SCOTTISH ENVIRONMENT PROTECTION
AGENCY
Send form to local SEPA office
Details of local offices can be found at www.sepa.org.uk
Receipt Date Stamp
Reference No.
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NON-AERIAL HERBICIDE USE IN OR NEAR
WATER:
APPLICATION FORM
IMPORTANT Please read the notes on the attached sheets before completing this
form
1.
Name of Herbicide
User:
Address:
Telephone:
NPTC/SSTC
Certificate No.:
(Please enclose a copy of the certificate for the first application
- not necessary for subsequent applications unless details
change)
2.
Name of Agent:
Address:
Telephone:
3.
Location/Name of
Site
Ordnance Survey Map
Reference (six figures)
e.g. NJ 123 456
NOTE: PLEASE ENSURE THAT A SCALED SITE PLAN IS ENCLOSED AND
THAT THE INSTRUCTIONS IN THE EXPLANATORY NOTES ARE FOLLOWED.
4.
Total area of waterbody/watercourse/bankside to
be treated (hectares):
5.
Was the site approved for
herbicide use previously ?
If “yes”, please specify date:
6.
Local Authority
Area(s):
7.
Name of Riparian Owner:
Address:
Telephone:
8.a.
If you do not own or control adjacent or downstream fishings, have you the
owner's agreement? (please give details):
8.b.
Are there other adjacent or downstream users of the watercourse ? e.g.
abstractions for public or private water supply, water used for crop irrigation.
If so, please give details.
(Please note that you are responsible for notifying all potentially affected users)
9.a.
Proposed date of application:
9.b.
If the pesticide application is
to be repeated over the same
area, please indicate proposed
dates:
10.
Weeds to be controlled - species and % cover
Submerged
Floating
Emergent
Names of other plants present:
11.
Does the site have
conservation status
e.g. SSSI, Local Nature
Reserve, National Nature
Reserve ?
12.
Proposed herbicide name:
YES/NO
If “yes” please
specify:
Active ingredient:
Manufacturer:
Is the herbicide approved for treating the
target
weed ?
Method of application (e.g. tractor, knapsack
from bank, by boat):
Type of nozzle on sprayer:
Total amount of herbicide concentrate to be
used (kgs or litres):
13.
What alternative methods of
weed control have been
considered ?
14.
Any other information that you
consider relevant:
YES/NO
Bankside
IMPORTANT The applicant is responsible for ensuring the notification of all agencies (e.g.
the Water Authority, Local Authority Environmental Services and Scottish
Natural Heritage) and any adjacent or downstream water users who may be
affected by the herbicide application. SEPA may be able to provide some
information to assist with this task.
Signature of Applicant/Agent:
_____________________________
Position of Applicant:
_____________________________
Date:
_____________________________
CHECK LIST FOR APPLICANTS/AGENTS
1.
Has a copy of the NPTC/SSTC certificate been enclosed?
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2.
Has a scaled site plan been enclosed?
3.
4.
Has the form been signed and dated?
Have all relevant agencies/interests been notified (see above box

& Question 8) ?
PLEASE
NOTE THAT FAILURE TO INCLUDE THE REQUESTED INFORMATION MAY
DELAY THE DETERMINATION OF THIS APPLICATION
FOR OFFICIAL USE ONLY
Acknowledgement Letter Sent
Consultation: SEPA Biology Section
 
Scottish Natural Heritage
LA Environmental Services
Water Authority
District Salmon Fishery Board/Fishery Trust
Others
Approval
 

Objection

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



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Explanatory Notes For Applicants
Herbicides should only be used once all other methods of weed control have been
considered.
The information on the application form is required in order to :
a)
b)
c)
Protect the environment;
Determine whether the proposed treatment will achieve its objectives;
Determine whether the proposed treatment will interfere with adjacent or
downstream water uses/users (e.g. crop irrigation, stock watering).
Approvals are given subject to:
i)
ii)
iii)
The details given to SEPA being correct;
The statutory procedures being adhered to;
The applications only being made in the correct weather conditions.
Consultation procedures are necessary to ensure that consultation takes place
between the herbicide user, SEPA and other relevant organisations. It is therefore
essential that an application is submitted at an early date to allow adequate time for
this process to occur - preferably at least 3 weeks before the spraying operation.
Please note that this application only relates to SEPA approval, and not to other
regulations relating to the use of pesticides. Statutory controls under the Control of
Pesticides Regulations 1986 (as amended)/Plant Protection Products (Basic
Conditions) Regulations 1997 also place a number of responsibilities on herbicide
users, including:
1)
Users must take all reasonable precautions to protect the health of human
beings, creatures and plants and to safeguard the environment and, in
particular, avoid the pollution of water. (Guidance on safe transport, storage,
use and disposal of herbicides can be found in the “Guidelines for the Use of
Herbicides on Weeds in or Near Watercourses and Lakes” and the “Code of
Practice for the Safe Use of Pesticides on Farms and Holdings”, both of which
are available from MAFF publications.)
2)
Users must comply with the instructions on the product label or in the
published approval for the pesticide. Failure to follow these instructions is an
offence.
3)
All users must be competent in their duties and have received adequate
instruction and guidance in the safe, efficient and humane use of pesticides.
4)
The application of the herbicide must be confined to the area to be treated.
If you decide that it is necessary for you to use a herbicide in or near a watercourse,
please complete the attached form and return it to:Area Office
Scottish Environment Protection Agency