Brandon Biomedical Waste Treatment Facility Brandon, Manitoba

Tel: 519.823.1311 Fax: 519.823.1316

RWDI AIR Inc. 650 Woodlawn Road West Guelph, Ontario, Canada N1K 1B8

Final Report

Environmental Assessment RWDI #1301084 October 30, 2014

SUBMITTED TO: SUBMITTED BY:

Raj Rathamano Melissa Annett, d.E.T. [email protected] Senior Project Manager / Associate [email protected] Manitoba Conservation and Water Stewardship Environmental Approvals Branch Peter Klaassen, P.Eng., MBA 123 Main Street, Suite 160 Senior Consultant Winnipeg, MB R3C 1A5 [email protected]

Michael Ratcliff, Ph.D., P.E. Senior Specialist [email protected]

Brian Sulley, B.A.Sc., P.Eng. Senior Specialist [email protected]

Andrew de Jong, B.Sc., M.A.Sc., EIT Environmental Engineering Intern [email protected]

This document is intended for the sole use of the party to whom it is addressed and may contain information that is privileged and/or confidential. If you have received this in error, please notify us immediately.

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Brandon Biomedical Waste Treatment Facility Final Environmental Assessment Report RWDI#1301084 October 30, 2014 Page i

TABLE OF CONTENTS

1. EXECUTIVE SUMMARY ...... 1 2. INTRODUCTION AND BACKGROUND ...... 1 2.1 City of Brandon and the Brandon Regional Hospital ...... 2 2.2 Preliminary Design Considerations ...... 3 2.2.1 Biomedical Waste Generation ...... 3 2.2.2 Biomedical Waste Characterization ...... 4 3. ENVIRONMENTAL ASSESSMENT PROPOSAL PROCESS ...... 5 3.1 Applicable Legislation ...... 5 3.2 Scoped Project Evaluation ...... 7 3.2.1 Surface and Ground Water ...... 7 3.2.1.1 Effects on Surface Water Quality, Quantities or Flow ...... 7 3.2.1.2 Effects on Ground Water Quality, Quantity or Movement ...... 8 3.2.1.3 Cause of Sedimentation, Soil Erosion or Shoreline or Riverbank Erosion On or Off-Site 8 3.2.1.4 Effects on Surface or Ground Water from Accidental Spills or Releases to the Environment ...... 9 3.2.2 Land ...... 9 3.2.3 Air and Noise ...... 10 3.2.4 Natural Environment ...... 10 3.2.4.1 Wildlife and Fish Habitats ...... 10 3.2.5 Resources ...... 10 3.2.6 Socio-economic ...... 10 3.2.7 Heritage and Culture ...... 10 3.2.8 Aboriginal ...... 11 3.2.9 Other ...... 11 3.3 Approvals ...... 11 3.3.1 The City of Brandon ...... 11 3.3.2 Manitoba Conservation and Water Stewardship ...... 11 4. DESCRIPTION OF THE PROPOSED UNDERTAKING (“THE PROJECT”) ...... 11 4.1 Proposed Facility Location ...... 11 4.1.1 Design Considerations ...... 12 4.1.2 Location and Zoning ...... 13 4.2 Conceptual Layout ...... 13 4.2.1 Design Concept ...... 16 4.2.2 Considerations for Energy Efficiency ...... 17 4.3 Proposed Technology ...... 17 4.3.1 Proposed Technologies ...... 17 4.3.1.1 Incineration ...... 18 4.3.1.2 Autoclaving ...... 18 4.4 Assessment of Transportation and Collection Logistics ...... 19 4.4.1 Process Flow of Waste ...... 19 4.4.2 Transportation Route through Brandon ...... 20 4.4.3 Waste Receiving and Containment ...... 21 4.5 Operational Parameters ...... 22 4.5.1 Current Operations ...... 22 4.5.2 Brandon Hospital Operating Structure ...... 22 4.5.2.1 Autoclave ...... 25

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4.5.2.2 Yellow Bag Waste / Autoclave Process...... 25 4.5.2.3 Incinerator ...... 26 4.5.2.4 Red Bag Waste / Incineration Process ...... 26 4.5.2.5 Improper Waste Segregation ...... 27 4.5.2.6 General Housekeeping Procedures ...... 27 4.5.2.7 Equipment Downtime Procedure ...... 27 4.5.2.8 Employee / Operator Training ...... 28 4.5.2.9 Equipment Specific Operation ...... 28 4.5.2.10 Emergency Response ...... 28 4.5.2.11 Health, Safety and Environmental Procedures ...... 28 4.6 Remote RHA Operations ...... 28 5. EMERGENCY PROCEDURES ...... 29 6. OTHER CONSIDERATIONS ...... 30 6.1 Construction Phase ...... 30 6.1.1 Noise ...... 30 6.1.2 Dust ...... 30 6.1.2.1 Dust Control ...... 31 6.1.2.2 Summary of Recommendations ...... 32 6.1.3 Traffic ...... 32 6.1.4 Operations ...... 33 6.2 Waste Processing, Containment and Management...... 33 7. DESCRIPTION OF EXISTING ENVIRONMENT POTENTIALLY AFFECTED ...... 33 7.1 Baseline Air Quality ...... 33 7.2 Baseline Meteorology ...... 34 7.3 Sensitive Receptors ...... 35 8. EFFECTS ASSESSMENTS ...... 37 8.1 Air Quality ...... 37 8.2 Exhaust Re-entrainment ...... 39 8.2.1 Description of Sources and Contaminants ...... 40 8.2.2 Dispersion Modelling Assessment ...... 42 8.2.3 Results ...... 42 8.3 Socio-Economic Impacts ...... 47 8.3.1 Health Risk Assessment ...... 47 8.3.2 Increase in Truck Traffic ...... 47 8.3.3 Waste Materials Requiring Disposal ...... 47 9. NET EFFECTS MANAGEMENT, MONITORING AND FOLLOW-UP PLANS ...... 47 9.1 Noise ...... 47 9.2 Air Quality ...... 47 9.2.1 Odour and Dust ...... 47 9.2.2 Stack Testing ...... 48 9.2.3 Continuous Emissions Monitoring ...... 48 10. MALFUNCTIONS OR ACCIDENTS AND CONTINGENCY PLANS ...... 48 10.1 Spills and Emergency Response Plans ...... 48 11. CONSULTATIONS ...... 48 11.1 City of Brandon...... 48 11.2 Manitoba Conservation and Water Stewardship ...... 49 11.3 Public ...... 49 12. CONCLUSIONS ...... 49 13. REFERENCES ...... 50

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Tables

Table 1: Biomedical Waste Analysis Results Table 2: Estimated Waste Generation Table 3: Ambient Air Quality Stations Table 4: Brandon Ambient Air Quality Data Table 5: Coordinates of Sensitive Receptors Table 6: Air Quality Criteria Table 7: Predicted Maximum Cumulative Concentrations Table 8: Results of Dispersion Modelling Assessment at On-Site Location of Maximum Modelled Concentration Table 9: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 6 Table 10: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 14 Table 11: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 15

Figures

Figure 1: Manitoba Conservation Environmental Approvals Branch (November 2013) Figure 2: Preliminary Layout for the Proposed Location Figure 3: Preliminary Layout Superimposed over Existing Facility Figure 4: Process Flow of Waste Figure 5: Transportation Route through Brandon Figure 6: Brandon Hospital Reporting Structure Figure 7: Brandon Biomedical Waste Treatment Facility Organizational Structure Figure 8: Wind Rose Figure 9: Site Plan Showing Source and Receptor Locations Figure 10: Hospital Site Plan

Appendices

Appendix A: Report – Consulting Services to Assess Existing Processes for Biomedical Waste Under Contract No. Bran-Incin-2010 Appendix B: EA Screening Checklist Appendix C: Public Open House Documents Appendix D: City of Brandon Zoning Clarification Letter Appendix E: Report – Biomedical Waste Collection and Transportation – Logistics and Feasibility Recommendations Appendix F: Spills and Emergency Response Plans Appendix G: Operations Contingency Plans during Construction Appendix H: Intrinsik Environmental Services Inc. – Human Health Risk Assessment

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1. EXECUTIVE SUMMARY

Manitoba Health is currently undergoing an EA/Permit application process for the operation of a biomedical waste treatment facility to be located in the Brandon Hospital campus. This document is intended to be the support document toward this application, and contains the essential information toward the capital changes and operating procedures that will be applied in the new operation.

The new facility is intended to process all biomedical waste generated from all RHA facilities in the province except those located in Winnipeg, and in Churchill. The intent of the Brandon operation is to work alongside a collection and transportation process that will operate under a separate application and subsequent permit.

From analysis of the number of beds located in the respective RHA facilities, it was determined that approximately 440,000 kg of biomedical waste was generated from the RHA facilities, which will grow to 505,000 kg in 2020. Based on seasonal and daily variations, it is anticipated that this translates to a capacity requirement of 358 kg per hour. Of this, based on industry average, approximately 15% of the waste is considered red bag (pathological, pharmaceutical and cytotoxic), the remainder (sharps, gauze, tubes etc.) is considered to be yellow bag waste.

A screening process has been undertaken to assess the relevant and critical items that required more detailed review (which has translated into the design aspects)

RWDI has furthermore undertaken a matrix review of technologies available to treat the biomedical waste, and determined that the most appropriate treatment for red bag waste is incineration, and for yellow bag waste is autoclaving. In addition, RWDI did a matrix evaluation of potential locations (6 were reviewed) and determined that the most appropriate location for the new facility is the current incineration location.

The process has been designed to maximize efficiency, and reduce risk as a biomedical waste treatment facility. All transport activities (coming in and going out) are done from the facility itself, without going through the hospital property, and air modeling has been done to confirm that emissions will be held within regulatory requirements, and that there will be no re-entrainment. A risk assessment has also been done for the emissions that can occur, and these indicate that the emission thresholds are acceptable.

2. INTRODUCTION AND BACKGROUND

In 2010, the Province of Manitoba (through Manitoba Health) initiated a process to assess existing procedures for biomedical waste management and to develop recommendations for a facility located in Brandon that would provide a best practice solution for the management of biomedical waste generated within the province. The scope of this assessment was to include all biomedical waste management facilities located throughout the Regional Health Authorities (RHAs) of Manitoba, with the exception of the Winnipeg RHA.

The primary driver for this project was the closure and replacement of the various incinerators operating throughout the province with a single facility which can manage all of the “non-Winnipeg” biomedical waste. As Brandon is the largest waste generator outside of Winnipeg in Manitoba, it was chosen as the candidate location for this facility.

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In January 2011, Stericycle Inc. (Stericycle), in association with RWDI AIR Inc. (RWDI) and Byrne Engineering Inc. (Byrne), were retained by the Brandon RHA (now part of Prairie Mountain Health) to undertake a study of the biomedical waste generation and potential treatment for all Regional Health Authorities in Manitoba, with the exception of Winnipeg. The study was divided into 7 key tasks, these being:

1. Confirm the biomedical waste stream, volume data, and current technology available for waste disposal. 2. Develop a functional space program for the processing of the biomedical waste based on the determined types and volumes. 3. Provide technical assessment, sizing and specification development for appropriate technologies and identification of equipment to process the biomedical waste. 4. Review and assess the potential Brandon site options, which may include a new facility or expansion of the existing facilities in Brandon. 5. Identify external and internal relationships between components of the biomedical waste facility to other programs. Prioritize relationships according to the frequency and importance of interaction. 6. Provide a recommended site location in Brandon including a zoning analysis and identification of any development agreement or permit requirements; and, 7. Outline the anticipated one-time capital costs and the annual facility operating cost for human resources, equipment and buildings.

Over the course of 2011 and 2012 the study was undertaken by Stericycle, in association with RWDI and Byrne, with the findings being presented to Manitoba Health in June 2012 as provided in Appendix A of this report. The findings and recommendations presented, including the treatment technologies, facility location, and conceptual design, were accepted by Manitoba Health.

2.1 City of Brandon and the Brandon Regional Hospital

Brandon Regional Hospital employs over 2500 staff and offers health services and programs to the citizens of Brandon and the rural municipalities of Cornwallis, Elton and Whitehead, along with being a regional referral centre for the “Westman” area (Brandon RHA, 2013 (now called Prairie Mountain Health)). A large component of the Prairie Mountain Health RHA is the Brandon Regional Hospital.

The Brandon Regional Hospital is a 298-bed acute care facility offering a number of services including palliative care, intensive care and neonatal intensive care units, medical and surgical units, a cancer program, day treatment and surgery, among other services (Brandon Regional Hospital, 2013). The Brandon Regional Hospital is located in the eastern region of the City of Brandon, in Ward 9, between Victoria Ave E and Van Horne Ave E. The area surrounding the Brandon Regional Hospital is largely residential property with some disseminated commercial, educational and restricted industrial zones, and a large general industrial area to the southwest (City of Brandon, 2013).

