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FORM R REPORTS



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Reference Point/Description Latitude Longitude Collection Method Accuracy Value
CENTER OF A FACILITY OR STATION 41.7561 -81.2307 ADDRESS MATCHING-HOUSE NUMBER 30

RCRA ID NUMBER
OHD000804633

NPDES PERMIT NUMBER
NO DATA

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: 1321220356315

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356315

Section 1. Toxic Chemical Identity

1.1 CAS Number: 95-63-6       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: 1,2,4-Trimethylbenzene

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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: 10000 to 99999

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
NO
 45
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 1702
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 16657
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 1037
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 1364
 1747
 1747
 1747
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 16192
 16657
 16657
 16657
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 NA
 1037
 1037
 1037
8.6
 Quantity Treated Onsite
Pounds
 354344
 449619
 449619
 449619
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356327

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4445344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356327

Section 1. Toxic Chemical Identity

1.1 CAS Number: 140-88-5       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Ethyl acrylate

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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
NO
 3
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 118
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 1153
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 72
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 118
 121
 121
 121
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 1373
 1153
 1153
 1153
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 NA
 72
 72
 72
8.6
 Quantity Treated Onsite
Pounds
 30036
 31134
 31134
 31134
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356339

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356339

Section 1. Toxic Chemical Identity

1.1 CAS Number: 100-41-4       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Ethylbenzene

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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
NO
 4
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 156
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 1531
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 95
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 139
 160
 160
 160
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 1617
 1531
 1531
 1531
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 NA
 95
 95
 95
8.6
 Quantity Treated Onsite
Pounds
 35381
 41324
 41324
 41324
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356341

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344920

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356341

Section 1. Toxic Chemical Identity

1.1 CAS Number: 67-56-1       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Methanol

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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
NO
 3
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 120
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 1175
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 73
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 104
 123
 123
 123
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 1240
 1175
 1175
 1175
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 NA
 73
 73
 73
8.6
 Quantity Treated Onsite
Pounds
 27146
 31721
 31721
 31721
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356354

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356354

Section 1. Toxic Chemical Identity

1.1 CAS Number: 110-54-3       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: n-Hexane

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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: 10000 to 99999

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
NO
 19
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 715
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 7000
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 436
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 279
 734
 734
 734
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 7766
 7000
 7000
 7000
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 2
 436
 436
 436
8.6
 Quantity Treated Onsite
Pounds
 72515
 188936
 188936
 188936
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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
DQA98 Change in the total quantity of production-related waste This change in release totals was expected.

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356467

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356467

Section 1. Toxic Chemical Identity

1.1 CAS Number: 108-88-3       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Toluene

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
Article Component: NO
Repackaging: NO
Impurity: NO
Recycling: NO

3.3 Otherwise Use the Toxic Chemical:

Chemical Processing Aid: YES
Sub-Uses:
Z101 Process solvents
Manufacturing Aid: YES
Sub-Uses:
Z299 Other
Ancillary or Other Use: YES
Sub-Uses:
Z301 Cleaner

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

Maximum Chemical Amount: 100000 to 999999

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
NO
 1912
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 9294
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 90964
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 5663
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 9483
 11206
 11206
 11206
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 72668
 90964
 90964
 90964
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 19
 5663
 5663
 5663
8.6
 Quantity Treated Onsite
Pounds
 1590266
 2455317
 2455317
 2455317
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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
DQA98 Change in the total quantity of production-related waste This change in release totals was expected.

PART I. FACILITY IDENTIFICATION INFORMATION (FORM R)

DOCUMENT CONTROL NUMBER: 1321220356479

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110000385985

Section 1. Reporting Year

Reporting Year: 2021

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
JACOB FRIEND
 JACOB FRIEND
 Electronic
 30-JUN-22

Section 4. Facility Identification

TRI Facility ID: 44077VRYDR670HA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 LAKE
 OH
 44077

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
AVERY DENNISON - BUILDING 11
 670 HARDY RD
 PAINESVILLE
 OH
 44077

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
ALISA FEINGOLD
 4405344854

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
322220
 YES
 Paper Bag and Coated and Treated Paper Manufacturing

4.7 Dun Numbers

DUNS NUMBER
622634905

5. Parent Company Information

Parent Company Name: AVERY DENNISON CORP

Parent Company DUNS Number: 008256364

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1321220356479

Section 1. Toxic Chemical Identity

1.1 CAS Number: 1330-20-7       PFAS Indicator: NO
1.2 Toxic Chemical or Chemical Category Name: Xylene (mixed isomers)

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: NO

 Import: NO

 On-Site Use/Processing: NO
Sale/Distribution: NO

 Byproduct: NO

 Impurity: NO

3.2 Process the Toxic Chemical:

Reactant: NO
Formulation Component: YES
Sub-Uses:
P205 Solvents
P201 Additives
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: 10000 to 99999

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
NO
 20
 Pounds
 O - Other Approaches

5.2 Stack or Point Air Emissions

NA TOTAL RELEASE (per year) UNIT OF MEASURE BASIS OF ESTIMATE
NO
 752
 Pounds
 O - Other Approaches

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: ADDRESS:
CITY: STATE:
COUNTY: ZIP CODE:

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

6.2 Transfers to other Off-Site Locations

1 RCRA Number: IND000646943

 Parent Company Controlled: NO
Name: TRADEBE TREATMENT & RECYCLING LLC

 Address: 4343 KENNEDY AVE
City: EAST CHICAGO

 State: IN
County: LAKE

 Zip Code: 46312
Country Code (Non - US):

Province:

OFFSITE AMOUNT SEQUENCE TOTAL TRANSFERS (per year) UNIT OF MEASURE BASIS OF ESTIMATE WASTE MANAGEMENT TYPE
1
 7355
 Pounds
 M2 - Monitoring, Periodic/Random
 M92 - Transfer to Waste Broker-Energy Recovery
2
 458
 Pounds
 M2 - Monitoring, Periodic/Random
 M20 - Solvents/Organics Recovery

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

7A.1a. Waste Stream: GASEOUS
7A.1b.
 WASTE TREATMENT METHOD(S) SEQUENCE
1
 H040 - Incineration - thermal destruction other than use as a fuel
7A.1d. Waste Treatment Efficiency Estimate: Greater than 99% but less than or equal to 99.99%

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
 Pounds
 655
 772
 772
 772
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
NA
 NA
 NA
 NA
8.2
 Quantity Used for Energy Recovery Onsite

NA
 NA
 NA
 NA
8.3
 Quantity Used for Energy Recovery Offsite
Pounds
 3314
 7355
 7355
 7355
8.4
 Quantity Recycled Onsite

NA
 NA
 NA
 NA
8.5
 Quantity Recycled Offsite
Pounds
 1
 458
 458
 458
8.6
 Quantity Treated Onsite
Pounds
 169951
 198533
 198533
 198533
8.7
 Quantity Treated Offsite

NA
 NA
 NA
 NA

8.8 One-Time Event Release: NA

8.9 Production Ratio   or   Activity Ratio : 1.24

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