Waste Management Licensing (Scotland) Regulations 2011 ("the Regulations") Paragraph 19 Form to register or renew an exemption




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WMX-FM19 v4


Waste Management Licensing (Scotland) Regulations 2011

("the Regulations")

Paragraph 19 - Form to register or renew an exemption

(Waste for construction and other ‘relevant works’)

PLEASE RETURN THIS FORM TO YOUR NEAREST SEPA OFFICE (see list at end of form)
Please read the accompanying guidance note WMX-TG19 as it gives technical advice relating to paragraph 19 exemptions as well as SEPA’s policy on certain topics. Please refer to the legislation for details of the exemption and your obligations. Other forms to give notice of separate exemptions under different paragraphs may be obtained from our website www.sepa.org.uk or from any SEPA office.

This notice must be received by SEPA at least 21 days before the activity is due to begin. A separate form must be filled out for each activity. SEPA will either:



  1. enter the particulars of the exempt activity on the register and confirm this in writing to you before the expiry of the 21 day period; OR

  2. serve on you a notice of refusal stating that registration is refused and giving reasons for that decision before the expiry of the 21 day period.



The Data Protection Act 1998

“The Scottish Environment Protection Agency is responsible for maintaining and improving the environment and regulating environmental emissions. It has a duty to discharge its functions to protect and enhance the environment and to promote conservation and recreation.

The information provided will be processed by the Scottish Environment Protection Agency to deal with your registration, to monitor compliance with the legislation, to process renewals, and for maintaining the relevant public register(s).

We may also process and/or disclose it in connection with the following:



  • offering/providing you with our literature/services relating to environmental affairs

  • consulting with the public, public bodies and other organisations (eg Health and Safety Executive, Local Authorities, Emergency Services, Scottish Executive) on environmental issues

  • carrying out statistical analysis, research and development on environmental issues

  • providing public register information to enquirers

  • investigating possible breaches of environmental law and taking any resulting action

  • preventing breaches of environmental law

  • assessing customer service satisfaction and improving our service.

We may pass it on to our agents/representatives to do these things on our behalf.


You should ensure that any persons named on this form are informed of the contents of this Data Protection Notice




For Office Use Only

Reference No.




Operations Team:




First Notice:

Yes/No

Previous Reference No.




Date Received:




Date of Expiry:




Date Entered onto Register:




Entered within 21 days:

Yes/No




1. Contact Details of the Establishment or Undertaking i.e. the sole trader, company, partnership, authority, society, trust, club, charity or other organisation that will carry on the exempt activity (Print All)

Name & Designation




Organisation




Address





Registered Office Address




Postcode




E-mail




Tel No.




Fax No.







2. What are you attempting to register?

(i) Tick all that apply

Paragraph 19(1) for the storage of waste to be used for relevant works




Paragraph 19(2) for the use of waste for the purposes of relevant works




(ii) Tick one only

If you are renewing a registration complete the relevant section of this form where minor changes exist. Where major changes exist, it should be registered as a new activity.




a) You wish to register the exempt activity for the first time.




b) You wish to renew a registration for a currently registered activity.




c) You wish to register an activity that was previously registered but isn’t currently registered.




If b) give exemption reference number (e.g. WMX/E/12345 or WML/XC/12345); if c) give exemption reference number and state reason why it isn’t currently registered.



3. The location of the exempt activity

(i) Address of location of activity





(ii) Give an 8 figure grid reference of a key point of the treatment area, e.g. NS 7808 9469




(iii) Is the activity within a designated area (eg SSSI, NVZ etc)? If yes state designation(s)







4. The Relevant Activity

(i) What is the Relevant Activity?

(Tick one only)




The construction, maintenance or improvement of a building, road, railway, airport, dock or other transport activity




The construction, maintenance or improvement of recreational facilities




The construction, maintenance or improvement of drainage




Engineering works relating to or adjacent to any part of the water environment. (does not include work involving land reclamation)




(ii)If waste tyres are to be used will they be baled to BSI PAS 108?

Y/N

(iii) Will the activity involve land reclamation?

Y/N

(iv) Intended start date of activity




(v) Intended completion date of activity




(vi) Give the area of the activity in square metres

m2

(vii) Give the total quantity of waste to be used (tonnes of wet weight)

Tonnes

(viii) If shells from fish processing are to be used will they be used in accordance with the Animal By-Products (Enforcement) (Scotland) Regulations 2011 (And hence Regulation (EC) No 1069/2009 and (EC) No. 142/2011 of the European Parliament and Council

Y/N

(ix) Describe the activity you wish to carry out in your own words.







