Canada Gazette, Part I, Volume 152, Number 45: DEPARTMENT OF THE ENVIRONMENT

November 10, 2018

DEPARTMENT OF THE ENVIRONMENT

CANADIAN ENVIRONMENTAL PROTECTION ACT, 1999

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 published in the Canada Gazette, Part I, on April 18, 2015, the Proposed notice requiring the preparation and implementation of pollution prevention plans in respect of hydrazine related to the electricity sector.

Whereas persons were given the opportunity to file comments with respect to the proposed Notice for a comment period of 60 days; and

Whereas the Minister of the Environment has considered all comments received,

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

The Minister of the Environment will measure the performance of the Notice, throughout the preparation and implementation periods, in order to determine its effectiveness in meeting the risk management objectives set out in section 4 of the Notice. This evaluation will determine whether additional measures, including regulations, may be required.

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 relating to pollution prevention and pollution prevention planning can also be found in the "Pollution Prevention Planning Notices" section of the Government of Canada website.

Catherine McKenna
Minister of the Environment

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.

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

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 use and 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 their 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.

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 13, 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)". 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 submitted 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 13, 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)". 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 submitted 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. 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 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.

13. 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)". The written request must be submitted using the form that the Minister provides that contains the information set out in Schedule 3 of the Notice, and be made before the expiry of the time period referred to in section 5 or section 6 or before the expiry of any extended period.

14. 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)". 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.

15. 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 on the Pollution Prevention Planning section of the Government of Canada website.

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.

16. Resources

Guidance on preparing pollution prevention plans may be obtained from

Additional information and guidance on pollution prevention can be found on

17. Notice Reference Code: P2Hydrazine

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

18. Public Disclosure of Information and forms

The Minister of the Environment intends to publish information submitted in response to the Notice in schedules 1 and 5 in the Pollution Prevention Planning section of the Government of Canada website.

Under section 313 of the Act, a person or class of persons submitting information to the Minister may submit with the information a written request that specific information be treated as confidential. A person or class of persons submitting such a request should also include the reasons for every section where confidentiality is being requested.

The Notice includes the following forms:

Forms referred to in the Notice (schedules 1 to 5) are published as part of the Notice and should be filled out electronically using the Pollution Prevention Planning Online Reporting Tool through the Single Window Information Manager system.

For guidance on how to complete the schedules, please refer to the Instructions for Completing the Schedules Required by the Pollution Prevention Planning Notice in Respect of Hydrazine Related to the Electricity Sector.

For additional guidance on how to complete the schedules online, please refer to the How to use the P2 notice reporting tool.

19. Environment Canada contact information

For technical questions about the Notice, please contact

Electricity and Combustion Division
Environment Canada
351 Saint-Joseph Boulevard
Gatineau, Quebec
K1A 0H3
Email: ec.electricite-electricity.ec@canada.ca

For more information about pollution prevention planning, please contact

Regulatory Innovation and Management Systems
c/o Innovative Measures Section
Environment Canada
351 Saint-Joseph Boulevard, 20th Floor
Gatineau, Quebec
K1A 0H3
Telephone (toll-free): 1-844-580-3637
Fax: 819-420-7386 or toll-free: 1-844-580-3638
Email: ec.planp2-p2plan.ec@canada.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 website.

The Act is enforced in accordance with the Compliance and Enforcement Policy for the Canadian Environmental Protection Act, 1999.

Suspected violations under the Act can be reported to the Enforcement Branch by email at environmental.enforcement@canada.ca.

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 16 to 19 in the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only. The format and design of the online version may slightly differ from this version.

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)

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? ☐ Yes ☐ No

If yes, please specify the amended part(s) and reason(s) 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

Company

Company name: _______________________________________________________________________

Canadian Federal Business Number: _________________________________________________________

Facility Information

Facility Name: ________________________________________________________________________

Physical Address

Unit Number: ________ Street Number: ________ Street Name: ____________________________________

Street Type: ___________________ Street Direction: ______________ City: _________________________

Province/Territory: ___________________ Postal Code: ____________ Country: _______________________

Mailing Address

Same as Physical Address ☐

PO Box: _______________ Rural Route Number: _________ Unit/Suite/Building Number: _________________

Street Number: ____________ Street Name: _______________________________ Street Type: ___________

Street Direction: _______ City: ____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

