Scottish Landfill Tax Waste Producers application to Revenue Scotland for discounting of water content of waste PART 1 About this form Use this form to make an application for discounting of water content of waste for Scottish Landfill Tax purposes. You must complete Part 1 and Part 2 and answer all the questions except those marked ‘optional’. