anticipated action in the P2 Plan.

5.2 Total Anticipated Results

The table below summarizes, for the activity identified in Part 3.0 of this Declaration, the total anticipated change in annual uses, releases and transfers of the substance, in kilograms (kg), and as a percentage relative to the Preparation Year 2015.

Report the total anticipated changes to be achieved by implementing only the anticipated actions described in Part 5.1 of this Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity and percentage.

Type of Use/Release/Transfer Total Anticipated Change Relative to the Preparation Year (kg) Total Anticipated Change Relative to the Preparation Year (%)
5.2.1 On-site Uses (related to Part 4.2)    
5.2.2 On-site Releases to Water (related to Part 4.3.3)    
5.2.3 On-site Releases to Land (related to Part 4.3.4)    
5.2.4 Off-site Transfers for Disposal (related to Part 4.4.2)    
5.3 Detailed Anticipated Results Information

The table below summarizes the total anticipated change in the concentration of the substance in effluent at each final discharge point as a result of the anticipated actions in μg/L and as a percentage (%) relative to the Preparation Year 2015 (related to Part 4.5.1).

Report the total anticipated changes to be achieved by implementing only the anticipated actions described in Part 5.1 of this Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported concentration and percentage.

Final Discharge Point Total Anticipated Change (in Concentration) Relative to the Preparation Year (μg/L) Total Anticipated Change (in Concentration) Relative to the Preparation Year (%)
1    
2    
3    
4    
5    
6    
7    
Total n/a n/a

6.0 Monitoring and Reporting

Describe the anticipated monitoring and reporting that will be used to track progress in implementing the Pollution Prevention Plan.

 

7.0 Risk Management Objective

As identified in subsection 4(2) of the Notice, the environmental risk management objective for hydrazine is to achieve and maintain a total hydrazine concentration in effluent at the final discharge control points of the facility that is less than or equal to the specified levels.

Describe how the elements of the Pollution Prevention Plan will meet the risk management objective for hydrazine. If you anticipate that this Plan will not meet the risk management objective, explain why.

 

8.0 Factors to Consider

Describe what was done by the person or class of persons subject to the Notice to take into account the “Factors to Consider” set out in subsections 4(3) to 4(5) of the Notice, except those factors for which a waiver has been granted by the Minister of Environment.

4(3) Priority to Pollution Prevention

 

4(4) Identification of Effluent Streams

 

4(5)(a) Sampling Activities

 

4(5)(b) Analysis Activities

 

9.0 Certification

I hereby certify that a Pollution Prevention Plan in respect of hydrazine has been prepared and is being implemented and that the information provided in this Declaration is true, accurate and complete.

_____________________________________________________
Signature of the Person Subject to the Notice
or Duly Authorized Representative

_____________________________________________________
Date

Name:

_______________________________________________________
Please Print

Title/Position:

_______________________________________________________
Please Print

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 18 and 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only.

Schedule 2: Request for Waiver of the Requirement to Consider a Factor or Factors — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 56(5) of CEPA 1999)

Notice Reference Code: P2Hydrazine

For guidance on how to complete this Request, please refer to the Instructions for Completing the Schedules.

Is this an amendment to a Request previously submitted? check box Yes check box No

If yes, please specify the amended parts and reasons below. In addition, please complete Parts 1.0 and 4.0 and any other parts of this Request for which previously reported information has become false or misleading. Previously reported information that is unchanged need not be resubmitted.

If no, please proceed to Part 1.0 of this Request.

Amendment Part(s)

Please specify the part(s) of the Request that you would like to amend.

 

Amendment Reason(s)

Please specify the reason(s) for each of the amendments that you would like to make.

 

1.0 Information on the Person or Class of Persons Subject to the Notice

Name of the Person or Class of Persons Subject to the Notice:_________________________

Facility Name: __________________________________________

Street Number: __________ Street Name: _____________________________

Street Type: _____________________ Street Direction: ________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: _________________________ Province/Territory: _________________________ Postal Code: _________________________

Telephone Number: _____________________________________
(with area code)

Email: _______________________________________________________

Mailing Address of Facility (if different from Street Address)

Street Number: __________ Street Name: __________________________________

Street Type: __________________ Street Direction: _____________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: _________________________ Province/Territory: _________________________ Postal Code: _________________________

National Pollutant Release Inventory ID (if no ID, leave blank): _________________________________________________________

Six-digit North American Industry Classification System (NAICS) code (if no Code, leave blank): _____________________________

Facility Technical Contact: _________________________________________________

Email: _______________________________________________________

Telephone Number: ______________________________
(with area code)

Fax Number (if available): ________________________________________________
(with area code)

Please enter the name of a General Contact for the facility. This contact information will be used by Environment Canada to correspond with your facility on items related to your submission, including your facility registration and password required for login and reporting online.