National Pollutant Release Inventory (NPRI) ID: __________________________________________________

North American Industry Classification System (NAICS) code: ________________________________________

Technical Contact

Name: ___________________________________________

Position/Job Title: ___________________________________

Mailing Address

PO Box: _______________ Rural Route Number: _________ Unit/Suite/Building Number: _________________

Street Number: ____________ Street Name: _______________________________ Street Type: ___________

Street Direction: _______ City: ____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

Telephone Number: ____________________ Extension: ________ Fax Number: _______________________

Email: ______________________________________________________________________________

General Contact

Same as Facility Technical Contact ☐

Name: ___________________________________________

Position/Job Title: ___________________________________

Mailing Address

PO Box: _______________ Rural Route Number: _________ Unit/Suite/Building Number: _________________

Street Number: ____________ Street Name: _______________________________ Street Type: ___________

Street Direction: _______ City: ____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

Telephone Number: ____________________ Extension: ________ Fax Number: _______________________

Email: ______________________________________________________________________________

2.0 Use of Existing Plans

Prior to this Notice, did your facility have a Pollution Prevention Plan (P2 Plan) in regards to hydrazine? ☐ Yes ☐ No

If yes, the P2 Plan was previously prepared:

 
 

If a P2 Plan was previously prepared, did you use that P2 Plan (all or in part) to meet the requirements of the Notice? ☐ Yes ☐ No

3.0 Information on the Size of the Receiving Freshwater Body (other than the Great Lakes)

Did this facility release an effluent containing hydrazine during the Preparation Year to a large freshwater body, as defined in section 1 of the Notice?

☐ Yes ☐ No

If yes, the table below must be completed separately for each effluent that was released to a large freshwater body.

Name of discharge point: _________________________________________________________________

Name of receiving water body: ______________________________________________________________

Please specify the ratio of receiving water flow to effluent flow calculated using the 10th percentile of the receiving water flow (or equivalent), and the highest expected effluent flow containing hydrazine.

  Flow Rate Flow Rate Unit
Receiving water    
Effluent    
Ratio   n/a

Estimation Methods

4.0 Baseline Information

Indicate the Preparation Year for which you are reporting: from (Year-Month-Day) to (Year-Month-Day).

All information provided in this Declaration will refer to this Preparation Year.

In Part 4.0, where indicated, use the following Basis of Estimate Codes to describe how each quantity reported in this part of the Declaration was determined:

4.1 On-site Uses

Did this facility use Hydrazine on site in the Preparation Year? ☐ Yes ☐ No

If yes, please specify the Use/Process (select all that apply).

☐ As a physical or chemical processing aid (e.g. boiler water chemistry control)

☐ Other

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

4.2 Releases to Receiving Water

Did this facility release hydrazine to receiving water during the Preparation Year?

☐ Yes ☐ No

If yes, report the quantity of all releases of hydrazine to receiving water.

Type of Releases to Waters Quantity Released During the Preparation Year
(kg)
Basis of Estimate Code
(a) Release to receiving water from all final discharge points    
(b) Release to receiving water not through designated final discharge points (spills, leaks)    
TOTAL   n/a

4.3 Release to On-site Water Treatment System

Did this facility release hydrazine to an on-site water treatment system during the Preparation Year?

☐ Yes ☐ No

If yes, report the quantity.

Release to On-site Water Treatment System
(Kg)
Basis of Estimate Code
   

4.4 Off-site Transfers for Disposal

Did this facility transfer hydrazine off-site for disposal in the Preparation Year?

☐ Yes ☐ No

If yes, report the quantity of all off-site transfers for disposal.

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      
(i) Other      
TOTAL   n/a n/a

4.5 Sampling and Analysis — Concentration of Hydrazine at Final Discharge Points

The table below must be completed separately for each Final Discharge Point.

Name of discharge point: _________________________________________________________________

Name of receiving water body: ______________________________________________________________

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

Comments

 

5.0 Anticipated Actions and Anticipated Results

5.1 Anticipated Actions

Parts 5.1.1 through 5.1.5 must be completed separately for each anticipated action. (i.e. Part 5.1 will be completed as many times as there are actions taken to date to report).

5.1.1 Action to be taken

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

___________________________________________________________________________________

What is the current status of this action?

☐ Planned/To Be Initiated

☐ In Progress

☐ Completed

Describe the anticipated action to be taken.

