�� ࡱ � > �� � � ���� � � � ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ����������������������������� '` � � @� bjbj$�$� x� �� � F� F� �� �? �� $ 2 _R �j 2 � &N �L ( NN �L NN �L P NN �L L NN 6M � =R " kR $ el �i h �i �n l �i j Q �i �i �i �i 3U IQ � =R 3U 3U j NN v NN � ij gX gX gX 3U NN NN �i 3U h gX �i gX gX � �e �f NN N � (�j� 0 �j �f .f �L � 9o 9o �U W r � -f 9o &g � •j �f X �j 2 �= 2 X sR � S sR r �S sR gX sR ^ \ sR 3U �C � 3U 2 3U 2 3U 2 �C �S j R j sR 2 2 sR 2 2 ���� Part B Application form Application for a permit 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 This environmental permitting regime is known as and referred to as Local Authority Pollution Prevention and Control (�LAPPC�). Installations permitted under this regime are known as Part �B� installations. Use this form if you are sending an application for a �Part B� permit to a Local Authority under the Environmental Permitting (England and Wales) Regulations 2007 (�the EP Regulations�). Before you start to fill in this form You are strongly advised to read relevant parts of the Defra general guidance manual issued for LA-IPPC and LAPPC, republished in 2008 and available at HYPERLINK "http://www.defra.gov.uk/environment/ppc/localauth/pubs/guidance/m anuals.htm" http://www.defra.gov.uk/environment/ppc/localauth/pubs/guidance/ manuals.htm . 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 Process Guidance note as relevant The EP Regulations can be obtained from The Office of Public Sector Information, or viewed on their website at: HYPERLINK "http://www.opsi.gov.uk/stat.htm" http://www.opsi.gov.uk/stat.htm . 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 will 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, which 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 the Authority in conducting any necessary consultation process. 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 Applicant details A1.1 Name of the installation A1.2 Please give the address of the site of the installation Postcode Telephone The Ordnance Survey national grid reference 8 characters, for example, SJ 123 456 (can be obtained from typing postcode into one of the on-line mapping sites). A1.3 Existing permits: Please give details of any existing LAPPC or LA-IPPC authorisation for the installation, 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, partnership 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 1159 of the Companies Act 2006? 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 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 number Fax number email 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 1, Box A, 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 1, Box B 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 2, for Boxes A and B please quote the Chapter number, Section number, then paragraph and sub-paragraph number as shown in Part 2 of Schedule 1 to the EP Regulations [For example, Manufacturing glass and glass fibre where the use of lead or any lead compound is involved, would be listed as Chapter 3, Section 3.3, Part B(b)]. B1.1 Installation table for new permit application COLUMN 1 COLUMN 2 Box A Activities in the stationary technical unit Section in Schedule 1 to the EP Regulations Box B Directly-associated activities Schedule 1 references (if any) B1.2 Why is