TRI_FORM_R Search

FORM R REPORTS

Reference Point/Description	Latitude	Longitude	Collection Method	Accuracy Value
N/A	44.03105	-73.17078	N/A	30

RCRA ID NUMBER
VTD020668174

NPDES PERMIT NUMBER
VTP030401
VTU000037
VTP000002

UIC ID NUMBER
NO DATA

To correct the FRS latitude, longitude or program ID values click on the "Report an Error" button in the top right corner of this page. Facilities wishing to correct other data elements with the FORM R or FORM A should refer to the related TRI-MEweb tutorial..

For more information, see Collection of Latitude, Longitude and Program ID Data Has Been Discontinued.

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1320219124106

The Facility Registry System ID is not submitted as part of the TRI Form R

Facility Registry System ID: 110040608205

Section 1. Reporting Year

Reporting Year: 2020

Section 2. Trade Secret Information

2.1 Trade Secret: NO

2.2 Sanitized Copy: Unsanitized

Section 3. Certification

CERTIFYING OFFICIAL'S NAME	CERTIFYING OFFICIAL'S TITLE	CERTIFYING OFFICIAL'S SIGNATURE	DATE SIGNED
THOMAS HERBICK	VP OPERATION	Electronic	29-JUN-21

Section 4. Facility Identification

TRI Facility ID: 05753CBTGR100EX

4.1 Facility Name and Address.

Facility Information

NAME	STREET	CITY	COUNTY	STATE	ZIP CODE
AGRI-MARK INC	869 EXCHANGE ST	MIDDLEBURY	ADDISON	VT	05753

BIA Tribal Code	Tribe
NO DATA	NO DATA

Mailing Information

NAME	STREET	CITY	STATE	ZIP CODE
AGRI-MARK INC	869 EXCHANGE ST	MIDDLEBURY	VT	05753

PROVINCE	COUNTRY (NON - US)
NO DATA	NO DATA

4.2 Facility Classification

ENTIRE FACILITY	PARTIAL FACILITY	FEDERAL FACILITY	GOCO FACILITY
YES	NO	NO	NO

4.3 Technical Contact

Not Available to the Public as this information is only for Intranet.

4.4 Public Contact

NAME	PHONE
JODI GIRARD	8023885851

4.5 NAICS Codes

NAICS CODE	PRIMARY	NAICS CODE DESCRIPTION
311513	YES	Cheese Manufacturing
311514	NO	Dry, Condensed, and Evaporated Dairy Product Manufacturing

4.7 Dun Numbers

DUNS NUMBER
166060368

5. Parent Company Information

Parent Company Name: No US Parent Company

Parent Company DUNS Number:

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1320219124106

Section 1. Toxic Chemical Identity

1.1 CAS Number: N511 PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Nitrate compounds (water dissociable; reportable only when in aqueous solution)

1.3 Generic Chemical Name: NA

1.4 Distribution of Each Member of the Dioxin and Dioxin like Compounds Category

NA	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17
NO

Section 2. Mixture Component Identity

2.1 Supplier Provided Generic Chemical Name: NA

Section 3. Activities and Uses of the Toxic Chemical

3.1 Manufacture the Toxic Chemical:

Produce: YES	Import: NO	On-Site Use/Processing: NO
Sale/Distribution: NO	Byproduct: YES	Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO

Formulation Component: NO

Article Component: NO

Repackaging: NO

Impurity: NO

Recycling: NO

3.3 Otherwise Use the Toxic Chemical:

Chemical Processing Aid: NO

Manufacturing Aid: NO

Ancillary or Other Use: NO

Section 4. Maximum Amount of the Toxic Chemical Onsite During the Calendar Year

Maximum Chemical Amount: 1000 to 9999

Section 5. Quantity of the Toxic Chemical Entering each Environmental Medium Onsite

5.1 Fugitive or Non-Point Air Emissions

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.2 Stack or Point Air Emissions

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.3 Discharges to Receiving Streams or Water Bodies

NA	STREAM/WATER BODY NAME	REACH Code	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE	% FROM STORMWATER
YES	NA

5.4-5.5 Disposal to Land Onsite

5.4.1 Underground Injection Onsite to Class I Wells.

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.4.2 Underground Injection Onsite to Class II-V Wells.