General Contact Information

First Name: ______________________________________________

Last Name: ______________________________________________

Position/Job Title: _________________________________________

Email: __________________________________________________

Telephone Number: _______________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

2.0 Factor(s) for Which a Waiver is Being Requested

Identify for which factor(s) listed in the Notice a waiver is being requested.

 

3.0 Rationale for Request

Explain why it would not be reasonable or practicable to consider each factor for which a waiver is being requested.

 

Explain how the outcome of the Pollution Prevention Plan will be affected if this or these “factor(s) to consider” is (are) not taken into account.

 

Identify which, if any, additional factor(s) you propose to consider in preparing the Pollution Prevention Plan (optional).

 

4.0 Certification

I hereby certify that the information provided in this Request is true, accurate and complete.

_____________________________________________________
Signature of the Person Subject to the Notice
or Duly Authorized Representative

_____________________________________________________
Date

Name:

_______________________________________________________
Please Print

Title/Position:

_______________________________________________________
Please Print

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 18 and 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only.

Schedule 3: Request for Time Extension — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 56(3) of CEPA 1999)

Notice Reference Code: P2Hydrazine

For guidance on how to complete this Request, please refer to the Instructions for Completing the Schedules.

Is this an amendment to a Request previously submitted? check box Yes check box No

If yes, please specify the amended parts and reasons below. In addition, please complete Parts 1.0 and 4.0 and any other parts of this Request for which previously reported information has become false or misleading. Previously reported information that is unchanged need not be resubmitted.

If no, please proceed to Part 1.0 of this Request.

Amendment Part(s)

Please specify the part(s) of the Request that you would like to amend.

 

Amendment Reason(s)

Please specify the reason(s) for each of the amendments that you would like to make.

 

1.0 Information on the Person or Class of Persons Subject to the Notice

Name of the Person or Class of Persons Subject to the Notice: __________________________________________________________

Facility Name: __________________________________________________________

Street Number: __________ Street Name: ________________________________________

Street Type: _________________________________________ Street Direction: __________________________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

Telephone Number: ____________________________________________
(with area code)

Email: ____________________________________________________

Mailing Address of Facility (if different from Street Address)

Street Number: __________ Street Name: _________________________________

Street Type: _____________________________ Street Direction: __________________________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

National Pollutant Release Inventory ID (if no ID, leave blank): _______________________________________________

Six-digit North American Industry Classification System (NAICS) code (if no Code, leave blank): _____________________________

Facility Technical Contact: ________________________________________________

Email: ____________________________________________________

Telephone Number: __________________________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

Please enter the name of a General Contact for the facility. This contact information will be used by Environment Canada to correspond with your facility on items related to your submission, including your facility registration and password required for login and reporting online.

General Contact Information

First Name: ______________________________________________

Last Name: ______________________________________________

Position/Job Title: _________________________________________

Email: __________________________________________________

Telephone Number: _______________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

2.0 Request for Time Extension

Identify for which of the following a time extension is being requested (choose one):

check box to prepare a Pollution Prevention Plan

check box to implement a Pollution Prevention Plan

For the person or class of persons identified in Part 1.0, it is requested that the date be extended to (specify exact date — YYYY-MM-DD): _______________________

3.0 Rationale for Request

Explain why additional time is needed to prepare or implement a Pollution Prevention Plan.

 

4.0 Certification

I hereby certify that the information provided in this Request is true, accurate and complete.

_____________________________________________________
Signature of the Person Subject to the Notice
or Duly Authorized Representative

_____________________________________________________
Date

Name:

_______________________________________________________
Please Print

Title/Position:

_______________________________________________________
Please Print

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 18 and 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only.

Schedule 4: Interim Progress Report — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999)

Notice Reference Code: P2Hydrazine

For guidance on how to complete this Report, please refer to the Instructions for Completing the Schedules.