the application being made? The installation is new The installation is existing, but changes to the installation or to the EP Regulations means that an LAPPC Part B permit is now required. B.1.3 Site Maps Please provide:* A suitable map showing 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 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 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 point source, (e.g. chimney / vent, identified by a number and detailed on a plan) 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. (Emission concentration = e.g. milligrams per cubic metre of air; mass emission = e.g. grams per hour, tonnes per year) 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 into the air. If no techniques are currently used and the emission goes directly to the environment, without abatement or treatment then this should be stated Doc Reference: B2.4 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: B2.5 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, 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: B2.6 Provide detailed procedures and policies of your proposed environmental management techniques, in relation to the installation activities described. Doc Reference: B3 Impact on the Environment B3.1 Provide an assessment of the potential significant local environmental effects of the foreseeable emissions (e.g. is there a history of complaints and/or is the installation in an air quality management area ?) Doc Reference: B3.2 Are there any sites of special scientific interest (SSSIs) or European protected sites which are within either - 2 kilometres for an installation which includes Part B combustion, incineration (but not crematoria), iron and steel, and non-ferrous metal activities, or - 1 kilometre for Part B mineral activities and cement and lime activities, or - � a kilometre for all other Part B activities 2 kilometres of the installation? No Y e s s i t e s q� q� p l e a s e g i v e n a m e s o f t h e B 3 . 3 P r o v i d e a n a s s e s s m e n t o f w h e t h e r t h e i n s t a l l a t i o n i s l i k e l y t o h a v e a s i g n i f i c a n t e f f e c t o n s u c h s i t e s a n d , i f i t i s , p r o v i d e a n a s s e s s m e n t o f t h e i m p l i c a t i o n s o f t h e i n s t a l l a t i o n f o r t h a t s i t e , for the purposes of the Conservation (Natural Habitats etc) Regulations 1994 (see appendix 2 of Annex XVIII of the General Guidance Manual). Doc Reference: B4 Environmental Statements B4.1 Has an environmental impact assessment been carried out under The Town and Country Planning (Environmental Impact Assessment)(England & Wales) Regulations 1999/293, or for any other reason with respect to the installation? Y o a d N o �� e s �� P l e a s e s u p p l y a c o p y f t h e e n v i r o n m e n t a l i m p a c t s s e s s m e n t a n d d e t a i l s o f a n y e c i s i o n m a d e D o c B 5 P i u c R e f e r e n c e : A d d i t i o n a l l e a s e s u n f o r m a t i s t o t a k o n s i d e r i i n f o r m a t i o n p p l y a n o n w h i c e a c c o u n g t h i s y a d d i t i o n a l h y o u w o u l d l i k e n t o f i n 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 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 subsistence 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 or industrial 