The Sterilization and Recycling of Medical Waste: A Plant Design

Transcription

1 The Sterilization and Recycling of Medical Waste: A Plant Design Item Type Electronic Thesis; text Authors Brauneis, Jacqueline Nicole Publisher The University of Arizona. Rights Copyright is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 02/05/ :46:55 Link to Item

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10 The Sterilization and Recycling of Medical Waste: A Plant Design April 29, 2011 Justin Black Jacqui Brauneis Kayla Hendricks Patrick Pasadilla Maria Rusnak

11 The Sterilization and Recycling of Medical Waste: A Plant Design April 29, 2011 Justin Black, Jacqui Brauneis, Patrick Pasadilla, Maria Rusnak, Kayla Hendricks

12 Summary Disposal methodology for medical waste has been a controversial topic for some time. With 729 kilotons of regulated medical waste (RMW) generated each year in the U.S., this controversy is understandable as it is important to consider the environmental effects and cost efficiency of these methods. Until recently, incineration has been the method of choice since it is inexpensive and fast. However, incineration also results in hazardous environmental emissions such as dioxins, furans and heavy metals, and so the Environmental Protection Agency (EPA) has imposed stringent emission guidelines for which compliance becomes expensive. This has led to a decrease of incineration use throughout the U.S. and a surge of new sterilization technologies. However, new technologies are expensive and are still in preliminary commercial stages, resulting in treatment plants that are few and far-between, especially in Arizona. The objective of this project is to design a local plant utilizing the best sterilization technology to treat 300,000 lbs of medical waste per month while adhering to restrictions set by the EPA, the Resource Conservation and Recovery Act (RCRA), the Health Insurance Portability and Accountability Act (HIPAA) and the Arizona Department of Environmental Quality (ADEQ), while returning a profit off of the recycled sterilized waste. The plant was designed to handle three types of waste commonly separated by hospitals red bag, which includes sharps and infectious waste, yellow bag, which is composed of pathological and trace chemo waste, and black box, which is hazardous chemicals and bulk chemo as well as confidential paper and baled cardboard. Four sterilization techniques were considered to achieve the ADEQ-required 4 log 10 kill-rate in the medical waste including the use of high-pressured steam, chlorine dioxide, and ozone. Since ADEQ has not approved any recent sterilization technique for the treatment of black box waste, and since only two of the evaluated sterilization methods have been approved for treating yellow bag waste, alternative methods had to be considered for their treatment. These included incineration and plasma torching technology. Waste sterilized by the plant needed to be separated for recycling and two methods were considered for this process: separation using air classifiers and electrostatic separation. Shredders were chosen to meet HIPAA requirements for confidential patient documents and a grinder was added to render treated waste non-recognizable as required by ADEQ. Finally, a system to wash RMW-containing bins was developed to efficiently sterilize them and return them for reuse.

13 The design resulted in a cumulative net present value of $2.7 million after 23 years. The plant yielded 20,000 lbs of recyclable stainless steel per month and 200,000 lbs of recyclable plastic per month. Both of these products contributed to the profit along with the collection fee for waste pick-up. The Mark-Costello autoclave was chosen as a sterilizer due to its price, operating cost, sterilization rate, and environmental and safety qualities. Off-site incineration was decided on as a method for treating both yellow bag and black box waste, since the autoclave is only approved for red bag waste. Although transportation costs increased with the off-site location, the installation of an incinerator in the plant was not justifiable. Air classifiers were chosen as the best stream separation method and a wheelie-bin washer was designed for the RMW bins. The main uncertainty with regard to the plants success is that the air classifiers will perform 100% separation during plant operation. The feasibility of profit from recyclables completely depends on this assumption since separated waste streams from throughout the day will be compacted together, so it is important that each compacted shipment is pure. Another big assumption is that the sterilizer will achieve a 4 log 10 kill-rate every single time it is used. This is important to avoid fees from the EPA or ADEQ, and to ensure the sanitation of our recycled waste. Also, the plant design assumes proper source separation at the hospitals. This assumes that hospitals are concerned with reducing waste disposal costs. The development of this plant is unlike anything that has been done before. The convenience offered to customers is unmatched in that all waste types, including paper and cardboard, will be picked-up and treated by the same company for just one fee. Landfill dependency will be drastically lowered as 73% of waste will be recycled and reused, as well as all shredded confidential paper. Finally, local waste-treatment companies will no longer need to ship red bag RMW to Phoenix daily for treatment. Although the profit generated from this plant is not incredibly high, it is safe to say that the benefits to both customers and waste-sterilization companies are immense and well worth the plant construction.

14 Table of Contents 1. Introduction Overall Goal Current Market Information Project Premises and Assumptions Process Description, Rationale and Optimization Block Flow Diagrams Process Flow Diagrams Plant Layout Equipment Tables Stream Tables Utility Tables Written Description of Process Rationale for Process Choice RMW Sterilization Technique EcoDas Mark-Costello TriNovaMed Ozonator Black Waste Sterilization Technique Incineration Plasma Technology Equipment Description, Rationale and Optimization R-101 Mark-Costello High Volume Sterilizer AS G-101 RG52M Single Shaft Rotary Grinder H-101 Storage Freezer H-102 Hurst Boiler Co. Boiler Series V Air Classifiers S Whitaker Brothers confidential document shredder K , 201, 202 Conveyers C-202 Confidential Paper Baler C-201 A/B Waste and Recycling compactor V-201, H-201, K-203, P-201 A/B Wheelie Bin Sterilizer... 35

15 4. Safety Statement Description of Hazards Safety of Materials (Biohazards) Red Bag Waste Yellow Bag Waste Black Box Waste Hydrox General Purpose Cleaner Safety of Equipment (Technical Hazards) Mark-Costello Sterilizer (R-101) Hurst Gas Boiler (H-102) Grinder (G-101) Confidential Paper Baler (C-202) Compactor (C-201 A/B) Paper Shredder (S ) Storage freezer and Storage Room (H-101) Air Classifier (V ) Wheelie Bin Washer (V-201, P-201 A/B, H-201) Conveyors (K , ) Forklift Pallet Jack Mark-Costello Heavy Duty Hydraulic Sterilizer Cart Dumper Bins Trucks Pumps (P-201 A/B) Environmental Impact Statement Economic Analysis Conclusions and Recommendations References Appendices... A Process Calculations... A Mass Balance...A Wheelie Bin Washer Calculations..A Economic Calculations... A Important s and Printouts... A s... A Printouts... A Phone Logs... A1

16 1. Introduction 1.1. Overall Goal The objectives of the project are to design a biomedical waste treatment plant capable of treating 300,000 lbs. per month of regulated medical waste (RMW) in Tucson, Arizona. The total mass of RMW encompasses both infectious and biohazardous waste with a ratio of 95:5, respectively. Recycling of sterilized infectious waste is investigated for plant efficiency and feasibility. Recyclable and profitable infectious waste products include 20,000 lbs. per month of stainless steel and 200,000 lbs. per month of plastic. The treatment plant should be capable of handling other hospital waste streams including: confidential papers, baled cardboard and hazardous wastes defined by the Resource Conservation and Recovery Act (RCRA). The plant should be capable of shredding and recycling 113,000 lbs. per month of confidential papers. There is a collection of 450,000 lbs. per month of baled cardboard. RCRA hazardous wastes amount to approximately 30 lbs. per month. There are collection fees charged to the customers for the previously defined wastes. A summary of all of the waste streams in found in Figure 1 ( , Harry Patton, 1/28/2011). Hospital Wastes for Treatment 13% 33% Cardboard 52% 35% Confidential Paper 2% Figure 1. The ratio of hospital wastes entering the treatment plant, excludes RCRA hazardous waste due to the small amount. 1 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

17 1.2. Current Market Information Current markets addressing the products and operations of the treatment plant are medical waste treatment, recycling, and landfill. There are handling and treatment charges applicable to all of the hospital waste streams. Incineration of RCRA hazardous waste and biohazardous RMW waste has higher handling fees as the companies must pay to have the waste incinerated in Texas. Steam sterilization of infectious RMW waste is will be conducted in the plant; due to its high volume, the associated handling cost is much lower than incineration. However, there are portions of the infectious RMW that can be recovered and recycled for further profit. Shredding of confidential papers is often presented as a package of hospital waste treatment at a much lower cost to retain hospital clients. The shredded confidential papers can be baled and recycled for a profit as well. Cardboard removal is offered for the same reasons as the confidential papers and that is to reduce the number of waste management companies that a hospital or facility has to deal with. This service does not result in sales for recycling the cardboard. In 2008, the quantity of municipal solid waste (MSW) produced in the United States was 243 million tons (US EPA, 2010). The most recent study states that RMW comprises 0.3% of MSW; therefore, approximately 729 kilotons of RMW is produced each year in the United States (Keene, 1991). RMW contains a mixture of infectious and biohazardous wastes. Treatment of RMW is divided into two sections: incineration and sterilization. Technologies currently exist to sterilize infectious and biohazardous waste; however, there is a high initial capital cost associated with these technologies. The typical fee charged to customers for pick-up and sterilization of infectious waste is approximately $0.55 per pound. Tucson Iron and Metal offers $0.85 per pound for recycled stainless steel (telephone, Gary Kippur, 3/4/2011) and Friedman Recycling offers $0.01 per pound for recycled plastic (telephone, Friedman 2 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

18 Recycling, 3/4/2011). The non-recyclable portions of the infectious waste are currently landfilled at a price of $0.016 per pound (Los Reales Landfill, 2010). If the sterilization technology is not approved to treat biohazardous waste, then both biohazardous and RCRA hazardous waste must be incinerated. The typical pick-up fees associated with biohazardous and RCRA hazardous wastes are $1.75 per pound and $2.50 per pound, respectively. Currently, incineration costs $0.75 per pound (telephone, Nord Sorenson, 3/1/2011). The facility will shred confidential papers and discard baled cardboard. Current charges of these services amount to $0.20 per pound and $0.15 per pound, respectively. Friedman Recycling offers $0.01 per pound for recycling of white paper waste (telephone, Friedman Recycling, 3/4/2011). The current cost for delivering and recycling 25 pallets of baled cardboard per day to Los Reales Landfill in Tucson, Arizona is $1,168 per month (Los Reales Landfill Recycling Rates, 2010). At this time, recycling of treated medical waste is a nonexistent practice in the United States and many parts of the world. In the past there has been a large push towards recycling, but medical waste has gone untouched by this revolution because of the attached stigma. However with pilot programs beginning to emerge in the United States, such as the alliance of Becton, Dickinson and Company with Rady Children's Hospital - San Diego, recycling of treated medical waste is becoming a tangible practice (Becton, Dickinson, and Company, 2011). It has been agreed to opt in to the development of treating and recycling medical waste because it offers a green alternative of current disposal methods to the growing health-care industry. This design supports the expanding green concept and provides a more sustainable practice that many are looking to achieve. 3 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

19 1.3. Project Premises and Assumptions The design involved researching four sterilization technologies including: Mark Costello steam sterilizer, EcoDas steam sterilizer with incorporated grinder, Ozonator, and Trinovamed chlorine dioxide sterilizer and incorporated grinder. Each of the sterilization technologies have been approved for medical waste treatment by Arizona Department of Environmental Quality (ADEQ). The technologies are rated by a microbial inactivation of 6 log 10 of Mycobacterium phlei or bovis, and a 4 log 10 Bacillus stearothermophilus or subtilis as defined in ADEQ R However, most technologies are graded on the kill rate of Bacillus stearothermophilus as it is the most difficult spore to inactivate. Also, ADEQ R requires the waste to be rendered non-recognizable. In addition to the sterilization technologies, plasma was researched as an alternative to on-site and off-site incineration of RCRA hazardous and/or biohazardous waste. Through approving the basis of the design, and the optimal sterilization and incineration techniques, the logistics, ancillary equipment, and efficiency of the design were addressed and optimized. The project premises consisted of designing a plant to treat and recycle 300,000 lbs/month of RMW. It is assumed that 95% is infectious waste and 5% is biohazardous waste. The composition of infectious waste, referred to as red bag waste, is illustrated in Figure 2 ( , Harry Patton, 1/28/2011). The composition of the red bag waste stream will fluctuate, thus it was deemed good practice to assume 100% separation during recycling as there will be days where there is more or less of a product. Biohazardous waste, commonly referred to as yellow bag waste, contains pathological, trace chemotherapeutic agent waste, and pharmaceutical waste that is not considered hazardous waste according to RCRA. Trace chemotherapeutic agent waste is defined as waste that contains less than 3% w/w of chemotherapeutic agents. A 96 gallon red 4 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

20 container and 38 gallon yellow container is assumed to have a net weight of 64 lbs and 25 lbs, respectively ( , Harry Patton, 1/28/2011). Red Bag Waste Composition 7% 11% 10% 2% Plastic Cotton Metal Glass Paper 70% Figure 2. The composition of red bag waste. RCRA hazardous waste, also known as black waste, is deemed hazardous by the U.S. Code of Federal Regulations (CFR) Title 40 Part 261. The hazardous wastes are defined as P-, U-, F-, and K-listed chemicals or pharmaceutical drugs based on characteristics of ignitability, corrositivity, reactivity, and toxicity. It is assumed that there is approximately 30 lbs per month of RCRA waste produced ( , Harry Patton, 1/28/2011). It is assumed that the major cardboard sources come from five local hospitals and there are five 600 pound bales per day produced for a single hospital ( , Harry Patton, 1/28/2011). It is also assumed that each of the five hospitals dispose of 750 lbs per day of confidential papers and each locked waste bin has a net weight of 225 lbs ( , Harry Patton, 1/30/2011). The confidential papers are assumed to have no MSW mixed in the waste and to only contain white paper. The design assumes that health-care facilities have implemented good source separation of the waste streams as it minimizes their cost of waste management. All mass balance calculations can be found in Appendix Process Description, Rationale and Optimization 5 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

21 2.1. Block Flow Diagrams Figure 3. Unit 1 BFD 6 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

22 Figure 4. Unit 2 BFD 7 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

23 2.2. Process Flow Diagrams Figure 5. Unit 1 PFD 8 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

24 Figure 6. Unit 2 PFD 9 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

25 2.3. Plant Layout Figure 7. Plant Layout 10 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