Is this an amendment to a Report previously submitted? check box Yes check box No

If yes, please specify the amended parts and reasons below. In addition, please complete Parts 1.0 and 9.0 and any other parts of this Report for which previously reported information has become false or misleading. Previously reported information that is unchanged need not be resubmitted.

If no, please proceed to Part 1.0 of this Report.

Amendment Part(s)

Please specify the part(s) of the Report that you would like to amend.

 

Amendment Reason(s)

Please specify the reason(s) for each of the amendments that you would like to make.

 

1.0 Information on the Person or Class of Persons Subject to the Notice

Name of the Person or Class of Persons Subject to the Notice: _________________________________

Facility Name: _____________________________________________________

Street Number: __________ Street Name: _________________________________________

Street Type: ________________________ Street Direction: _______________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

Telephone Number: __________________________________________________________
(with area code)

Email: ____________________________________________________________

Mailing Address of Facility (if different from Street Address)

Street Number: __________ Street Name: _____________________________________________

Street Type: ________________________ Street Direction: ______________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

National Pollutant Release Inventory ID (if no ID, leave blank): _________________________________________________________

Six-digit North American Industry Classification System (NAICS) code (if no Code, leave blank): _____________________________

Facility Technical Contact: _________________________________________

Email: _________________________________________________________

Telephone Number: __________________________________________________________
(with area code)

Fax Number (if available): ________________________________________________________
(with area code)

Please enter the name of a General Contact for the facility. This contact information will be used by Environment Canada to correspond with your facility on items related to your submission, including your facility registration and password required for login and reporting online.

General Contact Information

First Name: ______________________________________________

Last Name: ______________________________________________

Position/Job Title: _________________________________________

Email: __________________________________________________

Telephone Number: _______________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

2.0 Use of Plans Prepared or Implemented for Another Purpose — No data required for this Part

3.0 Substance, Activity and/or Class of Persons

Substance, Activity and/or Class of persons for which information is required:

check box Hydrazine (CAS RN (see footnote 3) 302-01-2)

4.0 Progress Information Towards Implementation of the Pollution Prevention (P2) Plan

The Preparation Year refers to the year identified in your Schedule 1 submission — Declaration that a Pollution Prevention Plan Has Been Prepared and Is Being Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999), herein referred to as “Declaration of Preparation.”

Notes:

Interim Progress Report Reporting Year Reporting Period
Interim Progress Report No. 1 2016 January 1 to December 31, 2016

Note that the Reporting Year associated with this Interim Progress Report Number is referred to as the Reporting Year throughout this Report.

d) If the person or class of persons became subject to the Notice after the date of publication in the Canada Gazette, reporting of data is required in one Interim Progress Report, as specified in the Notice.

4.1 Nature of Activity

For the activity identified in Part 3.0 of this Report, did this facility use the substance on-site in the Reporting Year? check box Yes check box No

If no, proceed to Part 4.3 of this Report.

If yes, for the activity identified in Part 3.0 of this Report indicate how the substance was used and the nature of such activity at the facility in the Reporting Year. Select all that apply:

Use/Process:

check box As a physical or chemical processing aid (e.g. boiler water chemistry control)
check box Other use or process (please specify): ____________________________

4.2 On-site Uses

Report the total quantity of all on-site uses of the substance, in kilograms (kg), for that year, and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below. For hydrazine in an aqueous solution, this total quantity refers only to the weight of hydrazine in the mixture, not the total weight of the mixture.

A. Total Quantity of all On-site Uses for the Reporting Year (kg) Basis of Estimate Code
   
4.3 On-site Releases

4.3.1 On-site Releases to Air — No data required for this Part

4.3.2 On-site Releases to Underground Injection — No data required for this Part

4.3.3 On-site Releases to Water

For the activity identified in Part 3.0 of this Report, did this facility release the substance to water in the Reporting Year? check box Yes check box No

If no, proceed to Part 4.3.4 of this Report.

If yes, report the quantity of all on-site releases of the substance to water, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below for the year in question.

Type of Releases to Waters Quantity Released for the Reporting Year (kg) Basis of Estimate Code
a) Direct discharges — total from all Final Discharge Points    
b) Spills    
c) Leaks    
D. TOTAL D1 n/a

4.3.4 On-site Releases to Land

For the activity identified in Part 3.0 of this Report, did this facility release the substance to on-site land in the Reporting Year?
check box Yes check box No

If no, proceed to Part 4.3.5 of this Report.