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5 Disposal to Land Onsite

5.5.1A RCRA Subtitle C Landfills

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5.1B Other Landfills

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5.2 Land Treatment/Application Farming

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5.3A RCRA Subtitle C Surface Impoundments

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5.3B Other Surface Impoundments

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

5.5.4 Other Disposal

NA	TOTAL RELEASE (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE
YES

Optional Waste Rock Piles Information

Section 5.5 quantities include "waste rock piles":	NO
Quantity of "waste rock piles" (pounds/year*):

*For Dioxin and Dioxin-like Compounds, report in grams/year

Section 6. Transfers of the Toxic Chemical in Wastes to Off-Site Locations

6.1 Discharges to Publicly Owned Treatment Works (POTWs)

1 - NAME: MIDDLEBURY WASTEWATER TREATMENT FACILITY	ADDRESS: 243 INDUSTRIAL AVENUE
CITY: MIDDLEBURY	STATE: VT
COUNTY: ADDISON	ZIP CODE: 057531140

POTW AMOUNT SEQUENCE	TOTAL TRANSFERS (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE	WASTE MANAGEMENT TYPE
1	38936.9	Pounds	E1 - Emission Factor, Published	P36 - Other or Unknown Disposal
2	350432.1	Pounds	E1 - Emission Factor, Published	P39 - Experimental and Estimated Treatment Data

6.2 Transfers to other Off-Site Locations

RCRA Number:	Parent Company Controlled:
Name:	Address:
City:	State:
County:	Zip Code:
Country Code (Non - US):	Province:

TOTAL TRANSFERS (per year)	UNIT OF MEASURE	BASIS OF ESTIMATE	WASTE MANAGEMENT TYPE
NO DATA		NO DATA	NO DATA

Section 7A. On-Site Waste Treatment Methods and Efficiency

7A.1a. Waste Stream: NA

7A.1b.	WASTE TREATMENT METHOD(S) SEQUENCE
1	NO DATA

7A.1d. Waste Treatment Efficiency Estimate:

Section 7B. On-Site Energy Recovery Processes

ON SITE ENERGY RECOVERY PROCESSES
NA

Section 7C. On-Site Recycling Processes

ON SITE RECYCLING PROCESSES
NA

Section 8. Source Reduction and Recycling Activities

SECTION	TYPE OF QUANTITY	UNITS	PRIOR YEAR	CURRENT REPORTING YEAR	FOLLOWING YEAR	SECOND FOLLOWING YEAR
8.1a	Total on-site disposal to Class I Underground Injection Wells, RCRA Subtitle C landfills, and other landfills		NA	NA	NA	NA
8.1b	Total other on-site disposal or other releases		NA	NA	NA	NA
8.1c	Total off-site disposal to Class I Underground Injection Wells, RCRA Subtitle C landfills, and other landfills		NA	NA	NA	NA
8.1d	Total other off-site disposal or other releases	Pounds	38937	38936.9	39000	39000
8.2	Quantity Used for Energy Recovery Onsite		NA	NA	NA	NA
8.3	Quantity Used for Energy Recovery Offsite		NA	NA	NA	NA
8.4	Quantity Recycled Onsite		NA	NA	NA	NA
8.5	Quantity Recycled Offsite		NA	NA	NA	NA
8.6	Quantity Treated Onsite		NA	NA	NA	NA
8.7	Quantity Treated Offsite	Pounds	350432	350432.1	350000	350000

8.8 One-Time Event Release: NA

8.9 Production Ratio or Activity Ratio : 1

8.10 Source Reduction Activities

SOURCE REDUCTION ACTIVITIES	METHOD 1	METHOD 2	METHOD 3	ESTIMATED ANNUAL REDUCTION
NA

8.11 Additional Data Indicator: NO

No Data Found

9.1 Miscellaneous, Additional or Optional Information regarding the Form R submission

COMMENT TYPE	DESCRIPTION	COMMENT TEXT
TOTRL	DQA: Change in Releases	Used default calculator; treatment plant indicated significant destruction of NO3 but final fate and transport numbers could not be determined by submission of this form