26 2.4. Equipment Tables Conveyors K-101 K-102 K-103 K-104 K-105 K-106 K-107 Type Belt Belt Belt Belt Belt Belt Belt Flow (lb/hr) MOC Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS Dimensions Length (m) Width (m) Conveyors Cont. K-108 K-109 K-110 K-201 K-202 K-203 Type Belt Belt Belt Belt Belt Belt Flow (lb/hr) bin/hr MOC Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS Vinyl, CS CS Dimensions Length (m) Width (m) Shredders/Grinders S-201 S-202 S-203 S-204 G-101 Type Document Shredder Document Shredder Document Shredder Document Shredder Single Shaft Rotary Grinder Capacity 20 sheets 20 sheets 20 sheets 20 sheets lb/hr Shred Size (mm) 0.8 x x x x 4.5 N/A Speed (ft/min) N/A Power (hp) Security Level N/A Hopper Opening (m 3 ) N/A N/A N/A N/A Rotor Diameter (m) N/A N/A N/A N/A Dimensions Height(m) Length (m) Width(m) Heaters H-101 H-102 H-201 Type Storage Freezer Steam Boiler Waste Bin Sterilizer Temperature ( C) Pressure (atm) MOC SS Steel and S.S. CS Capacity Flow (lbs/hr) N/A 4500 Dimensions Height (m) Length(m) Width (m) Table 1. Equipment List 11 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

27 Sterilizers R-101 V-201 Type Mark-Costello High Volume Waste Bin Sterilizer Temperature ( C) Pressure (atm) 4.42 N/A Pressure Head (ft) Flow (gpm) N/A 32 bins/hr Orientation H H MOC SS CS Dimensions Height (m) Diameter(m) Length(m) Vessels/Tanks V-101 V-102 V-103 Type Air Classifier Air Classifier Air Classifier Capacity Temperature ( C) Height (m) Dimensions Length(m) Width (m) Compactors C-201 A/B C-202 Type Waste Compactor Conf. Paper Baler Max. Pressure (atm) HP 20 N/A MOC Steel Steel Bale Size (ft) N/A 60 x 30 x 40 Bale Weight (lbs) N/A Dimensions Height (m) Width (m) Length (m) Pumps P201 A/B Type/Drive Centrifugal Flow (gpm) 50 MOC SS Power (hp) 75 Temperature ( C) 80 Pressure in (atm) 1.48 Table 2. Equipment List cont. 12 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

28 2.5. Stream Tables Stream Table-Medical Waste Sterilization Plant Stream Number Temperature [ C] Pressure [atm] Vapor Mass Fraction Liquid Mass Fraction Solid Mass Fraction Total Mass Flow [lbs/day] Mass Composition [lbs/day] Yellow Bag Waste Black Box Waste Paper Glass Stainless Steel Cotton and Paper Plastic Cardboard Water Cleaner Number of Waste Bins Red Yellow Black Table 3. Stream Table 13 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

29 Stream Table-Medical Waste Sterilization Plant Continued Stream Number Temperature [ C] Pressure [atm] Vapor Mass Fraction Liquid Mass Fraction Solid Mass Fraction Total Mass Flow [lbs/day] Mass Composition [lbs/day] Yellow Bag Waste Black Box Waste Paper Glass Stainless Steel Cotton and Paper Plastic Cardboard Water Cleaner Number of Waste Bins Red Yellow Black Table 4. Stream Table cont. 14 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

30 Stream Table-Medical Waste Sterilization Plant Continued Stream Number Temperature [ C] Pressure [atm] Vapor Mass Fraction Liquid Mass Fraction Solid Mass Fraction Total Mass Flow [lbs/day] Mass Composition [lbs/day] Yellow Bag Waste Black Box Waste Paper Glass Stainless Steel Cotton and Paper Plastic Cardboard Water Cleaner Number of Waste Bins Red Yellow Black Table 5. Stream Table cont. 15 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

31 2.6. Utility Tables Utility Annual Requirement Price Source Annual Cost Electricity 1,229,000 kwh $0.029/kWh Tucson Electric Power $36,000 Water 2,300 ccf $2.12/ccf Tucson Water $5,500 Natural Gas 182,000 therm $0.87/therm Southwest Gas $160,000 Gasoline - Diesel 12,700 gallon $4.00/gallon AAA $50,600 Table 6. Annual Utility Requirements 2.7. Written Description of Process As seen in Figures 3-6, and Tables 3-5, the biomedical and paper wastes are unloaded and conveyed to be weighed, scanned and transferred to the appropriate areas upon arrival to the plant. Yellow bag waste is unloaded into gaylord boxes to be stored in a freezer (H-101) kept at 4.4 C with the black box waste. Every other week, the gaylord boxes and black box waste are transported to Tyler, Texas for incineration. The confidential papers are visually inspected for MSW and conveyed to the document shredders (S ). The shredded papers are conveyed to a paper baler (C-202) to ensure efficient transport for recycling. The red bag waste is conveyed and transferred to the autoclave sterilizer carts. Once the sterilizer carts contain 3,000 lbs of red bag waste, they are pushed by the forklift into the Mark- Costello sterilizer (R-101). A boiler (H-102) produces steam for the sterilizer. The sterilization process lasts approximately one hour, during which the temperature and pressure remain around 141 C and 2.4 atm. After the waste is sterilized, the steam is condensed and sent to the sewer. The waste is then dumped out of the sterilization cart onto a conveyer. It is then sent to a grinder (G-101) for shredding. Once the sterilized waste is shredded, it is conveyed to the first of three air classifiers (V-101) to separate the plastic, paper and cotton from the glass and metal. The top product of the air classifier contains the plastic, paper and cotton while the bottom is composed of the glass and metal. The top product is conveyed to the second air classifier (V-102) to 16 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

32 separate the plastic from the paper and cotton. The bottom product is sent to the third air classifier (V-103) to separate the glass from the metal. The separated products from the second and third air classifiers are conveyed to the stationary compactors (C-201 A/B) and compacted separately. The compacted plastic and metal is sold to local recyclers while the compacted glass, paper and cotton are sent to the landfill. After being emptied, the un-cleaned red and yellow waste bins are transferred to an automated waste bin washer. The bins are placed on a conveyer upside down and sent through a horizontally oriented vessel (V-201). Inside this large vessel, a hot water heater (H-201) heats a mixture of water and Hydrox cleaning solution to 80 C. The mixture is pumped (P-201 A/B) through nozzles to clean the wheelie bins and is drained to the sewer. Once the wheelie bins are cleaned, they are dried with air knives within the vessel, and then stored on-site until they are sent back to the hospitals Rationale for Process Choice RMW Sterilization Technique Traditionally, incinerators have been used to treat RMW since their effectiveness is undeniable. However, the resulting product from an incinerator is obviously not salvageable nor recyclable. Since the goal of this project is to return a profit off of RMW, incineration is only considered to be a last resort because some processes are not yet approved to sterilize yellow waste. Furthermore, the release of dioxins and furans two of the most toxic chemicals known to science are associated with incineration and should be minimized as much as possible through the use of alternative sterilization techniques (Environmental Justice Activists, 2011). Instead, autoclaves and recently developed chemical processes were studied and evaluated. In order to ensure minimal cost while still achieving an acceptable level of sterilization, and 17 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

33 maintaining a safe and environmentally-friendly process, four sterilization processes were considered in the design of the plant: the EcoDas Autoclave, the Mark-Costello Autoclave, the TriNovaMed Green Machine, and the Ozonator EcoDas The EcoDas sterilizer relies on another industry-standard method steam. Autoclave technology has become a popular technique for disinfection, and unlike incineration techniques, it results in a product that is able to be recycled shredded and sterilized waste. Intense heat contact has been known to be an effective sterilizer for hundreds of years, but it was quickly discovered that sterilization time using heat can be greatly decreased by raising the humidity during the sterilization process (Thompson, 2011). High pressure steam sterilizers, called autoclaves, were first invented to sterilize medical equipment in 1879 and have been used consistently ever since (The Mark-Costello Co., 2011). The EcoDas T2000 with a built-in grinder was considered for this plant. Compared to other technologies, its sterilization rate is small only lbs/hr, meaning that the machine will need to be running longer than others (EcoDas, 2005). This is a major set-back since autoclave technology also requires the highest utility rates due to steam consumption. The utilities include 9 kwh/cycle of electricity and 330 L of water per cycle (EcoDas, 2005). A boiler is required to generate steam at 3.8 bars and 138 degrees Celsius (EcoDas, 2005). Additionally, the presence of steam is a safety hazard and could result in burns or pressure explosions. On the positive side, autoclave technology is proven and the T2000 has an 8 log 10 killrate (Ecodas, 2005), which far exceeds the ADEQ required 4 log 10 inactivation of the concentration of Bacillus stearothermophilus or Bacillus subtilis and 6 log 10 kill-rate of vegetative microorganisms (Office of the Secretary of State, 2011). Also, no hazardous 18 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

34 chemicals are involved, meaning that there are no environmental concerns. The machine is fairly small, at 9.8 ft x 9.8 ft x 21 ft, which would reduce the required plant size (EcoDas, 2005). The EcoDas T2000 comes with a built-in grinder so that a separate piece of equipment will not need to be purchased (EcoDas, 2005). Lastly, the process is ADEQ approved for treating both red and yellow waste, meaning that yellow waste will be able to be sterilized, sorted and recycled for profit and not destroyed (EcoDas, 2005). Additionally, only black waste will need to be sent to off-site for treatment, lowering the transportation frequency. Economically, the EcoDas T2000 was the least competitive. If a six-day workweek is considered with three to eight shifts per day, only one machine is required. However, this is a long workweek with an extremely high amount of shifts per day, which vastly increases the cost of employee labor. Even if this schedule is used and only one machine is purchased, the base cost is close to $1,000,000 (EcoDas, 2005) Mark-Costello Similar to the EcoDas T2000, the Mark-Costello AS634 utilizes autoclave technology. The high volume sterilizer was chosen to be evaluated to ensure maximum profit for the plant. However, unlike the EcoDas model, a grinder is not included in this process, resulting in extra necessary pieces of equipment. The RG52M Medical Waste Shredder, also from Mark-Costello, was decided on, adding an additional 10.1 ft x 7.85 ft x. 5 ft to the sterilization process footprint ( , Mike Kelleher, 2/20/2011). This outside grinder adds additional hazards since it is not contained within the machine and requires a high rotor speed of 120 rpm ( , Mike Kelleher, 2/20/2011). Similar to the EcoDas T2000, a boiler is needed to supply steam at 65 psi and at a flow rate of 4500 lb/hr ( , Mike Kelleher, 2/20/2011). This requires a huge amount of utility usage, almost 900 kwh/cycle of electricity and 504 therms/cycle natural gas, making the process expensive to operate ( , Terry Melot, 3/7/2011). As previously stated, a boiler also 19 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

35 contributes to safety concerns by introducing the risk of pressure explosions and extremely high temperatures. Finally, unlike the other considered technologies, the Mark-Costello process is not approved to handle yellow or black waste (personal communication, Harry Patton, 2/1/2011). This means that both yellow and black waste will have to be treated through some other method off-site, increasing the capacity of waste needing to be transported and therefore the frequency of long drives to Texas. Positive aspects of the AS634 machine include the fast rate of sterilization, at 3,000 lbs/hr (The Mark-Costello Co., 2011). This means that all red waste can be recycled in only five hours each day, greatly reducing the number of necessary employees as well as the length and number of shifts. Also, the Mark-Costello process has a fairly small size that is comparable to the EcoDas T2000 at 42.8 ft x 7.4 ft x 6.5 ft (The Mark-Costello Co., 2011). Even with the addition of a grinder and a boiler, the AS634 will result in a small required area, allowing for the plant to be smaller. Since no chemicals are used in this process, there are no hazards, and no environmental concerns (The Mark-Costello Co., 2011). Like the other technologies studied, the AS634 has an extremely high kill-rate with a maximum of 6 log 10 ( , Mike Kelleher, 2/3/2011). Finally, the Mark-Costello representatives were the most responsive, resulting in the most readily available information. Economically, the Mark-Costello AS634 was extremely reasonable, mostly due to its low base cost of $250,000 ( , Mike Kelleher, 2/20/2011). The required RG52M Medical Waste Shredder adds $200,000 to this cost ( , Mike Kelleher, 2/20/2011), along with about $59,900 from the 150 HP Boiler, $6,600 for a make-up feed tank, $2,700 for a blowdown separator ( , Terry Melot, 3/7/2011), and $8,000 for a water softener ( , Terry Melot, 4/12/2011). According to the Mark-Costello website, a hydraulic cart dumper is also necessary to 20 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

36 operate the equipment and costs $18,500 (The Mark-Costello Co., 2011). However, even with all of these additional charges, the Mark-Costello AS634 is the most economically feasible option. Along with low environmental and safety hazards and a small footprint, this was reason to select the Mark-Costello technology as our sterilization process TriNovaMed TriNovaMed technology works using a built-in grinder and aqueous ClO 2 as a sterilizer. Chlorine dioxide disinfects by interrupting cellular processes and disrupting metabolism through interaction with amino acids and cell RNA, killing bacteria (Lenntech, 2009). Furthermore, it kills viruses by prevention of protein formation a much more effective technique than using chlorine or ozone as well as spore-forming bacteria, biofilms, and fungi (Lenntech, 2009). Small portions of aqueous chlorine dioxide are dropped into the Green Machine filled with shredded RMW every ten seconds before the waste travels through a 150 ft treatment coil for a six to seven minute contact time. Then, the chlorine dioxide mixture is filtered out through a fine screen into a storage tank, where some will remain un-reacted, and re-fed into the system (Simpson et al.). Although chlorine dioxide has been shown to be an effective disinfectant, few processes rely on it for sterilization due to its hazardous nature and difficulty to acquire, even though it is only needed in very small concentrations. Chlorine dioxide is hazardous due to the fact that it is a strong oxidizer, and is said to cause respiratory ailments in humans and animals (Moorman, 2010). In fact, due to these hazards and the fact that it is explosive under pressure, the chlorine dioxide for this process would need to be generated on site (Lenntech, 2009). A patent was found to generate the chlorine dioxide fairly efficiently through the use of a cation exchange column and a catalytic reactor with an active metal catalyst (DiMascio, 2005). However, even with fairly easy production processes available, chlorine dioxide is rarely used due to environmental 21 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

