ࡱ>  _AbjbjVV qt<<73 = III$mmmP,mze"e"e"zzzzzzzp}*z-Ix#!e"x#x#zII Lz(%(%(%x#IIz(%x#z(%(%Yty텳Wmr$vH zbz0z9w<r$<y<Iy$e"0""(%""e"e"e"zz$.e"e"e"zx#x#x#x#<e"e"e"e"e"e"e"e"e" :  Part B Application form Application for a permit for respraying of road vehicles covered by process guidance note PG6/34b(06) Local Authority Pollution Prevention and Control Pollution Prevention and Control Act, 1999 Environmental Permitting (England and Wales) Regulations 2007 Introduction When to use this form Use this form if you are applying for a permit to a Local Authority to operate a vehicle refinishing installation as defined in Section 7 of Schedule 1 to the Environmental Permitting Regulations and covered by PG6/34(06). The appropriate fee must be enclosed with the application to enable it to be processed further. When complete, send the form and the fee and any additional information to: Environmental Protection Team, Regulatory Services, Level 3, Town Hall, Westoe Road, South Shields, Tyne & Wear, NE33 2RL, Contact Tel No: 0191 4247904 If you need help and advice We have made the application form as straightforward as possible, but please get in touch with us at the local authority address given above if you need any advice on how to set out the information we need. LAPPC application form: to be completed by the operator For Local Authority use Application reference  Officer reference Date received  A1.1. Name of the premises . A1.2. Please give the address of the premises . . . Postcode ............................................Telephone.......................................................... A1.3. Do you have an existing permit for a dry cleaning installation? .................................... A2.1. The Applicant - Please provide the full name of company or corporate body or the name of the sole trader or the names of the partners Trading/business name (if different) Registered Office address Postcode ............................................Telephone....................................................... A2.2. Holding Companies Is the operator a subsidiary of a holding company within the meaning of Section 736 of the Companies Act 1985? No? Yes? Name of ultimate holding company .................................................................. Ultimate holding company registered office address .. .. .. Postcode ............................................Telephone....................................................... A3 Who can we contact about your application? It will help to have someone who we can contact directly with any questions about your application. The person you name should have the authority to act on behalf of the operator - This can be an agent or consultant. Name . Position . Address .. .. .. Postcode ............................................Telephone....................................................... Fax number . email address .. B. About the installation Please provide written information about the aspects of your installation listed below. We need this information to determine whether you will operate the installation in a way in which all the environmental requirements of the Environmental Permitting Regulations are met. B1.1 Describe the proposed installation and activities and identify the foreseeable emissions to air from the process. Doc Reference: B1.2 Once all foreseeable emissions have been identified in the proposed installation activities, each emission should be characterised (including odour) and quantified. Atmospheric emissions should be categorised under the following: (i) point source (eg chimney/vent, identified by a number and detailed on a plan) (ii) fugitive source (eg from stockpiles/storage areas). If any monitoring has been undertaken please provide the details of emission concentrations and quantify in terms of mass emissions. If no monitoring has been undertaken please state this. Doc Reference: B1.3 For each emission identified from the installations activities, describe the current and proposed technology and other techniques for preventing or, where that is not practicable reducing the emissions. If no techniques are currently used and the emission goes directly to the environment, without abatement or treatment, this should be stated Doc Reference: B1.4 Describe the proposed systems to be used in the event of unintentional releases and their consequences. This must identify, assess and minimise the environmental risks and hazards, provide a risk based assessment of any likely unintentional releases, including the use of historical evidence. If no assessments have been carried out please state. Doc Reference: B1.5 Describe the proposed measures for monitoring all identified emissions including any environmental monitoring, and the frequency, measurement methodology and evaluation procedure proposed. (eg particulate matter emissions, odour etc). Include the details of any monitoring which has been carried out which has not been requested in any other part of this application. If no monitoring is proposed for an emission please state the reason. Doc Reference: B1.6 Provide detailed procedures and policies of your proposed environmental management techniques, in relation to the installation activities described. Doc Reference: B1.7 Attach a plan of the premises showing the location of: (a) the premises (b) spray booths (c) organic solvent-containing material storage (d) organic solvent-containing waste storage. Doc Reference: B1.8 Supply a description of the location and methods of storage of organic solvent- containing materials. Doc Reference: B1.9 Supply certification of spray booth performance Doc Reference: B1.10a Are VOC emitting stacks1 at least 3m above the roof ridge height of buildings within 15 m of the stack.  