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/Welsh Ministers 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, 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 C6 Declaration 5 � � D E � � � � � 6 7 F G g � � � � � � A B o p q � � � � � f g � � �������������ѽѭ���ќю�s�l��g��g`�� h 1� h 1� hN; 6 � hN; 0J 5 �! � j� hN; 5 �B* U � j hN; 5 �B* U ph � ph � hN; 5 �B* ph 5 �6 � h�d� hN; 0J 5 �- � j� h�d� hN; 5 j hN; 5 �U hN; CJ mH sH hN; 5 � CJ hN; hN; CJ OJ QJ mH sH hN; OJ QJ mH sH hN; ; � % 6 7 h � � � � � � � � � � � � � � � � s e �� � ��( &�#$ gdN; F kd $ $ If T �x � � {( �' � ! � � � � � � 4� x a� p� �T �: $ �� � ��( &�#$ If gdN; d� � $ �� � ��( &�#$ If gdN; d�� gdN; $ a $ gdN; gd 1� $ a$ gdN; 2� ?� �� hN; �U hN; � � � � � � � f � � g v � � � � � � � � � U V W q � � � � � � � � � � � � � � � � � � � � � � � � � gd 1� d�� gdN; gdN; gdN; U V q � � � � q � ^ � � � � � � � � � ) 6 7 t u � � � � K M Y q 4 @ B L M f g h � � � � � � � � � � ������������������������͵͵� ��۵����ͧ���۵͵ � h� \ hN; 5 �>* CJ aJ h�/� hN; CJ aJ hN; 5 �6 �CJ aJ h� \ hN; 5 �6 �CJ aJ h� \ hN; 5 �CJ aJ h� \ hN; >* CJ aJ h� \ hN; 5 �>* CJ aJ h� \ hN; CJ aJ hN; CJ h�k 5 � hN; h 1� 5 � hN; 5 � 3� � q r s � ^ _ ` � � � � � � � � � � � g w kdB $ $ If �l � � ��� Q! � t � � � �0 � � � � � � � 6 � � � � � � � � � �4� 4� � l a� � � � � p� $ � $ If � � � � � a$ gdN; � � $ a$ gdN; � � � � � � � � � gdN; � $ � �l $ If � � h � kd� gdN; � � � �F d�� � ��� � � � t 6 �0 � � � � � � � � � � � � � � � � � � � � � � � l a� � �4� $ If 4� gdN; � � � ) * c c �l � � � � t 6 � 6 �0 � � � � � � c c � c � � � � � c gdN; � �F ��� � � kdo h c $ � $ If � � � � � � � � � � � � � � � l a� 6 7 t S T � � � �4� 4� $ If gdN; u � � � � � � � U V W � � � � � � � � � � � � $ If gdN; � kd $ $ If ��h � � � � � gdN; �l � W L M P Q � R � � � � X �| ִ � , � �0 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �4� 4� l a� X Y Z q r 4 5 A B M N Z [ g h i + , � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; gdN; � � � : ; G H T U i j � � � � � � � # % K L X Y s � � � � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; : ; G H T U i � � � � � � � � # $ % * K L X Y r s � � � � � t 6 � � � � � �������������� ͓ ��۾酾 v����������h� hN; hN; 5 �>* CJ aJ h� \ hN; 5 �6 �>* CJ aJ h� \ hN; 5 �6 �CJ aJ + j h� \ hN; 5 �CJ U aJ mH nH u hN; 5 �CJ aJ h� \ hN; >* CJ aJ h� \ hN; 5 �6 �>* CJ aJ h� \ hN; 5 �>* CJ aJ h� \ hN; 5 �>* CJ aJ h� \ hN; 5 �CJ aJ h� \ hN; CJ aJ (s t � � � � � � � � � � � � � � � � L M ' ( 9 : N O b c o � � � � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; � � � � � L M ' - 9 C N W � � V W � f � � � � � � � ������ʿ������������� h� � � Q S T �ࡱ|n|ana� \ hN; CJ ^J aJ h� \ hN; 5 �CJ ^J aJ - h� \ hN; 5 �CJ \ �^J aJ h� \ hN; CJ \ �^J aJ hN; CJ \ �^J aJ h� \ hN; 5 �6 �CJ aJ h� \ hN; 6 �CJ aJ h� \ hN; CJ aJ hN; hN; 5 �>* CJ aJ h� \ hN; 5 �CJ aJ h� \ hN; 5 �>* CJ aJ h� \ hN; 5 �>* CJ aJ !o p � � � � � � � � � � � S T - �- �- �- �! q r � � � � � � � � � � � � � � � � � � � � � � � � � � � � � `� gdN; �� `�� gdN; �� ^�� gdN; gdN; f i - (- )- �- �! # $ ? � 8 o p q r � � � � � !! *! ,! /! 0! 