Medical Waste Regulations in North Dakota (2026)

Generator registration, storage limits, approved treatment, transport rules, and penalties under North Dakota Department of Environmental Quality, Division of Waste Management, with the primary statute behind every line.

Last verified against primary sources.
Changelog
  • Initial publication. Confirmed against NDAC 33.1-20-12 (ndlegis.gov rule text), NDCC chapter 23.1-08 (ndlegis.gov), and the ND DEQ Guide to Understanding North Dakota's Infectious Waste Regulations.

North Dakota medical waste rules at a glance

Regulated medical waste rules in North Dakota, at a glance
Governing agencyNorth Dakota Department of Environmental Quality, Division of Waste Management
Primary statute / rule
Generator registrationNorth Dakota does not require generators of regulated infectious waste to obtain a registration or permit; permits are required only of persons who treat or transport regulated infectious waste or who operate a regulated infectious waste management unit or facility, per NDAC 33.1-20-12-02(12). A generator who transports its own infectious waste to a treatment facility does not need a waste transporter permit but must meet U.S. DOT requirements. [source]
On-site storage time limitThere is no maximum time limit on how long a generator may store regulated infectious waste; the waste must be kept in a nonputrescent state, using refrigeration when necessary, and stored in enclosed, rodentproof, cleanable areas per NDAC 33.1-20-12-02(4). [source]
Approved treatment methods
  • Incineration (meeting air rules in NDAC article 33.1-15)
  • Steam sterilization (autoclaving)
  • Thermal treatment such as microwave technologies
  • Chemical or mechanical disinfection systems
  • EPA-registered tuberculocidal disinfectants for surfaces and reusable containers
[source]
Transport / manifest rulesCommercial transport vehicles must be fully leakproof and fully enclosed or covered, with no mechanical stress or compaction of the waste, and all off-site shipments must meet federal and state DOT packaging and labeling requirements. Generators must keep records (manifests, invoices, logs, or facility receipts) of the amount of regulated infectious waste sent off site for treatment for at least three years per NDAC 33.1-20-12-03(1). [source]
On-site treatment allowed?Yes. NDAC 33.1-20-12-02(7) requires all regulated infectious waste to be incinerated or disinfected before disposal, and on-site treatment is expressly contemplated (for example, sharps may be disinfected and rendered nonsharp on site under 33.1-20-12-02(2)(a)). Any person operating a regulated infectious waste treatment unit or facility must hold a valid department permit per 33.1-20-12-02(12). [source]
Penalty rangeUnder NDCC 23.1-08-23, a civil penalty of up to $12,500 per day per violation; a willful violation is a class C felony, as is willfully falsifying any required record or report. Knowingly depositing untreated infectious waste in a landfill is prohibited under NDCC 23.1-08-08. [source]

What is unique about North Dakota

North Dakota sets no maximum storage clock for generators (waste may be held indefinitely if kept nonputrescent and refrigerated when needed) and imposes no generator registration or permit, reserving permits for those who treat, transport, or run a treatment facility per NDAC 33.1-20-12-02(12). The rule also lets liquid blood and blood products go down a municipal sewer meeting NDAC article 33.1-16 without incineration or disinfection per 33.1-20-12-02(8).

Frequently asked questions

Does a North Dakota medical or dental practice need a permit to generate infectious waste?

No. NDAC 33.1-20-12-02(12) requires a department permit only of those who treat or transport regulated infectious waste or operate a treatment unit or facility, not of ordinary generators.

How long can a generator store regulated infectious waste in North Dakota?

There is no maximum time limit. The ND DEQ guide states waste may be stored as long as it is kept nonputrescent, using refrigeration when necessary, in enclosed and rodentproof areas under NDAC 33.1-20-12-02(4).

What treatment methods are allowed before disposal?

All regulated infectious waste must be incinerated or disinfected, and sharps not incinerated must be rendered nonsharp, per NDAC 33.1-20-12-02(7). Accepted disinfection methods include autoclave steam sterilization, microwave thermal treatment, and chemical or mechanical systems.

What are the penalties for violating North Dakota's infectious waste rules?

Under NDCC 23.1-08-23, a civil penalty of up to $12,500 per day per violation applies, and a willful violation is a class C felony. Knowingly placing untreated infectious waste in a landfill is separately prohibited by NDCC 23.1-08-08.

How must infectious waste be packaged and transported in North Dakota?

Under NDAC 33.1-20-12, infectious waste must be segregated and contained, with sharps in rigid, puncture-resistant containers and other waste in leakproof, properly labeled packaging. Commercial transport vehicles must be fully leakproof and fully enclosed or covered, with no mechanical stress or compaction of the waste, and all off-site shipments must meet federal and state DOT packaging and labeling requirements. Generators must keep records of the amount of regulated infectious waste sent off site for treatment, such as manifests, invoices, logs, or facility receipts, for at least three years (NDAC 33.1-20-12-03(1)). Liquid blood and blood products may be discharged to a municipal sewer meeting NDAC article 33.1-16 without prior incineration or disinfection.

Can treated infectious waste go to a regular North Dakota landfill?

Yes. All regulated infectious waste must be incinerated or disinfected before disposal (NDAC 33.1-20-12-02(7)), and sharps that are not incinerated must be rendered nonsharp. Once treated, the waste may be landfilled as solid waste, but knowingly depositing untreated infectious waste in a landfill is prohibited under NDCC 23.1-08-08 and is subject to the civil and criminal penalties of NDCC 23.1-08-23.