37 concerns. Although TriNovaMed claims that the Green Machine protects the environment and emits no harmful emissions, pollutants, odors or ash, other sources discredit this claim by stating that chlorine dioxide harms all forms of life and disrupts ecosystems and considering chlorine dioxide to be in the worst 10% of most hazardous compounds to ecosystems (Moorman, 2010). On the other positive side, the reaction takes place at room temperature and pressure, eliminating the need for a boiler or expensive steam. Additionally, the reaction works over a large ph range, making it an ideal solution for pharmaceutical waste (ICA TriNova). The Green Machine is located in a semi-truck bed, making it mobile but also able to be used inside a facility (although it is very large compared to both the EcoDas and Mark-Costello machines). It can handle large amounts of waste, with a maximum 1500 lb/hr sterilization rate (TriNovaMed). Kill-rates meet and exceed the ADEQ required rate of 4 log 10 with an absolute minimum kill-rate of 4.5 log 10, and an average kill-rate of 6.5 log 10 (Simpson et al.). Similar to the EcoDas technology, the Green Machine is ADEQ approved for treatment of both red and yellow waste, ensuring a larger profit for the plant (TriNovaMed). Economically, the TriNovaMed is unreasonable. Although chlorine dioxide only needs to be generated rarely and in small quantities, and hardly any utilities are needed (only electricity and water that only needs to be supplied monthly), the base cost of the machine is around $800,000 (telephone, Nord Sorenson, 3/1/2011). Since the rate of sterilization is high, a five-day workweek with two eight-hour shifts is required for operating one Green Machine Ozonator The Ozonator-NG-1000 is a sterilizing machine that utilizes ozone as a disinfectant. The ozone works by degrading the viruses and bacteria that have bonded with medical waste so that the waste may be safely disposed of in landfills (Rasmussen, 2008). The ozone needed for 22 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

38 sterilization is produced in the machine itself; canisters of source oxygen and water are mixed within the vessel to create ozone at 4000 ppm (EnviroSolutions, 2011). Ozone as a sterilizer is an incredibly new process; in fact, Ozonator Industries first machine was sold just three years ago in 2008 (Ozonator Industries, 2010). Due to industry s unfamiliarity with the process, there is much speculation as to whether or not the Ozonator technology can meet commercial standards, especially as to whether or not it is a reasonable solution for medical waste. Ozone is an acutely toxic chemical because it is extremely reactive and is a powerful oxidizing agent leading to respiratory ailments including permanently scarred lung tissue (Environmental Protection Agency, 2009, Environmental Protection Agency, 2010). Although the safety risks of ozone are comparable to those of chlorine dioxide, they are more acute and are definitely more hazardous than those with autoclave technology, even though high temperatures and pressures are not required (Environmental Protection Agency, 2009). The Ozonator system also converts the highly toxic ozone back into harmless oxygen before it is released from the vessel (Rasmussen, 2008). Additionally, Ozonator Industries claims that no emissions result from the process, implying that no environmental hazards need to be considered (EnviroSolutions, 2011). However, ozone is declared as a harmful pollutant by the EPA and causes damage to vegetation and ecosystems (Environmental Protection Agency, 2010). The Ozonator-NG-1000 includes a grinder, a reactor and a storage bin to store the treated waste all pieces of equipment that do not need to be purchased separately. The NG-1000 has been show to achieve a maximum kill-rate of 6 log 10, which, similarly to all other processes, is much higher than the Arizona mandated kill-rate (Envirosolutions, 2011). While ozone technology is claimed to result in total destruction of bacteria and viruses, there is no mention of destruction of fungi or spores. Finally, the Ozonator-NG-1000 can process 2640 lbs/hr, which is 23 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

39 a fairly fast rate (Envirosolutions, 2011). Economically, the Ozonator technology is the best option. The NG-1000 is quoted at a base cost of $180,000, which is the best price, even when compared to the Mark-Costello technology, especially since it already comes with a grinder. Due to its fast sterilization rate, a five-day workweek with only one eight-hour shift is required with just one machine. Required utilities include oxygen, electricity and water, and result in an extremely low monthly cost of $20.61/day when compared to the chlorine dioxide required for the Green Machine and the high pressures and temperatures required for the autoclaves (Envirosolutions, 2011). Despite these economic advantages, the Ozonator s recent development and lack of research data is discouraging Black Waste Sterilization Technique Since the Mark-Costello autoclave was chosen as the sterilization process, yellow and black waste processing still required consideration. Technologies considered include incineration and plasma torching. Recall that black and yellow waste accounts for about five percent of medical waste and recycling of this waste is not crucial to ensuring a profit Incineration When determining how to dispose of yellow and black waste, three viable options are available. The first of these options is shipping yellow and black waste to an approved incineration facility. While this practice is the current industry norm, it does not appropriately address the fate of the hazardous materials being dealt with, as it only passes the burden on to others for a moderate fee. In an attempt to improve on this practice, a waste management facility can either attempt to construct and maintain an incinerator of their own, or it can turn to new technologies, such as plasma torches, to eliminate the need for incineration and its hazardous byproducts. 24 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

40 Incineration is a thermal treatment process that renders hazardous wastes harmless by combustion of the organic materials the wastes contain. By essentially burning the incoming waste materials, incinerators convert toxic inputs into relatively safer solid ash effluent, and flue gas effluent. Often times the ash that results from incineration can be used as a concrete additive and thus a degree of recycle-ability is achieved. The flue gas however, often presents a problem as it remains a hazardous stream and must be further treated and contained to prevent its toxic components from doing harm. Dioxins and furans are an ongoing source of concern for those that live near incineration facilities, as well as the emissions of heavy metals that are very acutely toxic. Particulate matter is also present in the gases that leave incinerators and are extremely dangerous. Incineration consistently demonstrates that it can handle any incoming waste product but does not necessarily do so without collateral effects. As a side note, incineration qualified for renewable energy production tax credits in recent years (US EPA, 2008). While the profit potential for building an incinerator in our proposed Arizona plant is vast, several obstacles arise that prevent this path from being taken. The fuel and truck wear and tear saved by constructing a waste incinerator in Arizona instead of shipping waste to Texas over a ten year period amounts to much more than the actual cost of building an incinerator. However, the ADEQ has not approved the construction of an incinerator of this size in over twenty years (Global Spec, 2011). Despite the financial opportunity presented by being the only medical waste incinerator in Arizona, the regulatory impossibility of having an incinerator construction approved eliminates this option to deal with black and yellow waste. Even beyond the permission difficulties we would experience, the dioxins and furans associated with operating an incinerator would prove to be an unwanted hazard to the safety of all plant employees (Jette et. al., 1992). Since plasma technology works on a similar principle but with less hazards or 25 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

41 regulatory burdens, it was considered as the last alternative to shipping hazardous wastes to Texas Plasma Technology Plasma-arc gasification is a technology that has blossomed since the turn of the millennium. It involves passing waste streams through an incredibly hot plasma stream in a low oxygen environment to degrade organic materials contained within, rather than combusting them (Finney, 2005). As a result of the organic material being treated without being combusted, combustible fuel is recoverable from plasma gasification processes. Because fuels can be recovered from the process, plasma gasification is viewed as an energy recycling system, and in cases of best use has been documented to be a net producer of energy rather than a net consumer. Energy is recovered in the form of methane, carbon monoxide and other combustible organics. In order to economically compare plasma arc gasification to incineration, it was assumed that plasma gasification is a zero-net energy usage process. This assumption was made in wake of the fact that plasma gasification has about 25 times greater capital cost initially, so to determine if further comparison had grounds a best-case scenario was evaluated. The initial cost of the equipment and installation of a plasma arc unit amounts to $1,021,000. This cost was developed using a method from Seider et. al. (2009), and excludes the cost of the combustibles recovery system. Because no equipment provider could be found to comment on the utility usage, a mass and energy balance yielded annual operating costs of roughly $20,000 for the system. This cost is mostly due to the pure nitrogen gas feedstock ($15,500/year) that must be supplied to create the low-oxygen environment and prevent combustion during operation. The rest of the annual cost comes in the form of reaction chamber cleaning/maintenance and activated carbon replacement. The annual cost for shipping incineration materials to Texas is $135,000, making the operational costs of the plasma-arc unit 26 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

42 significantly lower than those of the off-site incineration process. However, the over one million dollar start-up of the plasma-arc unit must be recovered completely since there is no start-up costs for off-site incineration. While the difference in operation costs causes plasma-arc technology to be the $2.2 million favorite after twenty years, a number of practical issues serve as obstacles to its implementation. From a purely theoretical standpoint the plasma-arc system is a minefield of uncertainty and potential disasters. The validity of the zero-net energy usage assumption is completely dependent on the composition of the incoming waste. Since the composition of the waste stream will vary widely from month to month, and even day to day, forecasting the energy usage of the plasma-arc unit is impossible. The changing inlet and outlet compositions of the streams will also make it very difficult to successfully capture the organic combustibles and separate them from the useless byproducts they will be mixed with. This would cause improvements in the incoming waste composition to be lost due to difficulties in collecting the product gases. Finally, if operational stress caused the plasma torch portion of the assembly to become inoperable, the cost associated with replacing it represents an enormous setback. Even with all these problems in mind, the actual reason plasma-arc technology was not implemented had very little to do with finances. The primary complication with constructing a plasma-arc unit to treat hazardous medical waste is getting it approved for usage. Plasma-arc gasification is a brand new technology in the realm of hazardous waste disposal, and as a result has no compliance history in not only Arizona, but essentially the entire United States. While several facilities across the US claim to be using plasma gasification to recover condensed natural gas from landfills, no facility that is in place is actually treating mobile waste streams. These facilities are also not using plasma-arc 27 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

43 technology, but instead a gas condensing system to recover already decaying organic waste gases. Numerous research papers are available that focus on the plasma-arc technology, or even plasma gasification versus incineration specifically, but the vast majority of this research as been performed in Europe and other locations outside of the United States. As a consequence of international regulatory incongruencies and a lack of domestic research, regulatory bodies still view plasma gasification as another hazardous form of incineration; this viewpoint causes regulators to be equally hesitant about allowing the installation of a plasma-arc unit or a new incinerator. Because this plant design is being performed on a purely theoretical basis, the outcome of a permitting feud with the ADEQ should not be used as a primary design factor. To avoid using an uncertain technology, the already approved method of shipping hazardous waste to Texas for incineration was chosen. 3. Equipment Description, Rationale and Optimization Main pieces of equipment are discussed below. Reference Tables 1 and 2 for further equipment specifications R-101 Mark-Costello High Volume Sterilizer AS634 The Mark-Costello high volume sterilizer was the most logical among all of the models offered by Mark-Costello because of the waste capacity per sterilization cycle. The AS634 model treats 3,000 lbs. of red bag waste per cycle. The facility must process 14,250 lbs/day. One cycle lasts an hour; therefore, sterilization would take approximately five hours. The hours of operation are regulated by the capacity of the sterilizer and current demands require a single eight hour shift, five days a week. If the plant needed to expand due to a growing customer database there are a couple of feasible options to accompany such expansions. The addition of 28 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

44 two sterilization cycles could be added to a work day or the work week could be extended to six days. ( , Mike Kelleher, 2/20/2011) Studies show that the irreversible enzymatic inactivation of B. stearothermophilus at 194 F at a ph of 6.5 is a direct result of monomolecular conformational scrambling and the deamidation of amide residues (Tomazic, 1988). The AS634 is rated for 6 log 10 inactivation of B. stearothermophilus, which is 100 times greater than ADEQ requirements of 4 log 10. In addition, the steam technology does not pose major environmental risks. The dimensions of the sterilizer are 42.8 ft x 7.4 ft x 6.5 ft ( , Mike Kelleher, 2/20/2011). This is a result of the horizontal orientation of the vessel. The sterilizer requires ancillary equipment for proper operation and waste disposal, namely, a boiler and grinder. The sterilizer requires a throughput of 4,500 lbs. of steam per hour at 65 psi to maintain a pressure and temperature of 35 psi and 285 F ( , Mike Kelleher, 2/20/2011). The sterilized waste does not require a dryer after treatment as it is only slightly damp (personal communication, Harry Patton) G-101 RG52M Single Shaft Rotary Grinder The RG52M model was selected because it has a throughput capacity range similar to the sterilizer of 2,500 to 4,000 lbs. per hour. The grinder is manufactured by Vecoplan and is recommended for the processing of sterilized medical waste. This recommendation is largely based on the 60 cutters that render waste unrecognizable as required by ADEQ R (D1). The grinder also has a large hopper size, with an area and volume of 52 in x 58 in. and 3.75 yd 3, respectively. The large hopper size minimizes the risk of a spill and allows for easy dumping of the waste into the grinder. The model has a side push arm, which eliminates bridging through the prevention of material vibrations. The programmable logic controller (PLC) 29 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

45 adjusts the arm force to compensate for resistance from the medical waste. The model is sized at in. x in. x in. There are several safeguards that contribute to the large footprint. The safety features installed include: stainless steel bottom plates, additional drip plates, hard-faced holders for highly abrasive material, drainage gutter, and an optimized PLC programming design specifically for medical waste. ( , Mike Kelleher, 2/20/2011) 3.3. H-101 Storage Freezer Yellow and black bag waste must be stored in a freezer according to ADEQ. The recommended size of the storage freezer is approximately 1,000 ft 3 (personal communication, Harry Patton). Therefore, a freezer quote was obtained for a size of 38.5 ft. x 38.5 ft. x 10ft. The size of this freezer accommodates three weeks of storage. However, plant operation and safeguards will require semiweekly transports to Texas for incineration. The yellow bag and black bag waste are stored in gaylord boxes at a temperature below 40 F to minimize odor and bacterial growth as stated in ADEQ R (C). The storage of yellow waste in gaylord boxes provides a prompt turnaround on clean yellow waste wheelie bins H-102 Hurst Boiler Co. Boiler Series 500 The boiler is a horizontally oriented, cylindrical shell and tube, natural gas fuel boiler. The size of the boiler is 193 in x 84 in x 88 in. It is a four-pass turn-around with a wet back design as seen in Figure 8. This design eliminates refractory baffles between flue gas passes which reduces the cost of materials and specialized labor by thousands of dollars. The wet back allows for radiant heat transfer area allowing for quick heat absorption. The 150 hp. boiler is 30 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