Based on data from the 2011 Census, the City of Brandon is the second largest city in Manitoba with a population of 46,061, which represents an 11% increase since 2006. The median age of the population in 2011 was 35.6 years, with approximately 25% of the population being under the age of 20 years and 14% of the population being over the age of 65 years (Statistics Canada, 2013).

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2.2 Preliminary Design Considerations

2.2.1 Biomedical Waste Generation

As part of the study conducted in 2011/2012, in 2011 a survey was delivered to medical facilities throughout the RHAs of Manitoba, with the exception of Winnipeg, to produce an estimate of the total amount of biomedical waste generated annually within each RHA.

To ensure information collected through the survey provided an accurate representation of waste generation, two additional methods were used to confirm the annual biomedical waste amounts estimated from the survey. Annual biomedical waste amounts were calculated from industry waste generation data on a per bed basis and World Health Organization (WHO) waste generation factors on a per capita basis.

The final results from the three methods of analysis are as shown in Table 1 below:

Table 1: Biomedical Waste Analysis Results

WHO Based Data Industry Based Data Survey Results Total 2011 Waste 707,220 433,552 437,999 Flow (kg/yr)

The WHO based data is most likely skewed due to a larger urban population; the most likely choice of Manitoba populace who live in the proximity of Winnipeg would be to use Winnipeg health facilities. Focusing on the industry and survey results, it was determined that if the RHA’s (excluding Winnipeg RHA) all delivered their biomedical waste to a single facility the waste quantity would have been approximately 440,000 kg (970,000 lbs.) per year for 2011.

To project for future throughput for a single facility, biomedical waste generation was estimated for 2020 based on projections in population growth and corresponding bed number increases. Population projections from the Manitoba Bureau of Statistics (2011) were used along with two papers studying the future need for both acute and personal care home beds in Manitoba. The result of the analysis indicated an approximate 15% overall growth in healthcare beds by 2020 from 2011. Assuming a linear correlation between bed growth and waste generation, approximately 505,000 tonnes of waste per year is expected by 2020, a 15% increase from 440,000 tonnes in 2011.

From the data collected for the industry comparison, the deviation in monthly and seasonal waste generation per bed was calculated to be approximately ± 32% and ± 16%, respectively. With the industry variance totaling 48% (32%+16%), the estimated waste generation is as follows within Table 2:

Table 2: Estimated Waste Generation Maximum Total 2011 Total 2020 Hourly 2011 Hourly 2020 Hourly Total All 440,000 505,000 211 242 358 (2020) RHAs (kg)

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Based on restrictions of potential waste treatment technologies, it has been determined that a technology would be required to address both the “incinerable” waste stream (i.e. pathological, cytotoxic, and pharmaceutical) and the “non-incinerable” waste stream (i.e. all other biomedical waste). From the survey data acquired from the Manitoba RHA facilities (excluding Winnipeg RHA), it was determined that the “incinerable” waste accounts for approximately 15% of the total waste volume, while the “non- incinerable” waste accounts for the other 85%. Using the data acquired from the RHA facilities (excluding Winnipeg RHA), the estimated quantity for the Manitoba RHA system (excluding Winnipeg RHA) is thus:

Incinerated Waste Capacity – 50 kg (110 lbs.) per hour Non-incinerated Waste Capacity – 310 kg (680 lbs.) per hour

2.2.2 Biomedical Waste Characterization

Biomedical waste comes from a number of sources including: hospitals, personal health care centres, pharmacies, medical clinics, doctor’s offices, medical laboratories, dental clinics, university nursing departments, senior centres and veterinary clinics.

The following categories provide a characterization of biomedical waste (CCME, 1992):

1. Human Anatomical Waste i. This consists of human tissues, organs and body parts, but does not include teeth, hair and nails. 2. Animal Waste (Will not be handled) 3. Microbiology Laboratory Waste i. This consists of laboratory cultures, stocks or specimens of microorganisms, live or attenuated vaccines, and human or animal cell cultures used in research and laboratory material that has come in contact with any of these. 4. Human Blood and Body Fluid Waste i. This consists of human fluid blood and blood products, items saturated or dripping with blood, body fluids contaminated with blood, and body fluids removed for diagnosis during surgery, treatment or autopsy. This does not include urine or feces. 5. Waste Sharps i. Waste sharps are clinical and laboratory materials consisting of needles, syringes, blades, or laboratory glass capable of causing punctures or cuts. 6. Cytotoxic Waste i. Cytotoxic waste is the by-product of cytotoxic drug therapy administered to patients (such as chemotherapy). Cytotoxic waste typically includes all drug administrative equipment (i.e. needles, syringes, dripset etc.) as well as all gown and body fluids/waste from patients undergoing such treatment. 7. Pharmaceutical Waste i. Pharmaceutical waste is a form of medical waste that includes unused medications, over- the-counter personal care products and sometimes accessories such as sharps, used test trips and other supplies.

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Categories 1, 6 and 7 are typically considered incinerable red bag/red labelled waste, category 2 is orange bag/labelled waste and all others are yellow bag/labelled waste.

3. ENVIRONMENTAL ASSESSMENT PROPOSAL PROCESS

3.1 Applicable Legislation

The proposed project will be licensed as a Hazardous Waste Disposal Facility pursuant to the Manitoba Dangerous Goods Handling and Transportation Act (DGHTA). Under Section 10(2) of the Act, the director may require applicants requesting a license under the DGHTA to comply with environmental assessment and review process set out under the Environment Act of Manitoba. Figure 1 outlines Manitoba Conservation and Water Stewardship’s Environmental Approvals Branch (Manitoba Conservation 2009).

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Figure 1: Manitoba Conservation Environmental Approvals Branch (November 2013)

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The Environment Act of Manitoba is the overarching legislation which applies to all Environment Act Proposals (EAPs) and the Licensing Procedures Regulation (Manitoba Regulation 163/88) provides specific requirements of the EA Report contents, as outlined in the “Information Bulletin – Environmental Act Proposal Report Guidelines”, dated February 2014. The “Information Bulletin – Environmental Assessment and Licensing under The Environment Act”, dated June 2013 outlines the requirements when submitting an alternate proposal for licensing.

The incinerator to be located at the proposed bio-medical waste treatment facility in Brandon will be regulated under the Incinerator Regulation (Manitoba Regulation 91/88 R).

3.2 Scoped Project Evaluation

An initial screening checklist has been used as a guideline and is attached in Appendix B. While the subject categories and sub-categories can be changed, it addresses most key issues related to waste management facilities, and specifically has been applied to the Brandon waste treatment EA process. Based on this initial screening, it was determined that there are four subject categories that will need be included and addressed in the DGHTA application. Other areas, as denoted by stakeholder input, would be added as required.

Given the nature and location of the proposed project, this is a scoped EA Report covering the main studies of concern for this specific project. Based on the screening criteria checklist provided as Appendix B, the following studies have been completed as part of the EA and details are provided within this document:

. Review of the chosen location and technology for the bio-medical waste treatment facility. Technology assessment and selection of most suitable site for the treatment facility. . An air quality assessment was completed to determine air quality impacts at point of impingement. . Air entrainment studies have been completed to ensure that air sources within the hospital are not negatively affected by the combustion emissions. . Transportation (through City) – Review routes of trucks going through Brandon up to the receiving bays and provide guidelines for the eventual transportation service provider. Oversight spill action plans would be developed for potential emergencies (i.e. accidents).

The following sections briefly discuss other areas that were not identified as the main areas of concern which have been screened out.

3.2.1 Surface and Ground Water

3.2.1.1 Effects on Surface Water Quality, Quantities or Flow

Brandon Regional Hospital is located within the eastern region of the City of Brandon and is largely surrounded by developed urban properties, most of which being residential. There are no ecologically sensitive areas noted around the Brandon Regional Hospital, and the closest surface water body in the area is the Assiniboine River, which flows west to east through the northern extent of the City of Brandon. For drinking water, the City of Brandon primarily draws water from the Assiniboine River (Bell, 2011). The Brandon Regional Hospital is located approximately 1250 m south of the Assiniboine River; outside of the flood risk area for the River (MMM, 2013).

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The proposed project is expected to have no anticipated effects on surface water. As the proposed project location is at the site of the existing incinerator at the Brandon Regional Hospital there are no surface water bodies at or near the project site to be impacted during construction or operation of the facility. As there are no nearby surface water bodies and the existing incinerator is constructed on an impervious (paved asphalt) surface, there will be no anticipated effect on surface water by erosion or runoff during construction of the proposed project. During operation, the facility would rely on municipal water connections and will not require extraction or discharge of water from a surface water body.

3.2.1.2 Effects on Ground Water Quality, Quantity or Movement

The City of Brandon is located in the area of the Brandon Channel Aquifer Complex. The aquifer complex is an assemblage of bedrock channel, intertill, unconfined surficial and alluvial aquifers separated by till and clay aquitards. It is currently understood that the aquifer complex consists of two major sand and gravel aquifers, the Assiniboine Valley Alluvial Aquifer and the Brandon Channel Aquifer (Manitoba Water, 2010).

The Assiniboine Valley Alluvial Aquifer consists of an upper confined sand and gravel unit ranging in depth from about 2 to 12 m and a lower confined sand and gravel unit ranging in depth from about 15 to 90 m and separated by clay. The Assiniboine River is likely hydraulically connected to the upper unit. The Brandon Channel Aquifer is a deep buried sand and gravel channel aquifer located at a depth in the range of about 30 to greater than 90 m. The overlying soils consist of layers of clay, till, and sand and gravel of various thickness (Manitoba Water, 2010).

A subsurface drilling program was completed by the KGS Group at the Brandon Regional Hospital in 2007. The program involved the drilling of nine (9) test holes to determine the site stratigraphy in the area of what is now the Western Manitoba Cancer Centre. The drilling revealed the stratigraphy of the subsurface to generally consist of a variable thickness of sandy gravel soil over a deposit of dry fine grained sand overlying a layer of soft to firm grey clay, underlain by extensive thickness of a very stiff to hard clay till layer. The ground water level at the time of the drilling (August 2007) was observed at depths ranging from 5.5 m to 6.1 m below ground surface (KGS, 2007).

The proposed project is not anticipated to have an effect on ground water. As the recommended project location is at the site of the existing incinerator site, construction activity (i.e., excavation, compaction, backfill or dewatering) is not anticipated to occur at the above noted depths (i.e., will not have an impact on ground water). As the existing incinerator is constructed on an impervious (paved asphalt) surface, there will be no anticipated impact to ground water as a result of leaks, spills or infiltration. During operation, the facility would rely on municipal water connections and will not require extraction of, or discharge to, ground water. While the City of Brandon has two short-term ground water pumping wells, the primary municipal water supply source is the Assiniboine River.

3.2.1.3 Cause of Sedimentation, Soil Erosion or Shoreline or Riverbank Erosion On or Off-Site

As previously discussed, the Brandon Regional Hospital is located approximately 1250 m south of the Assiniboine River. There are no other notable surface water bodies within a distance of 1250 m from the Brandon Regional Hospital. The area between the Brandon Regional Hospital and the Assiniboine River is largely developed urban property, most of which is residential.

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Given the distance between the project site and the Assiniboine River and that the project site is on a developed property, the proposed project is expected to have no anticipated effects on sedimentation or erosion on or off-site.

3.2.1.4 Effects on Surface or Ground Water from Accidental Spills or Releases to the Environment

As previously discussed, there are no notable surface water bodies within a distance of 1250 m from the proposed project site. As well, it is expected that the ground surface at the proposed site will be paved and thus considered to be impermeable. Given these conditions, it is not expected that accidental spills or releases to the environment will have a direct impact on surface or ground water. However, the surface elevation of the current, and proposed, loading area at the project site is below the surface elevation of the surrounding area, notably that of the adjacent Brandon Regional Hospital facilities to the north and east, and Van Horne Ave. to the south. During periods of high precipitation and surface water levels, which may cause back-ups in the local storm water collection system, this difference in surface elevation can cause surface water to pond in the area of the loading dock.

The risk associated with water ponding in the area of the loading dock would exist where the water level rises to the point of contact with untreated waste, or other hazardous materials, on the floor of the proposed treatment facility. Should hazardous material become mixed with the ponded water, it may then be transported through the storm water collection system to the point of discharge when water levels recede. It will be necessary for mitigation measures to be incorporated into the design and operation of the proposed facility to minimize the potential for this contact. Possible measures include:

. Minimization, where feasible, of the storage of waste or other hazardous materials on or near the floor of the treatment facility. . Removal of waste or other hazardous materials from the floor of the treatment facility where the level of ponded water in the loading area is observed to rise to an unsafe level. . Spill Kits should be present at the proposed facility to clean-up accidental spills and minimize the movement of spilled materials, with training for employees. . Temporary barriers may be placed around the loading dock during periods of rising water levels in the area. . Ponded water may be pumped and transported out of the loading area where there is a risk of water rising above the level of the loading dock.

There is also a risk for spills or leaks to occur during the construction or operation of the proposed facility, which could drain directly into a storm water collection system. Mitigation measures, such as those noted above, will also be required to address this risk.