If yes, report the quantity of all on-site releases of the substance to land within the boundaries of the facility, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below for the year in question.

Type of Releases to Land Quantity Released for the Reporting Year (kg) Basis of Estimate Code
a) Spills    
b) Leaks    
c) Other releases    
E. TOTAL E1 n/a

4.3.5 Total On-site Releases

For the activity identified in Part 3.0 of this Report, report the total quantity, in kilograms (kg), for that year, of the substance released on-site.

Total Quantity Released On-site (D1 + E1) = _____________________________ F1

4.4 Off-Site Transfers

4.4.1 Off-site Transfers for Distribution — No data required for this Part

4.4.2 Off-site Transfers for Disposal

For the activity identified in Part 3.0 of this Report, did this facility transfer the substance off-site for disposal in the Reporting Year?
check box Yes check box No

If no, proceed to Part 4.5 of this Report.

If yes, report the quantity of all off-site transfers of the substance for disposal, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b), as well as the name and address of the facility that received the off-site transfer for disposal, in the appropriate fields below. Report only the net mass of the substance that was sent off-site, not the total mass of the mixture containing the substance. Report transfers to the first off-site location only and not any subsequent transfers by the waste disposal company.

Type of Transfers for Disposal Quantity Transferred for the Reporting Year (kg) Basis of Estimate Code Facility Name and Address
a) Physical treatment      
b) Chemical treatment      
c) Biological treatment      
d) Incineration/thermal      
e) Containment      
f) Municipal Sewage Treatment Plant (MSTP)      
g) Underground injection      
h) Land treatment      
H. TOTAL H1 n/a n/a

4.4.3 Off-site Transfers for Recycling — No data required for this Part

4.5 Additional Progress Information

4.5.1 Sampling and Analysis — Concentration of Hydrazine in Effluent at Final Discharge Points

For the activity identified in Part 3.0 of this Declaration, indicate the concentration of hydrazine in effluent in micrograms per litre (µg/L) determined by laboratory analysis, the dates of sampling and analysis activities, as well as the laboratory name, address and accreditations for analysis of hydrazine at each final discharge point that contains hydrazine, as described in paragraph 4(5)(b) of the Notice, for the Reporting Year. In addition, provide the average concentration in the appropriate field below by totalling the column and dividing by the number of samples taken. Names of the final discharge points should be consistent with those identified and labelled in the facility map described in subsection 4(4) of the Notice.

Final discharge point — 1 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

Final discharge point — 2 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

If you need to report more than two final discharge points, you must copy the table above for each additional final discharge point. If you have fewer than four samples in a calendar year, you must provide an explanation in the comment field.

5.0 Action(s) Taken and Results Achieved To Date

5.1 Action Taken to Date

Parts 5.1.1 through 5.1.6 must be completed separately for each action taken to date in implementing the P2 plan, i.e., Part 5.1 will be completed as many times as there are actions taken to date to report.

In Part 5.1.1, for the activity identified in Part 3.0 of this Report:

If the action taken to date includes the use of alternative substances, please include the chemical name, the common name or CAS registry number of the substance. If the action taken includes the use of pollution control, please include a description of the pollution control method.

5.1.1 Action Taken to Date

What is the name of the action taken to date in implementing the Pollution Prevention Plan?

_________________________________________________________

What is the current status of this Action?

check box Planned/To Be Initiated

check box In Progress

check box Completed

check box Discontinued

Please provide an update on the action or describe any new action taken to date. If the action was “Discontinued,” please provide the reason why.

 

For the action taken to date reported above, identify whether it represents a pollution prevention method listed in Part 5.1.2 OR an environmental protection method listed in Part 5.1.3.

5.1.2 Types of Pollution Prevention Methods

Select from the list of options provided below one or more pollution prevention methods to describe the action taken to date reported in Part 5.1.1.

check box Material or feedstock substitution

check box Product design or reformulation

check box Equipment or process modifications

check box Spill and leak prevention

check box On-site reuse, recycling or recovery

check box Inventory management or purchasing techniques

check box Good operating practices or training

check box Other: _________________________________

5.1.3 Types of Environmental Protection Methods

Select from the list of options provided below one or more environmental protection methods to describe the action taken to date reported in Part 5.1.1.

check box Energy recovery

check box Off-site recycling

check box Incineration with energy recovery

check box Waste treatment

check box Pollution control

check box Disposal

check box Other: _________________________________

In Part 5.1.4, report, where possible, the corresponding change in annual uses, releases or transfers of the substance achieved to date by implementing that action in kilograms (kg). Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity. Note that estimating a quantitative change for some actions taken, such as employee training, may not be possible.