46 capable of providing the necessary 4,500 lbs of steam per hour at 65 psi ( , Terry Melot, 3/7/2011). Figure 8. Hurst 150 hp, 4-pass turn-around, wet-back boiler configuration. ( , Terry Melot, 3/7/2011) The boiler was fitted to include a blow down separator, a water treatment system, and a make-up tank. The blow down separator allows for water monitoring and can prevent foaming and priming. The 160,000 grain water softener is necessary for the typical southern Arizona water hardness of 25 grain hardness and a 50% condensate return. The make-up tank is T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

47 gallons and preheats water prior to entering the tank which allows for natural gas utility savings. ( , Terry Melot, 4/12/2011) 3.5. V Air Classifiers The General Kinematics 36 in., single knife vibratory de-stoners were recommended as the units were used in similar projects in Australia and Japan. The classifier has a vibratory and blower sections to stratify and separate the components as seen in Figure 9. The light and heavy components are separated to an upper and lower discharge chute, respectively. The size of each of the air classifiers is 16 ft. x 5 ft. x 6.8 ft. ( , Ron Zorn, 3/16/2011). V-101 is used to separate the metal and glass from the paper, cotton and plastic. V-102 separates the plastics from the paper and cotton, while V-103 separates the metal from the glass. Figure 9. Diagram of air classifier. (e -mail, Ron Zorn, 2/7/2011) 32 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

48 3.6. S Whitaker Brothers confidential document shredder The Datastroyer DS-7 was selected as confidential document shredders because they are approved by the NSA and meet a security level of six. Health Insurance Portability and Accountability Act (HIPAA) does not have a specified shred size for compliance. However, the Department of Defense (DoD) has a standard shred size of 7/16 in. and 1/32 in. shown in Figure 10; therefore, industrial shredding of confidential papers typically adheres to the DoD standard as to avoid HIPAA non-compliance issues and fines. Figure 10. Shredded paper approved as security level 6 shred. (Whitaker Brothers, 2011) The DS-7 shredders were chosen from other security level six shredders as it had the highest sheet capacity and speed of 20 sheets and 60 ft/min, respectively (Whitaker Brothers, 2011). High security level shredders do not operate at an industrial scale and it is necessary to have four shredders to properly destroy the documents in a timely manner. Each shredder has dimensions of 26.5 in. x 32.3 in. x 55.5 in. 33 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

49 3.7. K , 201, 202 Conveyers All of the conveyors were chosen to be belt conveyors to ensure minimal contact between employees and waste. The scrap is finely shredded and requires a belt conveyor in order to contain the waste. K-101 and 102 transfer the wheelie bins from the unloading dock to the scale and scanner. The scanned wheelie bin will be mechanically assisted to the appropriate area. K transfer the sterilized medical waste through the air classifying systems. K-201 and 202 transport the confidential paper waste to the shredders and paper baler, respectively. The conveyors are 36 in. and 20 ft. long (Mark-Costello Co., 2010) C-202 Confidential Paper Baler The closed end, horizontal baler, manufactured by Allegheny Shredders (model CE) was selected because of the maximum bale weight. With a bale weight of 1,200 lbs., there will be three bales produced each day. The size of each bale is approximately 60 in. x 30 in. x 40 in. The baler uses an automated ram cycle with a maximum operating pressure of 2,300 psi. The dimensions of the paper baler are 195 in. x 48 in. x 85 in. (telephone, Allegheny Shredders, 3/14/2011) C-201 A/B Waste and Recycling compactor A stationary compactor was chosen for the landfill and recycle items. This allowed for the purchase of only two compactors and multiple storage bins. If the compactor had been selfcontained, a minimum of four would have been necessary as there is not detachment between the bin and compactor (Nedland, 2011). The stationary compactor would always be located on the property rather than inefficiently taking truck bed space for transport. For these reasons a stationary compactor was chosen for the process. 34 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

50 Nedland Industries manufacture the NC-300 stationary compactor. The compactor utilizes a biodegradable hydraulic fluid. The compactor is 3 cubic yards and was the recommended size for the amount of waste requiring compacting. The compactor has a maximum ram force and cycle time of 65,000 lbs. and 50 sec., respectively. The opening for charging waste is 60 in. x 60 in. The dimensions of the compactor are 120 in. x 73 in. x 57 in. (Nedland, 2011) V-201, H-201, K-203, P-201 A/B Wheelie Bin Sterilizer The need for a waste bin sterilizer comes from the desire to improve safety for employees of the plant. A typical medical waste treatment plant has no set method of cleaning the waste bins, so hand washing by PPE covered workers is employed in an inefficient effort to complete this necessary task. Waste Management s medical waste sterilization plant in Phoenix, AZ has a worker that spends 4 hours a day hand cleaning 100 red dumpster bins. With our projected capacity, one full-time employee is required to clean all the bins, while having no efficient drying means to improve storability or a way to minimize water usage. The hand cleaning method also results in potentially unsafe work environments. Exposure to residual biological matter present in the emptied bins is a likely hazard for the person cleaning the bins, as well as skin burns and heat exhaustion from working with the hot water for long durations. To overcome this problem, an automated waste bin sterilizer design is implemented as a tool for the employee to more quickly and safely clean the bins. The system is designed to function in a manner similar to a small carwash, or, a large dishwasher. After emptying a bin, an employee will invert the emptied waste bin onto the notched conveyor at the beginning of the bin washer unit. The conveyor will be grated metal so that water can be sprayed upwards into the open, inverted dumpster bin. After the bin has been 35 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

51 placed on the conveyor, the cycle is then started and it is not required to interact with the bin until it is completely cleaned and dried. The bin is then conveyed into the first portion of the enclosure where water at 80 o C mixed with dilute Hydrox general cleaning solution is sprayed at high pressure into the bin. The pump head provided is based on an estimation of the necessary abrasive force required to clean the inside of bin of fluids no more adhesive than blood. The amount of water required was estimated based on a correlation of cleaning water needed per surface area to be cleaned, and was then reduced using a water recycle program in which dirty cycle water is used to initially clean the bin followed by a cleaning with fresh, uncontaminated water. All materials freed from the inner walls of the bin and the water sprayed into the bin leave by draining back through the grated conveyor to a drain beneath the pipe nozzles. Draining water is channeled through a heat exchanger to preheat the water entering the fired heater and reduce natural gas costs for the process. After the cleaning process has concluded, the bin moves on to the final segment to be dried. This drying is done with a series of air knives or fans to remove residual water from the bins so that they can later be stacked. After the drying process the cleaned bin is conveyed all the way to the clean bin storage area where it can be stacked with other bins to optimize storage space usage. The entire cycle takes approximately three minutes, and a new bin can be added on to the conveyor once the first bin has reached the drying cycle. The Hydrox cleaning solution only needs to be added once a day to the system and is automatically added in a set dilution pattern. Specific values and calculations for each step of the process and equipment component can be found on the Bin washer design spreadsheet in the Dropbox. 36 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

52 4. Safety Statement 4.1. Description of Hazards It is crucial to consider any potential hazards in the design stages of an engineering process or plant. If possible, these hazards should be avoided and designed out; however, should this prove impossible, precautions must be taken in order to mitigate the risks of accidents. Furthermore, should these precautions fail, it is necessary to establish a protocol allowing for a safe repair before plant operation begins in case of a catastrophic event or accident. Worker safety should be the primary concern when evaluating hazards, since these protocols could mean the difference between life and death. The safety of biohazardous materials, as well as the safety of the equipment used in the plant was evaluated. In addition, hazard and operability analysis forms (HAZOPs) were completed to assure all aspects of hazardous plant equipment were considered (See HAZOPs in Dropbox). It is recommended that the aforementioned protocols be written in accordance with the following hazards to ensure a safe workplace during normal operation as well as during an accident Safety of Materials (Biohazards) The plant discussed in this report is hazardous in nature due to the materials being processed. As discussed previously, inlet streams include medical waste separated into infectious waste, biohazardous waste, and RCRA-defined hazardous waste. Due to the variations in the composition of the waste streams, each will be closely examined. It is important to remember not to contaminate clean areas of the plant with equipment that has been exposed to medical waste or with contaminated personal protective equipment (PPE). For this reason, the plant contains a clean side, a dirty side, and a shower station and PPE storage cleaning station in between (See 37 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

53 Figure 7). The PPE required for this plant is slightly more extensive than usual instead of just gloves, goggles, and closed-toed shoes, it is recommended that employees wear disposable gowns and aprons to the avoid soak-through of hazardous materials, disposable gloves, face shields, masks, goggles with side protection, caps and shoe coverings to avoid skin contact with biohazards and infectious materials (Kaleida Health, 2007). Only one chemical is required as feedstock a general purpose cleaner for the wheelie bin washer (See Figure 6). The safety of this additive is also discussed in this section. All employees should be educated on the hazardous nature of content processed in this lab. They should adhere to the established protocols in order to avoid biohazard-related accidents in the work place Red Bag Waste Infectious medical waste, or red bag waste, was defined for the purpose of this plant to be 70% plastic, 10% glass, 7% metal, 2% paper, and 11% cotton (Wong, 1994). However, actual red bag waste is less ideal in terms of recyclability and contains other miscellaneous items such as non-hazardous pharmaceuticals, antibiotics, strips from clinical lab, rubber, empty IV bags and tubing, pipettes, and blood tubes (Smith, 2002). Additionally, waste that is noticeably more hazardous is also categorized as red bag waste, including any solid or liquid that could release blood or infectious material during normal handling (Lab Safety Supply). Items that fall into this category include human anatomical waste, small body parts, contaminated animal carcasses, used bedding, gloves, and gowns, isolation waste, cultures and stocks of infectious agents, associated biologicals, and pathological waste (Li, 1993). For this reason, it is necessary to ensure that red bag medical waste that is not immediately sterilized is stored in closed containers in a sealed storage room to avoid possible contamination in the case of a spill or a leak. It is 38 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

54 assumed that closed red bag containers are able to prevent the spreading of infectious waste even during transportation from hospitals or other pick-up sites. Furthermore, red bag waste contains sharps, vacutainers, glass ampules, empty nonchemo vials, empty non-chemo syringes and needles, and scalpels all of which add an additional hazard should the waste be held in any container that is able to be perforated (Nalder, 2009). The bins intended for red bag waste use in this plant are assumed to be sturdy and are expected to be non-penetrable to any sharp objects. However, should a spill occur, it should be noted that red bag contents will be sharp and dangerous Yellow Bag Waste The second most collected waste is biohazardous, or yellow bag waste. Contents of these bins are similar to those of red bag waste, however they may also include pathological and pharmaceutical waste along with trace chemo (Lab Safety Supply). Pathological and pharmaceutical items include discarded cultures and stocks, discarded organs and body parts removed during surgery, research animal waste, and non-combustible contaminated human blood products and infectious pathological, pharmaceutical, and genotoxic, items contaminated with blood and bodily fluids (Taghipour and Mosaferi, 2009). Trace chemo waste pertains to empty chemo IV bags, chemo IV tubing, PPE used for chemo administration such as gowns, gloves, goggles, and wipes, empty chemo vials, empty chemo syringes and needles, as well as trace chemo which is defined as being less than 3% wt/wt (Nalder, 2009). Due to the biohazardous nature of yellow bag waste it is even more important for the yellow bins to be secure both during transportation and in storage. Yellow bag waste is stored for longer periods of time, since it cannot be treated in the plant. It must be stored in a storage freezer kept under 40 F to avoid contamination (ADEQ 40CFR82.302, 2010). 39 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

55 Comparable to red bag waste, yellow bag waste can also contain sharp items such as hypodermic needles, syringes, pipettes, blood vials, broken or unbroken glassware, infusion sets, scalpels, and blades (Taghipour and Mosaferi, 2009). The presence of sharps, as well as the presence of pathological and pharmaceutical waste, should result in an increased cautionary protocol to be adhered to in this plant. Predetermined actions should be carried out in the case of a spill or leak, and should account for both liquid and solid discharge containing sharp and biohazardous material Black Box Waste Black box waste is comprised of hazardous materials as defined by RCRA in the U.S. Code of Federal Regulations (CFR) Title 40 Part 261. It is the most dangerous out of all the other waste collected and is the least common waste accumulated by hospitals. In fact, for the design of this plant, it is assumed that black box waste accounts for only 0.01 percent of all collected medical waste. Since so little black box waste is stored in the plant at any given time, handling is less common than with other waste types, although this should not be reason to treat black waste protocols lightly. Similar to yellow waste procedures, black waste is shipped to Texas twice a month to be incinerated. While it is stored in the plant, it needs to be kept in a storage freezer to avoid contamination (ADEQ 40CFR82.302, 2010). Black box waste consists of pathological and pharmaceutical content similar to that of yellow bag waste, although with the additional hazard of being corrosive, reactive, ignitable and toxic ( , Harry Patton, 1/28/2011). All included chemicals are defined as toxic and hazardous to the environment by being P-, U-, D-, or F-listed. P-listed chemicals include epinephrine, nicotine, chloroform and warafin, while U-listed chemicals include chemoparaldehyde, mercury, and phenol (Lab Safety Supply). Other contents include partial doses of chemo, bulk chemo agents, chemo spill clean-up, heavy metals, oxidizers, ignitable compressed 40 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

56 gas, expired products, patient personal medications, partial vials, and any solid that is ignitable, corrosive, reactive, or toxic (Smith, 2002). Due to the nature of black box content, it is critical to ensure that black box waste it kept in tightly sealed boxes and within a contained storage space. Spills and leaks of this waste should be handled especially carefully and special precautions should be made to make sure that crosscontamination of black waste does not occur. It is important to note that this waste could be both aqueous and solid. Since chemicals in black box waste are ignitable and reactive, it is crucial to make sure that all ignition sources and stored chemicals are kept far away from any spills Hydrox General Purpose Cleaner A concentrated general purpose cleaner is required to sterilize red and yellow bins after they have been used to transport hazardous medical waste (See V-201). Diversey Hydrox General Purpose Cleaner with hydrogen peroxide was chosen for this process (Diversey, 2010). It contains hydrogen peroxide and alcohol ethoxylates and is only slightly hazardous causing mild skin and eye irritation in the case of direct contact and with an oral LD 50 of above 5000 mg/kg (Diversey, 2010). Should the cleaner be ingested, it can also cause irritation to the mouth, throat and stomach (Diversey, 2010). Only few protocols are recommended for the first-aid of contact with the cleaner including immediate flushing of the eyes and skin, and the drinking of water or milk in the case of ingestion. Like any chemical, Hydrox General Purpose Cleaner should be kept in a tightly shut container in a dry and well-ventilated area. Although it is not flammable, it does need to be stored separately from all medical waste spills since it is an oxidizer and can therefore intensify fires (Diversey, 2010). The cleaner is a clear and odorless liquid at standard temperature and pressure so that a spill would be extremely hard to detect (Diversey, 2010). This heightens the need for a separate cleaner storage area far away from any medical waste storage. Furthermore, 41 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