No (If no, complete B1.10b)  Yes. B1.10b Provide a written plan for the construction, operation and maintenance of stacks emitting VOCs. Doc Reference: & & & & & & & & & & & & B1.11 Provide details how the mass of VOC emitted and of paint solids used will be determined and recorded Doc Reference: & & & & & & & & & & & & B1.12 Provide a written plan for the maintenance, inspection and replacement of extract air filters of the spray booth and abrasive blasting equipment plant. Doc Reference: B1.14 Provide a written plan for measuring particulate emissions from abrasive blasting equipment, using manual extractive testing methods. Doc Reference: B1.15 Provide a written plan for control of VOC emissions from spray gun testing and sprayout following cleaning. Doc Reference: B1.16 Provide a written plan for the control of VOC emissions from spray gun and equipment cleaning. Doc Reference: B1.17 Provide a written plan for the control of VOC emissions from solvent contaminated wipes and other wastes Doc Reference: B1.18 State whether any structured environmental management system (such as ISO 14001, EMAS or BS8555) or a tailored system is being used or is planned, and if so what. Doc Reference: B1.19 Specify what training and instruction staff will be given to ensure that this permit (if granted) is complied with. Doc Reference: B2 Impact on the environment B2.1 Provide an assessment of the potential significant local environmental effects of the foreseeable emissions (for example, is there a history of complaints, is the installation in an air quality management area?) Doc Reference: B2.2 Are there any sites of Special Scientific Interest (SSSIs) or European Sites, which are within 500 metres of the installation?  No  Yes. Please give the names of the sites . . Doc Reference: B2.3 Provide an assessment of whether the installation is likely to have a significant effect on such sites and, if it is, provide an assessment of the implications of the installation for that site, for the purpose of the Conservation (Natural Habitats etc) Regulations 1994. Doc Reference: B3 Environmental Statements B3.1 Has an environmental impact assessment been carried out under The Town and Country Planning (Environmental Impact Assessment) (England And Wales) Regulations 1999, or for any other reason with respect to the installation?  No  Yes. Please supply a copy of the environmental impact assessment Doc Reference: B4 Additional Information Please supply any additional information, which you would like us to take account of in considering this application. Doc Reference: C1. Fees and Charges The enclosed charging scheme leaflet gives details of how to calculate the application fee. Your application cannot be processed unless the application fee is correct and enclosed. C1.1. Please state the amount enclosed as an application fee for this installation. ................................ Cheques should be made payable to: We will confirm receipt of this fee when we write to you acknowledging your application. C1.2. Please give any company purchase order number or other reference you wish to be used in relation to this fee. C2. Annual charges If we grant you a permit, you will be required to pay an annual subsistence charge. If you dont pay, your permit can be revoked and you will not be able to operate your installation. C2.1. Please provide details of the address you wish invoices to be sent to and details of someone we may contact about fees and charges. .. ..... .. Postcode............................................Telephone........................................................ C3. Commercial confidentiality C3.1. Is there any information in the application that you wish to justify being kept from the public register on the grounds of commercial or industrial confidentiality? If Yes, please provide full justification, considering the definition of commercial confidentiality within the PPC regulations (See the general guidance manual). C4. Data Protection The information you give will be used by the Local Authority to process your application. It will be placed on the relevant public register and used to monitor compliance with the permit conditions. We may also use and or disclose any of the information you give us in order to: consult with the public, public bodies and other organisations, carry out statistical analysis, research and development on environmental issues, provide public register information to enquirers, make sure you keep to the conditions of your permit and deal with any matters relating to your permit investigate possible breaches of environmental law and take any resulting action, prevent breaches of environmental law, offer you documents or services relating to environmental matters, respond to requests for information under the Freedom of Information Act 2000 and the Environmental Information Regulations 2004 (if the Data Protection Act allows) assess customer service satisfaction and improve our service. We may pass on the information to agents/ representatives who we ask to do any of these things on our behalf. It is an offence under regulation 38 of the EP Regulations, for the purpose of obtaining a permit (for yourself or anyone else) to: make a false statement which you know to be false or misleading in a material particular, recklessly make a statement which is false or misleading in a material particular. If you make a false statement we may prosecute you, and if you are convicted, you are liable to a fine or imprisonment (or both). C5 Declaration: previous offences (delete whichever is inapplicable) I/We certify EITHER No offences have been committed in the previous five years which are relevant to my/our competence to operate this installation in accordance with the EP Regulations. OR The following offences have been committed in the previous five years which may be relevant to my/our competence to operating this installation in accordance with the Regulations: Signature . Name Position. Date . 6 Declaration C6.1 Signature of current operator(s)* I/We certify that the information in this application is correct. I/We apply for a permit in respect of the particulars described in this application (including supporting documentation) I/We have supplied. Please note that each individual operator must sign the declaration themselves, even if an agent is acting on their behalf. For the application from: Premises name .................................................................................................. Signature .. Name . Position... Date Signature .. Name . Position... Date * Where more than one person is defined as the operator, all should sign. Where a company or other body corporate an authorised person should sign and provide evidence of authority from the board of the company or body corporate. 1 NB All new VOC emitting stacks are required to vent VOCs at a height greater than 3m above the roof ridge height of buildings within 15 m of the stack     7, D Z  M f ٻnXnXnXn@n.h~H?B*CJOJQJ\^JaJnH phtH +h~H?B*CJOJQJ^JaJnH phtH .h~H?B*CJOJQJ\^JaJnH phtH h~H?CJOJQJaJh~H?CJOJQJ&h~H?B*OJQJ\^JnH phtH h~H?5CJmH sH h~H?OJQJ*h~H?5B*CJOJQJaJmH phsH !h~H?5CJOJQJaJmH sH h~H?5;CJaJjh~H?U^J   * + , - . }{{" (&#$Fkdcz$$IfTx{(' ! 4 xap T:$(&#$Ifd$(&#$Ifd$a$!. 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