Consideration of these risks will be needed during the final design process and construction of the project site.

3.2.2 Land

The new facility will be located within the hospital campus and as the facility is to be located in the current waste processing site and extending in the asphalted loading area, no adverse effects are anticipated. No other issues were identified.

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3.2.3 Air and Noise

Potential air quality impacts to the surrounding environment were assessed and are discussed in Section 8 of the report. Upon installation of the facility, continued air quality and noise plans are discussed in Section 9 of the report.

3.2.4 Natural Environment

The proposed project is not anticipated to have a negative effect on the surrounding natural environment flora and fauna. The City of Brandon is found within Manitoba’s Aspen Parkland Ecoregion and although the Ecoregion is the home of vulnerable species of flora and fauna, it is highly unlikely that these species would experience negative impacts from the proposed project given that the project location will be the existing incinerator site location. The site of the existing incinerator is at the Brandon Regional Hospital and there are no habitats, protected natural areas, wetlands or ecosystems at or near enough to the project site to be impacted during construction or operation of the facility.

3.2.4.1 Wildlife and Fish Habitats

The proposed project is not expected to have negative effects on the surrounding wildlife and fish habitats. The proposed project location is at the site of the existing incinerator at the Brandon Regional Hospital and there are no habitats at or near enough to the project site to be impacted during construction or operation of the facility.

3.2.5 Resources

The initial screening process identified two areas for further review in the resources category, energy recovery and transport of waste. On further analysis and discussions with technology suppliers, it was determined that the recovery of energy (primarily from the incinerator) would be cost prohibitive and operationally impractical. The transport of biomedical waste is further discussed in Section 4.4.2.

3.2.6 Socio-economic

The project, should it be carried forward, is not anticipated to have negative socio-economic effects. There is the potential for an additional four (4) to five (5) vehicles per day of traffic to the site that has been addressed in the logistics study. Similarly, there is the potential for concern related to perceived public health and safety. PMH organized public meetings to address the potential for concern.

Two public meetings were held on the upcoming biomedical waste treatment facility to be located on the Brandon Hospital campus. Appendix C contains the details of the public meetings.

No further comments, either from the media or public have been received to date.

3.2.7 Heritage and Culture

The proposed project is expected to have no anticipated negative effects on the surrounding heritage and culture. The proposed project location is at the site of the existing incinerator at the Brandon Regional Hospital and any nearby heritage buildings, structures or sites or cultural heritage landscapes are not expected to be impacted during construction or operation of the facility. The proposed project will not negatively affect scenic or aesthetically pleasing landscapes or views.

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3.2.8 Aboriginal

As per Statistics Canada (Census 2011) approximately 9% of the population in the Brandon Region were aboriginal. As there is no aboriginal community within the Brandon Region, the aboriginal population is assumed to be transient (some potentially attending post-secondary classes in Brandon University and Assiniboine Community College). The new facility is not expected to have any impact on the aboriginal population.

3.2.9 Other

The processing of waste will generate residues such as treated autoclave waste, bottom ash and flyash. Further details of the process and residue generation are provided in Section 4.5.

3.3 Approvals

3.3.1 The City of Brandon

Applications will be put forth to the City of Brandon for zoning approval and amendment of the Transportation of Dangerous Goods route through the City to extend to the hospital. Agreements will also be made with the City regarding the collection frequency and fees for disposal of the autoclaved and incinerator ash wastes.

As discussed further in subsections 4.1.2 and 11.1, preliminary discussions have been held with the City of Brandon regarding zoning approval, amendment to the Transportation of Dangerous Goods route through the City, as well as collection and disposal of the autoclaved and incinerator ash wastes. Through these discussions and supplementary confirmation letters, there are no issues anticipated with receiving formal approvals from the City of Brandon.

3.3.2 Manitoba Conservation and Water Stewardship

As discussed in Section 3.1, the proposed project will be licensed by Manitoba Conservation and Water Stewardship as a Hazardous Waste Disposal Facility pursuant to the Dangerous Goods Handling and Transportation Act (DGHTA).

4. DESCRIPTION OF THE PROPOSED UNDERTAKING (“THE PROJECT”)

4.1 Proposed Facility Location

During site visits from August 2011 through to October 2011, potential internal sites throughout the Brandon hospital property and potential external (to Brandon) sites were inspected. The initial inspection included a review of site characteristics, logistics of waste movement and processing, identification of ground conditions, potential detriments and benefits, cost implications and other metrics. To determine which site location would be ideal for the Brandon treatment facility, a decision matrix was developed based on the attributes of the potential locations both on the existing Brandon hospital property and at potential off-site properties. The two top scoring options were further evaluated based on their advantages and disadvantages, and conceptual facility designs. The letter-report of recommendations has been provided in Appendix A.

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The site of the Existing Incinerator (Location 1) is proposed as it provides the most ideal site for a new biomedical waste treatment facility at the Brandon Regional Hospital. The following factors were integral in Location 1 being the proposed site: i) from the preliminary assessment of the location options, Location 1 achieved the highest total score in the decision matrix based on the various attributes considered, ii) the loading dock at the current incinerator location could be upgraded and modernized, based on the preliminary facility design, and iii) based on considerable face-to-face discussions with the Brandon RHA and Regional Hospital staff regarding the preliminary findings of this study, it was the preference of the staff that Location 1 would be the ideal option for coordination of a treatment facility with the hospital operations.

4.1.1 Design Considerations

Based on observations obtained from site visits in 2011, the following general design considerations should be reviewed for Location 1.

The proposed site would be located where the existing incinerator is currently housed. In the area located at the SW corner of the Brandon hospital property, the current incinerator facility is too small to house all the activities required for the new operations. The footprint required for the new operations was estimated to be up to 790 m2, but if some operations are undertaken within the current hospital area, this requirement can be decreased (in this case to 420 m2). A necessary extension would project out 20 m out (west) from the existing docking area (where waste is currently loaded), and extend out 22 m out (south) from the existing laundry rooms. Since the extension would create significant traffic issues, it is recommended to create a one way entrance from Van Horne and create a roadway which would run along immediately south of the new extension. The current entrance on Dennis Street would only be used as a one way exit.

Waste delivered from the outside RHA’s would be offloaded in a bay located on the SW side of the new extension, and waste that has been sterilized would be loaded on a middle bay. A bay located on the NW side of the extension would be used for food and laundry. The laundry would be brought to the 2nd floor via a lift.

The floor of the new extension would be the same height as the existing loading area. An incinerator and sterilizing unit would be located within explosion resistant block walls.

Among the operations shared with the current hospital area, the new extension would not need a change room, parking, shower, lunchroom or extensive administrative area. Waste from the hospital would continue to be delivered to the same location as it is now, and the recycling containers would be located on the South side of the existing laundry walls.

All utilities would be connected as per the existing incinerator installation, and the exhaust stack (from the incinerator APC) would be located in the same position as it is now.

To be considered during the construction of the new facility would be the disruption of medical waste incineration, laundry delivery and food delivery for the duration of construction. Food and laundry could be delivered to the materials management bay while all biomedical waste from the Brandon RHA would be treated off-site.

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4.1.2 Location and Zoning

The campus of Brandon Regional Hospital, (Lots 1/14, Block 14, Plan 9 BLTO) is designated “Institutional” within the Brandon and Area Planning District Development Plan, and classified as EI (Educational and Institutional) Zone according to the Brandon Zoning By-Law No. 6642. In a letter of clarification from the City of Brandon dated June 14, 2013 (Appendix D), the use of an incinerator on site is considered legally non-conforming. Considering the existing incinerator was established prior to the enactment of the Brandon Zoning By-Law No. 6642 and since it has not been discontinued for a period of 12 consecutive months, as long as there will not be an increase in intensity (it will operate less hours with less waste being incinerated), the future use contemplated in this report would be in conformance with the Planning Act.

4.2 Conceptual Layout

For the proposed location (at the current incinerator), a preliminary facility floor plan was produced by the consultant. The design was based upon the site characteristics for the location, which included finding an ideal “fit” with the existing footprint, the recommended space requirements for the facility components, as well as knowledge of efficient biomedical waste treatment facility design.

When approaching the additional analysis of the proposed location, it was necessary to consider several potential issues:

. The need to accommodate or “fit” the new facility technologies and operations into the existing location footprint. . The transportation logistics, transportation cost, and local biomedical waste collection and storage within each of the RHAs. . The potential need for permits with each of the RHAs (e.g. permits for transportation and storage of biomedical waste). . The potential requirement of an Environmental Assessment.

Figure 2 represents the preliminary layout for the proposed location. Figure 3 shows the proposed facility layout superimposed over the existing facility to show the anticipated changes.

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Figure 2: Preliminary Layout for the Proposed Location

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Figure 3: Preliminary Layout Superimposed over Existing Facility

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4.2.1 Design Concept

The design for the proposed location is to extend the existing loading dock and incinerator room approximately 16 m (53 ft.) west, up to the existing stairway extension. The total area for the facility and walkways is approximately 575 m2 (6,200 ft2), plus an added walkway on the second floor of 57 m2 (620 ft2).

The design would include three loading docks with two of the docks dedicated to the importation of RHA biomedical waste and the export of treated biomedical waste and regular hospital waste. The remaining dock would be used for the unloading of food and laundry. Of note, the design allows for the isolation of waste storage from food and laundry. The unloaded laundry would be rolled into a freight elevator to then be rolled into the laundry feed area on the second floor. It should be noted that laundry processing, food storage and food consumption (cafeteria) will not be adjacent to the waste treatment area.

The waste area can be either closed rooms or open, depending on the final footprint of the processing equipment. Waste from other RHAs and Brandon Regional Hospital would be brought to the staging area. Pathological waste from either source would be stored in the refrigerated room if not burned within the day. Treated waste would be loaded into a compactor, along with regular waste and cooled ash, to be hauled to the landfill. The remaining area in the facility would be dedicated to employee washrooms and change rooms, an office/administrative area, a storage room (for parts and supplies), and room for container cleaning if needed.

The building design would be comprised of the following components:

. A concrete slab floor, built on engineered support structure (on the same level as the current loading docks). . Metal frame walls and ceilings (columns, beams) designed for the loading requirements of the structure and equipment required for operations. . Steel exterior cladding, to match the surrounding buildings. . Roofing components to allow access to roof utilities and the incinerator stack. . Insulation on all exterior walls and ceilings to conform to LEED standards. . Windows on the south wall to allow ingress of as much natural lighting as possible. . Drywall on interior walls where required. . A high efficiency HVAC unit. . Connections to, and installation of, utilities related equipment such as lighting, steam, water, power, natural gas, and condensate return.

In addition, the design contemplates the addition of a new roadway located on the south side of the new addition, which would allow all traffic in the lower unloading zone to enter one way from Van Horne Ave. East, and exit on Dennis Street.

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4.2.2 Considerations for Energy Efficiency

As a component of the preliminary design for Location 1, it was desirable to incorporate energy efficient elements where possible. The efficient elements considered were those identified under the LEED program. Leadership in Energy and Environmental Design (LEED) is a rating system to evaluate the environmental performance of a building and encourage sustainable design. While not necessarily the objective to conform to the LEED program, a cost efficient design can be achieved by incorporating energy efficient elements. The energy efficient elements incorporated into the preliminary design include:

1. Natural Lighting – maximizing window space on the south wall for greater sun exposure. 2. Thermal Pane Windows with Reflective Coating. 3. Exterior Insulation around the Facility. 4. Stormwater Controls. 5. Maximizing use of the Existing Building. 6. Low-Energy Lighting 7. High-Efficiency Cooling System.

4.3 Proposed Technology

To identify potential treatment technologies for a biomedical waste treatment facility in Brandon, a literature review was conducted and industry sources were contacted to thoroughly characterize each technology. To determine which treatment technology would be ideal, a decision matrix was developed based on a variety of attributes. Based on the information gathered from the assessment of the various technologies, a relative score was assigned for each technology, under each category, and these scores were totalled to determine which technology offers the best overall solution. The full letter-report for the assessment of potential treatment technologies (Technical Assessment of Treatment Technologies) has been provided in Appendix A.

As described in Section 2.2.1, it has been determined that a technology would be required to address both the “incinerable” waste stream (i.e. pathological, cytotoxic, and pharmaceutical) and the “non- incinerable” waste stream. For evaluation, it was assumed that each technology would operate for 8 hours per day and 5 days per week. Based on the waste stream identified in Section 2.2.1, treatment technologies for “incinerable” waste would require a processing rate of no less than 50 kg/hour. Treatment technologies for “non-incinerable” waste would require a processing rate of no less than 310 kg/hour.

4.3.1 Proposed Technologies

Based on the results from the decision matrix, the ideal solution for the “incinerable” waste stream was determined to be a traditional incineration system with a gas treatment system to ensure emissions meet current and reasonable foreseeable future regulations. The ideal solution for the “non-incinerable” waste stream was determined to be a single autoclave system. The following is a summary of each of the proposed technologies.