57 it should not be stored in the storage freezer, as its MSDS advises against the freezing of the product (Diversey, 2010) Safety of Equipment (Technical Hazards) The recommended plant also contains numerous pieces of equipment with large, moving parts that are operating on the floor where the employees work. Therefore, it is important to recognize the hazards stemming from this equipment and notify all personnel of ways to avoid injury during both normal operation and in case of an equipment malfunction. Additionally, steam is recommended for sterilization purposes, and as a result, workers are around high temperatures and pressures. Protocols should be established and well displayed so that accidents due to moving parts, high temperatures, and high pressures are avoided and a safe work environment is maintained. Aside from establishing protocols, regular maintenance to these dangerous pieces of equipment should be performed in order to avoid the aforementioned equipment failure. Also, operators should be properly trained to operate equipment safely in the work area. Equipment should only be operated strictly according to the recommended design specifications, as well as to safety codes designated by the manufacturer, as exceeding these specifications could result in equipment failure and possible worker injuries. The most important piece of equipment for this plant is the Mark-Costello sterilizer (R- 101). If this piece of equipment fails, all downstream processes will be halted and all upstream medical waste will need to be stored for periods of time that exceed recommended limits. The plant is inoperable without it, so precautions must be taken to ensure that the shutdown or malfunction of the sterilizer does not occur (See Sterilizer HAZOP in Dropbox). There is absolutely no way to bypass this piece of equipment, so it is recommended that a second 42 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

58 sterilizer be purchased as a safeguard, although the proposed plant contains only one for budgeting purposes. HAZOPs were completed for eight pieces of equipment included in this plant; however, general safety concerns for each piece of equipment are listed below (See HAZOPs in Dropbox). Please refer to Figures 5 and 6, and Tables 3-5 for the following sections Mark-Costello sterilizer (R-101) The Mark-Costello high volume sterilizer is associated with many moving parts and is in operation for the majority of each shift. Additionally, during operation, it is filled with steam at 135 C and 4.4 atm. Employees should try to remain far away from this device, mainly to avoid burns, and access to any entry points should be guarded to ensure nothing unwanted enters the sterilizer. Should close employee proximity be necessary, the proper PPE should be worn. Personnel should also be weary of a possible pressure explosion inside the vessel at any given time Hurst Gas Boiler (H-102) Similarly to the sterilizer, the boiler produces steam at 135 C and 4.4 atm. Workers should remain a far enough distance away from this piece of equipment to avoid burns, and if close proximity is necessary, the proper PPE should be worn. Again, similar to the sterilizer, employees should be prepared in the case of a pressure explosion Grinder (G-101) Rotary grinders are extremely hazardous and all possible entrance and pinch points should be properly guarded during operation to minimize the risk of serious injuries such as amputation and even death. Additionally, the area around the grinder should be kept clear of spills so that a slip does not occur, resulting in unwanted contact with the grinder. An emergency stop switch should be present in case any employee or their clothing comes into contact with a 43 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

59 moving part during operation. The grinder should not be loaded with any more material than can be handled safely according to specifications Confidential Paper Baler (C-202) The confidential paper baler is considered to be a large piece of equipment and exerts 157 atm of pressure while crushing paper. It is important not to place hands or other extremities near the baler entry while it is running in order to avoid serious injury. An emergency stop switch should be present in case any employee or their clothing becomes in contact with a moving part during operation. Care should be taken while handling the finished paper bale, as it weighs nearly 1,000 lbs and can be hazardous if removed from the baler incorrectly. The baler should not be filled more than its maximum capacity Compactor (C-201 A/B) The compactors used for sterilized waste exerts 170 atm of pressure, and should be treated as a hazardous piece of equipment. Employees should be sure to avoid entry points as well as moving parts during operation in order to avoid accidents, and the compactor should not be filled more than its maximum capacity. An emergency stop switch should be present in case any employee or their clothing comes into contact with a moving part during operation Paper Shredder (S ) The document shredders are used constantly throughout plant operation, and are also considered to be hazardous pieces of equipment. As it is able to shred paper to 0.8 mm x 4.5 mm rectangles, it contains many sharp moving parts. Therefore, entry and pinch points should be avoided at all costs by employees while the shredders are operating. An emergency stop switch should be present in case any employee or their clothing comes into contact with a moving part during operation. 44 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

60 Storage freezer and Storage Room (H-101) The storage freezer is kept below 40 F at all times, so it is important that it contains a handle for employees to exit from the inside. Should this handle fail, some sort of back-up method such as an alarm should be implemented to ensure that no one is trapped inside the freezer for extended periods of time. If insulation degrades, or if the door is left open by a worker for too long, the temperature of the freezer will drop, leading to heated hazardous waste which is a safety threat for all employees. Both the freezer and storage room should be built with sloped floors and drains so that they may be cleaned and emptied in the case of raw materials spills. Since the nature of the material stored in both rooms is extremely hazardous, both should be well-ventilated to avoid air contamination in the case of a spill. Finally, both rooms should be washed down regularly so that employees working in them are not exposed to higher levels of contamination Air Classifier (V ) The air classifiers employ vibratory methods and air flow in order to separate heavy and light objects. Since the classifiers are fairly large and heavy, these vibrations can be hazardous to employees. Entry points should be guarded while the air classifiers are in operation, and workers should attempt to maintain a fair distance away from the machines during operation Wheelie Bin Washer (V-201, P-201 A/B, H-201) The bin sterilizer consists of a fire heater, a bin conveyor, an open storage tank, and a water pump and sprays water and a general cleaner over the contaminated bins. It is important to avoid entering the sterilization vessel while it is in operation, as very hot soapy water is pouring out and can burn employees. Additionally, the cleaner used is a skin irritant. Workers should also try to avoid contact with the fire heater, as it reaches temperatures up to 80 C and will cause burns upon contact. 45 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

61 Conveyors (K , ) Running conveyor belts exhibit many possible pinch points along their length, so it is important that a proper guard system is in place to ensure that all of these pinch points are not accessible. Emergency stop switches should be located along the conveyor in case an employee or part of their clothing becomes trapped on part of a conveyor. Furthermore, conveyers used to transport contaminated waste must be covered to avoid contamination of other areas of the plant, and to avoid accidental spills. Conveyors that come in contact with contaminated bins or waste regularly should be cleaned periodically to avoid the spreading of contaminants to employees or to other pieces of equipment Forklift The forklift is considered to be a heavy piece of equipment and can be dangerous if used incorrectly. So, it is important for operators to be properly trained. Also, the forklift should only be used for its intended purposes to avoid injury due to its large moving parts Pallet Jack The pallet jack is used to transport pallets of red waste, and so it is important that it is cleaned immediately in the case of a spill or leak. Similar to the forklift operation, the pallet jack can be hazardous if used incorrectly and so it is critical that it is only used for its intended purpose to avoid injury Mark-Costello Heavy Duty Hydraulic Sterilizer Cart Dumper The hydraulic cart dumper is capable of lifting extreme weights into the sterilizer, and therefore contains large moving parts. Operation should only be handled by qualified workers who strictly adhere to protocols. Since it comes in contact with contaminated bins, the cart dumper should be cleaned periodically to avoid hazardous contamination that could be spread to employees. Unlike the fork lift and pallet jack, the cart dumper is not strictly manually operated 46 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

62 and so it must contain an emergency stop switch in case any employee or their clothing becomes in contact with a moving part during operation Bins 96 gallon red bins, 43 gallon yellow bins, and non-reusable black 8 gallon bins are used to transport waste. It is extremely important that these bins are not stored for too long after waste is emptied from them, as contaminants could spread to workers. Yellow and black bins should be sent to Texas for incineration every other week so that they do not contaminate storage areas. Although black waste bins are never be emptied on site, it is critical that they be immediately disposed of should they be accidentally emptied in the case of a spill Trucks Four trucks are used by this plant for the transportation of medical waste, confidential paper, and cardboard. Drivers of these trucks should have proper licenses and operational training and should also be trained to handle the truck contents. Traffic laws should be strictly obeyed by personnel operating company trucks in order to avoid accidents, and even death Pumps (P-201 A/B) When running pumps continuously, it is possible that the unit may overheat, potentially causing severe burns and injury. Therefore, pumps should be run only within the guidelines set by the manufacturer, and should be kept out of reach of employees. No pumps should be used for reasons other than intended within this report. 5. Environmental Impact Statement The primary purpose of this plant is to mitigate the harmful effects of biohazardous medical waste. Since medical waste must be extensively treated, a certain amount of emissions, water, and energy consumption are expected. However, the emissions and energy consumption 47 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

63 cannot be excessive such that the operational efficiency of the plant is influenced. The net environmental effects of the plant are broken into sections. These sections include: material and energy consumption, potential spills or emissions, and gate to grave output analysis. The plant requires four utilities for operation: water, electricity, gasoline and natural gas. The utility usage focuses on what is used in the actual process and not on the municipal facilities also included within the building (i.e. clean room, bathrooms, office). The first utility analyzed is water because it is the most prominent environmental concern in the desert. Water rights issues have been substantial enough to determine whether or not fabrication plants were built within a municipal area. Fortunately the water consumption of the proposed plant poses minimal risk and should not cause any permitting obstacles. A conservative estimation puts our plant s water consumption below 150,000 gallons per month (See Economic Analysis, Utility Tab). A typical golf course in Tucson uses between 100,000 and 1,000,000 gallons of water per week (Vangerd, 2009). On average, the proposed medical waste treatment facility will use less than a tenth of the water that a single golf course uses, while still providing a necessary service to the community. Prior to the wheelie bins entering the wheelie bin washer, a visual inspection is conducted for remaining debris. Runoff water contains the Hydrox cleaning solution, making it safe for sewer dispensation. Additionally, the condensed steam from the autoclave had reached a temperature and pressure capable of denaturing bacteria. Therefore, the water exiting the plant is suitable to enter the sewer system without any pretreatment. Overall the plant does not have a negative effect on the environment in the area of water usage. The power consumption of the facility is projected to be 102,000 kwh/month (See Economic Analysis Utility, Dropbox). Since it is necessary to sterilize medical waste, it can be 48 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

64 expected that some power consumption is required. One potential method for reducing the nonrenewable energy consumed would be to utilize solar power. Arizona is renowned for more than 300 days of sunshine each year, and with a 38,000 sq. ft. facility it is possible to supply all the power the plant requires through installation of solar paneling (See Figure 7). While the initial capital of the current design does not account for solar paneling, it is a distinct possibility to reduce the carbon footprint. In addition to the electricity consumption, the plant also uses about 15,000 therms of natural gas per month (See Economic Analysis - Utility, Dropbox). This utility can be completely eliminated through the installation of an electrical water heater and boiler. The largest environmental effect of natural gas usage is the resulting carbon dioxide emissions. If the utility usage remains the same, the plant s carbon footprint is 132 metric tons of CO 2 per month (Carbon Footprint Program, 2011) based on the electric and natural gas utility consumption. Rather than trying to offset this footprint by other means, it is recommended that the plant design can be retrofitted to include renewable energy such as solar paneling, thus reducing the carbon footprint. The thermal sterilization process of the plant requires few chemical products to maintain operations. Only two chemicals in our process exist that need to be evaluated for potential environmental consequences: hydraulic fluid and Hydrox general purpose cleaning solution. In preparation for potential spills or leaks, a safe, biodegradable hydraulic fluid was incorporated into the plant design for each applicable piece of equipment. The selected compound is called Ultra Guard-BHF-3/68, and is produced by Newsom Oil Company. The entire product line is drain-safe and can be absorbed into soil due to its biodegradability. Ultra Guard also has a low 49 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

65 volatility and a high oxidative stability, so reactive hazards and inhalation concerns are minimized (Newsom Oil Company, 2011). Hydrox cleaning solution is only used in the wheelie bin washer and is diluted prior to use. However, exposure to highly concentrated forms of Hydrox is only mildly hazardous, resulting in skin irritation or eye irritation (Diversey, 2010). The primary compound is hydrogen peroxide allowing the cleaning solution to break down quickly in the event of a spill (Diversey, 2010). Neither of the chemical feedstocks in the process pose a serious environmental threat even when spilled since biodegradable products were selected. Another environmental consideration involved the end of life destination of the hazardous wastes. While the plant is designed to recycle uncontaminated paper, and metal and plastic from red bag waste, landfills or incineration is required for all other wastes. Paper, cotton and glass coming in as red bag waste is inevitably sent to a landfill after it is sterilized and separated from the more valuable metals and plastics. Approximately 32.7 tons of these materials are sent to the landfill every month because other uses are not available (See Economic Analysis - Seider Analysis, Dropbox). The most environmentally hazardous element of the process does not actually occur onsite at the sterilization facility. Yellow bag and black box wastes represent the most hazardous compounds in any part of the process. Hazards involved with them include potential spills during transport or within the plant. These compounds are not allowed to enter the sewage system or soil, so a well-sealed refrigeration space must contain them within the facility, and only specially permitted trucks are allowed for transport. These strict regulations are imposed by RCRA, the EPA, ADEQ, and the Department of Transportation (DOT) due to the extremely harmful effects of yellow bag and black box wastes. Despite these hazards, their real impact is at the point of 50 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

66 disposal. The designed plant is neither the generator nor the disposer of these particular waste streams, but a share of the responsibility for their fates rests with all who take part in their disposal. The final destination of yellow bag and black box wastes is an incinerator. While incineration is considered to sterilize yellow bag and black box materials, it simultaneously generates another hazard. The most publicized concerns from environmentalists about the incineration of municipal solid wastes (MSW) involve the fear that it produces significant amounts of dioxin and furan emissions. Dioxins and furans are considered by many to be serious health hazards. (Beychok, 1987). Dioxins and furans are airborne emissions of incinerators that are under intense scrutiny by regulatory bodies. A new technology should be implemented to treat yellow bag and black box waste without incineration, such as plasma gasification or irradiation treatment. Whether or not the new technologies will be applicable will depend on regulatory changes within the state of Arizona and not on financial constraints as plasma gasification presents significant economic advantages as discussed in the Process Rationale section of this report. While the process sterilizes pathological materials and prevents a large amount of metal, paper and plastic from ending up in a landfill, it also introduces the aforementioned negative environmental impacts. Therefore, the overall process poses minimal environmental impacts. Plans for further environmental improvement are in place and can be implemented as finances and regulations permit. 6. Economic Analysis The economic analysis begins with the calculation of the total bare module cost of the equipment, C TBM. All but one piece of equipment, the wheelie bin washer, were obtained through manufacturer s price quotes. The wheelie bin washer requires a pump, conveyor, pre- 51 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

