Wilton Park House, Wilton Place, Dublin 2, Ireland
Tel +353 1 607 3003 Fax +353 1 607 3109
E-mail inab@inab.ie Web www.inab.ie
Application for Registration of a site under EMAS
(Eco-Management and Audit Scheme)
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The Irish National Accreditation Board (INAB) is a division of Forfás. INAB’s obligations, powers and policy
in respect of any information provided to it (including but not limited to the confidentiality thereof) are
set out in the INAB Terms and Conditions.
Instructions
1) This form is for application to INAB as the competent body designated in the Republic of Ireland for
registration under EMAS.
2) This application form should be completed in full and returned with two copies of the applicant
organisation’s validated environmental statement, application fee (cheques should be made payable
to Forfás) and other relevant documents to:
The INAB Executive, Wilton Park House, Wilton Place, Dublin 2.
3) Additional information may be provided by the applicant organisation on supplementary sheets, which
should be clearly cross-referenced with the question numbers to which they refer.
4) Additional advice or information may be obtained by contacting the Irish National Accreditation Board
Executive at the above address or
Telephone: (01) 607 3003;
Fax: (01) 607 3109; or
E-mail: inab@inab.ie.
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Application for Registration of a site under EMAS
Issue 3
April 2011
Confidential
Page 1 of 10
General Information
1)
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Name and address of the applicant organisation (Please ensure that the specific entity seeking
accreditation and the legal entity are precisely identified):
Telephone:
Fax:
E-mail:
Note: These details will be used by INAB on directories, certificates, etc.
2)
(a) Invoicing contact name, address, telephone, fax and e-mail (if different to No.1 above).
Telephone:
Fax:
E-mail:
(b) VAT number:
(c) Do you claim VAT exemption?
Yes
No
If Yes, please attach a copy of the VAT exemption certificate (VAT Form 13B).
(d) If you require order numbers to be included on invoices please state the name of the person
who issues order numbers.
3)
What is the legal status of the organisation?
Yes
No
Quality manual clause
reference
a)
Owned by an individual:
b)
Owned by a private company or partnership:
c)
Owned by a public limited company:
d)
Owned by a company with activities/products/
services, other than those subject to the
application for accreditation:
e)
Owned by an academic institution:
f)
Part of a learned or professional institution:
g)
Owned by a public body or nationalised industry:
h)
Another category? If so, please specify:
i)
Company registration number:
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Application for Registration of a site under EMAS
Issue 3
April 2011
Confidential
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General Information
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4)
Name and other contact details of the parent company, if any:
5)
Name and position of the senior manager with responsibility for the organisation’s environmental
management system:
6)
Name and position of the applicant organisation’s main contact with the Irish National
Accreditation Board (This is the person to whom all correspondence from INAB will be addressed):
7)
Name and position of the applicant organisation’s deputy contact with the Irish National
Accreditation Board.
Note: If contact address for questions 4 – 7 differs from question 1 please supply relevant details.
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Application for Registration of a site under EMAS
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April 2011
Confidential
Page 3 of 10
Section A – details of the site to be registered
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A.1 Location(s) covered by this application:
Address (if different to above):
National grid reference number:
Name of site manager:
Telephone:
Fax:
E-mail:
Site area (in hectares):
A.2 Approximately how many people does the organisation employ in Ireland?
Direct company employees:
Indirect, sub-contract and other personnel on site:
A.3 Approximately how many people does the organisation employ worldwide?
A.4 Is this your organisation’s first time to apply for EMAS?
Yes
No
A.5 Estimated turnover for the first full year after registration:
A.6 Does your company manage the entire site?
Yes
No
If no, please give details:
A.7 Does your company manage any adjoining land not included in the application?
If yes, why is the land not included?
A.8 Has your company applied for registration under EMAS in any other EU state?
If yes, specify which state:
A.9 Please attach a location map of the site and relevant site layout maps.
Reference number(s) of the relevant site map(s):
A.10 What activities are carried out at the site?
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Application for Registration of a site under EMAS
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April 2011
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Page 4 of 10
Section A – details of the site to be registered
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(use NACE code, numbers and descriptions)
Section B – environmental management system
B.1 Please give a brief description of the environmental management system:
Does I.S. EN ISO 14001 form the basis of the EMS?
Yes
No
If not, please give details below, or continue on a separate sheet:
If I.S. EN ISO 14001 is the basis of the management system, has it been certified as conforming to the
requirements of the standard?
If so, what is the name of the certification body which certified it?
B.2 What is the auditing programme established for the site?
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Application for Registration of a site under EMAS
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April 2011
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Section C – environmental statement
C.1
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Details of the verifier who validated the statement:
Name:
Address:
Telephone:
Fax:
E-mail:
C.2
Deadline for submission of the next validated environmental statement:
C.3
Details of the person at your company who will supply copies of the statement to the public on
request:
Name:
Telephone:
Section D – Environmental and planning background
For each site relevant to the application please specify:
D.1
Name of the planning authority:
D.2
Are the environmental discharges authorised by:
Planning permission?