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4.3.1.1 Incineration

A traditional incinerator is very effective in terms of the ability to kill microbiological organisms and reduce the volume and weight of the waste. Relative to the other incineration technologies (i.e., pyrolysis or plasma systems), a traditional incinerator is a more established technology which should aid maintenance requirements and parts availability. For the processing rate required, a traditional incinerator provides a more cost effective solution as pyrolysis and plasma systems are typically intended for larger waste streams.

Incineration is a high-temperature, dry oxidation process using controlled-air combustion to reduce organic and combustible waste to inorganic, incombustible matter. As incineration incorporates a combustion process the primary products will include carbon dioxide, water and solid residue in the form of ashes. Primary benefits of incineration include the significant reduction in waste volume and weight (up to 90%) and the treated waste being “unrecognizable”.

Gas emissions from an incineration process are inevitable and, due to the potential release of harmful substances, must be treated. With the installation of a gas treatment system, the concentration of potentially harmful substances can be significantly decreased to meet air emissions criteria. The incineration process itself produces no wastewater effluent; however, discharge is possible if a ‘wet’ system is used to treat gas emissions. As it is a known source of harmful gas emissions, public perception of incinerators is typically poor but knowledge of gas treatment system capabilities may improve the perception.

Incineration can be used to treat all types of medical waste; however segregating waste that is a known source of toxic substances (e.g. PVC products) can significantly improve gas emissions. As a result, incineration is only ideal for hazardous organic substances, and items which require complete destruction. Processing only these waste streams requires a lower processing rate than for “non-incinerable” waste, as such, smaller equipment can be used which can reduce equipment footprint, and costs.

There are typically no special educational qualifications necessary for incinerator operators and training would be provided by the equipment manufacturers, but a thorough understanding of the incineration process is necessary for efficient operation. Due to the nature of incineration it is difficult to assess the efficacy of the process, but microbial inactivation by incineration is considered to be greater than that of non-incineration based technologies.

4.3.1.2 Autoclaving

Autoclave systems are well-established and effective technologies with minimal utility requirements. For the processing rate required, an autoclave provides a more cost effective solution, with lower capital and operating costs than chemical or microwave systems. The potential health risk from the gas emissions or wastewater effluent from an autoclave is minimal and treatment systems are not typically required.

Autoclaving is based on the exposure of medical waste to pressurized steam to sterilize infectious waste, without causing airborne emissions. An autoclave consists of a metal chamber sealed by a charging door, and can have a steam jacket for pre-heating and reducing condensation inside the chamber. Some autoclave designs also incorporate mixing or shredding technology in an effort to increase sterilization efficiency and reduce waste volume (up to 80%); however, shedding technology can be susceptible to breakdowns. Once treated, waste can join the municipal waste collection stream, although without shredding the waste, volume will not be reduced and will still be “recognizable”. Reputation Resources Results Canada | USA | UK | India | China | Hong Kong | Singapore www.rwdi.com

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Health risks are not typically associated with gaseous emissions from an autoclave. It is possible that toxic contaminants can be released through air emissions should waste containing hazardous chemicals not be segregated prior to treatment; however, this risk is minimal and autoclaves do not generally incorporate a gas treatment system. With insufficient ventilation odour can be an issue around autoclaves. Autoclaves are known to produce wastewater discharge (e.g., steam condensate); however, with proper waste segregation the discharge should be sterile and can be drained directly into municipal collection systems. As autoclaving is not typically associated with the release of harmful substances, its’ public perception is typically good.

Autoclaving is not appropriate for volatile and semi-volatile organic compounds, bulk chemotherapeutic wastes, mercury, other hazardous chemical wastes, and radiological wastes. An autoclave may not be able to efficiently treat other bulky materials, anatomical waste or waste that may impede the transfer of stream or heat.

There are typically no special educational qualifications necessary for autoclave operators and necessary training would be provided by the equipment manufacturers. Under ideal conditions, autoclaving has

shown to achieve a 6log10 (99.9999%) kill of bacterial spores or greater; however a level of efficacy between 4log10 (9,999/10,000) and 6log10 (999,999/1,000,000) is typical.

4.4 Assessment of Transportation and Collection Logistics

4.4.1 Process Flow of Waste

As noted in Section 2.2 biomedical waste will be segregated at source into two discrete streams. Approximately 15% of the total waste stream is considered red bag (pathological, cytotoxic and pharmaceutical), and the rest (yellow bag) is all other biomedical waste. The segregation at each of the RHA sources will be undertaken by the staff person who initially handles the waste who then will select the proper waste container for use. It is anticipated that the majority of the smaller RHAs will only generate the “yellow bag” waste and will not have to segregate the waste, and larger RHAs (i.e. that have surgical units) will have both types of containers throughout the facilities.

RHA Hospitals

• Pathological and other Biomedical Waste

RHA Clinics Transportation Brandon Processing

• Sharps and • Collection • Autoclaving other Vehicles biomedical • Incinerating Biomedical Brandon Waste pathological Landfil Other • Autoclaved waste • Ash • Sharps and other Biomedical Waste

Figure 4: Process Flow of Waste

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The timing and routing for each of the approximately 50 to 60 RHA (excluding Winnipeg) facilities will be dependent on the size, and respective generation rate of each of the generators, but is initially calculated that 2 to 3 collection vehicles will collect waste throughout each week. Each vehicle storage area will be kept at minimum 4oC, with full spill containment and spill kits (this is as per section 6.5 of the CCME Guidelines for the Management of Biomedical Waste in Canada). While the vehicles may be out for one to four days, transit time will be based on the size of the truck and generation rate of the respective off site generators. It is expected that the movement of vehicles, including delivery and offloading of waste to Brandon, will occur between Monday and Friday.

Vehicles collecting waste from the RHA will conform to Transport of Dangerous Goods legislation in Manitoba, requiring at minimum the requirement for manifesting and full spill protocol. A separate report on the collection and transportation has been undertaken by RWDI, and recommendations from this study are included in Appendix E.

4.4.2 Transportation Route through Brandon

Waste entering into Brandon will observe strict requirements to traverse to the facility. The primary routes will be:

. From the North, West and East, the transport vehicles will head south on PTH 110 (Eastern Access), turn left (west) on Richmond Street, right (north) on 17th Street North and left (west) on Van Horne Ave E to the facility . From the South, the transport vehicles will head north east on PTH 110 (Eastern Access), left (north) on 17th Street North and left (west) on Van Horne Ave E to the facility

These routes will conform to the designated hazardous waste routes for Brandon. Figure 5 below provides a map of the proposed transportation route through Brandon.

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Figure 5: Transportation Route through Brandon

4.4.3 Waste Receiving and Containment

Waste generated within Brandon and waste received from other RHA facilities can be directed in the following manner.

Waste will be received at the central loading bay. As each waste container is brought out of the transport truck, the container area will be inspected, each container’s respective bar code will be scanned and the container will be examined for spills as per the Spill Protocol (see below). On receipt of the waste from vehicles, staff at the facility will attest to the accuracy of the load records and sign off on the provincial manifest. Of note, the bar code, applied and scanned at each respective source (RHA facility), will allow the operator to see where the waste was generated and what the material characteristics are. The container will then be weighed (the weight information becomes part of the container information to be stored throughout the process).

The operator will choose which area the container will go for processing; the autoclave process (if it is yellow bag waste) or to the incinerator process (if it is red bag waste).

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The operator will ensure the processing equipment is ready for loading and the material will be processed. If there is a backlog of material in either of the autoclave or incinerator processes, the operator has the option to place the respective container in the designated storage areas: yellow bag waste on the north side of the room and red bag waste in the cooler located on the southwest side. Once there is no longer a backlog of material, the stored waste can be moved from the storage area to its respective process area.

All waste, including the waste generated within the hospital, will be weighed prior to being charged into the processing units. The information generated from the bar codes, manifests and weights will be stored in a data base for a period of time prescribed by provincial regulations, or 7 years, whichever is greater.

In all cases, the receipt and storage of the waste will be based on the principle of FIFO, First In First Out. As noted in the preliminary design phase denoted in Section 4.2, the storage area has been designed to accommodate a maximum of 4 days’ worth of waste. The storage areas will be designed with spill containment (sloped floors to drains) and raised curbs at all entrances. Drains will be located beneath the storage areas, and the processing area. Details for these locations will be finalized when the architectural building design is undertaken. All containers delivered or generated within the hospital will be durable double lined for leak protection and safety. Furthermore, the facility will be accessible only through secure access doors, with coded or key lock doors controlled by staff. Similarly, the bay doors for trucks either delivering waste or hauling the residue will only be open during the loading and offloading periods.

4.5 Operational Parameters

4.5.1 Current Operations

Brandon Hospital currently operates a Trecan Combustion Limited, Trecaire 40R incinerator which was installed in the early 1990’s. It has a capacity of 400 lbs./hr (181 kg/hr) with a constant feed hydraulic feed. The unit typically runs 8 to 10 hours per day, 5 days a week, and on occasion for the weekend when there is a requirement. During the night, the unit cools down, and bottom ash is extracted in the morning to metal bins for disposal to the Brandon landfill. The Trecaire unit is operated by an internal plc control unit which controls both the feed rate and internal temperatures. Waste derived from within the hospital is brought in rolling carts and deposited in stainless steel rolling carts (which allows tipping into the incinerator). Waste delivered to the hospital from neighbourhood clinics is deposited direct on receipt to the stainless steel rolling carts. Each stainless cart is weighed prior to charging to the incinerator, and hourly charge information stored for a duration of no less than 5 years.

4.5.2 Brandon Hospital Operating Structure

The Brandon Biomedical Waste Treatment facility will operate with hospital staff, but as a separate and distinct business group. The structure of the group within Brandon Hospital is shown below in Figures 6 and 7.

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Ceo Prairie Mountain Health

VP Finance, Capital and Infrastructure

Regional Manager

Manager Biomedical Waste

Brandon Biomedical Waste Treatment Facility

Figure 6: Brandon Hospital Reporting Structure

BBWT Facility Manager

Support from

Brandon Administrative Services Other RHA Support from Facilities

Brandon FES (Maintenance Services)

Support Staff Support Staff Support Staff

Figure 7: Brandon Biomedical Waste Treatment Facility Organizational Structure

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While the waste treatment facility will operate independently, it will use hospital overhead (Brandon Administrative Services) and (major) maintenance services (Brandon Maintenance Services). Waste treatment operations will include all aspects of waste receipt, internal handling of waste, record keeping, manifest requirements, inventory management (e.g., bags, containers etc.), equipment operations, logistics with transportation and other RHA facilities and potentially billing. Furthermore, all staff operating at this facility will be fully trained in hazardous waste handling (particularly biomedical waste), emergency procedures (i.e., spills) and coordination with Manitoba Conservation as per regulation and the operating permit.

The goals of this operation are to safely process all biomedical waste generated from RHA sources (non- Winnipeg) in as fiscally sound manner as possible, and in a timely and environmentally correct manner.

Proposed Operations

As noted in the sections above, the new operation will have features that will allow for a larger throughput with state of the art treatment technologies. The facility will have:

. A larger footprint to house storage and processing capability . Operations that are physically separated and secure from other hospital operations . New processing technologies with air pollution equipment (described below)

The new facility has been designed to accommodate the capacity requirements for 2020, and handle seasonal and daily variations of waste flow through the year. The facility has furthermore been designed to operate 8 to 10 hours per day, Monday to Friday, with the ability to operate longer days or weekends if needed.

As noted in Section 4.4.3, waste is received, each container shipped by truck will be recorded and the load manifests signed off. The waste containers will be weighed either when received, or when charged into the processing units. The waste containers will be stored in the staging areas.

It has not been determined whether reusable or disposable containers will be utilized within the system:

. If reusable containers are used, there will be two types of containers in the system. Red containers will be used for pathological waste, and will have two plastic (red) liners inside the containers to hold all collected waste. When charging the incinerator, the content of the reusable containers will be taken out and deposited in the incinerator. Similarly, biomedical waste (yellow bag) will be shipped in double lined yellow reusable containers, and when charged to the autoclave the yellow double liner (autoclavable) will be taken out of the reusable container and put into carts which will then be rolled into the autoclave. Both types of containers will then be washed and sterilized prior to shipment back out the generating facilities. Any disinfectant used in this process will be sewer friendly, and all wash water will drain to the sanitary sewer system. . If disposable containers are used, the following is the process of use. For red bag waste, the complete containers will be charged into the incinerators. For biomedical (yellow bag) waste, where cardboard or hardshell containers are use, the double (autoclavable) bags will be removed from the container and put into carts which will then be rolled into the autoclave. The containers will be inspected and if found not to be contaminated then the resultant cardboard or hardshell

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containers will then be stored in the recycling area and subsequently sent to the appropriate recycling companies. If contaminated (i.e. visible stains), the containers will be incinerated.