67 heater, nozzles, containment vessel, and a dryer. The wheelie bin washer price calculations are calculated through Seider et al. (2009) correlations and are shown in detail (See Bin Washer Design, Dropbox). Table 7 shows the equipment and installation costs obtained from manufacturers. Equipment Source Amount Total Cost a C 201 A/B Nedland 2 $19,900 C 202 Allegheny Shredders 1 $14,000 G 101 Mark Costello 1 $200,000 H 101 TRJ Refrigeration 1 $120,000 H 102 Hurst Boiler Co. 1 $69,100 K Mark Costello 12 $150,000 R 101 Mark Costello 1 $250,000 S Whitaker Brothers 4 $27,200 V General Kinematics 3 $210,000 V 201 Seider et al. 1 $152,000 a. Includes the purchase price and installation. Table 7. Equipment requirements and pricing. In addition to the major pieces of equipment, there is a large amount of ancillary equipment essential to the plant efficiency. Table 8 shows the total price, including the purchase price and delivery fees, associated with each piece of ancillary equipment. Equipment Source Amount Total Cost a Dumpster Bins Nedland 4 $5,400 Storage Bins East Tex Trash 4 $320 Autoclave Carts Mark Costello 5 $2,500 Forklift Toyota Equipment 1 $5,500 Pallet Jack Toyota Equipment 1 $1,350 Water Softener System Hurst Boiler 1 $8,000 Odor Control System Mark Costello 1 $4,100 Cart Dumper Mark Costello 2 $37,000 Flatbed Truck Freightliner of Arizona 1 $30,000 Covered Truck Freightliner of Arizona 3 $96,000 Red 96 gallon bins Rehrig Pacific 750 $86,250 Yellow 43 gallon bins Rehrig Pacific 120 $4,590 Scale Fairbanks 1 $1,300 Table 8. Ancillary equipment requirements and pricing. The annual operating costs were obtained through correlations by Seider et al. (2009) and detailed calculations are presented in Appendix 9.2. There are three auxiliary accessories: wood 52 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

68 pallets, gaylord boxes, and 8 gallon black RCRA waste bins. Prices were obtained through supplier quotes. The wood pallets and gaylord boxes were priced through Uline for $6 and $16 a piece, respectively. The 8 gallon black waste bins were priced through Fisher Science for $26 each. The sole feedstock is Hydrox general purpose cleaner for the wheelie bin washer. The price of the cleaner is $190 per gallon (personal communication, Neal Beenenga, 4/8/2011). The annual utilities were calculated through the manufacturer's specifications, daily usage, and local utility company prices. Table 6 shows a breakdown of the utilities. The operation costs include: operator salaries, wages, benefits, supplies and services, technical assistance to manufacturing, and control laboratory. The overall operation costs are $1,182,000. The maintenance costs include: maintenance salaries, wages, benefits, materials and services, and a maintenance overhead. The total maintenance costs are $226,000. The annual cost of manufacturing also includes property taxes, insurance and equipment depreciation. Finally, to compute the annual production cost, one must determine general expenses which include incineration, landfill, and permitting costs. Table 9 shows the breakdown of these costs. 53 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

69 Auxiliary Accessories Annual Cost Pallets $18,000 Shipping boxes $53,300 RCRA waste bins $9,300 Feedstock Hydrox general purpose cleaner $1,700 Utilities Electricity $34,300 Water $5,500 Natural Gas $160,000 Gasoline - Diesel $49,900 Operations (O) Direct wages and benefits $874,000 Direct salaries and benefits $131,000 Operating supplies and services $52,400 Technical assistance to manufacturing $60,000 Control laboratory $65,000 Maintenance (M) Wages and benefits $98,300 Salaries and benefits $24,600 Materials and services $98,300 Maintenance overhead $4,900 Operating overhead General plant overhead $80,100 Mechanical department services $27,100 Employee relations department $66,500 Business services $83,400 Property taxes and insurance $65,500 Depreciation $174,800 Cost of manufacturing $2,237,000 General expenses Incineration $135,000 Landfill $26,600 Transportation permit $1,500 Total production cost $2,402,000 Table 9. Annual operating costs. The sales from the plant are from the recycling of the confidential papers, plastic, and stainless steel, and the handling fees for all wastes charged to customers. The recycling sales 54 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

70 represent 6.8% of the total sales and it lends a "green" portfolio for the plant. If recycling was omitted, the associated landfill expense would nearly triple. Table 10 illustrates the annual sales. Recycling Sales Amount (lb/yr) Price ($/lb) Yearly Sale Paper 1,350, $13,500 Plastic 2,390, $23,900 Stainless Steel 239, $203,000 Handling Fees Cardboard 5,400, $810,000 Paper 1,350, $270,000 Red Waste 3,420, $1,880,000 Yellow Waste 180, $315,000 Black Waste $900 Table 10. Annual sales from recycling and handling charges. The venture profit is $663,000 per year and the annualized cost is $2,409,000. The return on investment (ROI) is 23% with a payback period of approximately 2.6 years. The ROI and payback period are favorable toward the build; however, the payback period is generally not a good indication of the quality of the investment because it ignores the time value of money. A solution to achieving a better analysis of the economical feasibility of the plant is to calculate the net present value (NPV). The NPV was calculated using twenty year MACRS depreciation with a zero scrap value, an interest rate of 12% and a tax rate of 40%. The analysis assumes a three year build with onethird of the depreciable capital assigned to each year of the build. The sales include the selling of plastic, paper, and stainless steel for recycling. In addition, there is a collection fee charged to customers for waste pick-up. The NPV after twenty years is approximately $2,412,000. Detailed calculations of the net present value are presented in Appendix 9.2. There are economic hazards associated with the design, namely the fluctuations in utilities. The most obvious of the utilities is the price of diesel gasoline. Diesel fuel is one of the 55 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

71 most volatile commodities in terms of price stabilization (Diesel Service and Supply, 2008). One option to mitigate the extreme fluctuations of diesel is to invest in trucks that utilize compressed natural gas (CNG). The trucks would have a slightly higher initial capital cost, but it would be offset by the cheaper CNG prices. However, the lack of available refueling stations would make trips to Texas for incineration nearly impossible. Figure 11 shows the price fluctuations of a gallon of diesel from October 2008 to April 2011 (US EIA, 2011). Figure 11. US diesel prices per gallon from October 2008 to April In addition to the price fluctuations of diesel, the locality of the plant presents another obvious utility hazard, that being water. It is hard to use the price of water in the United States and apply that to Arizona because there is a short supply of water in the region. This is a large concern for the design because it utilizes a steam sterilizer and a wheelie bin washer. According 56 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

72 to the National Resources Defense Council, a study performed by the consulting firm Tetra Tech, showed that 93% of Arizona counties will be at-risk for water shortages by the year 2050 as shown in Figure 12 (Natural Resources Defense Council, 2010). Figure 12. Water supply shortages in the year 2050 with climate changes. The electricity supply prices in Arizona have been relatively stable in the past two decades despite seasonal changes. There is a slight upward trend for Arizona resulting in a 20% increase of price per kilowatt-hour over two decades. An obvious choice to reduce the cost of electricity is to install solar panels. The power generated would cover the electricity requirements of the plant and any extra could be sold to Tucson Electric Power. Figure 13 shows the electricity fluctuations for Arizona from 1990 to 2010 (Schnapp, 2010). 57 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

73 Dollars per kilowatt-hour April 29, Year Figure 13. Average historical prices of electricity for the industrial sector in Arizona from 1990 to The average price of natural gas has declined in the past five years from a high of approximately $10.50 per thousand cubic feet. The main issue with the use of natural gas for a large scale process is that the purchase contracts tend to have short terms and is often interrupted due to increased prices or shortages (US EIA, 1998). One way to mitigate this problem is to purchase an electric boiler. The boiler could be powered by solar panels to offset the high utility costs associated with running an electric boiler for long periods of time. The average historical prices of natural gas for industrial use in Arizona are illustrated in Figure T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

74 Dollars per Thousand Cubic Feet April 29, Year Figure 14. Average historical prices of natural gas for the industrial sector in Arizona from 1997 to The utilities are not the only threats as economic hazards, federal and state regulations non-compliance can result in large fines. One of the fines associated with the design is failure to correctly log the transport of the medical waste. Each manifest that is not completed properly is subject to a $20 resubmission fee under ARS If non-compliance orders are issued with a time period for corrective actions, each day past the deadline a penalty of no more than $1,000 each day may be assessed as defined in ARS If a violation of any permit or order issued is subject to a penalty of no more than $25,000 for each day of violation as described in ARS The standards are more stringent for RCRA waste. If a company is given a period of time to take corrective actions, every day past that period, the company is subject to fines of no more than $25,000. For a company who knowingly violates provisions a fine of up to $50,000 applies. If the provision is knowingly violated and it results in the death or serious bodily injury, the company will be held to a fine of up to $1,000,000. (O'Grady, 2003) 59 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

75 The overall economic risks are relatively low because the biomedical waste disposal market is stable. The two concerns abating the design include utility prices and fines. However as utility prices increase, collection prices will have to be adjusted accordingly. To facilitate the increased collection prices, it is suitable to have short term contracts with health facilities. To mitigate unnecessary fines, all employees should receive comprehensive training and annual refresher courses. Based on the economics, it is recommended to proceed with the construction of the plant. 7. Conclusions and Recommendations The design of the biomedical waste treatment plant has proven to be economically feasible with the assumptions made. The most economically viable option for treatment was the Mark Costello sterilizer, mainly because of the initial capital required for the other technologies, associated environmental concerns, and smaller treatment loads. Future technology advancements will minimize the concerns with Trinovamed Green Machine, Ecodas sterilizer, the Ozonator, and plasma gasification. The largest assumptions that affect the accuracy of the design are proper source separation and the material recovery from the air classifiers. Many hospitals have implemented training for waste disposal because it reduces costs for treatment. Assuming that the hospitals look for ways to mitigate excessive operating costs negates the assumption of proper source separation as having a large impact on accuracy. As for the latter assumption, there is not any data to support or refute the assumption. Recently, there has been one large commitment by Becton, Dickinson and Company with Rady Children's Hospital - San Diego; however, information has yet to be released as to how much the company is able to recycle. 60 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

76 In continuance of the treatment plant's "green" portfolio, it is recommended that the design take advantage of Arizona's solar energy through the installation of solar panels to mitigate electrical expenses. In addition, further data is necessary to accurately determine the waste separation in the air classifiers. Nonetheless, the amount of medical waste produced increases every year and the plant must be retrofitted to accommodate the increase in sterilization demand. 61 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

77 8. References Arizona Department of Environmental Quality (2010), Title 18. Environmental Quality Beenenga, Neal. Waste Management North 34 th Drive Phoenix, AZ Plant Manager Beychok, Milton R. (January 1987). "A data base for dioxin and furan emissions from refuse incinerators". Atmospheric Environment 21 (1): doi: / (87) Carbon Footprint Program City of Tucson (2010), Los Reales Landfill Recycling Rates e%281%29.pdf Diesel Service and Supply (2008), "Diesel Fuel Prices" DiMascio, Felice (2005), System and process for producing halogen oxides United States Patent 6,913,741 B2. urce=gbs_overview_r&cad=0#v=onepage&q&f=false Diversey (2010), HYDROX General Purpose Cleaner with Hydrogen Peroxide MSDS. 7EN%27\%27NAM%27\%27MS %27\%27MTR%27\%27ANSI%27\{ts% :35:52%27} EcoDas (2005), T2000 Technical Specifications Environmental Justice Activists (2011), Dioxin Homepage Environmental Protection Agency (2009), Ozone-Good Up High, Bad Nearby Environmental Protection Agency (2010), Ground-level Ozone: Health and Environment EnviroSolutions (2011), Ozone technology systems 62 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

78 Finney, Helen (2005), PyroArc: Gasification and Pyrolysis Treatment of Hazardous Waste Global Spec (2011), Incinerator Suppliers in Arizona ICA TriNova. ICA TriNova, LLC Slide show presentation. Kaleida Health (2007), Regulated Medical Waste Policy and Procedures nagement/ss-d_05.doc Keene, John H. (1991), Medical Waste: A minimal Hazard Infect Cont Hosp Ep, 12(11): Kelleher, Mike. Mark-Costello Co. Engineering Sales Representative. logs. February 3 rd March 14 th, Lab Safety Supply. Separating medical and hazardous waste GHC Specialty Brands. Document # Lenntech (2009), Disinfectants: Chlorine Dioxide Li, C.S., Jeng, F.T. (1993), Physical and chemical composition of hospital waste Chicago Journals. 14: Melot, Terry. Arizona Boiler Co. Engineering Sales Representative. logs. March 7 th April 12 th, Moorman, Claire (2010), Environmental Impact of Chlorine Dioxide ehow. MSDS. Hydrox General Purpose Cleaner with Hydrogen Peroxide. Diversey, Inc Bristol Circle Oakville, Ontario L6H 6P Nalder, N. (2009), RCRA regulated pharmaceutical hazardous waste. University of Utah. Slide show presentation. Natural Resources Defense Council (2010), "Climate Change, Water, and Risk - Current Water Demands Are Not Sustainable" Newsom Oil Company. Ultra Guard Product Information Sheet T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

