Clean Air  

BREDL Comments on Stericycle Title V Permit

BLUE RIDGE ENVIRONMENTAL DEFENSE LEAGUE ~ PO Box 88 Glendale Springs, North Carolina 28629 ~ Phone (336) 982-2691 ~ Fax (336) 982-2954 ~ Email:

January 15, 2002
Michael Landis, Public Hearing Officer Division of Air Quality-MRO
919 N. Main St.
Mooresville, NC 27107  

Re: Stericycle, Inc, Haw River, Alamance County Air Quality Permit No. 05896T14 Facility ID: 04/01/00010

Dear Mr. Landis:

On behalf of the Board of Directors of the Blue Ridge Environmental Defense League, I write to comment on the proposed Title V permit for Stericycle, Inc.

General Comments

The state of North Carolina cannot at present ensure that medical waste incinerators are operated without threatening public health and the environment. Blue Ridge Environmental Defense League is working with our members to end pollution from commercial medical waste incineration in two North Carolina communities: Matthews in Mecklenburg County and Haw River in Alamance.

Medical waste incinerators are the second largest known source of dioxin in the United States. Health effects of prolonged dioxin exposure include impairment of immune, nervous and endocrine systems. Dioxin is a known human carcinogen. In addition to dioxin, toxic air pollutants from medical waste incinerators include arsenic, chromium IV, cadmium, lead, hydrochloric acid, and mercury. Medical waste incinerators are even bigger polluters than other types of waste burners; North Carolina permits medical waste incinerators to emit 60% more cadmium, 108% more dioxin, and 580% more mercury than solid waste incinerators.

Overloading the Incinerator

Stericycle is permitted to burn 1,911 pounds per hour in each of the two units, a total of 33,480,720 pounds of medical waste a year. Investigations by the Blue Ridge Environmental Defense League show that the company exceeded its allowable burn rate eight times in a five months period during 2000. Stericycle’s operators overloading waste by as much as 11% over the maximum, oftentimes between the hours of midnight and 7:00 AM.

In November 2000 the state recommended civil penalties for five episodes of excess waste burning in the incinerator. But Stericycle said the computer system which recorded the weight violations was only a “billing tool for accounting purposes,” and that the hand written operating logs recorded no excess weights. After issuing a series of violations to Stericycle, North Carolina’s Division of Air Quality, which can levy fines of $10,000 per violation, opted to let the company off the hook. No fines were imposed.

Failed Stack Tests

Stericycle’s must test its incinerators periodically to demonstrate compliance with pollution limits. In October 2000 Stericycle submitted test results which indicated that state and federal standards were met. But the Division of Air Quality discovered “computational errors” in the report filed by Stericycle which falsely indicated compliance with the particulate matter (PM) standard. The incinerator had actually emitted PM 5.4% above the maximum. Each day of operation over the limit makes the operator subject to a civil penalty of $10,000 per day. In February DAQ issued a notice of violation and recommended enforcement.

In March Stericycle employed the same testing firm, Custom Stack Analysis, Inc., to repeat the PM emission test and analysis. This time the results indicated a PM emission rate in compliance with state regulation. The DAQ, upon reviewing the data, levied a fine of only $4,000.

The Blue Ridge Environmental Defense League is on record asking for a further, independent verification of the test results at Stericycle. We question the validity of emissions tests for dioxins and furans— two highly toxic products of waste combustion. Medical waste incinerators are known to emit high levels of dioxin, but the October 2000 test results for dioxin were below detection limits, virtually zero. Even one state official remarked that non-detection of dioxin was “surprising.”

Specific Comments

Excess Emissions

The draft permit Section 3.F requires that pollution control devices be operated at all times to reduce air pollution.


The facility shall be properly operated and maintained at all times in a manner that will effect an overall reduction in air pollution. Unless otherwise specified by this permit, no emission source may be operated without the concurrent operation of its associated air pollution control device(s) and appurtenances.

However, plant neighbors report that they observe frequent use of the bypass stack. State and federal regulations prohibit the circumventing of air pollution control devices. Compliance with NAAQS would not be possible without control devices. For example, particulate matter is typically reduced by 93% to 99.9% by common pollution control devices. Operation without such a device would result in actual emissions would be from 100 to 1000 times higher than permitted.

