                                                  OMB Control No. 20XX-XXXX    
                                            								Approval expires XX/XX/XX  
                                       
The public reporting and record keeping 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.
*Please Note:  This is a complete list of the questions found in this survey.  Depending on how the respondent answers the subsequent questions asked will vary.
Data Tracking Form for Stand-Alone Anaerobic Digesters
Project/Facility Information
 Please provide the following information about your Project/Facility.
Project/Facility Name
Street address
City/Town
State
Zip code
Phone Number

 Please provide the following information for the contact person for facility operations
Name
Title
Email Address
Phone number

 Please provide the contact address (if different from Facility Address)
Street address
City/Town
State
Zip code

Type of Stand-Alone digester
 Which of the following choices best describes your facility?
 Multi-source Food Digester
 Industry dedicated digester
 Other
Facility operating status: 

 Please identify the status of your facility
 Planning stage/ Design stage/Permitting process 
 Under construction
 Operational
 Temporary shut-down
 Ceased operation
 Other

 What is the targeted date for your facility to be operational?

 What date did your facility become operational?

 What date did your facility temporarily shut-down?

 What is the targeted date for your facility to re-start operations?

 What date did your facility cease operations?

 Please state the reason your facility ceased operations.

Facility Total Capacity
 Is the total capacity available at your facility for processing feedstocks measured in gallons per year or tons per year? 

 Please provide the total capacity of your facility in the units identified above.

 During year the 2015, how many months was your facility operational?

 Does your facility accept and process food-based feedstocks?

 What was the total volume of food-based materials received in liquid form and processed at your facility during the 2015 calendar year?  Please express your answer in gallons.

 What was the total weight of food-based materials received in solid form and processed at your facility during the 2015 calendar year?  Please express your answer in tons.

 Does your facility accept and process non-food-based feedstocks?

 What was the total volume of non-food-based materials received in liquid form and processed at your facility during the 2015 calendar year?  Please express your answer in gallons.

 What was the total weight of non-food-based materials received in solid form and processed at your facility during the 2015 calendar year?  Please express your answer in tons.
Types of Feedstocks
 Please identify the specific types of feedstocks that are processed in your digester.  Check all that apply.
 Beverage processing industry waste 
 Crop residues 
 Crude glycerine 
 De-icing fluid 
 Fats, oils and greases (FOG) 
 Food processing industry waste
 Food service waste, pre & post-consumer 
 Fruit/vegetative wastes 
 Lab (or Pharma) wastes
 Litters 
 Manures 
 Mixed yard waste
 Paper mill wastes 
 Rendering wastes 
 Retail food waste 
 Septage 
 Source-separated commercial, institutional or residential organic wastes 
 Wastewater solids (sludge) 
 Other (please specify) 

 Are your tipping fees equal for all materials?

 Which of the following ranges best represents your tipping fees for processing liquid materials?
 N/A  -  Facility does not process liquid feedstock. 
 Business Confidential/Prefer not to say 
 $0.00-$0.05 per 
 $0.06-$0.10 per gallon 
 $0.11-$0.20 per 
 $0.21-$0.50 per gallon 
 $0.51-$1 per gallon 
 > $1 per gallon 

 Which of the following ranges best represents your tipping fees for processing solid materials? 
 N/A  -  Facility does not process solid feedstock. 
 Business Confidential/Prefer not to say 
 $0-$10 per ton
 $11-$20 per ton 
 $21-$30 per ton 
 $31-$40 per ton 
 $41-$50 per ton 
 $51-$60 per ton
 $61-$70 per ton 
 $71 or more per ton 

 You indicated that you collect the following types of feedstocks.  The feedstocks identified in your answer to question 21 above will be listed on this page.  Are the feedstocks liquid (with tipping fees in dollars per gallon) or solid (with tipping fees in dollars per ton) or both?