Daily records will be kept for all waste material received, stored and charged into the respective processing units. These records will be kept for a period of 7 years, or as prescribed by Manitoba Conservation. Similarly, weights and/or volume shipments of all residue materials (i.e. autoclaved waste, ash, etc.) shipped out will be kept in weekly records.

All personnel involved with this operation will be fully trained in Transport of Dangerous Goods, emergency response, the operation of the respective units and the method of record keeping. Operations personnel will also be responsible for signing off and handling manifests for receipt of waste and shipment of hazardous waste if so required.

4.5.2.1 Autoclave

Biomedical waste (yellow bag) will be sterilized in a standard autoclave. The autoclave will measure approximately 7m by 2m, and will house either one or two stainless steel carts. (The load rate will be dependent on the final size of autoclave). The autoclave will operate with steam available within the hospital with pressures ranging in the 50 to 60 psi at temperatures of 120 to 150 deg. C. Residence time will vary depending on the load but approximate cycle time will be 60 minutes from closing to opening the autoclave. The autoclave will achieve no less than 6 log 10 kill rate and will be tested on a weekly basis with biological spore test patches inserted in the waste load, and inspected after the autoclave has finished its run. A 6 log 10 kill rate is currently used in the province of Ontario (Guideline C-4) whereas 4 log 10 kill rate is used in most other provinces. The efficacy test will be a pre-manufactured test kits with such thermophile bacteria as geobacillus stearothermophilus (also called bacillus stearothermophilus). The supplier protocol will be used in this process and the test will be done by trained operations staff. (Note that regular hospital waste will also use the South bay door for disposal). If the test fails, a second test will be undertaken. If the second test fails, the unit will be brought down for detailed inspection by maintenance personnel. When full, the compactor load will be picked up and taken to the Brandon landfill.

4.5.2.2 Yellow Bag Waste / Autoclave Process

Observing the policy of FIFO (First In, First Out), the oldest material will be processed first. For yellow bag material, the container will be brought to a ramp for easy loading into an autoclave cart (either by hand or with a mechanical container tipper). Before being tipped, the container bar code will be scanned to indicate that the material will be processed. Once full, the cart will be pushed into the autoclave. Where containers are re-usable, they will be brought to the sanitizing station. The bar code label will be removed; the container will be washed in a washing station, sterilized and stored in the container storage area. Where containers are recyclable (i.e., cardboard), it will be brought to the recycling box (to be located west of the new facility).

When two autoclave carts have been filled, and moved into the autoclave, the operator engages the sterilization process. The autoclave process is typically considered a log 6 Destruction process. Depending on the final selection of equipment, the typical cycle time for log 6 Destruction is 1 hour, after which the unit is decompressed and when safe opened and the carts are left to cool. Steam derived from the decompression stage is vented through the ceiling. No odour issues are expected from this process. When the carts are safe to handle, the carts are taken out of the autoclave, and rolled over to the compactor/disposal bin, and the contents tipped into the bin. Once the bin is filled, it is taken out of the Reputation Resources Results Canada | USA | UK | India | China | Hong Kong | Singapore www.rwdi.com

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south bay and transported to the landfill. At this time, Brandon landfill management has indicated that they will landfill the Brandon material at a location separate from the public drop-off area.

4.5.2.3 Incinerator

Also from Section 4.3, the incinerator will have the capability to process an average of 50 kg of waste per hour, 8 hours a day for 5 days a week. The incinerator will be continuous feed with charging capacities ranging in the 100 to 200 kg/hr to allow for fluctuations in loads. The incinerator will be two stages, with pyrolysis combustion (limited air) in the primary chamber. The incinerator second chamber will have excess air and will achieve flue gas temperatures of no less than 1000 deg. C for a 2 second residence time. This is as per the recommendation of the “National Guidelines for Hazardous Waste Incinerators (Volume 1 March 1992)” Flue gases will be cleaned to ensure that emission rates are within provincial air regulations (see Section 7.1 for emission rates). Although the final design of the scrubber will be as per the designated technology provider, it is anticipated that it will have either a wet or dry acid scrubber, a possible bag house, and may involve the injection of carbon or ammonia as needed. Note that emission rates will be equal to or lower than the emission rate values noted in the Screening Level Human Health Risk Assessment of Air Quality Impacts for the Proposed Brandon Bio-Medical Waste Treatment Facility dated September, 2013 as provided in Appendix H of this report. They will also conform to CCME EPC WM 42E. Specific operational aspects of the final scrubber design will be provided once the technology proponent has been selected. While the incinerator will run for up to 8 hours per day, it will only operate on a normal basis for 2 to 3 days, except when there are fluctuations in loads. At no point in time will the capacity and throughput of the new incinerator exceed the current incinerator. In the morning of the incinerator run day, natural gas will be used to attain the charging temperatures before any waste is loaded. At the end of the daily run, the incinerator will run at the charging temperatures again with natural gas until the last load has completed full combustion. Bottom ash will be offloaded the following morning (to allow for cooling). The ash will be placed in metal canisters and shipped via the north bay door to the Brandon landfill. Bottom ash will be tested using standard the Toxicity Characterization Leaching Procedure (TCLP) protocol (US EPA Method 1311) to ensure that the ash meets the landfill requirements. As per other biomedical waste operations the typical parameters are heavy metals, fluoride, cyanide and total organic carbon. It is proposed that 4 tests be undertaken in the first year of operation, and once a year thereafter.

4.5.2.4 Red Bag Waste / Incineration Process

Observing the policy of FIFO (First In, First Out), the oldest material will be processed first. In this case, the red bag bar code will be scanned, and the complete container tipped into the incinerator (will not be re-used).

The incinerator operation will be undertaken on a week by week basis, depending on the amount of material that is received. Under a steady state flow, it is believed that the unit will operate 2 to 3 days a week. After a one day cycle, the unit is cooled, and the bottom ash removed in metal drums. As with the autoclave bin, the metal drums are taken to the Brandon landfill and deposited in the same location as the autoclaved waste.

Fly ash or liquid residue collected from the Air Pollution Control (APC) will be stored and removed as hazardous material by a licensed hauler if it is deemed hazardous utilizing a standard TCPL test. The frequency of this operation will be dependent on the final technology selection.

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4.5.2.5 Improper Waste Segregation

Where it can be seen or known that regular garbage or recycled material is being deposited in the biomedical waste containers, steps will be taken to prevent this contamination. In some cases the waste can be seen through the plastic bags, otherwise, the generation rate for biomedical waste may appear high for the size of the facility. In either case, the source of the waste can be tracked through the bar code system. Waste received at the facility will not be opened, or rejected unless there is apparent issue that can make processing dangerous. Instead, the generating facility will be contacted and behavior of the facility staff expected to improve the sorting/segregation processes

4.5.2.6 General Housekeeping Procedures

All areas which are exposed to waste, including the interior of the transport vehicles, the receiving area, the loading areas, and the storage areas will be cleaned on a regular basis. For vehicles, the truck box will be cleaned weekly with a disinfectant. The residue liquid collected in the excess spill container (located beneath the box) will be emptied during the weekly clean-up or after a spill. Similarly, the floor area, and surface areas within the facility that are exposed to waste, will be cleaned with a disinfectant on a daily basis (during operations). When a spill occurs, the surface which is exposed to the spill will be contained, the spill absorbed, and the area cleaned with a disinfectant. In all cases, the disinfectant will be sanitary sewer friendly. Spill kits will be distributed throughout the facility for easy access.

4.5.2.7 Equipment Downtime Procedure

In the event of the autoclave or incinerator not operating due to equipment failure, or maintenance, the following will be observed:

. The manager of the operations will make an assessment of the potential downtime. At this time, it is projected that the two storage areas can accommodate up to 4 days of waste (2020 flow rates). If the equipment will be operational within the 4 day period, the manager will continue the offloading operations and move the waste to the storage areas. . If the process is operational within the 4 day period, the manager may operate the equipment over a 24 hour period, or over the weekend to alleviate the backlog. . If the processing equipment is projected to be down for a longer period of time, the manager will engage the following procedure: o If the downtime is anticipated to be of a short duration (i.e., <1 week) the manager may choose to hold collection from the off-site RHA facilities. As denoted above, the manager may choose to operate longer hours upon equipment commencement to alleviate the accumulated waste loads. o For longer downtime (i.e.,>1 week), an alternative processing site (private company) will be contacted for disposal. The company would be licensed to operate in Manitoba. Waste accumulating at Brandon will then be picked up at the facility and waste collected from the sites by the transport group can be hauled direct to the private company transfer station or treatment facility.

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4.5.2.8 Employee / Operator Training

All staff involved with the operation will be fully trained in the respective areas of operations, emergency response and health, safety and environmental compliance.

4.5.2.9 Equipment Specific Operation

Staff will be trained on start-up, ongoing operations, shut down, and light maintenance of the incinerator, its applicable APC, the autoclave, the container wash system and other equipment used within the facility. The training will also include the operation of the bar scanning system and record keeping requirements as denoted above.

4.5.2.10 Emergency Response

For emergency response, all staff will be trained in conjunction with other hospital staff on issues relevant to the facility, including spills and accidents (defined in additional detail below).

4.5.2.11 Health, Safety and Environmental Procedures

For health, safety and environmental compliance, staff will be trained on transport of dangerous goods regulations (and requirements), proper PPE use (as mandated by Brandon Hospital), Manitoba Conservation permit and regulatory requirements and other hospital HSE training (including hygiene).

Personal hygiene will be a main priority at all times. Staff will be required to wash any body parts which may be exposed to waste at all times. At the end of shift, staff will be encouraged to shower in the change room and don fresh clothes before leaving the facility. In the event of exposure to any hazardous materials on site, staff can also use the emergency wash/shower unit located beside the change room.

4.6 Remote RHA Operations

While the premise of operations for the generating facilities has similar characteristics, staff at the RHA facilities will face less issues. The three primary issues will be conformance to operational procedures at Brandon (i.e., are the units operational etc.), handling the waste material safely, and conforming to regulatory requirements.

. Each of the remote facilities will have different staff either collecting or assembling the biomedical waste. It will be essential for the staff to ensure that proper segregation is followed (i.e. yellow and red bag, no other waste etc.), and that proper packaging is used. This will require the respective staff to be fully trained in the procedures for the segregation and packaging of the waste. This training should occur prior to the beginning of shipments to Brandon, and will involve several levels of staff (could include RNs, cleaning staff etc.). While the shipping containers will be provided by the transportation fleet, it is believed that the remote sites may have nuances in the inter-facility movement of waste. . Safety in the handling of waste will be paramount for the respective operations. As denoted above, staff will be trained to deposit the waste safely in the containers located throughout the facility. The training will conform to the overall safety training with staff, but include such issues as sharp pricks, reduction of potential aerosols, and spill containment (primarily body fluids) that are relevant to biomedical waste.

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. Once the material has been consolidated in a storage area, red bag waste in a cooler and yellow bag waste at room temperature, all material should be placed in proper waste containers. The waste containers will clearly show the proper biohazard symbols and prior to shipment have the proper labels and bar code, to be applied by the transport group. Each label should denote the generating location, the date and time of loading, the type of waste and any other information deemed important for the generating facility (may have specific source within the hospital for tracking purposes). At this time, the label will have a unique bar code, which will be scanned by the transport group. In addition to the label, a manifest will be filled out as per the requirements of Manitoba Conservation. Staff at the facility who are responsible for the shipment of the waste will be trained in the relevant requirements of Transport of Dangerous Goods legislation, and will furthermore sign the manifests and handle paperwork as required.

5. EMERGENCY PROCEDURES

As a hospital organization, the overreaching emergency procedures apply to all areas of the hospital. Appendix F provides the Disaster & Emergency Preparedness Program (DEPP) (or shows the colour code procedures) for PMH which will apply to the biomedical waste facility. Each of the codes applies to specific types of emergencies which when activated, trigger specific procedures. In some cases, emergencies that occur within the hospital, but outside the biomedical waste facility will cause the staff within the biomedical waste react appropriately. Staff working within the biomedical waste facility will be required to be fully compliant with these procedures.

Within the biomedical waste facility, the primary codes that can apply to the operations can be RED – Fire, and BROWN – Hazardous Materials. An example of the procedures for BROWN are shown in Appendix F.

In the aforementioned operating procedures there are several aspects that touch on “emergency” procedures. These may fall outside the DEPP procedures as they apply solely to the facility, and are characteristic to the issues related to operations. Some of these issues may be: equipment malfunction, leaks or spills, staff exposure to infection (i.e. sharp pricks) or chemicals, or other unique issue derived from operations.