79 Office of the Secretary of State (2011), Title 18. Environmental Quality Arizona Department of State. O'Grady, Michael, (2003) Environmental Law Deskbook 7th Edition, Environmental Law Institute, Washington, DC, pp 811. Ozonator Industries (2010), Patton, Harry. Mentor. Rasmussen, Colin (2008), Treatment of biomedical waste with ozone. Minneapolis, MN. ScanArc Plasma Technologies. Stockholm, Sweden. Schnapp, Robert (2011), "U.S. Electric Utility Sales, Revenue and Average Retail Price of Electricity" U.S. Energy Information Administration. Seider, Warren D. Product and Process Design Principles. 3rd Edition. John Wiley & Sons, Inc Simpson, Greg D. and Associates. Letter Re: Observations on TriNova s New Technology. Smith, C. (2002), Managing pharmaceutical waste. Journal of the Pharmacy Society of Wisconsin Taghipour, H., Mosaferi, M. (2009), Characterization of medical waste from hospitals in abriz, Iran Science of the Total Environment. 407: The Mark-Costello Co. (2011), Medical Waste Sterilizers Thompson, Lauren (2011). Autoclave Sterilizing Process ehow. Tinyprints Co. Paper Thickness and Weight. Tomazic, SJ, and AM Klibanov (1988), "Mechanisms of irreversible thermal inactivation of Bacillus alpha-amylases". J Biol Chem. 263(7) : TriNovaMed. About TriNovaMed and the Monarch Green Machine 64 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

80 United States Energy Information Administration (2011), "Natural Gas" United States Energy Information Administration (2011), "Weekly Retail On-Highway Diesel Prices" United States Energy Information Administration (1998), "Why Do Natural Gas Prices Fluctuate?" uctuate/html/ngbro.html United States Environmental Protection Agency (2010), Code of Federal Regulations Title 40 Protection of the Environment =Title+40&oldPath=&isCollapsed=true&selectedYearFrom=2010&ycord=1710 United States Environmental Protection Agency, Office of Solid Waste (1990), "Medical Waste Management in the United States" First Interim Report to Congress. Vangerd, Timothy. Water Consumption on Golf Courses. Golf Environment Organization White, Colleen T. (2011), BD and Rady Children s Hospital-San Diego Announce Pilot Project to Reduce Environmental Impact of Sharps Disposal Becton, Dickinson, and Company, &BusinessCode=20001&d=BD+Worldwide&s=&dTitle=&dc=&dcTitle Wong, K.F., Narasimhan, R., Kashyap, R, Fu, J. (1994), Medical waste characterization Journal of Environmental Health. 57: T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

81 9. Appendices 9.1. Process Calculations Mass Balances Red waste Yellow waste A1 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

82 Waste Bins Cardboard Paper Shredders A2 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

83 Wheelie Bin Washer Calculations The wheelie bin washer was designed and priced based on correlations from Seider et. al., as well as practical considerations derived from contact with industry experts. The components were valued based on a combination of these correlations and actual price quotes. A brief explanation of parameter choices follows with justifications for each component. The actual calculations and the equations used can be found in the Bin Washer Design spreadsheet in the Dropbox. The conveyor that transports the bins was sized based on the dimensions of the actual bins being washed, 3 ½ foot width allows the 3 foot opening of the bins to rest on only the conveyor. The length of the conveyor was chosen to allow 4 different sections of the washer: loading, washing, drying, unloading. Using these dimensions of the conveyor its bare-module cost was calculated using a Seider method. The fired heater was sized based on the heat that was needed to raise the temperature of the cleaning water to 80 o C. Both the heat and water required can be found on the Water/Thermo tab of the Bin Washer Design spreadsheet in the dropbox. The bare-module cost was then directly calculated from the heat supply required using a Seider correlation. The open storage tank is essentially a sheet metal cover for the entire process that prevents water from being sprayed out of the washing area, and was sized using a conservative estimation. Its cost was calculated from a Seider correlation once its dimensions were estimated. A3 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

84 The type of pump and power of the pump needed to supply pressure for the water cleaning the bins was selected using a pump curve that referenced the necessary pump head. The amount of pump head required was estimated based on methods currently being used to sterilize waste bins. Stainless steel was chosen as the material of construction in order to ensure minimal corrosion from any cleaning solutions that might be used with the system. The price of the pump was calculated using all of these parameters and these calculations can be seen on the Water Pump tab of the Bin Washer Design spreadsheet. In conjunction with the pressure supplied by the pump, pipe nozzles were chosen to optimize spray patterns. These nozzles were priced with actual quotes and the types were chosen through recommendations from an industry expert (Beenenga, 2011). Finally the air knives, or fans, were added in as the final step of the process. These fans make direct contact with the water flowing out of the bins and are made of fiberglass to prevent corrosion or mineral build up on the blades that would damage the equipment. The power was estimated using proportionality from car wash air knives, and the price was calculated using a Seider correlation that was based on material of construction and fan motor horsepower Economic Calculations The economic assessment was initiated by attaining quotes from either manufacturers or proven correlations. The wheelie bin washer is not currently manufactured; however, equipment prices were developed using the Guthrie Method from Seider et al. for a fired heater, pump, conveyor, storage tank, nozzles, and air knives to design a wheelie bin washer. The purchase price, C P, of each piece of equipment is calculated as demonstrated in Spreadsheet Bin Washer Design. Factors that affect C p include the bare-module factor, F BM, pressure factors, F P, material factors, F M, and design factors, F D. The pressure and material factors are one when the A4 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

85 equipment is based on atmospheric pressure and carbon steel. The design factors are individual to each piece of equipment. There are cost indexes to account for price inflation, the most current cost index, I, is 575; however, C P correlations are calculated using a reference index, I b, of 500. The bare module costs, C BM, of each piece of equipment is then calculated and it includes delivery, insurance, taxes, and direct materials and labor for installation (Seider et al., 2009) The C P for the belt conveyor is based on two parameters, the width and length of the belt. The justifications for the width and length of the conveyor are described in Section The pressure, material, and design factors were one, but Seider et al. does not include F BM for a conveyor, so it was estimated at 1.1. The C BM for the conveyor is shown in Table The C P for the fired heater is calculated from the heat transfer rate, Q. The rationale and supporting calculations for the heat transfer are shown in Appendix 9.1. The design, pressure, and material factors are all one. For a field-fabricated fired heater, F BM is The C BM for the fired heater is shown in Table The C p of the containment vessel for the wheelie bin washer was correlated using an open storage tank. The design, pressure, and material factors were one. The F BM was not listed for an open storage tank and thus was assumed to be 1.1. The C BM for the open storage tank is shown in Table The pump accounts for two base prices, the pump and the motor. The pump base cost factors in the size of the pump, including the pump head and flow rate. The rationale for the pump head and water flow is shown in Section The chosen pump is a single phase, 3,600 rpm, VSC centrifugal pump so the type factor F T is one. The MOC was chosen as stainless steel giving F M a value of 2. The base cost of the motor is correlated through the power consumption. A5 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

86 The power consumption factors in the pump brake horsepower, motor efficiency, and pump efficiency. The motor is a 3,600 rpm, open, drip-proof enclosure which makes F T equal to one. The F BM for a pump and motor is 3.3. The C BM for the pump and motor is shown in Table Air knives were modeled after fan correlations in Seider et al. A centrifugal backward curved fan was chosen as it fit the necessary flow rate and head requirements. The supporting calculations for the flow rate and head are shown in Appendix 9.1. The MOC was chosen as fiberglass making the F M equal to 1.8. The head factor associated with 16 in. H 2 O is F BM is not defined by Seider et al. (2009); therefore, it was assumed to be 1.1. The C BM for the air knives is shown in Table Equipment C BM Belt Conveyor $57,100 Fired Heater $23,700 Open Storage Tank $45,400 Water Pump a $46,500 Pipe Nozzles $3,000 Air Knives $14,000 Total $190,000 a. Price contains a spare. Table Bare module cost of the wheelie bin washer The quotes of other pieces of equipment were attained through manufacturers and include the cost of delivery and installation. Table shows the prices of the main and ancillary pieces of equipment. Equipment Amount Total Cost Source Shredded Paper Baler 1 $14,000 Allegheny Shredders Compactor 2 $19,880 Nedland Dumpster Bins 4 $5,400 Nedland A6 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

87 Small Storage Bins 4 $320 East Tex Trash Paper Shredder 4 $27,200 Whitaker Brothers Freezer 1 $120,000 TRJ Refrigeration Scale 1 $1,300 Fairbanks Air Classifier 3 $210,000 General Kinematics Autoclave 1 $250,000 Mark Costello Grinder 1 $200,000 Mark Costello Carts 5 $2,500 Mark Costello Wheelie Bin Washer 1 $199,684 Seider et al. McKenna Gas 40 HP Boiler 1 $34,875 Hurst Boiler Co. Conveyor 12 $150,000 Mark Costello Toyota Equipment Forklift 1 $5,500 Company Toyota Equipment Company Pallet Jack 1 $1,350 Vapor Mist Odor Control System 1 $4,100 Mark Costello Cart Dumper 2 $37,000 Mark Costello Water Softener 1 $8,000 Hurst Boiler Co. Flatbed Truck 1 $30,000 Freightliner of Arizona Covered Truck 3 $96,000 Freightliner of Arizona Red 96 gallon 750 $86,250 Rehrig Pacific Yellow 43 gallon 120 $4,590 Rehrig Pacific Table Equipment and ancillary equipment manufacturer quotes. The total bare module cost for all equipment is the total price of all pieces of equipment which is $1,530,000. Annual permitting for the amount of biomedical waste intake is $13,000 (personal communication, Neal Beenenga, 4/8/2011). The total permanent investment, C TPI, was calculated using the correlations presented in Seider et al. (2009). The investment site factor for a U.S. Southwest location is The site factor corrects C TPI for the availability of labor, workforce efficiency, local rules and customs, union status, and other items. The corrected C TPI is $2,469,000. The plant was assessed for recurring auxiliary accessories and feedstocks. There are three necessary auxiliary accessories: gaylord boxes, pallets, and eight gallon black waste containers. Each gaylord box is rated to hold 160 lbs.; therefore, to store a daily intake of 750 A7 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

88 lbs black and yellow bag waste, it necessary to have five boxes and pallets per day. It is necessary to replace one eight gallon black waste container every day. The only feedstock necessary is Hydrox general purpose cleaning solution for the wheelie bin washer. It was recommended that the concentrated solution be diluted to 1:18,000 (personal communication, Neal Beenenga, 4/8/2011). The cost of the annual auxiliary accessories and feedstock are shown in Table Item Annual Amount Annual Cost Gaylord boxes 1,800 $54,000 Pallets 1,800 $18,000 8 gallon RCRA waste containers 360 $9,300 Hydrox cleaning solution 9 gallons $1,700 Table Annual cost of auxiliary accessories and feedstock. The utilities were calculated using current information from local utility companies. The amount of the utility was given by each of the manufacturer s product information. The wheelie bin washer utilities were calculated using Seider et al. (2009). For electricity, each piece of equipment was estimated for the number of hours of operation in a working day. The amount of water for the wheelie bin washer was given as an estimation of water for proper cleaning of each container (personal communication, Neal Beenenga, 4/18/2011). The amount of natural gas for the fired heater and boiler were determined through Seider et al. and manufacturer specification, respectively. The gasoline requirements for waste collection and trips to Texas for incineration were extrapolated from current data provided by Harry Patton. Spreadsheet Economic Analysis - Utility (Dropbox) shows the annual utility requirements and costs. The operating and manufacturing costs were based on correlations retrieved from Seider et al. (2009). There are four sections to the plant with 3 operators per section. There is a five day working week with one eight hour shift each day. The general expenses were based on yearly transportation permits, incineration prices, and landfill costs. There is a $500 transporting A8 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

89 fee per truck per year. The costs to incinerate and landfill are $0.75 per pound and $32 per ton, respectively. Spreadsheet Economic Analysis Seider Analysis (Dropbox) shows the resulting annual costs. The recycling sales were calculated using quotes from Friedman Recycling and Tucson Iron and Metal. Friedman Recycling offers $0.01 per pound for paper and plastic. Tucson Iron and Metal offers $0.85 per pound for non-ferrous stainless steel. The annual sales are shown in Spreadsheet Economic Analysis Sales (Dropbox). The net present value was calculated based on a 20 year plant life and a three year initial plant construction timeframe. The fraction of C TDC was divided evenly for each year of the construction and the working capital was introduced in year three of construction. The depreciation was based on MACRS with zero scrap value for equipment. The tax rate was assumed to be 40% as recommended by Seider et al. (2009). For a 12% interest rate, the net present value after 20 years is $2,412,000. Spreadsheet Economic Analysis Net Present Value (Dropbox) contains the net present value table Important s and Printouts s Boiler Quote Terry Melot <terrymelot@azboiler.com> To: Patrick Pasadilla <patrick2@ .arizona.edu> Mon, Mar 7, 2011 at 2:23 PM Patrick, my steam tables show that if you want 280 F steam, 35 psi will be very close. Of course any boiler operating over 15 psi is considered High Pressure and is generally designed for 150 psi. They can be operated at any pressure up to 90% of the design pressure. If you need 4500 pph, that equates to 131 boiler horsepower. Boiler manufacturers list a 125 and a 150 hp. Suggest you go with the 150 hp. A9 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

90 See the attached Hurst brochure for dimensions, outputs, inputs, etc, on a 150 hp boiler. Do you need prices? Do you need auxiliary equipment such as boiler feed system, blowdown system, water treatment system, etc? Please let me know if you need any prices or any other information. Best Regards, Terry R. Melot Arizona Boiler Co., Inc. Phoenix Oil Heater N. 75th Avenue Peoria, AZ Fx Direct line Boiler Quote Terry Melot <terrymelot@azboiler.com> To: Patrick Pasadilla <patrick2@ .arizona.edu> Mon, Mar 7, 2011 at 4:23 PM Patrick, prices below. Fob the Hurst factory with full freight allowed to AZ hp, 150 psi, gas fired steam boiler as per ASME and State code.$59, Make-up feed tank with one pump..$ 6, Blowdown separator..$ 2, You may also need a water softener and chemical feed system. The water would need to be tested to size these properly. Best Regards, Terry R. Melot Arizona Boiler Co., Inc. Phoenix Oil Heater N. 75th Avenue Peoria, AZ Fx Direct line Boiler Quote Terry Melot <terrymelot@azboiler.com> To: Patrick Pasadilla <patrick2@ .arizona.edu> Tue, Apr 12, 2011 at 9:52 AM A10 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