5.1.4 Changes Achieved to Date: ______________________________________

In Part 5.1.5, select which Baseline Elements are affected by the changes reported in Part 5.1.4 (see below). For more information, please refer to the Instructions for Completing the Schedules. Note that actions may affect more than one Baseline Element.

5.1.5 Baseline Elements Affected: _______________________________________

In Part 5.1.6, identify the completion date for the action taken.

5.1.6 Completion Date (YYYY-MM-DD): __________________________

This ends Parts 5.1.1 through 5.1.6 that must be completed separately for each action taken to date in the P2 plan.

5.2 Total Results Achieved To Date

The table below summarizes, for the activity identified in Part 3.0 of this Report, the total change achieved to date in annual uses, releases and transfers of the substance, in kilograms (kg), and as a percentage relative to the Preparation Year 2015 as reported in the Declaration of Preparation.

Report those changes achieved from ALL actions taken to date in implementing the Pollution Prevention Plan described in Part 5.1 of this Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity and percentage.

Type of Use/Release/Transfer Total Change Achieved To Date Relative to the Preparation Year (kg) Total Change Achieved To Date Relative to the Preparation Year (%)
5.2.1 On-site Uses (related to Part 4.2)    
5.2.2 On-site Releases to Water (related to Part 4.3.3)    
5.2.3 On-site Releases to Land (Related to Part 4.3.4)    
5.2.4 Off-site transfers for Disposal (Related to Part 4.4.2)    
5.3 Detailed Results Achieved To Date Information

The table below summarizes the total change achieved to date in the concentration of the substance in effluent at each final discharge point in µg/L and as a percentage (%) relative to the Preparation Year 2015 (related to Part 4.5.1).

Report those changes achieved from ALL actions taken to date in implementing the Pollution Prevention Plan described in Part 5.1 of this Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported concentration and percentage.

Final Discharge Point Total Change (in Concentration) Achieved to Date Relative to the Preparation Year (μg/L) Total Change (in Concentration) Achieved to Date Relative to the Preparation Year (%)
1    
2    
3    
4    
5    
6    
7    
Total n/a n/a

6.0 Monitoring and Reporting

Describe the monitoring and reporting used to track progress in implementing the Pollution Prevention Plan.

 

7.0 Risk Management Objective

Describe the progress or additional details on how the Pollution Prevention Plan will meet the environmental risk management objective identified in subsection 4(2) of the Notice.

 

8.0 Factors to Consider

Describe any progress made in this Reporting Year towards taking into account the “Factors to Consider” set out in subsections 4(3) to 4(5) of the Notice, except those factors for which a waiver has been granted by the Minister of the Environment.

4(3) Priority to Pollution Prevention

 

4(4) Identification of Effluent Streams

 

4(5)(a) Sampling Activities

 

4(5)(b) Analysis Activities

 

9.0 Certification

I hereby certify that the information provided in this Report in respect of hydrazine is true, accurate and complete.

_____________________________________________________
Signature of the Person Subject to the Notice
or Duly Authorized Representative

_____________________________________________________
Date

Name:

_______________________________________________________
Please Print

Title/Position:

_______________________________________________________
Please Print

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 18 and 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only.

Schedule 5: Declaration That a Pollution Prevention Plan Has Been Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(2) of CEPA 1999)

Notice Reference Code: P2Hydrazine

For guidance on how to complete this Declaration, please refer to the Instructions for Completing the Schedules.

Is this an amendment to a Declaration previously submitted? check box Yes check box No

If yes, please specify the amended parts and reasons below. In addition, please complete Parts 1.0 and 9.0 and any other parts of this Declaration for which previously reported information has become false or misleading. Previously reported information that is unchanged need not be resubmitted.

If no, please proceed to Part 1.0 of this Declaration.

Amendment Part(s)

Please specify the part(s) of the Declaration that you would like to amend.

 

Amendment Reason(s)

Please specify the reason(s) for each of the amendments that you would like to make.