. Equipment malfunction may occur at any time, and has the potential to cause a hazard to human health and / or cause environmental or regulatory exceedences. Either will require some form of emergency reaction. Both the autoclave and incinerator have high heat sources (steam or flame) that can cause human harm. Operators should be trained to minimize potential exposure to these heat sources, and undertake measures to react appropriately when unplanned events occur. In the event of equipment failure causing emission exceedences, operators will be trained to undertake the following procedures. o Assess the problem, and if workable undertake solutions to alleviate the exceedences o If not solvable, start the process of shutdown o Undertake steps necessary to solve the issue. In some cases this may involve FES or the manufacturer o Record and report the incident as required in the permit or regulation. . It should be noted that each equipment manufacturer may have alternative recommended procedures for their equipment. Reputation Resources Results Canada | USA | UK | India | China | Hong Kong | Singapore www.rwdi.com

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. For small spills of body fluids (which may be derived from leaky containers, or handling issues, procedures are detailed in the operating procedures noted above. All staff will conform to hospital procedures when these events occur. Leaky bags or leaking containers should be placed inside leak proof containers to ensure that no further leaks occur on site. . If staff are punctured or ingest hazardous materials as denoted in the Code BROWN procedures, they will immediately alert the relevant staff.

6. OTHER CONSIDERATIONS

6.1 Construction Phase

The current plan for the construction phase will be the removal of existing west and south facing walls of the current incinerator and loading docks, the removal of the existing incinerator, the addition of a new slab floor, the construction of a new building to house the new treatment facility and loading docks and the addition of new equipment for the treatment room. Utilities located within the existing structure may have to be moved to accommodate the new building, and doors and ancillary structures may be modified. (This will be detailed in the final design). Demolition and construction is expected to occur over a 4 to 5 month period. Other environmental considerations are noted below.

6.1.1 Noise

Construction noise impacts are temporary in nature, and therefore higher noise levels are generally acceptable to affected residents. However it is recommended that where feasible, mitigation measures be used to minimize noise impacts on nearby residents during the construction. The following mitigation measures, while not all directly applicable, are recommended:

1. Conduct construction activity between the hours of 07:00 and 22:00 to reduce the potential impact of construction noise; 2. Advise nearby residents of significant noise-causing activities and schedule these events to reduce disruption to them; 3. Ensure that all internal combustion engines are fitted with appropriate muffler systems; and 4. Take advantage of acoustical screening from existing on-site buildings to shield dwellings from construction equipment noise.

Where feasible, temporary construction accommodations should be sited to avoid potential construction noise impacts, per measure four.

6.1.2 Dust

The potential dust sources during construction activities may include the following:

1. Impact from wrecking balls, high hoes, jack hammers, etc.; 2. Breakup of large pieces using grapple jaws; 3. Materials falling to ground during demolition; 4. Travel on internal routes;

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5. Loading of rubble into trucks; 6. Trucking rubble materials off site; 7. Excavation for new addition; and 8. Drag out of soil onto surrounding streets from trucking of excavated soil.

6.1.2.1 Dust Control

Demolition is an inherently dusty process and some of the potential dust sources are difficult to control. The first two sources listed (impacts from wrecking balls and the breakup of large pieces) above fall into this category and little can be done to limit the dust emissions from these sources. It is recommended that these activities be curtailed if ground wind speeds exceed 20 kph.

Other dust generating activities on the site may be controlled to some extent through watering. The activity on the site will be fairly intensive; however, because of the relatively small footprint of the site, maintaining adequate watering will be a relatively easy task that can be achieved with hoses.

Materials falling to the ground generate dust as they fall from the building and upon impact with the ground. There is a limited amount of control that can be achieved with this process. If it is operationally possible to maintain a floor sweeping regime on floors about to be demolished, there will be a reduction in dust liberated as the pieces fall or are dropped. This will also help with wind erosion. It is also possible to limit the dust generated from impact on the ground or into lugger boxes located on the ground through the use of light watering of the ground or the materials in lugger boxes. Clearly the amount of watering required will be dependent on the materials falling and the material on the ground. It is recommended that if there are visible dust emissions as the material is dropped that watering should be applied until visible emissions cease.

Dust emissions from loading rubble into trucks should be controlled by the watering of rubble material if required. If there is a significant “puff” of dust as rubble is dropped into the trucks, the material should be watered.

As the excavation of soil begins for the new addition, it is assumed that the actual excavating activity will generate relatively little dust. The soil should be fairly moist and the activity will be below grade. In the event that there is an extended dry period, some watering in the excavating area may be required. It is recommended that watering take place if visible dust emissions occur.

The trucking of rubble material and excavated soil from the site will be a significant dust source. There will be dust generated as the trucks pass on the internal haul routes and from the surrounding roadways. As stated before, the dust generated from the internal haul routes can be controlled through watering and we would recommend that if visible dust plumes from wheels are longer than one metre, watering is required. We would also recommend that speeds on site for all moving vehicles be limited to 10 kph, though given the small size of the site this should not be an issue. There will also be a significant amount of dust generated from the material that is dragged out onto Van Horne Avenue from the truck traffic. It is recommended that a wet street sweeper be used on an as needed basis. It is also proposed that if there are visible dust emissions from traffic on Van Horne Avenue, the street sweeper should be used.

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6.1.2.2 Summary of Recommendations

The site is not large and it is understood that there are restrictions that may make some recommendations unfeasible from an operational standpoint. Some of the recommendations below were not mention in the previous text but our past experience has shown them to be of value for similar operations.

1. Appoint an individual (dust manager) responsible for maintaining the dust control recommendations. 2. All dust complaints should be forwarded to the dust manager who will make a log of the specific time and location of the complaint as well as the site activities that were taking place. 3. The dust manager should be given a hand held anemometer to measure ground wind speeds from time to time and should pay attention to forecasted wind speeds. Special diligence should be taken when ground wind speeds are over 20 kph. High wind speed events should also be logged. 4. Internal roadways should be watered when visible dust plumes behind moving vehicles are greater than one metre in length. 5. Moving vehicles should be restricted to a speed of 10 kph while on site. 6. Watering of the ground or lugger boxes should occur where materials are being dropped from the building demolition. 7. A floor sweeping regime should be established on the floors about to be demolished. 8. Watering of rubble material should occur if loading of the material into trucks causes significant “puffs” of dust. 9. Watering in the excavation area should occur if significant dust is being generated, though this is not likely. 10. Wet street sweeping of Van Horne Avenue should take place if dust emissions become visible from passing traffic.

6.1.3 Traffic

While there will be increased truck traffic during the construction phase, it is not expected to exceed 2 to 5 loads per day for construction materials and personnel. All construction traffic will be directed to use 1st Street or Van Horne Ave E using City designated truck routes. Off-loading will be undertaken in the SW parking area (where the current offloading activities occur) or off the Van Horne curb. In the event that Van Horne offloading impedes the westerly traffic flow, traffic will either be controlled or alternative traffic routes (i.e. Frederick or Dennis Streets) will be available.

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6.1.4 Operations

During the construction period, there will be a disruption of hospital activities that normally use the SW loading area. It is expected that the disruption will be over a 4 to 5 month period. Brandon hospital has developed a contingency plan for these activities diagrammatically as detailed in Appendix G. In summary:

. All waste (regular garbage, biomedical waste and recyclable materials) will be taken to alternative storage and loading areas located on the central east area of the campus (west of Frederick St, south of the Nurses residence). . Food and supplies will be delivered to the west bay of the SW loading area which is normally used only for supplies. The west bay will be held clear for the duration of the construction period. . Soiled and clean laundry will also use the west bay, with designated routes within the hospital.

6.2 Waste Processing, Containment and Management

All biomedical waste generated within Brandon Hospital will be shipped off-site during the construction period. It is also expected that waste processing during the commissioning stage will be limited. During these two periods, the waste will be packaged and shipped to licensed processors. Waste generated from construction activities will be stored in 10 to 20 CY containers located beside the new facility. The construction group will be encouraged to recycle all possible materials where practicable.

7. DESCRIPTION OF EXISTING ENVIRONMENT POTENTIALLY AFFECTED

7.1 Baseline Air Quality

The Project site is located within the City of Brandon. Current air quality conditions were determined by looking at historical air pollutant monitoring data from the most representative available station closest to the Project site. Data were obtained for the most recent available consecutive five years (2008 to 2012) from NAPS Station No. 70203 located in Brandon, NAPS Station No. 70119 located in Winnipeg and NAPS Station No. 80110 located in Regina.

Table 3 provides a description of the stations used for contaminants of interest. Table 4 provides a summary of the ambient monitoring data, for all contaminants that were both modelled with respect to the proposed incinerator and monitored at the ambient monitoring stations. The average values are representative of everyday conditions and the maximum values are more representative of rare peak events. The 90th percentile values are representative of the maximum background conditions likely to coincide with maximum contributions from the project-related emissions. The 90th percentile concentrations are those that are exceeded only 10% of the time, and are the background value normally used for the purposes of conducting environment assessments involving air quality impacts.

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Table 3: Ambient Air Quality Stations Contaminant Station IDs City Location Year CO 70119 Winnipeg 65 Ellen Street 2008- 2012

NOX 70203 Brandon 1430 Victoria Avenue East 2008- 2012

PM2.5 70203 Brandon 1430 Victoria Avenue East 2008- 2012 Sulphur Dioxide 80110 Regina 2505 11th Avenue 2008- 2012

Table 4: Brandon Ambient Air Quality Data Ambient Air 2008-2012 Ambient Quality Pollutant Averaging Period Statistic Concentrations Criteria (µg/m³) (µg/m3) 90th Percentile 801 1-hr 35,000 Maximum 6640 CO 90th Percentile 801 8-hr 15,000 Maximum 2175 90th Percentile 36 1-hr 400 Maximum 380 90th Percentile 17 NO [1] 24-hr 200 X Maximum 126 Average Mean 16 Annual 100 Maximum 18 90th Percentile 11 PM 24-hr 30 2.5 Maximum 58 90th Percentile 2.6 1-hr 900 Maximum 60.2 90th Percentile 1.7 SO 24- 300 2 Maximum 11.6 Average Mean 0.6 Annual 60 Maximum 0.8

Notes: [1] Ambient air quality criteria for NO2 shown here

7.2 Baseline Meteorology

Wind speed and direction recorded at the Brandon Airport over a period of five years (2007 – 2011) is shown in the form of a windrose in Figure 8. A windrose is essentially a bar graph in polar format where the direction of the bar indicates the direction from which the wind is blowing, the colour indicates the wind speed class and the length of the bar indicates the frequency of occurrence. The windrose for the Brandon Airport shows that winds were predominantly blowing from the west-south west through to the north west and also from north east to east. The highest hourly wind speed during the five-year period is 19.5 m/s and the mean hourly wind speed is 4.3 m/s. The frequency of calms (i.e., wind speeds less than 1 m/s) is 8.9% and the calculated average hourly wind speed is 4.3 m/s.

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Figure 8: Wind Rose

7.3 Sensitive Receptors

The locations identified in Table 5 below represent the nearest sensitive impact locations. These locations are shown in Figure 9. Location R1 is a Retirement Home, R2, R3, R5 and R6 are individual residences and R4 represents King George Elementary School.

Table 5: Coordinates of Sensitive Receptors Receptor ID Description X Coordinates Y Coordinates R1 Retirement Home 432522.3676 5521390.427 R2 Residence 432893.5094 5521161.254 R3 Residence 432800.5382 5521334.203 R4 King George Elementary School 432893.1425 5521338.834 R5 Residence 433092.9034 5521129.812 R6 Residence 432690.0744 5521015.38

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Figure 9: Site Plan Showing Source and Receptor Locations

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8. EFFECTS ASSESSMENTS

8.1 Air Quality

The air quality impact of emissions from the Brandon Regional Health Centre was assessed using the AERMOD dispersion model. The AERMOD model is an advanced dispersion model that is currently the primary regulatory dispersion model supported by the U.S. EPA, and has been approved for use in Canada by several jurisdictions. AERMOD is a steady-state Gaussian model that is capable of handling multiple emission sources. Within the model, receptor grids as well as discrete receptor locations of interest can be considered. In lieu of specific modelling guidance from the Province of Manitoba, the modelling assessment was conducted in accordance with the Ontario Ministry of the Environment Guideline A11: “Air Dispersion Modelling Guideline for Ontario”, March 2009.

Sources of air emissions included in the assessment are:

. The proposed biomedical waste incinerator exhausting to the atmosphere at a rate of 0.87 cubic meters per hour, through a stack having an inner diameter of 0.30 meters, which discharges at a height of 12 meters, above grade, . Three (3) existing natural gas-fired Cleaver Brooks Model boilers, designated Boiler850 (CB-200- 700-150), Boiler600 (WT-200-CN2) and Boiler900 (WT–200-CN3) with maximum heat input of 29,291,000, 44,669,000 and 52,285,000 BTU/h, respectively. . One (1) existing natural gas-fired boiler CB-200-700-150, rated at 29,291,000 BTU/h, exhausting to the atmosphere at an approximate volumetric flow rate of 3.4 cubic meters per second, through a stack having an inner diameter of 0.85 meters, extending 25 meters above grade. . One (1) existing natural gas-fired boiler W-200-CN2, rated at 44,669,000 BTU/h, exhausting to the atmosphere at an approximate volumetric flow rate of 5.24 cubic meters per second, through a stack having an inner diameter of 0.6 meters, extending 25 meters above grade. . One (1) existing natural gas-fired boiler W-200-CN3, rated at 52,285,000 BTU/h, exhausting to the atmosphere at an approximate volumetric flow rate of 6.12 cubic meters per second, through a stack having an inner diameter of 0.9 meters, extending 25 meters above grade. . Two (2) existing diesel generators, each capable of burning 70 US gal/h of diesel at 100% load, each exhausting through a stack having an inner diameter of 0.3 meters, extending 14.7 meters above grade. . Two (2) existing large dryers in the laundry facility (Washex Challenge 702239 and 702237), each with a maximum gas input of 22,000,000 BTU/h, exhausting through a stack having an inner diameter of 0.5 meters, extending 11.5 meters above grade. . Two (2) existing small dryers in the laundry facility (American Dryer Corp. 580021 and 580022), each with a maximum gas input of 550,000 BTU/h, exhausting to a stack with an inner diameter of 0.45 meters, extending11.5 meters of above grade.

