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A2 Application
form
Application for a Permit
Local Authority - Integrated Pollution Prevention and Control
Pollution Prevention and Control Act, 1999
Environmental Permitting (England and Wales) Regulations 2007
Introduction
When to use this form
This regime is known as Local Authority Integrated Pollution
Prevention and Control, LA-IPPC. Installations permitted under
this regime are known as A2 installations. Use this form if you
are sending an application for a �Part A2� installation to a
Local Authority under the Environmental Permitting (England and
Wales) Regulations 2007.
Before you start to fill in this form
Please read the Defra general guidance manual issued for LA-IPPC
and LAPPC. This contains a list of other documents you may need to
refer to when you are preparing your application, and explains
some of the technical terms used. You will also need to read the
relevant sector guidance note, BREF note or Process Guidance note
as relevant. Copies of the Environmental Permitting (England and
Wales) Regulations 2007 (�the EP Regulations�)can be obtained
from The Office of Public Sector Information, or viewed on their
website at: http:// HYPERLINK "http://www.opsi.gov.uk/si/si"
www.opsi.gov.uk/si/si 2007/uksi_2007358_en_1
Which parts of the form to fill in
You should fill in as much of this form as possible. The
appropriate fee must be enclosed with the application to enable it
to be processed further. When complete return to:
Pollution Team
Environmental Health
Civic Offices
Holton Road
Barry
CF63 4RU
Email: RegServ@valeofglamorgan.gov.uk
Telephone:01446 709105
Other documents you may need to submit
There are number of other documents you may need to send us with
your application. Each time a request for a document is made in
the application form you will need to record a document reference
number for the document or documents that you are submitting in
the space provided on the form for this purpose. Please also mark
the document(s) clearly with this reference number and the
application reference number, if you have been given one, it will
be at the top of the form overleaf. If you do not have either of
these, please use the name of the installation.
Using continuation sheets
In the case of the questions on the application form itself,
please use a continuation sheet if you need extra space; but
please indicate clearly on the form that you have done so by
stating a document reference number for that continuation sheet.
Please also mark the continuation sheet itself clearly with the
information referred to above.
Copies
Please send the original and 3 copies of the form and all other
supporting material, to assist consultation.
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.
A1.1
Name of the installation
A1.2
Please give the address of the site of the installation
P o s t c o d e
T e l e p h o n e
O r d n a n c e
S u r v e y
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a u t h o r i s a t i o n s :
P l e a s e
g i v e
d e t a i l s
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a n y
e x i s t i n g
L A P C
o r
I P C
a u t h o r i s a t i o n
f o r
t h e
i n s t a l l a t i o n , or any waste management licences or
water discharge consents, including reference number(s) and
type(s):
Please provide the information requested below about the
�Operator�, which means the person who it is proposed will have
control over the installation in accordance with the permit (if
granted)
A2.1 The Operator � Please provide the full name of company or
corporate body
Trading/business name (if different)
Registered Office address
Postcode:
Principal Office address (if different)
Postcode:
Company registration number
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
Registered office address
Postcode
Principal Office address (if different)
Postcode
Company registration number:
A3.1 Who can we contact about your application?
It will help is to have someone who we
any questions about your application.
have the authority to act on behalf of
an agent or consultant rather than the
can contact directly with
The person you name should
the operator. This could be
operator.
Name
Position
Address
Postcode
Telephone number
Fax number
E.
Mail address
B1
About the Installation
Please fill in the table below with details of all the current
activities in operation at the whole installation.
In Column 1a Activities in the stationary technical unit
Please identify all activities listed in Schedule 1 to the EP
Regulations that are, or are proposed, to be carried out in the
stationary technical unit of the installation.
In Column 1b Directly associated activities
Please identify any directly associated activities that are, or
are proposed, to be carried out on the same site which:
* have a technical connection with the activities in the
stationary technical unit
* could have an effect on pollution
In column 2a and b Schedule 1 references, please quote the Chapter
number, Section number, A(2) or B, then paragraph and subparagraph number as shown in Part 1 of Schedule1 to the EP
Regulations. For example, Manufacturing glass, unless falling
within Part A(1) of this Section, where melting capacity of the
plant is more than 20 tonnes per day, would be listed as Chapter
3, Section 3.3, Part A(2)(a).
B1.1
Installation table for new permit application
COLUMN 1a
COLUMN 2a
Activities in the Stationary Technical Unit
Schedule 1 References
COLUMN 1b
COLUMN 2b
Directly associated activities
Schedule 1 References
B1.2 Why is the application being made?
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A
s u i t a b l e
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s h o wing the location of the
installation clearly defining extent of the installations in red
Doc Reference
* A suitable plan showing the layout of activities on the site,
including bulk storage of materials, waste storage areas and any
external emission points to atmosphere
Doc Reference
* A suitable plan showing the site drainage system and all
discharge points to drainage or water courses.
Doc Reference
B2
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 EP Regulations are met.
B2.1 Describe the proposed installation and activities and
identify the foreseeable emissions to air, water & land from each
stage of the process (this will include any foreseeable emissions
during start up, shut down and any breakdown/abnormal operation)
The use of process flow diagrams may aid to simplify the
operations
Doc Reference:
B2.2 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, (e.g. chimney / vent, identified by a number
and detailed on a plan)
(ii) fugitive source (e.g. 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.
(Mass Emission - the quantification of an emission in terms of
its physical mass per period of time. Eg. Grams per hour, tonnes
per year)
water emissions should be identified at discharge points and
copies of any discharge consents from either the Environment
Agency or sewerage undertaker should be submitted, detailing the
permitted discharge limits.
