Implementing a Dental Amalgam Program for the San José/Santa Clara Water Pollution Control Plant Presented by: Roberta Dunlap City of San José Dental Amalgam Program • Program Design • Implementation • Lessons Learned •Q&A SJ0509i1_overall SJ/SC WPCP Milpitas 5% Santa Clara 8% Cupertino 4% Saratoga 2% Monte Sereno SJ0509i1_overall San José 71% Campbell 3% Los Gatos 2% SJ0509i1_overall Dental Amalgam Program San Francisco Bay Mercury exceeds allowable levels Dental Amalgam Program • November 2007 Mercury Watershed Permit for Dischargers to SF Bay • Requirement for Pre-treatment Strategy for Dental Offices. Target : 85% of Dental Offices Participating within Five Years. Dental Amalgam Program Mine tailings are a significant source of mercury in the Central Valley and SF Bay Watersheds Dental Amalgam Program Sources of Mercury in Wastewater Hospitals Universities Vehicle Services Medical Clinics Human Waste - Amalgam Household Products Dental Offices AMSA/EPA Mercury Pollution Prevention Project (2001) Laundry Greywater Dental Amalgam Program Where Amalgam Goes 70% Amalgam Removal Procedure 10% 20% Vacuum Plastic Suction Tip Chairside Screen Swallowed By Patient Collected For Recycle 7% Amalgam Placement & Carving 1% Plastic Cuspidor Chairside Screen Filling In Tooth Collected For Recycle 2% 90% Dental Amalgam Program Four Phases: • Program Design • Pre-Implementation Tasks • Implementation • On-going Program Dental Amalgam Program Decisions, Decisions, Decisions! • Permit vs Self Certification • Mandatory vs “Recommended” • Do we inspect? • Mandate Best Management Practices? Dental Amalgam Program Program Design • Dental practices as critical users • Five-year Wastewater Discharge Permit – No Fee • Self-Certification of Best Management Practices • Installation of ISO Certified Amalgam Separator • Maintenance & amalgam disposal records • Annual Report • Inspections – once during permit period Dental Amalgam Program Pre-Implementation • • • • • Identify dentists Reach stakeholders & build partnerships Amend the Muncipal Code Develop several forms Modify an existing database Dental Amalgam Program Locating the Dentists • California State Department of Consumer Affairs http://www.dca.ca.gov/consumer/public_info/index.shtml • Business Licenses • County Department of Environmental Health • Phone Book/Internet Dental Amalgam Program Stakeholder Process • Local Dental Society - Dinner Meetings - Presentations - Newsletter • California Dental Association http://www.cda.org • Vendor Workshops Dental Amalgam Program Forms! • Permit Application • Identify who owns practice • Who works with whom • Shared Separators! • Permit • BMPs • Certifications • FAQs • Approved Separators & Vendors • Sample Maintenance Log Dental Amalgam Program Shared Separators • Two or more dentists share a vacuum line • Need to ID who is responsible • Aligning permit effective dates • Challenge of determining how they are sharing Dental Amalgam Program Brochure • Step by Step Guide • Visual BMPs • Common FAQ’s on back Dental Amalgam Program Issue permits Dental Amalgam Program Dental Amalgam Program Database • Able to use existing Source Control Database • Track Dentists - who has and has not responded • Track Permits Issued • Track Inspections Dental Amalgam Program Some Logistic Suggestions • Guidance Document • Decide who is responsible for what • Filing protocol • Finalize Forms • Order Supplies in Advance Dental Amalgam Program Implementation • Sent Application Packet to each individual dentist • Cover letter • Permit Application • Brochure Dental Amalgam Program Permits From effective date of permit: • Implement BMPs for amalgam waste - 90 days to certify BMPs • Install an approved amalgam separator -180 days to certify separator installation • Keep maintenance records • Annual report due every January Dental Amalgam Program Inspections • Check placement and operation of the amalgam separator • Confirm implementation of the BMPs • Review amalgam waste management practices • Review waste shipment records • Enforcement Plan Dental Amalgam Program Lessons Learned • Simple forms Shared separators – list suite #’s/names • Send certified mail • Be prepared – files, labels, etc. • Communication with stakeholders/partners key • 10-15% will be hard to find • Need to send reminders It will take time! Dental Amalgam Program • Over 1,800 dentists identified • 740 permits issued to date • Processing BMP & separator installation certifications • Sending reminders • Started doing some inspections – Two inspectors, part-time – Ramping up this summer Dental Amalgam Program City of San José web site http://www.sanjoseca.gov/esd/wastewater/dental-amalgam-program.asp California Dental Association http://www.cda.org/ Baywise.org http://www.baywise.org Roberta Dunlap email@example.com (408) 277-5364 Dental Amalgam Program Questions?