                                                  OMB Control No. 20XX-XXXX    
                                            								Approval expires XX/XX/XX  
                                                                               
                                     DRAFT

Sample Data Tracking Form for Collection of Information on Anaerobic Digestion Facilities Processing Wasted Food to Support EPA's Sustainable Food Management Programs  

Section I.	Facility and Contact Information
_____________________________________________________________________________________
 Project/Facility Name:

 Type of Stand-Alone Facility: 
 Multi-Source Digester 
 Industry Dedicated Digester
 Other  -  please specify. 

 Street address of facility:

 City, County, State:

 Contact information for facility operational data:
 Name
 Phone number
 Email 
 Mailing address

 Facility operating status: 
 Planning stage; 
 In permitting process; 
 Under construction; 
 Operational; 
 Temporary shut-down;
 Ceased operation;
 Other  -  please specify.










Section II.	Feedstock and Capacity Information: 
_____________________________________________________________________________________ 
 In Table 1 below, please identify the types of Food-Based Materials (feedstocks) that are processed in your digester.   Check all that apply.  

Feedstock Type: 
Accepted (Y/N?):
Generated Onsite/Offsite?
Source of Feedstock:
Volume processed in 2015 (in tons or gallons  -  pls specify)
Fruit/vegetative wastes




Food processing industry waste




Beverage processing industry waste




Food service waste, pre & post-consumer




Retail food waste




Source-separated commercial, institutional or residential organic wastes




Fats, oils and greases (FOG)




Rendering wastes




Other (please specify):

                        Table 1: Food-Based Feedstocks

 Please provide the total amount of Food-Based Materials processed at this facility.  The preferred units are total tons or total gallons (please specify).
 During calendar year 2014 = _______________________ 
 During calendar year 2015 = _______________________
 During calendar year 2016 = _______________________

 In Table 2 below, please identify the types of Non-Food-Based Materials that are processed in your digester.  Check all that apply.  

                      Table 2: Non-Food-Based Feedstocks
                           Non-Food-Based Feedstocks
Feedstock Type: 
Accepted (Y/N?):
Generated Onsite/Offsite?
Source of Feedstock
Volume processed in 2015 (in tons or gallons  -  pls specify)
Mixed yard waste




Crop residues




Manures




Wastewater solids (sludge)




Litters




De-icing fluid




Lab (or Pharma) wastes




Paper mill wastes




Crude glycerine




Other (please specify):


 Please provide the total amount of Non-Food-Based Materials processed at this facility.  The preferred units are total tons or total gallons (please specify).
 During calendar year 2014 = _______________________ 
 During calendar year 2015 = _______________________ 
 During calendar year 2016 = _______________________

 Please describe any feedstock pre-processing and the reason for pre-processing

 Please describe your de-packaging process, if applicable. 

 Please identify the tipping fee charged for offsite feedstocks including units (e.g., $/ton or $/gal).  

Section III.	Design Specifications:
_____________________________________________________________________________________
 Please answer the following questions about your digester: 
 What is your temperature range? 
 Unheated 
 Ambient 
 Thermophillic
 Mesophillic)
 Is your digester Wet or Dry?
 Is your digester Batch or Continuous Flow?
 Is your digester Single or Multi-stage?
 How would you describe your digester?
 Continuous Stirred Tank Reactor 
 High Rate Bioreactor 
 Plug Flow
 Complete mix
 Covered Lagoon
 Induced Blanker Reactor
 Hydraulic Self-stir Reactors
 Hybrid
 Fixed Film
 Unknown
 Other







Section IV.	Product End-Uses
_____________________________________________________________________________________

BIOGAS
 Please provide the average biogas production volume at your facility in Standard Cubic Foot (SCF)/minute, SCF/hour or SCF/year:
 During calendar year 2014 = _______________________ 
 During calendar year 2015 = _______________________ 
 During calendar year 2016 = _______________________

 Please identify what the biogas produced at this facility is used for, check all that apply.
 Power engines to produce:
 Mechanical power;
 Heat; and/or
 Electricity 
 Fuel boilers and furnaces to: 
 Heat digesters; and/or 
 Heat other spaces 
 Compressed to vehicle fuels
 Sold to the grid (electricity)
 Renewable natural gas (processed for pipeline injection)
 Other

 Are you able to utilize all of the biogas produced? Yes/No 

 If you can't utilize all the gas, do you flare the excess? Yes/No

 What type of engine(s), turbine(s), boilers, gas purification or fuel cell(s) do you employ?  