 

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

5.1.2 Types of Pollution Prevention Methods (select all that apply)

☐ Material or feedstock substitution

☐ Product design or reformulation

☐ Equipment or process modifications

☐ Spill and leak prevention

☐ On-site reuse, recycling or recovery

☐ Inventory management or purchasing techniques

☐ Good operating practices or training

☐ Other (please specify): ____________________________________

5.1.3 Types of Environmental Protection Methods (select all that apply)

☐ Energy recovery

☐ Off-site recycling

☐ Incineration with energy recovery

☐ Waste treatment

☐ Pollution control

☐ Disposal

☐ Other (please specify): ________________________

5.1.4 Anticipated Changes: ________________________________
5.1.5 Baseline Elements Affected by Anticipated Changes

☐ Quantity of on-site uses

☐ Releases to receiving water from all final discharge points

☐ Releases to receiving water not through designated final discharge point

☐ Releases to on-site water treatment system

☐ Quantity of off-site transfers for disposal

☐ Concentration in effluent at final discharge points

5.1.6 Planned Completion Date for Anticipated Action (YYYY-MM-DD): _____________________________________

5.2 Total Anticipated Results

Report the total anticipated change from ALL anticipated actions described in Part 5.1 of this Declaration.

Type of Use/Release/Transfer Total Anticipated Change Relative to the Preparation Year
(kg)
Total Anticipated Change
Relative to the Preparation Year
(%)
On-site uses    
Releases to receiving water from all final discharge points    
Releases to receiving water not through designated final discharge points    
Releases to on-site water treatment system    
Off-site transfers for disposal    
Total    

5.3 Detailed Anticipated Results Information

Report the total anticipated change from ALL anticipated actions described in Part 5.1 of this Declaration.

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

6.0 Monitoring

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

 

7.0 Risk Management Objective

 

Do you anticipate meeting the Risk Management Objective?

☐ Yes ☐ No

Describe how the elements of the Pollution Prevention Plan will meet the risk management objective for hydrazine. If no, explain why.

 

8.0 Factors to Consider

 

Describe how the factors to consider set out in subsections 4(3) to 4(5) of the Notice were taken into account when preparing the Pollution Prevention Plan.

4(3) Priority to Pollution Prevention Activities

 

4(4) Coverage of Effluent Streams and their Identification

 

4(5)(a) Sampling Activities

 

4(5)(b) Analysis Activities

 

9.0 Certification

The information submitted in this Schedule will be made available to the public except for the

☐ 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.

Name: _________________________________________________

Title/Position: ____________________________________________

Email: _________________________________________________

Date: __________________________________________________

General Comments

 

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 16 to 19 in the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only. The format and design of the online version may slightly differ from this version.

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)

Notice Reference Code: P2Hydrazine
Contacts (Part 1.0)
Company

Company Name: ______________________________________________________________________

Canadian Federal Business Number: ________________________________________________________

Facility Information

Facility Name: _______________________________________________________________________

Physical Address

Unit: __________________ Street Number: __________________ Street Name: _______________________

Street Type: _______________ Street Direction: ________________________________________________

City: ____________________ Province/Territory: ___________________________ Postal Code: __________

Country: ____________________________________________________________________________

Mailing Address Same as Physical Address ☐

PO Box: _________ Rural Route Number: _______________ Unit: _________________ Street Number: _________________

Street Name: _________________ Street Type: ______________ Street Direction: _______________________

City: ___________________ Province/Territory: _____________________ Postal Code: _________________

Country: ____________________________________________________________________________

National Pollutant Release Inventory (NPRI) ID: _________________________________________________

Six-digit North American Industry Classification System (NAICS) code: __________________________________

Facility Technical Contact

Name: ________________________________ Position/Job Title: _________________________________

Mailing Address: _____________________ Telephone Number: ______________ Fax Number: _____________

Email: ______________________________________________________________________________

General Contact Same as Facility Technical Contact ☐

Name: ______________________________ Position/Job Title: ___________________________________

Mailing Address: ______________________ Telephone Number: ________________ Fax Number: ___________

Email: ______________________________________________________________________________

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

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

 

Rationale for Request (Part 3.0)

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).

 

Certification (Part 4.0)

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

Name (required): _________________________________________

Title/Position (required): ___________________________________

Email (required): _________________________________________

General Comments

 

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 16 to 19 in the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only. The format and design of the online version may slightly differ from this version.

