(Official user only) Pre-consent reference no. PRE-CONSENT APPLICATION FORM in accordance with Article 14(1) of Regulation EC 1013/2006 (“the Regulation”) Please read through the guidance notes before you fill in the form. Please write your answers clearly in the spaces provided on the form. Who may apply for pre-consent status The Environment Agency may issue preconsent to those recovery facilities operating under its jurisdiction. The person entitled to submit an application for pre-consent recovery status must be either the permit holder or a duly authorised person on behalf of the permit holder for the facility where the waste recovery operation takes place. Completion and submission Applications must be submitted in writing using the form. Completed applications must be submitted to the Environment Agency: E-mail: shipments@environment-agency.gov.uk Or alternatively: International Waste Shipments Team Environment Agency Richard Fairclough House Knutsford Road Warrington WA4 1HT What information is required The following information must be provided within the application form – 1. Applicant details – Insert company name and the company’s registration number, address and contact details. 2. Recovery facility details – Insert details of the address and contact details of the recovery facility where the pre- consent operation(s) will be carried out. If the application is for a renewal or modification, provide the existing preconsent reference number. 3. Wastes applied for under pre-consent List details of waste types to be accepted for recovery under pre-consent: the Basel/OECD codes (where applicable), EWC codes and quantity/yr. 4. Recovery operations applied for under pre-consent – Identify which recovery operations apply to the pre-consent: the recovery code, the technology employed and the environmental permit(s) to which it relates. 5. Signature, date and designation – Make sure the document is signed and dated by the permit holder for the recovery site or someone who is authorised to do so on his behalf. State the position held by the signatory in the company. Further information deemed relevant to the application may be submitted as an annex. Page 1 of 3 (Official user only) Pre-consent reference no. Assessment of the application All applications received will be assigned a unique reference number which will be notified to you in writing. Following receipt of your application an initial assessment will be carried out to determine whether it is complete for processing. Incomplete applications will be returned for amendment. You should receive our decision in writing normally within 2 months of the date of receipt of a complete application. Pre-consent Certificates Approval of the pre-consent will be confirmed in writing by issue of a signed Certificate. The pre-consent will be valid for up to 10 years from the date of issue, unless revoked before the pre-consent expires. All pre-consents issued are reported annually through DEFRA’s hazardous waste division to the European Commission who will publish the details of your facility and pre-consent on its website. Renewal or Modification of pre-consent Applications to renew or modify an existing pre-consent issued under the above Regulation must be submitted to the Environment Agency in writing using the application form and providing the preconsent reference number in section 2. Assessment of the application to renew or modify the pre-consent will take place in the same manner, and within the same time scales, as an application for the original issue of a pre-consent. The Data Protection Act 1998 We, the Environment Agency, will process the information you provide so that we can deal with your application, make sure you keep to the conditions of the licence, permit or registration and process renewals. We may also process or release the information to: offer you documents or services relating to environmental matters; consult the public, public organisations and other organisations (for example, the Health and Safety Executive, local authorities, the emergency services, the Department for Environment, Food and Rural Affairs) on environmental issues; carry out research and development work on environmental issues; prevent anyone from breaking environmental law, investigate cases where environmental law may have been broken, and take any action that is needed; assess whether customers are satisfied with our service and to improve our service; and respond to requests for information under the Freedom of Information Act 2000 and the Environmental Information Regulations 2004 (if the Data Protection Act allows). We may pass the information on to our agents or representatives to do these things for us. Page 2 of 3 (Official user only) Pre-consent reference no. 1. Name of applicant Company Name: Registration No: Address: Tel: Fax: Contact person: Email: 2. Recovery facility Existing pre-consent reference no. (If applicable): Name: Address: Tel: Fax: Contact person: Email: 3. Wastes applied for under pre-consent Basel/OECD Waste description code EWC code Quantity/yr (Tonnes or m3) Total quantity/yr 4. Recovery operations applied for under pre-consent Permit: Recovery Description of Code technology employed Issue date No. 5. Signed: Expiry date (If applicable) Date: Designation: Page 3 of 3