 Does the size of your gas utilization system limit your energy production

 Is the biogas produced at this facility used onsite or sold? 

DIGESTATE:
 Is further processing of digestate occurring? Yes/No

 If yes, please specify what kind of processing is occurring and for what reason. 
 Dewatering
 Nutrient recovery 
 to meet NPDES permit requirements
 to recover Nitrogen 
 to recover Phosphorous
 to recover Potassium
 for other use 
 Drying
 Composting
 Other

 Please identify how the liquid digestate is used or managed, check all that apply.  
 Fertilizer/land application
 Re-circulated through digester
 Discharge to Wastewater Treatment Plant
 Other

 Please identify how the solid digestate is used or managed, check all that apply.  
 Direct land application/agricultural use 
 Animal bedding
 As is
 Further processed
 Further processed into a soil amendment, then (check all that apply).  
 Land applied
 Bagged and sold or sold in bulk
 Other
 Made into other products (please specify the products) 
 Other 

 Is any amount of your digestate disposed of in a landfill or incinerated? Yes/No
 If yes, how much digestate was disposed of in a landfill in 2015?  Units = tons or gallons (please specify). 
 If yes, how much digestate was incinerated in 2015?  Units = tons or gallons (please specify). 

Section V.	Identification of other Anaerobic Digestion Facilities Processing Wasted Food
_____________________________________________________________________________________

 Please review the names and locations of facilities in the list provided.  If you are aware of any anaerobic digestion facilities that are processing Food-Based Materials that are not identified in this list, please provide the following information:
 Project/Facility Name
 Type of Facility: 
 Stand-Alone Facility: 
 Multi-Source Digester 
 Industry Dedicated Digester
 Anaerobic digester at a wastewater treatment plant that co-digests organic feedstocks other than wastewater solids/sludges 
 On-farm anaerobic digester that co-digests organic feedstocks other than livestock manures
 Other -  please specify. 
 Street address of facility
 City, County, and State 
 Contact information for facility operational data
 Name
 Phone number
 Email
 Mailing address


The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response.  Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed form to this address.

GLOSSARY
 Co-digestion - Co-digestion happens when more than one type of organic material is digested at the same time.  Digesters are often built for a single purpose.  For example, a farmer may build an anaerobic digester to handle cow manure.   If the farmer also takes food waste from a local grocery store and puts the food waste in the digester along with the cow manure, it is called co-digestion.    

 Feedstocks  -  Feedstocks are organic waste streams that can be processed in an anaerobic digester. Common feedstocks include manure; sewage sludge; wasted food; yard waste; fats, oils, and greases (FOG); and industrial organic residuals.

 Food-Based Materials - Organic wastes suitable for digestion that are food-based including but are not limited to: food scraps that have been separated and collected by municipalities from residential sources; food scraps that have been separated and collected from institutions or venues (prisons, hospitals, stadiums, etc.); food scraps from food preparation at restaurants, cafeterias, and other food services; plate scrapings from restaurants, cafeterias, and other food services; fats, oils and greases; unused food collected from retail stores (bakery items, bruised fruit, items passed shelf life, etc.) and food and beverage processing industry wastes.

 Industry Dedicated Digester - Is a type of Stand-Alone Facility that is typically developed in a certain location for a food-processing plant. These digesters are built to process a specific waste stream or streams from a specific industry location (e.g., brewery waste from a beer company, yogurt by-products from a yogurt company, etc.)

 Multi-Source Digester  -  Is a type of Stand-Alone Facility that could manage source-separated organic waste streams from one or more municipality, institution (e.g., a prison, a university or a hospital), or other source.

 Non-Food-Based Materials  -  Organic wastes suitable for digestion that are not food-based including but not limited to: mixed yard waste, crop residues, manures, wastewater solids (sludge), litters, de-icing fluid, lab (or pharma) wastes, paper mill wastes and crude glycerine.   

 Stand-Alone Facility  -  A Stand-Alone Facility may take other feedstocks but it is designed to process the organic fraction of municipal solid waste (MSW).  Although feedstocks can include yard waste, manures and wastewater solids, the primary feedstock is food-based materials.  This type of facility could be for-profit organics recycling, community-based or built by a municipality to accommodate MSW. 