DAQ Inspection Reports reveal that no records of bypass stack use or precautions to minimize bypass are kept by Stericycle (NCDAQ WSRO Inspection Report 08/15/2001 attached). Under these circumstances, operation of the bypass stack is a violation of both state and federal regulations. The state cannot permit an ongoing violation.


(a) For this Rule the following definitions apply: (1) "Excess Emissions" means an emission rate that exceeds any applicable emission limitation or standard allowed by any rule in Sections .0500, .0900, .1200, or .1400 of this Subchapter; or by a permit condition; or that exceeds an emission limit established in a permit issued under 15A NCAC 2Q .0700.

(2) "Malfunction" means any unavoidable failure of air pollution control equipment, process equipment, or process to operate in a normal and usual manner that results in excess emissions. Excess emissions during periods of routine start-up and shut- down of process equipment shall not be considered a malfunction. Failures caused entirely or in part by poor maintenance, careless operations or any other upset condition within the control of the emission source shall not be considered a malfunction.

(c) Any excess emissions that do not occur during start-up or shut- down shall be considered a violation of the appropriate rule unless the owner or operator of the source of excess emissions demonstrates to the Director, that the excess emissions are the result of a malfunction….All malfunctions shall be repaired as expeditiously as practicable. However, the Director shall not excuse excess emissions caused by malfunctions from a source for more than 15 percent of the operating time during each calendar year. The Director may require the owner or operator of a facility to maintain records of the time that a source operates when it or its air pollution control equipment is malfunctioning or otherwise has excess emissions.

(g) Start-up and shut-down. Excess emissions during start-up and shut-down shall be considered a violation of the appropriate rule if the owner or operator cannot demonstrate that the excess emissions are unavoidable. To determine if excess emissions are unavoidable during startup or shutdown the Director shall consider the items listed in Paragraphs (c)(1), (c)(3), (c)(4), (c)(5), and (c)(7) of this Rule along with any other pertinent information. The Director may specify for a particular source the amount, time, and duration of emissions allowed during start-up or shut-down. The owner or operator shall, to the extent practicable, operate the source and any associated air pollution control equipment or monitoring equipment in a manner consistent with best practicable air pollution control practices to minimize emissions during start-up and shut-down.

emphasis added  15A NCAC 2D .0535

Enforcement is Lacking

The DAQ must rely on complaints from citizens to enforce regulations which limit visible emissions and odor [15A NCAC 2D .0521 and .1806]. However, DAQ’s record on Stericycle reveals a lack of will or ability to respond to plant neighbor’s complaints. I submit the following examples drawn from DAQ files:

January 15, 2001: Sam Kiser, who lives in Haw River, complains to the NC Division of Air Quality’s regional office about black smoke coming from the incinerator. He says he observed the smoke at about nine o’clock in the evening. He adds that the stacks emit smoke frequently. Rather than going to the facility to check, the inspector at DAQ calls Stericycle’s plant manager on the phone. The manager faxes records which reveal elevated carbon monoxide emissions and a spike in scrubber pH at 9:15 PM on the 15th. DAQ concludes that medical waste with a high moisture content could have caused the increase in visible emissions seen by Mr. Kiser. In his report, the state inspector wrote, “Since the emission occurred at night, it is difficult…to categorize a visible emission, and there is no real reason to believe the incinerators were operating…in violation.” Also, he cites stack tests completed in October which showed that the incinerator was operating within permitted limits.

February 21, 2001: Sam Kiser again sees black smoke coming from the incinerator. This incident begins at 6:00 AM and lasts for two hours. DAQ’s second investigation-by-telephone determines it may have been the “lighting conditions” on that morning. No further action was taken.

These are but two examples of poor enforcement which can and must be corrected. Visible emissions regulations are federally enforceable, odor rules state enforceable. Since DAQ will continue to rely on calls from residents to ensure compliance with VE and odor, the permit must stipulate where and how citizens complaints shall be recorded, what actions shall be initiated by DAQ, and a time frame for resolution of the complaint.