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A total of 16 contaminants were identified with respect to the facility, emitted from a total of 10 point sources. The 16 contaminants were identified as either being emitted from the existing onsite sources of air emissions or the expected air emissions from the proposed biomedical waste incinerator based on stack testing results from a similar operation. Of the identified contaminants, 12 have limits under the Manitoba Ambient Air Quality Criteria (MAAQC). For those contaminants that do not have relevant limits under the MAAQC, relevant criteria from Ontario Ambient Air Quality Criteria (OAAQC) were used. One of the contaminants does not have published limit criteria, as it reflects a mixture of hydrocarbons. A summary of relevant air quality criteria is presented in Table 6 below.

Table 6: Air Quality Criteria

Contaminant Criterion (µg/m³) Averaging Period Source

PM2.5 30 24-hour MAAQC Lead 2 24-hour MAAQC Manganese 0.4 24-hour OAAQC Chromium 0.5 [1] 24-hour OAAQC Copper 50 24-hour MAAQC Arsenic 0.3 24-hour MAAQC Nickel 2 24-hour MAAQC Cadmium 2 24-hour MAAQC Mercury 2 24-hour OAAQC Dioxins and Furans 0.0008 24-hour OAAQC 900 1-hour MAAQC

SO2 300 24-hour MAAQC 60 Annual MAAQC 400 1-hour MAAQC

NOX 200 24-hour MAAQC 100 Annual MAAQC 35,000 1-hour MAAQC CO 15,000 8-hour MAAQC HCl 100 1-hour MAAQC 0.85 24-hour MAAQC Fluorides (as HF) 0.35 30-day MAAQC 0.20 70-day MAAQC Organic Compounds N/A N/A N/A

Notes: [1] 24-hour OAAQC for Chromium (metallic, divalent and trivalent forms) comes into effect on July 1, 2016

Table 7 presents a summary of the predicted maximum cumulative concentrations (maximum AERMOD predicted project contribution plus 90th percentile of the 1-hour, 8-hour or 24-hour background concentration or average annual background concentration). The resultant concentrations are compared to applicable limits.

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Table 7: Predicted Maximum Cumulative Concentrations

Modelled Applicable Averaging Background Cumulative % of Contaminant Project Criteria Period Concentration Concentration Criteria Concentration (µg/m³)

PM2.5 24-hr 6.1 11 17.1 30 57% Lead 24-hr 0.011 0.011 2 1% Manganese 24-hr 0.011 0.011 0.4 3% Chromium 24-hr 0.011 0.011 0.5 2% Copper 24-hr 0.011 0.011 50 <1% Arsenic 24-hr 0.011 0.011 0.3 4% Nickel 24-hr 0.011 0.011 2 1% Cadmium 24-hr 0.000023 0.000023 2 <1% Mercury 24-hr 0.000068 0.000068 2 <1% Dioxins and 24-hr 0.00000061 0.00000061 0.0008 <1% Furans 1-hr 2 2.6 4.6 900 <1% Sulphur 24-hr 0.83 1.7 2.53 300 <1% Dioxide Annual 0.16 0.6 0.22 60 <1% 1-hr 180 36 216 400 54%

NOX 24-hr 79 17 96 200 48% Annual 11 16 27 100 27% Carbon 1-hr 151 801 950 35,000 3% Monoxide 8-hr 105 801 906 15,000 6% Hydrogen 1-hr 1 1 100 1% Chloride 24-hr 0.025 0.025 0.85 3% Fluorides (as 30-day 0.0061 0.0061 0.35 2% HF) 70-day 0.20 Organic 1-hr 0.56 0.56 N/A N/A Compounds

It can be seen in Table 7 that the cumulative concentration (i.e. the combined maximum project concentration + background concentration) for all pollutants and averaging times are less than their applicable criteria.

8.2 Exhaust Re-entrainment

This section describes the assessment of re-entrainment of exhausts from the proposed treatment facility into building outside air intakes and pedestrian receptors on the Health Centre campus itself. The exhaust re-entrainment assessment is similar to the air quality assessment in Section 7.1, the difference being the receptors are on-site rather than off-site.

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8.2.1 Description of Sources and Contaminants

The exhaust sources examined include the same sources as described in Section 7.1, namely the new biomedical waste incinerator for the proposed treatment facility, the three existing natural gas boilers at the energy centre (located on the southwest corner of the site), the existing diesel generators at the energy centre, the two existing large dryers at the laundry, and the two existing small dryers at the laundry.

Figure 10 provides the site plan of the facility. There were 17 on-site outside air intakes or pedestrian locations considered as shown in the figure. The receptor elevations are also shown in the figure. Receptors 2, 16, and 17 were on elevated rooftops on campus buildings. The remaining receptors were on lower roofs or pedestrian locations with elevations less than 15 m above grade.

The contaminants considered were the same as for the air quality assessment in Section 7.1. The existing sources, which are all combustion sources, were considered to have only emissions of nitrogen oxides, carbon monoxide, particulate matter, and sulphur dioxide. The remaining contaminants are emitted only by the proposed incinerator. The relevant standards are the same as described in Section 7.1.

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Figure 10: Hospital Site Plan

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8.2.2 Dispersion Modelling Assessment

The on-site assessment used a combination of atmospheric dispersion models. For receptors close to the incinerator and receptors below the stack top, a model specifically designed for dispersion near buildings was used, the ASHRAE model. The ASHRAE model is based on Chapter 45 of the 2011 Applications Handbook published by ASHRAE (American Society of Heating Refrigeration and Air Conditioning Engineers). The ASHRAE model was developed and adapted from previous wind tunnel modelling for exhaust stacks on building roofs. The wind and air flow around buildings can increase turbulence, reduce plume rise, and create higher concentrations than might be predicted by traditional dispersion models for nearby receptors.

The ASHRAE model for dispersion around buildings was not developed for receptors significantly above the stack top. For three outside intakes on taller buildings that are significantly higher than the incinerator stack top, the AERSCREEN model was applied. These receptors are far from the incinerator stack, and the taller buildings do not directly influence the incinerator plume behaviour. AERSCREEN is a screening version of AERMOD, the dispersion model previously used for off-site receptors as described in Section 7.1. The AERSCREEN model was also used for the sources on the energy centre. The modelling assessment was conducted for 1-hour, 8-hour and 24-hour averaging periods.

For 14 of the 17 on-site receptors, the impact of emissions from the boilers, dryers, and generators would not contribute significantly to concentrations for the same wind conditions as would the incinerator. Therefore, for these 14 receptors, only the incinerator was considered.

Several receptors received contributions from one or more existing sources at the same time as from the incinerator. For Receptor 6 to the east of the energy centre, the combined impacts from the incinerator and the energy centre were considered. For Receptors 14 and 15 to the northwest of the incinerator, the effects of the large and the small dryers, respectively, were considered with the incinerator emissions.

8.2.3 Results

The results of the on-site assessment for exhaust re-entrainment are provided in Tables 8 through 11. Table 8 shows the maximum concentrations from emissions from the incinerator. Tables 9 to 11 show the combined effects of the incinerator and existing sources at three on-site receptors where combined effects were significant.

Predicted concentrations for all of the contaminants were found to be less than their respective criteria at all on-site receptors with a stack height of 4.1 meters above the rooftop of the MRI building. The 4.1 m stack height (above adjacent roof top) is recommended for the incinerator to meet the air quality criteria at nearby air intakes.

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Table 8: Results of Dispersion Modelling Assessment at On-Site Location of Maximum Modelled Concentration

Modelled Modelled Modelled Modelled Modelled Manitoba Manitoba Manitoba Manitoba Manitoba Manitoba

Contaminant 1-hour 8-hour 24-hour 30-Day Annual 1-Hour 8-Hour 24-Hour 30-Day 70-Day Annual Concentration Concentration Concentration Concentration Concentration Criteria Criteria Criteria [1] Criteria Criteria Criteria

PM (assumed to be all PM2.5) -- -- 14.1 µg/m³ ------30 µg/m³ ------Pb + Mn + Cr + Cu + As + Ni ------No Value No Value No Value No Value No Value No Value Pb -- -- 0.245 µg/m³ 0.060 µg/m³ ------2 µg/m³ 1 µg/m³ -- -- Mn -- -- 0.245 µg/m³ ------0.4 µg/m³ ------Cr 0.597 µg/m³ ------4.5 µg/m³ ------Cu -- -- 0.245 µg/m³ ------50 µg/m³ ------As -- -- 0.245 µg/m³ ------0.3 µg/m³ ------Ni -- -- 0.245 µg/m³ ------2 µg/m³ ------Cd -- -- 4.90E-04 µg/m³ ------2 µg/m³ ------Hg -- -- 1.47E-03 µg/m³ ------2 µg/m³ ------Dioxin/Furan -- -- 1.32E-08 µg/m³ ------1.00E-07 µg/m³ ------SO2 44.1 µg/m³ -- 18.13 µg/m³ -- 3.52 µg/m³ 900 µg/m³ -- 300 µg/m³ -- -- 60 µg/m³ NOX 199.2 µg/m³ -- 81.83 µg/m³ -- 15.9 µg/m³ 400 µg/m³ -- 200 µg/m³ -- -- 100 µg/m³ CO 9.5 µg/m³ 5.3 µg/m³ ------35000 µg/m³ 15000 µg/m³ ------HCl 19.1 µg/m³ -- 7.84 µg/m³ -- -- 100 µg/m³ ------HF -- -- 0.539 µg/m³ 0.132 µg/m³ ------0.85 µg/m³ 0.35 µg/m³ 0.20 µg/m³ -- Organic Compounds -- -- 4.410 µg/m³ -- 0.856 µg/m³ No Value No Value No Value No Value No Value No Value Incinerator Unit Emission Rate [2] 6264 µg/m³ 3499 µg/m³ 2573 µg/m³ 632 µg/m³ 499 µg/m³ ------

Notes: [1] 24-hour criteria for manganese, mercury and dioxins/furans are taken from the Ontario's Ambient Air Quality Criteria. [2] Concentration reflects a unit emission rate of 1 g/s from the incinerator stack, with no emissions from other sources. This value can be expressed as µgm³ per g/s, and is used to scale the concentrations of contaminants emitted from the incinerator alone.

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Table 9: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 6

Modelled Modelled Modelled Manitoba Manitoba Manitoba Contaminant Emission Rate 1-hour 8-hour 24-hour 1-Hour 8-Hour 24-Hour Concentration Concentration Concentration Criteria Criteria Criteria [1] Incinerator PM (assumed to be all PM2.5) 0.0055 g/s -- -- 2.0 µg/m³ -- -- 30 µg/m³ SO2 0.0070 g/s 6.4 µg/m³ -- 2.62 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.0318 g/s 28.8 µg/m³ -- 11.81 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.0015 g/s 1.4 µg/m³ 0.8 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Incinerator Unit Emission Rate [1] 904 µg/m³ per g/s 505 µg/m³ 371 µg/m³

Boiler850 (CB-200-700-150) PM (assumed to be all PM2.5) 0.0275 g/s -- -- 1.1 µg/m³ -- -- 30 µg/m³ SO2 0.0000 g/s 0.00000 µg/m³ -- 0.0 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.3618 g/s 35.87039 µg/m³ -- 14.7 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.3039 g/s 30.13113 µg/m³ 16.8 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Boiler 850 Unit Emission Rate [1] 99 µg/m³ per g/s 55 µg/m³ 41 µg/m³

Boiler600 (WT-200-CN2) PM (assumed to be all PM2.5) 0.0419 g/s -- -- 1.2 µg/m³ -- -- 30 µg/m³ SO2 0.0000 g/s 0.00000 µg/m³ -- 0.0 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.5518 g/s 39.85616 µg/m³ -- 16.4 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.4635 g/s 33.47918 µg/m³ 18.7 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Boiler 600 Unit Emission Rate [1] 72 µg/m³ per g/s 40 µg/m³ 30 µg/m³

Boiler900 (WT-200-CN3) PM (assumed to be all PM2.5) 0.0491 g/s -- -- 1.5 µg/m³ -- -- 30 µg/m³ SO2 0.0000 g/s 0.00000 µg/m³ -- 0.0 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.6459 g/s 46.65539 µg/m³ -- 19.2 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.5426 g/s 39.19053 µg/m³ 21.9 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Boiler 900 Unit Emission Rate [1] 77 µg/m³ per g/s 43 µg/m³ 32 µg/m³

Combined PM (assumed to be all PM2.5) -- -- 5.8 µg/m³ -- -- 30 µg/m³ SO2 6.4 µg/m³ -- 2.6 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 151.1 µg/m³ -- 62.1 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 104.2 µg/m³ 58.2 µg/m³ -- 35000 µg/m³ 15000 µg/m³ --

Notes: [1] Concentration reflects a unit emission rate of 1 g/s from each stack individually.