6! v! �! �! �! �! �����ŵ����� ���औ���ŔŔӔӔŔӊ•s h� hN; 5 �CJ aJ h� hN; CJ aJ hN; CJ ^J aJ - h� hN; 5 �CJ \ �^J aJ ! h� hN; 5 �6 �CJ ] �^J aJ - h� hN; 5 �6 �CJ ^J aJ h� hN; CJ \ �^J aJ h� hN; CJ ^J aJ h� hN; 5 �CJ ^J aJ ! h� hN; 5 �CJ \ �] �^J aJ $� � � � � � � � ! � � � � � � � � � i kd� $ $ If T �x � P \ \ \ \ \ \ \ \ \ � � � • � �0 ��x �" � x a� �: � p� $ If � ��� � ��� gdN; ��� 4� ��� � @# � �T � � � d�� ! ! !! �: $ If "! • #! $ If gdN; $! � gdN; � • � d�� �" � $ If gdN; i kd{ P $ $ If T �x �0 ��x � � ��� � � x a� p� ��� *! +! ,! � � J kd� $ $ If T P ��� � @# � � 4� ��� �T $! %! � � � � �x �0 ��x �" � � &! � '! � (! )! N � @# � � x a� �: 4� �T $ If gdN; � � � � d�� �" � $ If gdN; N P kd* $ $ If T �x �0 ��x � @# � � 4� x a� �T ,! ! .! /! 0! 6! � � � T �x �0 U! � V! � ��x �" � W! � v! � � � � � � � N P kd, $ $ If � @# � � x a� �: 4� �T $ If gdN; � � � � d�� v! � �: $ If w! x! $ If gdN; y! z! } gdN; {! � � } d�� ��b �" $ If � gdN; k kd� f $ $ If T �x �� �0 � � ��� � x a� p� �! �! �! � N kd� $ P � ��� � J $ If ��� T � @# � � � 4� ��� �T {! |! }! � � � � �x �0 ��x �" � � ~! •! � �! � @# � � x a� �: 4� �T $ If gdN; � � � � d�� �" � $ If gdN; N P kdg $ $ If T �x �0 ��x � @# � � x a� � �T � $ 4� �! $ If �! � J T � �! �x �! �0 � �! � � �! ��x �" �! �! � N kd� � � �! � � P � @# � � x a� 4� �T N kdi $ $ If T � �x �0 � ��x �" � � � P � @# � � x a� �: 4� �T $ If gdN; � � � � d�� �! � $ If � � N $ $ If �! gdN; � T kd] �x �0 �! �! � � ��x �" �! �! �! � �! �! �! � � � P � @# � � x a� �: 4� �T $ If gdN; � � � � d�� $ If gdN; �! �! �! �! �! �! �! i" j" �" # # �# � � � � � � � � � � � � �� ^�� gdN; � `� gdN; gdN; N kd� $ $ If T �x �0 ��x �" � z" � {" � �" �" �" � � � P � @# � � x a� # �T 4� �! �! � �! �! � j" � z" � �# �# �# �# �$ �$ �$ �% �% & & *& .& 2& �& �& �' �' c( �( �( ^* a* d* h* �+ �+ �+ �+ �+ �- �- �- �X. \. ]. {. |. �. d/ h/ i/ m/ ����������Ҷ���Ҷ ���������������ݶĜ�������������� ݎ h� \ hN; CJ \ �^J aJ h� \ hN; 5 �>* CJ aJ h� \ hN; 6 �CJ aJ h� \ hN; 5 �6 �CJ aJ h� \ hN; 5 �>* CJ aJ h� \ hN; CJ aJ h� \ hN; 5 �CJ aJ + j h� \ hN; 5 �CJ U aJ mH nH u 4�# �# �# �# �# �# �# �$ �$ �% �% & & .& �& �& ' ' m' �' �' c( d( �( �( M* N* � � � � � � � � � � � � � � � � � � � � � � � � � � # & & F � � `� gdN; `� gdN; gdN; N* b* c* d* �+ �+ �+ �+ ��- �- �H. I. ]. ^. {. |. T/ U/ i/ �/ �/ ~0 �0 1 � � � � � � � � � � � � � � � � � � � � � � � � � �� ���^�� `���gdN; �� �L�^�� `�L�gdN; � `� gdN; gdN; m/ �/ �0 2 2 2 2 L2 R2 j2 l2 t2 L4 �4 �4 �4 �6 �6 �6 �6 �6 27 8 8 -8 "8 ��ࡱ���u�����g�u����g�ug_� 2 �4 �4 �4 �4 6 #8 $8 �8 ����� h& z CJ aJ h� \ hN; 5 �6 �CJ aJ h� \ hN; 5 �>* CJ aJ hN; 5 �CJ aJ h� \ hN; 5 �CJ aJ h� \ hN; CJ aJ h� \ hN; 6 �CJ aJ - h� \ hN; 5 �>* CJ ^J aJ - h� \ hN; 5 �6 �CJ ^J aJ - h� \ hN; 5 �8 �CJ ^J aJ # h� \ hN; 5 �CJ OJ QJ ^J aJ h� \ hN; 5 �CJ ^J aJ " 1 !1 2 P2 R2 j2 l2 �4 �4 �4 �4 �4 �4 �4 �5 � 5 6 �6 �6 �6 �6 27 47 8 8 #8 $8 88 98 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � `� gdN; gdN; 98 �8 �8 D9 E9 �9 �9 _: `: l : m: n: �: �: T; U; �; �; < < < < #< $< A< B< `< a< = � � � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; gdN; �8 �8 �8 D9 E9 G9 P9 Y9 s9 �9 �9 �9 �9 _: m: �: U; Y; �; #< $< A< B< `< a< e< = U? = l@ = 0A = �= �A �= �= �= ;> <> => >> C> D> @? T? B �B `E �E �E ����ż�ų���������ܧΟ����܉܉������܉܉ ������܀܀ hN; 5 �CJ aJ + j h� \ hN; 5 �CJ U aJ mH nH u hN; CJ aJ 5 �CJ aJ \ hN; 5 �>* \ hN; 5 �CJ \ hN; CJ aJ \ hN; >* CJ = h& z hN; 5 �CJ aJ h& z 5 �CJ aJ h� CJ aJ h� aJ h� h� aJ 2 h 1� 5 �CJ aJ h� } = = = = �= �= �= �= �= <> => B> C> K> L> @? A? T? U? l@ �@ �@ 0A �A �A � � � � � � � � � � � � � � � � � � � � � � � � � � = & F gdN; gdN; � `� gdN; gdN; �A B RB �B 6C 7C �C �C D .D �D �D �D �D �D E `E aE �E �E �E eF hF G MG � � � � � � � � � � � � � � � � � � � � � � � � & F � � gdN; & F gdN; & F gdN; gdN; & F gdN; MG ~G •G �G �G �G �G �G �G �G �G �G �G (� )� �� �� u� v� �� �� �� �� �� • Õ ԕ Օ � � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; g dN; & F � �G � � gdN; �E ~G •G �G �G � )� u� �� �� � �G �G �G �� �� • �G �G �G �G ȕ ԕ � � �ݕ � � � *� 4� :� E� G� 0� 1� 2� 3� 5� 6� 8� 9� ; � <� ?