Procurement and Waste Management

Proper procurement practices can help to reduce the amount of packaging, find alternative non-toxic products (latex, mercury, PVC), and reduce the use of disposable items.

Waste segregation can drastically reduce the volume and toxicity of the waste stream. It is a necessary component of recycling, and requires some training and education. Waste segregation will reduce the amount of materials incinerated, since only Pathological Wastes must be disposed of by incineration, according to the Centers for Disease Control guidelines. Medical products which are made of PVC plastic (#3) should especially be segregated and NOT incinerated because they can produce dioxin-like substances, which are endocrine disruptors and carcinogens.

Permit condition 2.1.A.1.d)(5) stipulates that Stericycle must comply with 40 CFR 60.55c which requires a management plan. The EPA medical waste MACT rule requires hospitals that operate incinerators to have medical waste management plans (see Attachment 1: FR48347-8, 9/15/97). To prevent circumvention of the requirement to control toxic emissions with waste management controls, Stericycle should not accept waste from any hospital that does not have a waste management plan as outlined in the MACT rule. This should be stipulated in the Title V permit.


Louis Zeller

1) Federal Register Document HMIWI Waste Management Plans-Final Rule

2) DAQ Inspection Report 8/15/01


[Federal Register: September 15, 1997 (Volume 62, Number 178)] [Rules and Regulations] [Page 48347-48391] From the Federal Register Online via GPO Access [] [DOCID:fr15se97-10] [[Page 48347]]

"Therefore, the final HMIWI standards and guidelines require that health care facilities which operate incinerators develop and implement a waste management plan.

The waste management plan would identify both the feasibility and the approach to separate certain components of solid waste from the health care waste stream in order to reduce the amount of toxic emissions from incinerated waste. The waste management plan may include elements such as paper, cardboard, plastics, glass, battery, or metal recycling; or purchasing recycled or recyclable products. A waste management plan may include different goals or approaches for different areas or departments of the facility and need not include new waste management goals for every waste stream. It should identify, where possible, reasonably available additional waste management measures, taking into account the effectiveness of waste management measures already in place, the costs of additional measures, the emission reductions expected to be achieved, and any other environmental or energy impacts they might have. A copy of the waste management plan would be submitted to EPA along with the results of the initial performance test demonstrating compliance with the emission limits. In addition, the waste management plan may be reviewed by the Joint Commission on Accreditation of Health Care Organizations during the accreditation process. Health care facilities are encouraged to review and incorporate into their waste management plans the waste minimization techniques discussed in ``An Ounce of Prevention: Waste Reduction Strategies for Health Care Facilities,'' which is published by the American Society for Health Care Environmental Services of the American Hospital Association. This document may be obtained by contacting AHA Services, Inc., P.O. Box 92683, Chicago, Illinois 60675-2683, or by calling 800-242-2626. The cost of the document is $50.00 plus $10.95 for shipping and handling. The document is available for public inspection at EPA's Air and Radiation Docket and Information Center (Docket A-91-61, item IV-J-124). See the ADDRESSES section at the beginning of this preamble for the location of the Docket. Note that because of copyright law, this document may not be copied. This document was approved for incorporation by reference by the Director of the Federal Register in accordance with 5 U.S.C. 552(a) and 1 CFR part 51."


Part II

Environmental Protection Agency


40 CFR Part 60 Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources: Hospital/Medical/Infectious Waste Incinerators; Final Rule [[Page 48348]] ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 60 [AD-FRL-5878-8] RIN 2060-AC62 Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources: Hospital/Medical/Infectious Waste Incinerators AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule.