5. Description of the waste involved in the exempt activity

(i) In the table below identify which waste streams you intend to use and stipulate the quantity to be use for the proposed activity. Note, the EWC Codes listed are the only wastes which can be used in this registration.

EWC Code

Description of Waste

Proposed Quantity (Tonnes) to be used for land treatment

01 04 08

Waste gravel and crushed rocks from physical and chemical processing of minerals




01 04 09

Waste sand and clays from physical and chemical processing of non-metalliferous minerals




02 01 99

Clean shells




02 04 01

Soil from cleaning and washing beet from sugar processing




10 01 02

Pulverised fuel ash from power stations and other combustion plant




10 01 99

Gypsum from power stations and other combustion plant




10 02 02

Unprocessed slag from the iron and steel industry




10 09 03

Furnace slag from the casting of ferrous pieces




10 10 03

Furnace slag from the casting of non ferrous pieces




10 12 08

Waste ceramics, bricks, tiles and construction products




10 13 14

Waste concrete and concrete sludge




16 01 03

Waste tyre bales




17 01 01

Concrete




17 01 02

Bricks




17 01 03

Tiles & Ceramics




17 01 07

Mixtures of concrete, bricks, tiles and ceramics




17 03 02

Road base and road planings




17 05 04

Soil and stones




17 05 06

Dredging spoil




17 05 08

Track ballast




19 01 12

Bottom ash and slag




19 05 03

Off-specification compost




19 06 04

Digestate consisting only of biodegradable waste




19 06 06

Digestate from anaerobic treatment of animal and vegetable waste




19 12 09

Minerals from the mechanical treatment of waste eg sand, stones




19 13 02

Solid waste from soil remediation




20 02 02

Soil and stones from garden and park wastes




Total

Tonnes



(ii) Describe the process from which the waste has arisen




(iii) Has the waste been mixed with any other wastes? If yes give the name of the waste(s)

Y/N


Waste:

(iv) Please identify any potential risks to the environment associated with the inherent hazards of the waste and any preventative measures that will be put in place to protect the environment.

(Additional sheets may be appended if required.)









6. Description of any waste storage pending the exempt activity

Note: storage includes anywhere deposited greater than 12 hours prior to use

(i) Do you intend to store the waste?

Y/N

(ii) Is the storage location the same as the area where the relevant work will take place?

Y/N

(iii) Intended start date of storage




(iv) Intended completion date of storage




(v) Give an 8 figure grid reference of the treatment area, e.g. NS 7808 9469




(vi) Give the total quantity of waste to be stored (tonnes of wet weight)

Tonnes

(vii) State the method and type of storage (give capacity)

Tonnes

(viii) Is the storage secure?


Y/N

(ix) Describe what reasonable precautions will be taken to ensure that the waste cannot escape from storage and members of the public are unable to gain access to it?






7. Land Ownership Details

(i) Tick each correct statement in the list below

You are the owner or have control of the land where the activity is to be carried on




If you are not the owner or have control of the land please state the name and address of the owner of the land in the space below




The activity will be carried out with the consent of the owner of the land




If the activity will be carried out without the consent of the owner of the land please state why you are entitled to carryout the activity and detail any consents necessary for you to carry out the activity.







8. This notice shall be accompanied by the following documents

Please tick all boxes where the relevant documents have been included.



For Initial registration - the following additional documents are required

(a) A plan of each place at which the exempt activity will be carried on showing the boundary of that place and the locations within that place at which the exempt activity is to be carried on and where storage will take place. Where more than 2500 cubic metres of waste is used a cross-sectional plan showing the proposed levels must be provided




(b) Where waste type 02 01 99 (clean shells from agriculture, horticulture, aquaculture, forestry, hunting and fishing) is used evidence must be appended confirming that the waste is treated in accordance with the Animal By-Products (Enforcement) (Scotland) Regulations 2011 (And hence Regulation (EC) No 1069/2009 and (EC) No. 142/2011 of the European Parliament and Council).




(c) The prescribed charge (cheques made payable to “Scottish Environment Protection Agency”) The current charges can be obtained on the SEPA website www.sepa.org.uk at http://www.sepa.org.uk/charging/fees_charges/index.htm or from your local SEPA office.