Doc Reference:
B2.3 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:
B2.4 Identify the raw and auxiliary materials, other substances
and water that you propose to use in carrying on the activities
listed in the table in B1.1
Doc Reference:
B2.5 Characterise and quantify each waste stream from the
installation and describe the proposed measures for waste
prevention and reduction. Please also include waste management,
issues storage and handling of the waste. For each waste stream
identify if an environmental appraisal has been undertaken, and
provide details, if not please state if an appraisal has been
carried out. If you propose any disposal of waste explain why
recovery of that waste is technically and economically
impracticable and describe the measures planned to minimise the
production of that waste and to avoid or reduce any impact on the
environment.
Doc Reference:
B2.6 Identify if there may be a discharge of any List I or List
II substance and if any are identified, explain how the
requirements of the Groundwater Regulations 1999 have been
addressed (see attached lists). Also describe the current
techniques used to prevent and reduce discharges to groundwater.
Doc Reference:
B2.7 Provide a breakdown of the proposed energy consumption and
generation by source and end-use and describe the proposed
measures for improvement of energy efficiency. If you have entered
a climate change levy agreement please provide details.
Doc Reference:
B2.8 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:
B2.9
Detail the following with respect to noise & vibration
1.
The main sources of environmental noise and vibration as
identified from your proposed installations� activities
(including infrequent sources);
2.
Identify the nearest noise sensitive locations and include
any relevant environmental noise measurement surveys which have
been undertaken;
3.
The current and proposed technology and techniques for the
control of noise.
If no assessment has been carried out, please state this.
Doc Reference:
B2.10 Describe the proposed measures for monitoring all identified
emissions including any environmental monitoring, and the
frequency, measurement methodology and evaluation procedure
proposed. (e.g. particulate matter emissions, noise measurements,
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:
B2.11 Describe the proposed measures to be taken,
pollution risk to land and return the site of the
a satisfactory state upon definitive cessation of
may wish to refer to the site report requested at
to avoid any
installation to
activities, you
B3.1 below.
Doc Reference:
B2.12 Provide detailed procedures and policies of your proposed
environmental management techniques, in relation to the
installation activities described.
Doc Reference:
B3
Site Report
B.3.1 Please provide a site report which demonstrates the
condition of the land on the site of the installation. The report
must identify any existing or potential sources of contamination,
quantifying the presence of materials in, on or under the land
which may constitute a pollution risk either in terms of toxic or
polluting potential or the potential generation of toxic,
flammable or asphyxiant gases. The report should consider, in
relation to such sources the potential existence of pathways via
which the contaminants travel and the proximity and nature of
potentially sensitive receptors.
During consideration of the likely presence of materials and the
design of any intrusive sampling strategies particular regard
should be given to the locations and extent of any former or
existing potentially contaminative uses and the locations, nature
and likely emissions to land of processes forming part of the
installation.
It is acceptable to provide site reports undertaken for other
purposes, e.g. planning applications, which have been carried out
up to 6 months prior to this application. Older site reports may
be accepted where a further site survey and risk assessment based
on the present condition of the site are submitted.
Note: As a first step you should undertake a desk study to produce
the information necessary for the report. If that study suggests
that there are matters which warrant more detailed investigation,
then extensive site surveying work may be necessary.
Doc Reference:
B4
Impact on the Environment
Please provide written information about the impact the
installations� emissions may have on the environment as listed
below:
Information required:
B4.1 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:
B4.2
Provide an assessment of whether the installation is
likely to have a significant effect on sites of special scientific
interest (SSSIs) or European Sites and, if it is, provide an
assessment of the implications of the installation for that site,
for the purposes of the Conservation (Natural Habitats etc)
Regulations 1994.
Doc Reference:
B5
Environmental Statements and the Non Technical Summary
B5.1 Has an environmental impact assessment been carried out
under The Town and Country Planning (Environmental Impact
Assessment)(England & Wales) Regulations 1999, or for any other
reaso n
w i t h
r e s p e c t
t o
t h e
i n s t a l l a t i o n .
N
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P l e a s e
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r e q u i r e d
a b o v e .
T h i s
w i l l enable the public to understand your installation and its
environmental impact when viewing the public register.
Doc Reference:
B6 Statutory Consultees
We will use the information in this section to identify who we
must consult about your proposals
B6.1 In which Primary Care Trust (formerly health
authority)/Health Board area is the installation located?
If premises are on a boundary please give names of all relevant
authorities
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i n v o l v e
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r e l e a s e
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B8 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:
For the local authority
�
. Cheques should be made payable to :
Vale of glamorgan Council
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, failure to do so will result in revocation of
your permit 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 within your finance section.
Postcode:
C3
Telephone:
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 confidentiality ?
No
Yes
Please provide full justification, considering the definition of
commercial confidentiality within the EP regulations.
Doc Reference
C3.2 Is there any information in the application that you believe
should be kept from the public register on the grounds of national
security ?
No
Yes
Do not write anything about this information on the form. Please
provide full details on separate sheets, plus provide a copy of
the application form to the Secretary of State for a Direction on
the issue of National Security.
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,
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inv
estigate possible breaches of environmental law and take any
resulting action,
prevent breaches of environmental law,
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 32 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
C5.1
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:
Installation 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.
LA-IPPC Application Form: to be completed by the operator For
Local Authority use only:
Application Reference: Officer
Reference: Date received:
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