 

1.0 Information on the Person or Class of Persons Subject to the Notice

Name of the Person or Class of Persons Subject to the Notice: __________________________________________________________

Facility Name: _______________________________________________________

Street Number: __________ Street Name: _______________________________________

Street Type: _________________________________________ Street Direction: __________________________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

Telephone Number: ___________________________________________
(with area code)

Email: ___________________________________________________________

Mailing Address of Facility (if different from Street Address)

Street Number: __________ Street Name: ________________________________________

Street Type: _____________________________ Street Direction: ___________________________________

Unit/Suite/Building Number: _____________________ P.O. Box: _____________________ Rural Route: _____________________

City: ____________________________ Province/Territory: _____________________________ Postal Code: ___________________

National Pollutant Release Inventory ID (if no ID, leave blank): _________________________________________________________

Six-digit North American Industry Classification System (NAICS) code (if no Code, leave blank): _____________________________

Facility Technical Contact: _______________________________________________

Email: ______________________________________________________________

Telephone Number: ______________________________________________________________
(with area code)

Fax Number (if available): __________________________________________________________________
(with area code)

Please enter the name of a General Contact for the facility. This contact information will be used by Environment Canada to correspond with your facility on items related to your submission, including your facility registration and password required for login and reporting online.

General Contact Information

First Name: ______________________________________________

Last Name: ______________________________________________

Position/Job Title: _________________________________________

Email: __________________________________________________

Telephone Number: _______________________________________
(with area code)

Fax Number (if available): __________________________________
(with area code)

2.0 Use of Plans Prepared or Implemented for Another Purpose — No data required for this Part

3.0 Substance, Activity and/or Class of Persons

Substance, Activity and/or Class of persons for which information is required:

check box Hydrazine (CAS RN (see footnote 4) 302-01-2)

4.0 Information on Implementation of the Pollution Prevention (P2) Plan

The Preparation Year refers to the year identified in your Schedule 1 submission — Declaration That a Pollution Prevention Plan Has Been Prepared and Is Being Implemented — Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector (Subsection 58(1) of CEPA 1999) herein referred to as “Declaration of Preparation.”

Notes:

If you are reporting data for a year other than the above-specified year, check all those that apply:

check box Person or class of persons subject to the Notice has been granted a time extension to implement a Plan that results in an Implementation Year other than 2017

OR

check box Person or class of persons became subject to the Notice after the date of publication that results in an Implementation Year other than 2017

If either of the above is applicable, indicate the new Implementation Year for which you are reporting: ___________.

All references to the Implementation Year 2017 throughout this Declaration will be replaced by this new Implementation Year.

4.1 Nature of Activity

For the activity identified in Part 3.0 of this Declaration, did this facility use the substance on-site in the Implementation Year 2017?
check box Yes check box No

If no, proceed to Part 4.3 of this Declaration.

If yes, for the activity identified in Part 3.0 of this Declaration indicate whether the substance was used and the nature of such activity at the facility in the Implementation Year 2017. More than one nature of activity may be identified. Select all that apply.

Use/Process:

check box As a physical or chemical processing aid (e.g. boiler water chemistry control)
check box Other use or process (please specify): ____________________________

4.2 On-site Uses

Report the total quantity of all on-site uses of the substance, in kilograms (kg), for that year, and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below. Indicate how the substance was used. For hydrazine in an aqueous solution, this total quantity refers only to the weight of hydrazine in the mixture, not the total weight of the mixture.

Total Quantity of all On-site Uses for the Implementation Year (kg) Basis of Estimate Code
   
4.3 On-site Releases

4.3.1 On-site Releases to Air — No data required for this Part

4.3.2 On-site Releases to Underground Injection — No data required for this Part

4.3.3 On-site Releases to Water

For the activity identified in Part 3.0 of this Declaration, did this facility release the substance to water in the Implementation Year 2017?
check box Yes check box No

If no, proceed to Part 4.3.4 of this Declaration.

If yes, report the quantity of all on-site releases of the substance to water, in kilograms (kg), for that year, and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below.

Type of Releases to Surface Waters Quantity Released for the Implementation Year (kg) Basis of Estimate Code
a) Direct discharges — total from all final discharge points    
b) Spills    
c) Leaks    
D. TOTAL D1 n/a

4.3.4 On-site Releases to Land

For the activity identified in Part 3.0 of this Declaration, did this facility release the substance to on-site land in the Implementation Year 2017?
check box Yes check box No

If no, proceed to Part 4.3.5 of this Declaration.