For registration renewal - the following additional documents are required

(a) The prescribed charge (cheques made payable to “Scottish Environment Protection Agency”) The current charges can be obtained on the SEPA website www.sepa.org.uk at http://www.sepa.org.uk/charging/fees_charges/index.htm or from your local SEPA office.







8. Declaration

Important Please Note: It is an offence for a person to make a statement which he/she knows to be false or misleading in a material particular, or to recklessly make a statement which is false or misleading in a material particular.

Declaration of Notice / Renewal of Notice

(The declaration must be signed by applicants or their agents)

I/we certify that, to the best of my/our knowledge, the information provided in this form and any associated documents are correct.

Signature




Date




Name

(PRINTED)






Company Name




Please return this form to your nearest SEPA Office:

Aberdeen Office
Inverdee House
Baxter Street, Torry
ABERDEEN, AB11 9QA
Tel: 01224 266600
Fax: 01224 896657

Angus Smith Building

6 Parklands Avenue

Eurocentral

Holytown,

North Lanarkshire

ML1 4WQ 


Tel: 01698 839000
Fax: 01698 738155

Arbroath Office
62 High Street
ARBROATH
DD11 1AW
Tel: 01241 874370
Fax: 01241 430695

Ayr Office
31 Miller Road
AYR
KA7 2AX
Tel: 01292 294000
Fax: 01292 611130

Balloch Office
Carrochan
Carrochan Road
Balloch
G83 8EG
Tel: 01389 727770
Fax: 01389 755387

Dingwall Office
Graesser House
Fodderty Way
Dingwall Business Park
DINGWALL, IV15 9XB
Tel: 01349 862021
Fax: 01349 863987

Dumfries Office
Rivers House
Irongray Road
DUMFRIES
DG2 0JE
Tel: 01387 720502
Fax: 01387 721154

Edinburgh Office
Clearwater House
Heriot Watt Research Park
Avenue North
Riccarton
EDINBURGH, EH14 4AP
Tel: 0131 449 7296
Fax: 0131 449 7277

Elgin Office
28 Perimeter Road
Pinefield
ELGIN
IV30 6AF
Tel: 01343 547663
Fax: 01343 540884

Fort William Office
Carr's Corner Industrial Estate
Lochybridge
FORT WILLIAM
PH33 6TL
Tel: 01397 704426
Fax: 01397 705404

Fraserburgh Office
Shaw House
Mid Street
FRASERBURGH
AB43 9JN
Tel: 01346 510502
Fax: 01346 515444

Galashiels Office
Burnbrae
Mossilee Road
GALASHIELS
TD1 1NF
Tel: 01896 754797
Fax: 01896 754412

Glasgow Office
Law House
Todd Campus
West of Scotland Science Park
Maryhill Road
GLASGOW, G20 0XA
Tel: 0141 945 6350
Fax: 0141 948 0006

Glenrothes Office
Pentland Court
The Saltire Centre
GLENROTHES, KY6 2DA
Tel: 01592 776910
Fax: 01592 775923

Lochgilphead Office
2 Smithy Lane
LOCHGILPHEAD
PA31 8TA
Tel: 01546 602876
Fax: 01546 602337

Newton Stewart Office
Penkiln Bridge Court
Minnigaff
NEWTON STEWART
DG8 6AA
Tel: 01671 402618
Fax: 01671 404121

Orkney Office
Norlantic House
Scotts Road
Hatston
Kirkwall, ORKNEY
KW15 1RE
Tel: 01856 871080
Fax: 01856 871090

Perth Office
Strathearn House
Broxden Business Park
Lamberkine Drive
PERTH
PH1 1RX
Tel: 01738 627989
Fax: 01738 630997

Shetland Office
The Esplanade
LERWICK
Shetland
ZE1 0LL
Tel: 01595 696926
Fax: 01595 696946

Stirling Office
Bremner House
The Castle Business Park
STIRLING
FK9 4TF
Tel: 01786 452595
Fax: 01786 461425

Thurso Office
Strathbeg House

Clarence Street



THURSO

Caithness



KW14 7JS
Tel: 01847 894422
Fax: 01847 893365


Western Isles Office
2 James Square
James Street
STORNOWAY
Isle of Lewis
HS1 2QN
Tel: 01851 706477
Fax: 01851 703510










SEPA Form | WMX-FM19 | version 8 | issued January 2014

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