 You indicated that you receive and process the feedstocks identified below in liquid form.  The feedstocks identified in your answer to question 21 above will be listed on this page. Which of the following ranges best represents your tipping fee for these liquid feedstocks? 
 Prefer not to say 
 $0.00-$0.05 per gallon
 $0.06-$0.10 per gallon 
 $0.11-$0.20 per gallon
 $0.21-$0.50 per gallon 
 $0.51-$1 per gallon 
 > $1 per gallon 

 You indicated that you receive and process the feedstocks identified below in solid form.  The feedstocks identified in your answer to question 21 above will be listed on this page.  Which of the following ranges best represents your tipping fee for these solid feedstocks? 
 Prefer not to say 
 $0-$10 per ton
 $11-$20 per ton 
 $21-$30 per ton 
 $31-$40 per ton 
 $41-$50 per ton 
 $51-$60 per ton
 $61-$70 per ton 
 $71 or more per ton 

 Please identify the sources of the feedstocks that are processed at your facility.  Check all that apply.
 Airports
 Biodiesel production
 Corporate complexes
 Farmers Markets
 Food/Beverage Processors
 Fruit/Vegetable Farms
 Grocery Stores/Supermarkets
 Healthcare 
 Hospitality
 Industrial
 Laboratories/Pharmaceutical Companies
 Livestock Farms
 Municipal/Residential
 Prisons
 Restaurants and Food Service
 Retail Stores
 Schools
 Sports and Entertainment Venues
 Wastewater Treatment Plants
 Other (please specify)

 Please describe any pre-processing/de-packaging that is occurring at your facility.  

 Please identify the following specifications for your digester.
 Temperature range
 Wet or Dry
 Batch or continuous
 Number of stages

 How would you describe your digester? (select all that apply)
 Continuous Stirred Tank Reactor
 High Rate Bioreactor
 Plug Flow
 Complete Mix
 Covered Lagoon
 Induced Blanket Reactor
 Hydraulic Self-Stir Reactors
 Hybrid
 Fixed Film
 Unknown
 Other (please specify)
Product End-Uses
 Please provide the average biogas production volume at your facility during calendar year 2015 in one of the units identified below. 
 SCFM
 SCFD
 SCFY
 Other
 
 Is the biogas produced at this facility used onsite or sold?

 Please identify how the biogas produced at this facility is used.  It could be used onsite by the facility or offsite by a purchaser. Check all that apply.
 Produce mechanical power 
 Produce heat and electricity (CHP) 
 Produce electricity (including net metering) 
 Produce electricity (sold to grid) 
 Fuel boilers and furnaces to heat digesters 
 Fuel boilers and furnaces to heat other spaces 
 Compressed to vehicle fuels: used for company fleet/personal vehicles 
 Compressed to vehicle fuels: sold to customers 
 Renewable natural gas (processed in order to inject to pipeline) 
 Other (please specify) 

 Are you able to utilize all of the biogas produced?

 Do you flare the excess biogas?

 Do you have a gas purification system?

 What type of gas purification system do you have?

 What is removed by your gas purification system? Check all that apply.
 Moisture
 Sulfur
 Siloxanes
 Carbon Dioxide
 Compressed Gas
 Other (please specify)

 Do you beneficially re-use the solid digestate you produce? (Select all that apply)
 Yes, de-watered/dried and land applied
 Yes, land applied as is with no dewatering or drying
 Yes, composted into a reusable or salable product
 Yes, processed into other salable products (e.g., flower pots)
 No, landfilled
 No, incinerated
 Other (please specify)

 If any digestate was disposed of in landfills or incinerated in 2015, please specify the amount in tons or gallons (if known).

 Is the de-watered/dried digestate further treated prior to land application?

 Please indicate what the further treatment is and why it is necessary.

 How do you manage the liquid digestate you produce? Check all that apply.
 Beneficially reused as fertilizer via land application
 Recirculated through digester
 Discharged to a wastewater treatment plant
 Other (please specify)

 Is the liquid digestate further treated prior to land application?

 Please indicate what the further treatment is and why it is necessary.

 Do you recover nutrients from your digestate? 
 No
 Yes, phosphorous recovery by chemical precipitation (e.g., struvite)
 Yes, ammonia recovery
 Other (please specify)