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

P2 Notice Reference Code: P2Hydrazine
Contacts (Part 1.0)
Company

Company Name: ______________________________________________________________________

Canadian Federal Business Number: _________________________________________________________

Facility Information

Facility Name: ________________________________________________________________________

Physical Address

Unit: _____________________ Street Number: _________________ Street Name: _____________________

Street Type: ___________________ Street Direction: ____________________________________________

City: ____________________ Province/Territory: ___________________ Postal Code: __________________

Country: ____________________________________________________________________________

Mailing Address Same as Physical Address ☐

Unit: _________ PO Box: __________ Rural Route Number: _______________ Street Number: _____________

Street Name: _____________ Street Type: _____________ Street Direction: ____________________________

City: __________________ Province/Territory: ___________________ Postal Code: ____________________

Country: ____________________________________________________________________________

National Pollutant Release Inventory (NPRI) ID: _________________________________________________

Six-digit North American Industry Classification System (NAISC) code: __________________________________

Facility Technical Contact

Name: ______________________________ Position/Job Title: ___________________________________

Mailing Address: _______________________ Telephone Number: ______________ Fax Number: ____________

Email: ______________________________________________________________________________

General Contact Same as Facility Technical Contact ☐

Name: _________________________________ Position/Job Title: ________________________________

Mailing Address: __________________ Telephone Number: _______________ Fax Number: _______________

Email: ______________________________________________________________________________

Request for Time Extension (Part 2.0)

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

☐ to prepare a Pollution Prevention Plan

☐ to implement a Pollution Prevention Plan

Are you requesting to extend a time extension already granted by Environment and Climate Change Canada?

☐ Yes ☐ No

We request that the date be extended to: _____________________ (specify exact date – YYYY-MM-DD)

Rationale for Request (Part 3.0)

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

 
Certification (Part 4.0)

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

Name (required): _________________________________________

Title/Position (required): ___________________________________

Email (required): _________________________________________

General Comments

 

NOTE: Please contact Environment Canada for more information about electronic reporting, as provided in sections 16 to 19 of the Notice. Do not fill out this form as it appears in the Canada Gazette; it is for information only. The format and design of the online version may slightly differ from this version.

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)

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? ☐ Yes ☐ 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 parts of the Declaration that you would like to amend.

 
Amendment Reason(s)

Please specify the reason 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
Company

Company name: _______________________________________________________________________

Canadian Federal Business Number: _________________________________________________________

Facility Information

Facility Name: ________________________________________________________________________

Physical Address

Unit Number: ________ Street Number: ________ Street Name: _____________________________________

Street Type: ___________________ Street Direction: ______________ City: __________________________

Province/Territory: ___________________ Postal Code: ____________ Country: _______________________

Mailing Address Same as Physical Address ☐

PO Box: _______________ Rural Route Number: _________________ Unit/Suite/Building Number: __________

Street Number: _______________ Street Name: ________________ Street Type: ________________________

Street Direction: _______ City: ____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

National Pollutant Release Inventory (NPRI) ID: _________________________________________________

North American Industry Classification System (NAICS) code: ________________________________________

Technical Contact

Name: ___________________________________________

Position/Job Title: ___________________________________

Mailing Address

PO Box: _______________ Rural Route Number: _________ Unit/Suite/Building Number: _________________

Street Number: ____________ Street Name: _______________________________ Street Type: ___________

Street Direction: _______ City: _____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

Telephone Number: ____________________ Extension: ________ Fax Number: _______________________

Email: ______________________________________________________________________________

General Contact Same as Facility Technical Contact ☐

Name: ___________________________________

Position/Job Title: ___________________________

Mailing Address

PO Box: _______________ Rural Route Number: _________ Unit/Suite/Building Number: _________________

Street Number: ____________ Street Name: _______________________________ Street Type: ___________

Street Direction: _______ City: ____________________________________________________________

Province/Territory: ____________________ Postal Code: ________________ Country: __________________

Telephone Number: ____________________ Extension: ________ Fax Number: _______________________

Email: ______________________________________________________________________________

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

3.0 Information on the Size of the Receiving Freshwater Body (other than the Great Lakes) — No data is required for Part 3.0 of this Report.

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

Indicate the Implementation Year for which you are reporting: from (Year-Month-Day) to (Year-Month-Day).