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Table 10: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 14

Modelled Modelled Modelled Manitoba Manitoba Manitoba Contaminant Emission Rate 1-hour 8-hour 24-hour 1-Hour 8-Hour 24-Hour Concentration Concentration Concentration Criteria Criteria Criteria [1] Incinerator at Receptor 14 PM (assumed to be all PM2.5) 0.0055 g/s -- -- 2.1 µg/m³ -- -- 30 µg/m³ SO2 0.0070 g/s 6.6 µg/m³ -- 2.70 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.0318 g/s 29.6 µg/m³ -- 12.17 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.0015 g/s 1.4 µg/m³ 0.8 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Incinerator Unit Emission Rate [1] 932 µg/m³ per g/s 521 µg/m³ 383 µg/m³

Large Dryers (2) at Receptor 14 PM (assumed to be all PM2.5) 0.0052 g/s -- -- 1.3 µg/m³ -- -- 30 µg/m³ SO2 0.0000 g/s 0.00000 µg/m³ -- 0.0 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.0679 g/s 42.0 µg/m³ -- 17.2 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.0571 g/s 35.3 µg/m³ 19.7 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Large Dryers Unit Emission Rate [1] 618 µg/m³ per g/s 345 µg/m³ 254 µg/m³

Combined at Receptor 14 PM (assumed to be all PM2.5) -- -- 3.4 µg/m³ -- -- 30 µg/m³ SO2 6.6 µg/m³ -- 2.7 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 71.6 µg/m³ -- 29.4 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 36.7 µg/m³ 20.5 µg/m³ -- 35000 µg/m³ 15000 µg/m³ --

Notes: [1] Concentration reflects a unit emission rate of 1 g/s from each stack individually.

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Table 11: Results of Dispersion Modelling Assessment at On-Site Locations with Existing Sources, Receptor 15

Modelled Modelled Modelled Manitoba Manitoba Manitoba

Contaminant Emission Rate 1-hour 8-hour 24-hour 1-Hour 8-Hour 24-Hour Concentration Concentration Concentration Criteria Criteria Criteria [1] Incinerator at Receptor 15 PM (assumed to be all PM2.5) 0.0055 g/s -- -- 2.1 µg/m³ -- -- 30 µg/m³ SO2 0.0070 g/s 6.6 µg/m³ -- 2.70 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.0318 g/s 29.6 µg/m³ -- 12.17 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.0015 g/s 1.4 µg/m³ 0.8 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Incinerator Unit Emission Rate [1] 932 µg/m³ per g/s 521 µg/m³ 383 µg/m³

Small Dryers (2) at Receptor 15 PM (assumed to be all PM2.5) 0.0013 g/s -- -- 4.4 µg/m³ -- -- 30 µg/m³ SO2 0.0000 g/s 0.00000 µg/m³ -- 0.0 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 0.0170 g/s 141.6 µg/m³ -- 58.1 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 0.0143 g/s 118.9 µg/m³ 66.4 µg/m³ -- 35000 µg/m³ 15000 µg/m³ -- Small Dryers Unit Emission Rate [1] 8311 µg/m³ per g/s 4643 µg/m³ 3413 µg/m³

Combined at Receptor 15 PM (assumed to be all PM2.5) -- -- 6.5 µg/m³ -- -- 30 µg/m³ SO2 6.6 µg/m³ -- 2.7 µg/m³ 900 µg/m³ -- 300 µg/m³ NOX 171.2 µg/m³ -- 70.3 µg/m³ 400 µg/m³ -- 200 µg/m³ CO 120.3 µg/m³ 67.2 µg/m³ -- 35000 µg/m³ 15000 µg/m³ --

Notes: [1] Concentration reflects a unit emission rate of 1 g/s from each stack individually.

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8.3 Socio-Economic Impacts

8.3.1 Health Risk Assessment

Intrinsik Environmental Services Inc. (Intrinsik) has conducted a screening-level human health risk assessment to assess the potential human implications associated with air emissions from the proposed biomedical waste treatment incinerator and the existing hospital sources. The findings of their assessment are detailed in their report as contained in Appendix H.

8.3.2 Increase in Truck Traffic

During the processing period (Monday to Friday), it is expected that waste delivery trucks will number between 2 to 4, depending on the routes and amount of waste collected from the other RHA facilities. These trucks will typically arrive at the beginning or end of the day, using the Van Horne Ave route heading west from 17th St E. The truck will be large cube vans and will have minimal effect on regular traffic on Van Horne. There will also be truck flow from the residues (compactor or ash waste) which will occur approximately 2 to 3 times per day.

8.3.3 Waste Materials Requiring Disposal

As noted earlier, all waste derived from operations will be held within the facility until off-loaded to licensed vehicles. As the residue materials are considered regular waste, no issues are expected from these wastes.

9. NET EFFECTS MANAGEMENT, MONITORING AND FOLLOW-UP PLANS

9.1 Noise

Excessive noise emissions are not expected from the regular operation of the proposed waste treatment facility. Procedures will be put in place to appropriately document and address any noise complaints received. Should a number of complaints be received, follow up procedures will be completed which would include noise measurements and propagation modelling; followed by appropriate mitigation controls should they be required.

9.2 Air Quality

9.2.1 Odour and Dust

Excessive odour and dust emissions are not expected from the regular operation of the proposed waste treatment facility. Procedures will be put in place to appropriately document and address any odour and dust complaints received. Should a number of complaints be received, follow up procedures will be completed which would include detailed odour and dust quantitative assessments and modelling.

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9.2.2 Stack Testing

Brandon Hospital will undertake a full set of stack tests after the first three months of full operation and then annually until Manitoba Conservation and Water Stewardship determines that the data demonstrates adequate compliance with criteria and that the frequency of stack testing can be reduced. The initial test parameters will be determined in conjunction with advice from Manitoba Conservation and Water Stewardship. The results of the stack tests will be sent to Manitoba Conservation and Water Stewardship and be made public.

9.2.3 Continuous Emissions Monitoring

A Continuous Emissions Monitoring (CEM) Program will be implemented and installed in the incinerator

stack to measure O2, CO, CO2, NOX, opacity and temperature. Data generated from the CEM will be stored for a period of five years and will be made available to Manitoba Conservation. Thereafter; the information from the CEM will be archived. Exceedences of determined thresholds set out by Manitoba Conservation will be reported by the Brandon operations to Manitoba Conservation. During commissioning, the CEM unit will be RATA (Relative Accuracy Test Audit), tested to ensure the efficacy of the unit.

10. MALFUNCTIONS OR ACCIDENTS AND CONTINGENCY PLANS

10.1 Spills and Emergency Response Plans

As per Section 5 and Appendix F, Brandon Hospital has developed full spill action and emergency plans for the hospital campus. All personnel involved with the biomedical waste operation will be fully trained with the hospital plans. The Brandon Fire department will be invited to inspect the facility on an annual basis and offer further suggestions to improve safety, and allow the fire department to fully understand the operations.

11. CONSULTATIONS

11.1 City of Brandon

Discussions between City of Brandon (City) staff, RWDI and Prairie Mountain Health have been held with regards to zoning of the proposed treatment facility, disposal of the autoclaved and incinerator waste; as well as expansion of the Transportation of Dangerous Goods routes through the City.

As a result of these discussions, Prairie Mountain Health requested Zoning Confirmation from the City for the proposed incinerator location. As outlined in Section 4.1.7 the Zoning Confirmation Letter from the City received in response to the request is contained in Appendix D.

The proper disposal of the autoclaved and incinerator waste was discussed with City staff. The City landfill has the capacity to handle the waste and agreements will be formed to establish the frequency of pick up/disposal.

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Formal approval from the City will be required regarding additional routing above the current Transportation of Dangerous Goods routes through the City for the incoming biomedical waste being received at the proposed treatment facility.

11.2 Manitoba Conservation and Water Stewardship

Throughout the EA process and development of the EA report, RWDI has engaged in communication with Mr. Randy Webber, Environment Officer, Manager, Pesticides and Hazardous Waste Section of Manitoba Conservation and Water Stewardship’s Environmental Approvals Branch. Discussions were held in regards to the strategy for completion of the EA submission and the contents of the EA. It was determined through these discussions, as previously described in Section 3.1 that the proposed project will be licensed as a Hazardous Waste Disposal Facility pursuant to the Dangerous Goods Handling and Transportation Act (DGHTA), that the application would follow the EA process described under the Environment Act and that the incinerator is subject to the requirements outlined in the Manitoba Incinerator Regulation. Further it was determined that a scoped project EA process could be followed as previously described in Section 3.2. After receipt of initial comments from Manitoba Conservation and Water Stewardship, additional items requiring further evaluation were included in this EA report.

It was suggested to Manitoba Conservation and Water Stewardship, Environmental Approvals Branch that for the EA application, the air quality study would not include specific manufacturer specifications for the proposed incinerator as these details are not available. The intent throughout this process has been to use general, high performance incinerator data provided and to look at the point of impingement concentrations at sensitive receptors surrounding the facility. The outcome of the assessment would be that the stack height and other performance specifications would be provided to the chosen supplier and it would be required that they follow the specifications outlined in this application. Further, the operating license will reference/incorporate this EA document and any operating parameters outlined herein.

11.3 Public

As noted in Section 3.2.6 public meetings were held to appraise both neighbours and the general population of Brandon of the impending project. Posters used for the open houses are shown in Appendix C.

12. CONCLUSIONS

Based on the use of proven technologies, the processing of biomedical waste in Brandon will ensure that the treatment of biomedical waste within Manitoba (waste generated outside Winnipeg) is done effectively and safely. The proposed standards will also ensure that the province of Manitoba is maintaining strict and up to date criteria for the processing of biomedical waste.

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13. REFERENCES

Bell, J.J. (2011). Hydrogeology of the Brandon Channel Aquifer as Related to Water Supply – Brandon, Manitoba. GeoHydro 2011. Canadian Healthcare Association (2011). 2011 Guide to Canadian Healthcare Facilities, Volume 18, 152- 170. Canadian Council of Ministers of the Environment (CCME) 1992, Guidelines for the Management of Biomedical Waste in Canada City of Brandon (2013). Zoning Maps. Retrieved 2013 from http://brandon.ca/by-laws/zoning-maps Brandon Regional Hospital (2013). About Us. Retrieved 2013 from http://brandonhospital.com/about/index.dot Brandon RHA (2012). Health Centre Care. Retrieved 2013 from http://www.brandonrha.mb.ca/en/Health_Centre_Care/ Brandon RHA (2012). About Us. Retrieved 2013 from http://www.brandonrha.mb.ca/en/about/ Manitoba Conservation (2009). Conservation and Water Stewardship, Publications and Forms. Retrieved 2013 from http://www.gov.mb.ca/conservation/eal/publs/eal_flowchart.pdf Doupe M., Fransoo R., Chateau D., Dik N., Burchill C., Soodeen R., Bozat-Emre S., Guenette W. (2011). Population Aging and the Continuum of Older Adult Care in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy. Finlayson G.S., Stewart D.K., Tate R.B., MacWilliam L.R., Roos N. (2005). Anticipating Change: How Many Acute Care Hospital Beds Will Manitoba Regions Need in 2020? Canadian Journal on Aging, Volume 24, 133-140. KGS Group. (2007). Foundation Investigation and Design - New Radiation Treatment Centre - Brandon, Manitoba. File No. 07-1505-01. Manitoba Water Stewardship Division (2010). Central Assiniboine and Lower Souris River Integrated Watershed Management Plan – Groundwater. Retrieved 2013 from http://www.gov.mb.ca/waterstewardship/iwmp/central_assiniboine/documentation/groundwater_central_a ssiniboine.pdf Manitoba Bureau of Statistics (2011). Latest Population Estimates: January 2011. Retrieved 2011 from http://www.gov.mb.ca/mbs/ MMM Group Limited (2013). Brandon & Area Planning District Development Plan 2013. March 2013 I 5510061.101. Statistics Canada (2013). Census Profile – Brandon. Retrieved 2013 from http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/details/page.cfm?Lang=E& World Health Organization, Pruess A., Giroult E., Rushbrook P. (1999). Safe Management of Wastes from Health-Care Activities. Retrieved July 2011 from http://www.healthcarewaste.org/en/documents.html?id=1