� @� ����������������������������� ����������������ٻ hJ \ \ \ \ x hN; hN; hN; hN; j hJ x U h�J� h� 5 �6 �CJ aJ U h� 5 �>* CJ aJ h� 5 �CJ aJ hN; 5 �CJ \ �aJ CJ aJ / C6.1 mH nH u h� 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. Օ � � �� �� �� � � !� "� 5� 6� F� G� 0� 1� 2� 4� 5� 7� 8� :� ;� =� >� ?� @� � � � � � � � � � � � � � � � � � � � � � � � � � � gdN; H 0 P P &P P :pN; >0 BP ��. ��A!�� "�� #�� $�� %� �7 �7 �� , 1�h ��. ��A!� "� #�� $�� %� �� �� �� � $ $ If � !v h 5� �'#v �':V �x � ! � � � 5� �'/� 4� 4� x a� p� �T D ���y��� �� � K� ���y��� �� � K� � h t t p : / / w w w . d e f r a . g o v . u k / e n v i r o n m e n t / p p c / l o c a l a u t h / p u b s / g u i d a n c e / m a n u a l s . h t m � D ���y��� �� � K� ���y��� �� � K� @ h t t p : / / w w w . o p s i . g o v . u k / s t a t . h t m � $ $ If � !v h 5� J!#v J!:V �l � t � � � �0 � � � � � � � 6 � 5� Q!p� � � $ $ If � !v h 5� 5� 5� #v #v :V �l t � �0 � � � � � � � 6 � 5� � $ $ If � !v h 5� 5� 5� #v #v :V �l t � �0 � � � � � � � 6 � 5� � $ $ If � !v h 5� � 5� 5� 5� 5� 5� 5� 5� #v � #v :V �l �| t � � 6 � 5� � 5� /� � /� � /� � � /� � $ $ If � !v h 5� � 5� P #v � #v P :V �x � � ��� ��� � @# � 5� � 5� P /� x p� � 5� 4� ��� P 4� ��� �T � $ $ If � !v h 5� #v � #v P :V �x � � ��� ��� � @# � 5� � 5� P /� x p� � 5� 4� ��� P 4� ��� �T � $ $ If � !v h 5� #v � #v P :V �x � @# � 5� � 5� P /� /� x �T 4� x $ 4� $ If � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� x �T � 4� $ $ If 4� � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� /� x �T � 4� $ $ If 4� � !v h 5� � 5� f #v � #v f :V �x �� � � ��� ��� � @# � 5� � 5� f /� x p� � 5� 4� ��� P 4� ��� �T � $ $ If � !v h 5� #v � #v P :V �x � @# � 5� � 5� P /� /� x �T 4� x $ 4� $ If � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� x �T x 4� $ $ If 4� � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� x �T x 4� $ $ If 4� � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� x �T x 4� $ $ If 4� � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� x �T x 4� $ $ If 4� � !v h 5� � 5� P #v � #v P :V �x � @# � 5� � 5� P /� 4� 4� x �T � N @�� N � N; tH N o r m a l n @ n & 5 �CJ OJ QJ \ �_H aJ mH sH N; R I A H e a d i n g 1 , L 1 , H e a d i n g $ $ �� @& a$ 1 ; �CJ \ �aJ D A@��� D F o n t D e f a u l t R i@��� R P a r a g r a p h T a b l e N o r m a l l 4� a� ( k@��� ( � N o 4� L i s t B U@� � B N; H y p e r l i n k >* B* CJ OJ QJ ph � D Q@ D N; B o d y T e x t 3 �x 5 �CJ \ �aJ P >@ P N; sH T i t l e F "@ F $ 1$ 7$ 8$ H$ a$ CJ" OJ QJ \ �mH N; C a p t i o n 1$ 7$ 8$ H$ CJ ^J mH sH \ �O 2 \ N; L A T e x t n o r m a l & F d�� �� 5 �\ �aJ mH nH u j �@� C j N; T a b l e G r i d 7 :V � �0 ` � � � � � �? � ���� J� ���� 6 7 � � � � � � � � � � � g v � � � � � � � � � q � � � q r s � ^ h � U � � � f V W _ ` � � � � � � � � � � � � � � � � � � � � ) * 6 7 t u � � � � � � � L M P Q R S T U V W X Y Z q r 4 5 A B M N Z [ g h i + , � � � � � � � � � � � � � : ; G H T U i j � � � � � � � # % K L X Y s t � � � � � � � � � � � � � � � � L M ' ( 9 : N O b c o p � � � � � � � � � � � S T � � � � ! q r � � � � � � � � � � � � ! " # $ % & ' ( ) * + , . / 0 6 U V W v w x y z { | } ~ • � � � � � � � � � � � � � � � � � � � � � � � � � � � i j z { � � � � � � � � � � � � � � � - .