91 Patrick, there are many variables associated with water treatment. 1. Fresh water hardness. Typical in Southern Arizona is grains hardness. 2. Percent of condensate return; controlling percent of fresh water make up. This will determine gallons per day needing to be softened. With those two items known, the water softener can be sized. For a ball park, using 25 grain hardness and 50% make-up for the boiler firing at half fire (50%) That equates to needing 155 gallons per hour make up water. AT 25 grain hardness, that is 4000 grains per hour or 96,000 grains per 24 hours. (numbers rounded) So you could get by with a 160,000 grain water softener, with each tank needing regeneration every two days. A 160k softener, twin unit, will run around $6-8, Fwd: Vibratory De-Stoner -Light material / Heavy material separator Maria K Rusnak <mrusnak@ .arizona.edu> Mon, Feb 7, 2011 at 11:57 AM To: Jacqueline Nicole Brauneis <jnbraun@ .arizona.edu>, Justin Black <jblack1@ .arizona.edu>, Kayla Hendricks <kaylah@ .arizona.edu>, Patrick Pasadilla <patrick2@ .arizona.edu> Forwarded message From: Ron Zorn <ron@aicsw.com> Date: Mon, Feb 7, 2011 at 9:23 AM Subject: Vibratory De-Stoner -Light material / Heavy material separator To: mrusnak@ .arizona.edu Cc: Mike Boyko <mike@aicsw.com> Marie- Very interesting, I worked on a project with the recycle of medical waste a few years ago. It resulted in the supply of a single knife De-Stoner for exactly what you described. The units ended up in Australia and Japan, the US was still sterilizing the waste but land filling afterwards. The interest in the Japan project was the recycle of the plastics for fuel and injection molding. We have attached general brochures for both the single knife and two knife vibratory De-Stoner s. The capacity is based on a volume as you can see each are rated. The single knife unit actually start with a 24 wide unit (not shown) which sells for approximately $60k. The 36 is $70k, 48 $80k and ends with a 60 (not shown) for $90k. The 2-knife units start with a 24 for approximately $125k and go up to 72 at $200k. Please do not hesitate to contact me to discuss in more detail. Regards, Ron Zorn A11 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

92 V.P. Technical Sales (Manufacturers' Representatives for Bulk Material Transfer / Process Equipment) Phone: (480) ron@aicsw.com RE: Treatment Techniques Harry Patton <harry@awsaz.com> Tue, Jan 18, 2011 at 1:24 PM To: Maria K Rusnak <mrusnak@ .arizona.edu> Cc: Kayla M Hendricks <kaylah@ .arizona.edu>, Jacqueline Nicole Brauneis <jnbraun@ .arizona.edu>, "jblack1@ .arizona.edu" <jblack1@ .arizona.edu>, "patrick2@ .arizona.edu" <patrick2@ .arizona.edu> Thx for your question Maria, There are several different treatment technologies out there. Your job includes discovery, though I will give you a couple hints to start off: Then all five of you can find two more (and there are more yet). Technology three is heat sterilization, the classic technology. We are interested in looking at as many differing technologies as possible since each has plusses and minuses. Additionally, some are highlihted in journal given to Karla yesterday Technology One: Technology Two: Technology Three: Technology Four: tbd Technology Five: tbd Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office harry@awsaz.com info Harry Patton <harry@awsaz.com> Wed, Jan 26, 2011 at 8:04 AM To: "patrick2@ .arizona.edu" <patrick2@ .arizona.edu> Cc: Maria K Rusnak <mrusnak@ .arizona.edu>, Jacqueline Nicole Brauneis <jnbraun@ .arizona.edu>, "jblack1@ .arizona.edu" <jblack1@ .arizona.edu>, Kayla M Hendricks <kaylah@ .arizona.edu> Hey Patrick, Hope this provides general direction for your assurance of kill. Its all in biology studies arena. Much more out there. No one wants to propagate bacteria, virus, germs, and no one likes remnant odor, thus assurance of kill in A12 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

93 critical. Sodium Hypochlorite: Biopharmaceutical-Plant/ArticleStandard/Article/detail/ ADEQ - see enclosure Ultrasonics - do some research as it leads to killing biowaste in empty containers prior to reuse Use keyword 'validation" as it pertains to assurance that load in sterilizer (or any other technology) is 99 percent clean from harmful pathogens Try researching Log 4 kill of Bacillus stearothermophilus spores if nothing else Call me if need to discuss prior to working with associates. Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office harry@awsaz.com Waste composition Harry Patton <harry@awsaz.com> Thu, Jan 27, 2011 at 1:37 PM To: Maria K Rusnak <mrusnak@ .arizona.edu> Cc: Jacqueline Nicole Brauneis <jnbraun@ .arizona.edu>, Justin Black <jblack1@ .arizona.edu>, Kayla Hendricks <kaylah@ .arizona.edu>, Patrick Pasadilla <patrick2@ .arizona.edu> Maria and all, Waste for classic sterilizer is number we are aiming for at 300K lb/mo. Historically, my customers are about 95 red / 5 yellow (w/w). Great assumption on composite percentage of red waste! Yet I might suggest reducing paper and incr plastic. Glass can be hight (w/w) too. Yellow avg slightly less than 25 lb net per tub. Yellow tubs are 38 gal size. Each of five hospitals are placing four to five skids/bales of cardboard per 24 hr period. Avg is 425 lb per skid, maybe more. Carry that forward for monthly number. Great start. Thx. Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office A13 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

94 Conf. Paper per Day, Update Jacqueline Nicole Brauneis Sun, Jan 30, 2011 at 7:32 PM To: Maria K Rusnak <mrusnak@ .arizona.edu>, Kayla M Hendricks <kaylah@ .arizona.edu>, jblack1@ .arizona.edu, Patrick Pasadilla <patrick2@ .arizona.edu> Hey guys, Looks like we'll be assuming 750 lbs/day of confidential paper shred waste. Also, for an update, I've found out most of my stuff from the issue bin for our next presentation, I'm just waiting to hear back from a TrinovaMed rep and need to get in contact with a couple trucking companies I found in Tucson to get some estimates Forwarded message From: Harry Patton <harry@awsaz.com> Date: Sun, Jan 30, 2011 at 7:15 PM Subject: RE: [FWD: Re: TrinovaMed Questions] To: Jacqueline Nicole Brauneis <jnbraun@ .arizona.edu> Tuesday, we can ask Jim Seaney at St Mary's Hosp how much black box HazWaste they process each month. Confidential paper shred waste can be estimated at 750 pounds per day per hospital though it would also be a good question to ask of Jim. Have not heard back from Nord. If not by noon or so Monday, I'll give him a jingle. Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office harry@awsaz.com black bin waste Harry Patton <harry@awsaz.com> To: Patrick Pasadilla <patrick2@ .arizona.edu> Tue, Feb 1, 2011 at 3:22 PM Have never seen waste collection be larger than contents of about seven of those little sharps containers. The collector is required to package in carboy - a rigid container between about 2-1/2 gal and about 15 gal in size. For larger they use a metal or rigid plastic drum at abt 55 gal. Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box A14 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

95 Tucson, AZ mobile office [Quoted text hidden] black bin waste Harry Patton To: Patrick Pasadilla Cc: Jim Seaney Tue, Feb 1, 2011 at 9:36 PM Seven containers per month per hospital. Some months more, some less. Down at Nogales Hospital its less. Would be higher at TMC or VA and maybe even UMC. Should have let you hold one. Sorry. Little to no weight. All packaging materials really. Density was light. Generally nurses will not push down into any waste container as they do not want to be surprised by sharp object previously dropped in container. My estimate would be one pound per container. Jim, do you want to weigh (no pun intended) in on this issue? Thx for your time and effort today, Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office Tuesdays Presentation Harry Patton Fri, Feb 11, 2011 at 4:07 PM To: Jacqueline Nicole Brauneis Cc: Justin Miles Black Maria K Rusnak <mrusnak@ .arizona.edu>, Kayla Hendricks <kaylah@ .arizona.edu>, Patrick Pasadilla <patrick2@ .arizona.edu>, bright@u.arizona.edu Jacqui, Its efficacy testing in medical waste sterilization The results of the medical waste sterilization testing in most states requires demonstration that autoclave systems achieve 100 percent sterilization effectiveness using Bacillus stearothermophilus as the biological indicator. For example most manufacturers certify their equipment will have a bacterial kill rate in excess of log6 (in excess of %) to meet or exceed all regulations and standards established by the US Environmental Protection Agency and US state environmental agencies. AND to answer reactions question: A15 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

96 Decomposition reactions take place at elevated temperatures. We are primarily needing to gain microbiological references on this one. I've got a couple people in mind. Personally, I think it has to do with the cell walls of the bacteria when they fall apart. Spoke with my next door neighbor, Dr. Kelly Bright, from UA Soil, Water, and Envir Science (bright@u.arizona.edu). She also recommends looking into or denaturing enzyme. Each chemical treatment will be different from steam or heat sterilization. Microwave technology may be similar. Ozone, chlorine dioxide, or the other chemical technologies will each have different reaction mechanisms, rates, etc. Dr. Bright is open for some discussion as needed. Thx, Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office harry@awsaz.com Meeting with Harry Today/Research Harry Patton <harry@awsaz.com> Sun, Feb 13, 2011 at 9:51 AM To: Kayla M Hendricks <kaylah@ .arizona.edu> Cc: Jacqueline Brauneis <jnbraun@ .arizona.edu>, Justin Black <jblack1@ .arizona.edu>, Maria Rusnak <mrusnak@ .arizona.edu>, Patrick Pasadilla <patrick2@ .arizona.edu> Carla, Acreage size (3 acres or about 135,000 sq ft) was a suggested starting point. What is really needed is an inside facility or a building able to house walk-in in freezer, conveyors, sterilizer(s maybe build out space for second unit growth), front load (and possibly back end unload) of sterilizer, support equipment shredders, automated tub cleaning equipment, offices, and so forth - and outside space for cardboard and plastic re-balers, and most important ability for as many trucks as you calculate will be in yard at any one time. From an industrial engineer's perspective, use of space will be optimized to create flow pattern so that one effort is not stepping on ether's footprint creating process slowdown. Thin about the trucks coming and going. A driver arriving with a load will need to unload as quickly as possible without idling for hours. Or a driver picking up sterilized and possibly shredded waste needs only to back up and pick can and replace with another without idling waiting for some other truck to get out of their way. Thus flow dynamics in dock area also need to be optimized and are part of that three acre ballpark estimate. In both cases we have ballpark estimates, one of which is roughly three acres. An estimate of inside building space might be 20,000 sq ft for starting point. We need you to calculate same for your set of processes. When we put it all together, and select most economical process moving forward, the calculate info for housing that selected process will be part of final picture. Please calculate or optimize the building space and yard space needed for a medical waste management process and other business processes including confidential paper shred, cardboard recycling, hazardous (P and U Listed Waste streams, other revenues enhancing waste streams we have discussed. A16 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

97 To all: Your reaction equations, whether oxidation or cell wall breakdown, will provide time requirements for specific mass of waste input in each batch. Mass per load helps us determine if we are running five days eight hours or more shifts and relates to power consumption, cooling waters or other fluid requirements too. Don't forget to interact with Dr Bright. She will be helpful in your microbiology study areas. Thx, Harry Harry Patton Advanced Waste Solutions of Arizona, LLC PO Box Tucson, AZ mobile office Recycling Places Nord Sorensen To: Patrick Pasadilla Cc: Harry Patton Fri, Mar 4, 2011 at 12:17 PM Patrick: The best recycling source that I know in Arizona is as follows: Tucson Iron & Metal 690 East 36 th Street Tucson, AZ Contact: Gary Kippur, President/CEO Telephone: Gary@tucsoniron.net Best Regards, Nord S. Sorensen percent sterilization Mike Kelleher <mkelleher@mark-costello.com> Reply-To: mkelleher@mark-costello.com Thu, Feb 3, 2011 at 6:44 PM A17 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

98 To: Patrick Pasadilla Hello Patrick, First off, sterilization is a process not necessarily a product. The percent of sterilization depends on state requirements. In California (and Arizona) a log4 (99.99%) kill level is required using bacillus stearothermophilus. Some states require log5 and some states require log6. Obtaining different kill levels is simply a matter of temperature and cycle time duration. Best regards, Mike percent sterilization Mike Kelleher <mkelleher@mark-costello.com> Reply-To: mkelleher@mark-costello.com To: Patrick Pasadilla <patrick2@ .arizona.edu> Sun, Feb 20, 2011 at 9:00 PM Patrick, High Volume Sterilizer (3,000 lbs per cycle) is approximately $ 250, The RG52M rotary grinder is approximately $ 200, Yes, the temperature is F. The steam enters the sterilizer at 65psi at a flow rate of approximately 4,500 lbs. per hour. The steam pressure during the cycle is psi. Mike four attachments percent sterilization Mike Kelleher <mkelleher@mark-costello.com> Reply-To: mkelleher@mark-costello.com To: Patrick Pasadilla <patrick2@ .arizona.edu> Tue, Feb 22, 2011 at 6:42 PM Patrick, Yes the carts are included with that price. percent sterilization Mike Kelleher <mkelleher@mark-costello.com> Reply-To: mkelleher@mark-costello.com To: Patrick Pasadilla <patrick2@ .arizona.edu> Tue, Feb 22, 2011 at 6:45 PM Patrick, One 50HP Vacuum Pump at 460V 3 phase. One 3HP HPU 460V 3 phase (door lock, door swing, cart bridge) Mike A18 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

99 Fwd: FW: ing: , , , , , , Jacqueline Nicole Brauneis To: Patrick Pasadilla Wed, Apr 20, 2011 at 2:40 PM Forwarded message From: James Barker Date: Sat, Feb 12, 2011 at 10:59 AM Subject: FW: ing: , , , , , , To: Here is an example of a flat bed. This is a 2007 Freightliner that you will be able to haul plenty of weight with. this truck would cost you approximately $30,000 for the single axle unit something like this is around 32,000 James Barker <JBarker@fswaz.com> To: jnbraun@ .arizona.edu Sat, Feb 12, 2011 at 11:02 AM 2007 FREIGHTLINER BUSINESS CLASS M2 106 Close Window This Financial Calculator Add To Trucks Of Interest Print This A19 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n

100 Specifications Quantity 1 Stock Number X56985 Year 2007 Manufacturer FREIGHTLINER Model BUSINESS CLASS M2 106 Price Call Location Tolleson, Arizona Condition Used Engine Specs Mercedes Engine Type MBE900 Horsepower 230 Mileage 161,000 mi Fuel Type Diesel Transmission 6 Spd Suspension Spring Lift End Gate Yes Doors Roll up A20 T h e S t e r i l i z a t i o n a n d R e c y c l i n g o f M e d i c a l W a s t e : A P l a n t D e s i g n