SUMMARY: This action promulgates new source performance standards (NSPS or standards) and emission guidelines (EG or guidelines) to reduce air emissions from hospital/medical/infectious waste incinerator(s) (HMIWI) by adding subpart Ec, standards of performance for new HMIWI, and subpart Ce, emission guidelines for existing HMIWI, to 40 CFR part 60. The standards and guidelines implement sections 111 and 129 of the Clean Air Act (CAA) as amended in 1990. The standards and guidelines apply to units whose primary purpose is the combustion of hospital waste and/or medical/infectious waste. Sources are required to achieve emission levels reflecting the maximum degree of reduction in emissions of air pollutants that the Administrator has determined is achievable, taking into consideration the cost of achieving such emission reduction, any nonair-quality health and environmental impacts, and energy requirements. The promulgated standards and guidelines establish emission limits for particulate matter (PM), opacity, sulfur dioxide (SO2), hydrogen chloride (HCl), oxides of nitrogen (NOX), carbon monoxide (CO), lead (Pb), cadmium (Cd), mercury (Hg), dioxins and dibenzofurans (dioxins/furans), and fugitive ash emissions. Some of the pollutants being regulated are considered to be carcinogens and at sufficient concentrations can cause toxic effects following exposure. The standards and guidelines also establish requirements for HMIWI operator training/qualification, waste management plans, and testing/monitoring of pollutants and operating parameters. Additionally, the guidelines for existing HMIWI contain equipment inspection requirements and the standards for new HMIWI include siting requirements.

BLUE RIDGE ENVIRONMENTAL DEFENSE LEAGUE ~ PO Box 88 Glendale Springs, North Carolina 28629 ~ Phone (336) 982-2691 ~ Fax (336) 982-2954 ~

January 22, 2002  
Michael Landis, Public Hearing Officer Division of Air Quality-MRO
919 N. Main St.
Mooresville, NC 27107

Re: Stericycle, Inc, Haw River, Alamance County, Air Quality Permit No. 05896T14, Facility ID: 04/01/00010  

Dear Mr. Landis

I write to provide additional comments on the proposed Title V permit for Stericycle and to make some specific recommendations. First, as you are aware, we at BREDL are gravely concerned about the use of the bypass stack at the incinerator. Recommendation 1: The bypass stack should be tested for all emissions in the initial performance tests of the incinerator. Recommendation 2: Continuous emission monitoring of the bypass stack should be a requirement for continued incinerator operation.

We believe that the toxic air pollutant modeling is incomplete. Recommendation 3: Toxic emissions from the bypass stack and the backup diesel generator should be included. Any other toxic emissions omitted from the modeling should be included in a facility-wide model.

Confirmatory testing is incomplete. Recommendation 4: Air monitors should be a permanent requirement for the Stericycle incinerator, to include one or more monitors in the points of greatest impact identified by a facility-wide model and to include offsite air monitors also in the area of greatest modeled impact and in other offsite locations. The affected community should participate in the air monitoring program. Recommendation 5: Confirmatory tests for dioxins should be a requirement, to include soil testing, water testing, milk and tissue testing. Recommendation 6: Confirmatory tests for mercury should be required — both at the modeled greatest impact area and offsite.

We believe that the affected community residents have not had an adequate opportunity to review Stericycle’s waste management plan; therefore, we request an extended comment period for public review and comment on the plan. At a minimum, the plan should comply with the most stringent federal requirements for incinerators. Recommendation 7: Stericycle should not be allowed to incinerate wastes from any public, private, or commercial source which does not have a waste management plan. Recommendation 8: Wastes containing polyvinyl chloride should be categorically excluded from the Stericycle incinerator. Recommendation 9: All manifests for medical and infectious wastes should be accessible for public review, perhaps in files in the Winston-Salem Regional Office of DENR.

Partly because of problems with earlier stack tests and partly because of generic stack test limitations, state regulators and the public need to know what wastes are being incinerated during the testing. Recommendation 10: Through source codes, manifests and other means, the constituency of wastes burned during stack tests should be identified and characterized. For example, what percentage of the waste is liquid or solid, paper or plastic, etc?

Unpleasant, even noxious odors continue to be present offsite. Recommendation 11: Stericycle should implement an odor reduction regimen which does not add additional toxins to emissions. Problems persist on weekends and at night at the facility. Odors and emissions are greater at these times. Recommendation 12: A permanent onsite inspector to be paid by the state with funds provided by Stericycle should be hired.

Thank you for your consideration of these additional comments.


Janet Marsh Zeller Executive Director    

CC: Laura Butler Myron Whitley Dan March

More info:

Title V Fact Sheet
BREDL comments on other Title V permits