- �- �m � �c d � � M" N" b" c" d" �# �# �# �# �% �% �% �% H& I& ]& ^& {& |& T' U' i' �' �' ~( �( ) !) &) L) M) Y) Z) �* �* �* �* �* �* �* �+ � + �+ 4, 5, I, J, d, e, �, �, �, �, - �- �. . [. �. */ +/ 7/ 8/ 9/ X/ Y/ 0 0 �0 �0 �0 �0 �0 �0 �0 �0 1 1 3 +1 ,1 �1 �1 �1 �1 �1 �1 `2 a2 t2 u2 v2 3 3 3 4 3 3 4 4 4 75 w5 �5 �5 a6 �6 �6 7 �7 8 8 r8 s8 �8 �8 S9 �9 �9 �9 �9 �9 +: ,: s: �: �: 0; 3; �; < I< J< ^< _< p< q< �< �< �< �< �< �< �< �< �= �= > > 7> 8> S> T> U> i> j> {> |> �> �> �> � > �> �> �> �> �> �> �> �> �> �? �? �? �? �? �? �? �? �? �? �? �? 0 � � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � � 0 � � � 0 � � � 0 � � 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � �@ 0 � � 0 � � 0 � �@ 0 � � 0 � �@ 0 � �@ 0 � � 0 � � 0 � �@ 0 � �@ 0 � �@ 0 � �@ 0 � � 0 � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � 0 � � � � � � � � � � � � 0 0 0 0 0 � � � � � 0 � � � � � � � � 0 � � � 0 � � � � � � � � � � 0 � � � � � � � � � 0 � � � 0 � 0 � � � 0 � 0 � � � � � 0 � 0 � 0 � � � � � 0 � 0 � � 0 � � � � � � � � � � � 0 � 0 � 0 � 0 � 0 � � 0 � 0 � 0 � � � � � � 0 � � � � 0 � 0 0 0 0 0 � 0 � � � � 0 0 0 � 0 0 � 0 � � � � 0 � � � � � � � � 0 � � 0 0 0 � 0 � 0 � � 0 � � � � � 0 � � � � � 0 0 � � � 0 � 0 � � � 0 0 0 0 0 � � � � � � � � 0 0 � 0 0 0 0 � � � 0 � � � � � � � � � 0 0 � 0 0 0 � 0 � � � 0 � � � � 0 0 � � � 0 0 � � 0 � 0 0 0 0 � � � � � � � � � 0 0 � � � 0 0 0 0 � � 0 � � � � � � � � � � � � � � � � � 0 0 0 0 0 � 0 0 0 0 0 � � � � � � 0 0 � 0 � 0 � � 0 � 0 � � � � � � � 0 0 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 0 � � � 0 � 0 0 � � � � 0 � � � � 0 � � 0 � � � 0 0 � � � � � � 0 0 � � � � � � 0 0 � � � � � 0 � � � � 0 � � 0 � � 0 0 � � � � � � 0 0 � � � � � � 0 0 � � � � � � 0 0 � � � � � � 0 0 � � � � � � 0 0 � � � � � � � � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � � � � � � � � � � � � � � 0 � � 0 0 � � � 0 0 � � 0 0 0 0 0 0 0 0 0 0 � � � 0 0 0 � � � 0 � � � � � � � � 0 � � � 0 � � � � � 0 � 0 � � � � � � � � � � 0 � 0 � � � � � � � � � � � � � � � � � � � 0 0 0 0 0 � 0 � � � � � � � � � � � � � � � � � � � � � � 0 � � � � 0 � � � 0 � � � � � 0 � � � � � 0 � � � 0 � � � 0 0 � � � � � � 0 � � � 0 � � � 0 � � � � 0 � � � � 0 � � � � 0 � � � � 0 � 0 � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � � � � � � � � � 0 � � � 0 � � � 0 � � � 0 � � � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � 0 � 0 � 0 � 0 0 � � � � � 0 0 � � 0 � 0 0 0 0 � � � � 0 � � � 0 � � � � � � 0 0 � � � 0 0 0 � 0 � � 0 � � 0 0 � � � � � � � 0 � � � � 0 0 0 � 0 � 0 � � � 0 0 � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � � � 0 � � � � � 0 � 0 � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � 0 � � � � � 0 � 0 � � � � 0 � 0 � � � � 0 � 0 � � � � 0 � 0 � � � � 0 � 0 � � � 0 � 0 � � � � � � � 0 � 0 0 0 0 0 � � 0 0 � 0 0 � � � � � � � � � � � � � � � � � � � � � 0 � � � 0 � � � 0 � 0 � � � 0 � � � � � 0 � � � 0 � � � 0 � � � � � � � 0 � 0 � � � � � 0 � � � 0 � � � � � � 0 � � � 0 � � � � � � � � � � � � � � 