If yes, report the quantity of all on-site releases of the substance to land within the boundaries of the facility, in kilograms (kg), for that year, and the Basis of Estimate Code (see Part 4.0, Note b) in the appropriate fields below.

Type of Releases to Land Quantity Released for the Implementation Year (kg) Basis of Estimate Code
a) Spills    
b) Leaks    
c) Other releases    
E. TOTAL E1 n/a

4.3.5 Total On-site Releases

For the activity identified in Part 3.0 of this Declaration, report the total quantity, in kilograms (kg), for that year, of the substance released on-site.

Total Quantity Released On-Site (D1 + E1) = _____________________________ F1

4.4 Off-Site Transfers

4.4.1 Off-site Transfers for Distribution — No data required for this Part

4.4.2 Off-Site Transfers for Disposal

For the activity identified in Part 3.0 of this Declaration, did this facility transfer the substance off-site for disposal in the Implementation Year 2017? check box Yes check box No

If no, proceed to Part 4.5 of this Declaration.

If yes, report the quantity of all off-site transfers of the substance for disposal, in kilograms (kg), and the Basis of Estimate Code (see Part 4.0, Note b), as well as the name and address of the facility that received the off-site transfer for disposal, in the appropriate fields below. Report only the net mass of the substance that was sent off-site, not the total mass of the mixture containing the substance. Report transfers to the first off-site location only and not any subsequent transfers by the waste disposal company.

Type of Transfers for Disposal Quantity Transferred for the Implementation Year (kg) Basis of Estimate Code Facility Name and Address
a) Physical treatment      
b) Chemical treatment      
c) Biological treatment      
d) Incineration/thermal      
e) Containment      
f) Municipal Sewage Treatment Plant (MSTP)      
g) Underground injection      
h) Land treatment      
H. TOTAL H1 n/a n/a

4.4.3 Off-site Transfers for Recycling — No data required for this Part

4.5 Additional Information

4.5.1 Sampling and Analysis — Concentration of Hydrazine in Effluent at Final Discharge Points

For the activity identified in Part 3.0 of this Declaration, indicate the concentration of hydrazine in effluent in micrograms per litre (µg/L) determined by laboratory analysis, the dates of sampling and analysis activities, as well as the laboratory name, address and accreditations for analysis of hydrazine at each final discharge point that contains hydrazine, as described in paragraph 4(5)(b) of the Notice, for the Implementation Year. In addition, provide the average concentration in the appropriate field below by totalling the column and dividing by the number of samples taken. Names of the final discharge points should be consistent with those identified and labelled in the facility map described in subsection 4(4) of the Notice.

Final discharge point — 1 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

Final discharge point — 2 Name: ___________________________________

Sample Concentration of Hydrazine at the Final Discharge Point (µg/L) Date of Sampling Date of Laboratory Analysis Laboratory Name, City and Phone Number Laboratory Accreditation Number
No. 1          
No. 2          
No. 3          
No. 4          
Average   n/a

Comments:

 

If you need to report more than two final discharge points, you must copy the table above for each additional final discharge point. If you have fewer than four samples in a calendar year, you must provide an explanation in the comment field.

5.0 Action(s) Taken and Results Achieved

5.1 Action Taken

Parts 5.1.1 through 5.1.6 must be completed separately for each action taken in implementing the P2 plan, i.e., Part 5.1 will be completed as many times as there are actions taken to report.

In Part 5.1.1, for the activity identified in Part 3.0 of this Declaration:

If the action taken includes the use of alternative substances, please include the chemical name, the common name or CAS registry number of the substance. If the action taken includes the use of pollution control, please include a description of the pollution control method.

5.1.1 Action Taken

What is the name of the action taken in implementing the Pollution Prevention Plan?

__________________________________________________

What is the current status of this Action?

check box Completed

check box Discontinued

Please provide an update on the actions completed. If the action was “Discontinued,” please provide the reason why.

 

For the action taken reported above, identify whether it represents a pollution prevention method listed in Part 5.1.2 OR an environmental protection method listed in Part 5.1.3.

5.1.2 Types of Pollution Prevention Methods

Select from the list of options provided below one or more pollution prevention methods to describe the action taken reported in Part 5.1.1.

check box Material or feedstock substitution

check box Product design or reformulation

check box Equipment or process modifications

check box Spill and leak prevention

check box On-site reuse, recycling or recovery

check box Inventory management or purchasing techniques

check box Good operating practices or training

check box Other: _____________________________________________

5.1.3 Types of Environmental Protection Methods

Select from the list of options provided below one or more environmental protection methods to describe the action taken reported in Part 5.1.1.

check box Energy recovery

check box Off-site recycling

check box Incineration with energy recovery

check box Waste treatment

check box Pollution control

check box Disposal

check box Other: _____________________________________________

In Part 5.1.4, report, where possible, the corresponding change in annual uses, releases or transfers of the substance achieved by implementing that action in kilograms (kg). Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity. Note that estimating a quantitative change for some actions taken, such as employee training, may not be possible.

5.1.4 Changes Achieved: __________________________________________

In Part 5.1.5, select which Baseline Elements are affected by the changes reported in Part 5.1.4 (see below). For more information, please refer to the Instructions for Completing the Schedules. Note that actions may affect more than one Baseline Element.

5.1.5 Baseline Elements Affected: ______________________________________

In Part 5.1.6, identify the completion date for the action taken.

5.1.6 Completion Date (YYYY-MM-DD): _____________________________________

This ends Parts 5.1.1 through 5.1.6 that must be completed separately for each action taken in the P2 plan.

5.2 Total Results Achieved

The table below summarizes, for the activity identified in Part 3.0 of this Declaration, the total change achieved in annual uses, releases and transfers of the substance, in kilograms (kg), and as a percentage relative to the Preparation Year 2015 as reported in the Declaration of Preparation.

Report the total changes achieved from ALL actions taken as a result of implementing the Pollution Prevention Plan described in Part 5.1 of the Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported quantity and percentage.

Type of Use/Release/Transfer Total Change Achieved Relative to the Preparation Year (kg) Total Change Achieved Relative to the Preparation Year (%)
5.2.1 On-site Uses (related to Part 4.2)    
5.2.2 On-site Releases to Water (related to Part 4.3.3)    
5.2.3 On-site Releases to Land (related to Part 4.3.4)    
5.2.4 Off-site Transfers for Disposal (related to Part 4.4.2)    
5.3 Detailed Results Achieved Information

The table below summarizes the total change achieved in the concentration of the substance in effluent at each final discharge point in μg/L and as a percentage (%) relative to the Preparation Year 2015.

Report the total changes achieved from ALL actions taken as a result of implementing the Pollution Prevention Plan described in Part 5.1 of the Declaration.

Important: Indicate a decrease with a negative sign (“–”) and an increase with a positive sign (“+”) in front of the reported concentration and percentage.

Final Discharge Point Total Change Achieved (in Concentration) Relative to the Preparation Year (μg/L) Total Anticipated Change Achieved (in Concentration) Relative to the Preparation Year (%)
1    
2    
3    
4    
5    
6    
7    
Total n/a n/a

6.0 Monitoring and Reporting

Describe the monitoring and reporting used to track progress in implementing the Pollution Prevention Plan.

 

7.0 Risk Management Objective

As identified in subsection 4(2) of the Notice, the environmental risk management objective for hydrazine is to achieve and maintain a total hydrazine concentration in effluent at the final discharge control points of the facility that is less than or equal to the specified levels.

Describe how the elements of the Pollution Prevention Plan met the risk management objective for hydrazine. If this Plan did not meet the risk management objective, explain why.

 

8.0 Factors to Consider

Describe any progress made in the Implementation Year 2017 towards taking into account the “Factors to Consider” set out in subsections 4(3) to 4(5) of the Notice, except those factors for which a waiver has been granted by the Minister of Environment.

4(3) Priority to Pollution Prevention

 

4(4) Identification of Effluent Streams

 

4(5)(a) Sampling Activities

 

4(5)(b) Analysis Activities

 

9.0 Certification

I hereby certify that a Pollution Prevention Plan in respect of hydrazine has been implemented and that the information provided in this Declaration is true, accurate and complete.

_____________________________________________________
Signature of the Person Subject to the Notice
or Duly Authorized Representative

_____________________________________________________
Date

Name:

_______________________________________________________
Please Print

Title/Position:

_______________________________________________________
Please Print