All information provided in this Declaration will refer to this Implementation Year.

In Part 4.0, where indicated, use the following Basis of Estimate Codes to describe how each quantity reported in this part of the Declaration was determined:

4.1 On-site Uses

Did this facility use hydrazine on-site during the Implementation Year?

☐ Yes ☐ No

Use/Process (select all that apply)

☐ As a physical or chemical processing aid (e.g. boiler water chemistry control)

☐ Other

Total Quantity of all On-site Uses for the Implementation Year
(kg)
Basis of Estimate Code
   
4.2 Releases to Receiving Water

Did this facility release hydrazine to receiving water during the Implementation Year?

☐ Yes ☐ No

If yes, report the quantity of all releases of hydrazine to receiving water.

Type of Releases to Waters Quantity Released during the Implementation Year
(kg)
Basis of Estimate Code
a) Release to receiving water from all final discharge points    
b) Release to receiving water not through designated final discharge point (spills, leaks)    
TOTAL   n/a
4.3 Release to On-site Water Treatment System

Did this facility release hydrazine to an on-site water treatment system during the Implementation Year?

☐ Yes ☐ No

If yes, report the quantity.

Release to on-site water treatment system
(Kg)

Basis of Estimate Code
   
4.4 Off-Site Transfers for Disposal

Did this facility transfer hydrazine off-site for disposal in the Implementation Year?

☐ Yes ☐ No

If yes, report the quantity of all off-site transfers for disposal.

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      
i) Other      
TOTAL   n/a n/a
4.5 Sampling and Analysis — Concentration of Hydrazine at Final Discharge Points

The table below must be completed separately for each Final Discharge Point.

Name of discharge point: ___________________________________

Name of receiving water body: _______________________________

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

n/a

Comments

 
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.

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?

☐ Completed

☐ Discontinued

If the action was "Discontinued," please provide the reason why.

 

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

5.1.2 Types of Pollution Prevention Methods

☐ Material or feedstock substitution

☐ Product design or reformulation

☐ Equipment or process modifications

☐ Spill and leak prevention

☐ On-site reuse, recycling or recovery

☐ Inventory management or purchasing techniques

☐ Good operating practices or training

☐ Other (please specify): _________________________

5.1.3 Types of Environmental Protection Methods

☐ Energy recovery

☐ Off-site recycling

☐ Incineration with energy recovery

☐ Waste treatment

☐ Pollution control

☐ Disposal

☐ Other (please specify): ___________________________

5.1.4 Changes Achieved: __________________________________________________
5.1.5 Baseline Elements Affected

☐ Quantity of on-site uses

☐ Releases to receiving water from all final discharge points

☐ Releases to receiving water not through designated final discharge point

☐ Releases to on-site water treatment system

☐ Quantity of off-site transfers for disposal

☐ Concentration in effluent at final discharge points

5.1.6 Completion Date of Action (YYYY-MM-DD): ___________________________________________
5.2 Total Results Achieved

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.

Type of Use/Release/Transfer

Total Anticipated Change Relative to the Preparation Year
(kg)

Total Anticipated Change Relative to the Preparation Year
(%)

On-site uses    
Releases to receiving water from all final discharge points    
Releases to receiving water not through designated final discharge points    
Releases to on-site water treatment system    
Off-site transfers for disposal    
Total    
5.3 Detailed Results Achieved Information

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.

Final Discharge Point

Total Change of the Concentration Achieved to Date Relative to the Preparation Year
(μg/L)

Total Change of the 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

Do you meet the Risk Management Objective?

☐ Yes ☐ No

Describe how the elements of the Pollution Plan met the Risk Management Objective(s) for Hydrazine. If this Plan did not meet the Risk Management Objective, explain why.

 
8.0 Factors to Consider

Describe how the factors to consider set out in subsections 4(3) to 4(5) of the Notice were taken into account when preparing the Pollution Prevention Plan.

4(3) Priority to Pollution Prevention Activities

 

4(4) Coverage of Effluent Streams and their Identification

 

4(5)(a) Sampling Activities

 

4(5)(b) Analysis Activities

 
9.0 Certification

The information submitted in this Schedule will be made available to the public except for the

☐ 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.

Name: _________________________________________________

Title/Position: ___________________________________________

Email: _________________________________________________

Date: __________________________________________________

General Comments