0 � 0 � � � � 0 � 0 � 0 � � � 0 � � � � � � � � � � � � � 0 � 0 � � � � � � � � � � � 0 � � � 0 � � � � � 0 � � � 0 � � � � 0 � 0 0 � � 0 � 0 � 0 � 0 � 0 � 0 � 0 � 0 0 0 0 0 � � 0 � � 0 � � � � � � � � 0 � � � � � � 0 � � � � 0 � 0 � 0 � 0 � � � 0 � � � 0 � � 0 � � � 0 � � � � � � � 0 � � � � � 0 � 0 � � 0 � � � � � 0 � � � 0 � � � 0 � � � 0 � 0 � 0 � � � � 0 � 0 � 0 � � � 0 � � � 0 � � � 0 � 0 � � � � � 0 � � � 0 � � � 0 � 0 � � � � � � � � � 0 � � � 0 � � � 0 � � � 0 � � � � � � � 0 � 0 � 0 � � � 0 � � � 0 � � � � � � 0 � 0 � � � � 0 � 0 � � � � 0 � � � 0 � � � � �� 0 0 � 0 0 � � � 0 � � 0 � � 0 � � � 0 � � 0 � � � � � �� 0 0 � �� 0 0 � �� 0 0 � � 0 � 0 � 0 � � � � A� �� 0 0 � �� 0 0 DA� � � 0 0 � �� 0 0 0 � v � � � � � � � � � � � � � : ; G H T U i j � � � � � � � # % K L X Y s t � � � � � $ % ) * . / v w { | � � � � � � � � � � �? �� 0 0 � �� 0 0 � �� 0 0 � j� 0 0 (2B h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 h� 0 0 j� 0 0 0 � j� 0+0 , �{� H 0 v? � j� 00 . �{� 0 �I \ f f� j� 0/0 0 ,5� � ����� � ( �������� � j� 010 2 d5� d f� a � � � � j� 030 4 �5� 0 �? � j� 050 6 �5� 0 � j� 070 8 6� �P 0 0 � � j� 0=0 /� j� 0?0 j� 0A0 B � � � j� 090 � j� 0;0 > @ t~� <~� 0 < ~� 0? : �}� �}� � l0 0 . ? ? � � � 0 � �! m/ �8 �E @� $ ( 0 2 4 > A D H � � � � 6 W X � s o � ! $! ,! v! {! �! �! �! �# N* 1 98 = �A MG Օ @� % ' ) * + , . / 1 3 5 6 7 8 9 : ; < = ? @ B C E F G L ?� & D � � A p � �? X � � X � � �8 � @ -� �� � ��� � � � �P �( � � �< � # � f ? � # � � � � �< ? � # � � � � �< ? � # � � � � �< ? � # � � � � �< ? � # � � � � �< ? � # � � � � �< ? � # � � � � �< ? � � � � �B S �- � � ? � � - # � � �1 �1 3 �? 3 � h X � 6 & � t ����X t � , < t �� _ T o c 1 8 7 1 2 5 7 4 5 h � � � � � � � � � � � � � l� �� �� ,� � ,� ,� � l� ! ,� � � H � � � � t t 6 < , & � 6 T � O Y Y � � i+ � , t �? T � � & < �? �� s+ s+ �? p+ x+ x+ B *�urn:schemas-microsoft-com:office:smarttags t t < , �? �country-region �9 *�urn:schemas-microsoftcom:office:smarttags �place �; *�urn:schemas-microsoftcom:office:smarttags �address �: *�urn:schemas-microsoftcom:office:smarttags �Street � 8�} ? �? �? � � �' �' P. �? �? �? �? �? � � � � � X. �? �? �? �? �? � � 1 4 ! $ � � 0 8 � � j l � � � � m u � � #! +! L' S' �( ) g+ i+ �+ �+ . Z. �1 �1 �2 3 �7 �7 S9 ]9 �9 �9 �? �? �? �? �? �? �? �? �? �? �? �? �? 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 � � � � � 7 � � � W � + d �* �* �+ �+ . X. �0 ,1 a2 v2 �9 ? �? �? �? �? �? �? �? �? �? �? P. X. �? �? �? �? �? �? �? ? �$W j ^� � � � � � � � � n"��X �? �? �9 �? �? � �? �? �? � � � � � � � � � � �wB?.��7� � � � � � � � � �g]ab o� � � � � � � � � � Wp ?p`� � � � � � � � � h �� ��� � � ^�� `���OJ QJ o( �� h �� ��� � � ^�� `���OJ QJ o( o h �p ��� � p ^�p `���OJ QJ o( �� h �@ ��� � @ ^�@ `���OJ QJ o( �� � h � � � � ��� � ^� `���OJ �� h �� h �� h �P , � h ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( o QJ o( ��� � o � ��� � ��� � ��� � P ^�P `���OJ QJ o( �� ��� � � ^�� `���5 �� 6 B* � h QJ aJ0 o( ph�� �h �H �� �� � � ^�� `�6 CJ OJ QJ o( �h �H CJ0 OJ �5 - . . h . h �� ��� � ^�� `���5 6 CJ OJ ) h �� �x� � p ^�� `�x�o( �h �H h �� ��� � @ ^�� `���o( �h �H . . . . . h �� �X� � QJ o( �h . . . �H . ^�� `�X�o( �h �H . . h �� . . . . ��� � � ^�� `���o( �h �H . . h �� . . . . . �8� � H ^�� `�8�o( �h �H . . . . . . . . h . �� . �� �`� � . . . ��� � ^�� `�`�o( �h h � ^�� `���OJ QJ �H o( �� �� ��� � � o( o . . � h ^�� `���OJ QJ � h �p ��� � p ^�p `���OJ QJ o( h �@ ��� � @ ^�@ `���OJ QJ o( � �� � h �� � . . ��� � ^� `���OJ �� h �� h �� h �P � h ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( o QJ o( ��� � o � ��� � ��� � ��� � P ^�P `���OJ QJ o( � �� �� ��� � � ^�� `���OJ QJ o( �� �� ��� � � ^�� `���OJ QJ o( o h � h � h �p ��� � p ^�p `���OJ QJ o( h �@ ��� � @ ^�@ `���OJ QJ o( � �� � h �� � ��� � ^� `���OJ �� h �� h �� h �P � h ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( �� � � ^�� `���OJ QJ o( o QJ o( ��� � o � ��� � ��� � ��� � P ^�P `���OJ QJ o( � �� h �� ��� � � ^�� `����h �H . � �� ��� � � ^�� `����h �H . � h h �p �L� � p ^�p `�L��h �H h �@ ��� � ^�@ `����h � @ �H . � h . � ��� � ^� `����h �H . � h �� �L� � � ^�� `�L��h �H . � h �� ��� � � ^�� `����h �H . � h �� ��� � � ^�� `����h �H . � h �P �L� � P ^�P `�L��h �H . �g]a �$W �wB? n" � Wp ���������������������� �� � ����������������������������������� ��� ��������������������������������� ������ ������������������������������ ��������� ��������������������������� � �k N; �Y# }u6 : W @9h �Jk J x & z � } IR� �m� �J� �\� ^*� 1� � � � � _ ` � � � � � � � � � � � L M P Q R S T U V W X q � � " $ � � � z � r � � � � � % ' ) * , . / U � � � � � � � � .- b" �# �% ]& i' � v � &) w � �* y { | ~ � � � �0 1 1 �7 � � � �? � � 3 � � � � �0� @ @ n �� � 2 � W. @ R o m a n 3&� �z h @ �z 5 � � d � � �@ � W. W. L $) $* �+ �, �< �? @ @ p @ @ ( @ �� U n k n o w �� �� �� �� G � � T i m e s N e w � S y m b o l A r i a l A r i a l ( W 1 ) A r i a l 9"� G O m e g a ?5� �: � C o u r i e r N e w ; � s " 1 � �� h _j�f�j�f s � R6 s !$ � � � � � �� 4 � � W. @ 6 �� � � � � �? I"� C � � W i n g d i n g R6 �? 2�q � HX �� ? � ���•���•���•���•���•���•���•N; 2 �� P a r t B A p p l i c a t i o n f o r m r d a v i d s o n ����Oh �� � < +'��0 � � � �� � � � � H T ` form - h p - x � - Part B Application rdavidson - - - Normal.dot Word @ ��G R6 @ 3 z���j� @ Microsoft Office � �j� � ��՜. �� +,��D ��՜. �� �� +,��X h � � � p � � � � � � � � �? - ' West Berkshire Council Part B Application form s 8 Title @ � _PID_HLINKS � A D j { h t t p : d L h t t n m e n t / / m a n u a d / / w w n + p : / / p p c / l s . h w . o p s i . g o v . u k / s t a t . h t m w w w . d e f r a . g o v . u k / e n v i r o l o c a l a u t h / p u b s / g u i d a n c e t m - ! " # $ % 3 & 4 ' 5 ( 6 ) * + , - . / 0 1 2 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M ����O P Q R S T U ����W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~ • � � � � � � � � � � � � � � ������������������������������������ � � � � � � � ������������� ����� ���� ���������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ��������������R o o t E n t r y ���� ���� � F У�•��� � @ D a t a ������������ 1 T a b l e N ���� V Yo W o r d D o c u m e n t ���� x� S u m m a r y I n f o r m a t i o n ( ������������ � D o c u m e n t S u m m a r y I n f o r m a t i o n 8 �������� � C o m p O b j ������������ q ������������ ���� ���������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ���������������������������������������� ������������������������������ �� ���� � F Microsoft Office Word Document MSWordDoc Word.Document.8 �9�q �� ����Oh �� +'��0 t � d \ < 4 � � � � � � � $ , � - - Normal.dot Word @ ��G R6 Administrator grant R6 @ 3 z���j� @ B Microsoft Office � �j� � Mr System