(y/n)*
Discharge licenses for air, water, solid or waste?
(y/n)*
Integrated pollution prevention control licenses?
(y/n)*
D.3
Is the activity on the site subject to regulation by the Environmental Protection Agency?
D.4
Are wastes or residues removed from the site for ultimate disposal or recycling?
(y/n)*
(y/n)*
If yes, state nature and volume of each type of waste, ultimate destination, contractors involved,
and the licensing arrangements:
D.5
Is the activity on site subject to regulation by the Radiological Protection Institute of Ireland?
(y/n)*
* Where ‘yes’ Is answered to any of these questions please supply copies of all relevant permissions,
approvals, agreements, etc.
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April 2011
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Section D – Environmental and planning background
D.6
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Have any infringements of environmental licenses or approvals taken place since the last audit
of the Environmental Management System:
If yes, please provide details:
Section E – Consultants
If you have used a consultant to help prepare this application for EMAS, or to help install or develop
the environmental management system, please give the following details:
:
E.1
Organisation name:
E.2
Address:
E.3
Contact name:
E.4
Telephone:
Fax:
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Application for Registration of a site under EMAS
Issue 3
April 2011
E-mail:
Confidential
Page 7 of 10
Section F
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Statement by applicant organisation (“The Organisation”)
(This should be signed for and on behalf of the Organisation by the manager of the Organisation and by the
person designated in Q6 of General Information)
The Organisation identified below hereby applies to INAB to assess the Organisation for its eligibility to be
registered under EMAS. The applicant organisation agrees to abide by the terms and conditions of the EMAS
regulation (No. 1221/2009) and not to use the statement of participation and the EMAS logo other than in
accordance with the regulations.
The Organisation acknowledges that it has read the INAB terms and conditions and agrees to comply at all
times, during the currency of the application made herein and any resulting registration, with the INAB
terms and conditions as the same may be substituted, amended, supplemented or varied by INAB after the
date of this application.
In particular the Organisation notes the obligations as to insurance specified in clause 16 of the INAB terms
and conditions and confirms that such insurances are either already in place or will be in place prior to the
grant by INAB of any registration that may result from this application.
Where an application for registration is being made by a government department or a body acting under the
auspices of a government department where that body has no separate legal identity from that of the
department, INAB does not require the relevant minister to comply with the obligations as to insurance set
out in clause 16 of the INAB terms and conditions. This is in recognition of the fact that government
departments do not take out insurance to cover liabilities that may arise in their contractual arrangement.
This exemption does not however affect the obligation of the relevant minister to indemnify INAB in
accordance with clauses 9 and 15 of the INAB terms and conditions.
Further, the Organisation notes the fees set out in the fee schedule and payable in respect of the following:
the assessment now applied for; renewal fees, and any other fees necessary to maintain, supervise or review
any registration that may be obtained by the Organisation, including expenses of outside auditors etc., as
any and all such fees may be substituted, amended, supplemented or varied by INAB after the date of this
application and the Organisation agrees to pay such fees in accordance with the requirements set out in the
INAB terms and conditions.
The Organisation hereby confirms that it has a right to supply the data and information contained in this
application or which it otherwise gives to INAB, and gives its own consent and confirms that it has obtained
all properly informed consents from any individuals in respect of whom the Organisation is giving data or
information to INAB to enable INAB to lawfully receive such data and information and make use thereof for
the purposes of its functions (having particular regard to, but not limited to, applicable data protection
legislation) and also confirms that all such data and information is complete, accurate and correct and that
it will promptly provide any such further information and data as may be required by INAB to assess and
process this application.
The Organisation further gives permission for the use of relevant information (i.e. contact details) on the
INAB directory, website, and internal database.
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Section F (continued)
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Signed for and on behalf of:
Name of organisation
by:
Print name of signatory
Signature
Position
Date
Signature of company representative in Q6 of General Information, if different from above
Print name
Position
Date
In order that INAB might communicate with the organisation with efficiency and speed, please indicate
below the most up to date e-mail address for the organisation (and please update us of any change in such email address) so as to ensure that electronic notifications/communications from INAB might reach the
principals of the organisation and/or the appropriate contact within the organisation for accreditation
matters. Should the organisation have any problem in or objection to receiving electronic communications
from INAB, please let us know.
E-mail address of contact within the organisation:
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Application for Registration of a site under EMAS
Issue 3
April 2011
Confidential
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Section G For completion by INAB personnel only
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G.1 Assessment of:
Applicant organisation:
is assigned to INAB officer:
By:
Manager, INAB
Date
G.2 Assessor(s) assigned by INAB officer:
Name:
Role:
Name:
Role:
Name:
Role:
G.3 Application review:
Please highlight any issues observed in the application form review:
INAB officer
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Application for Registration of a site under EMAS
Issue 3
April 2011
Date
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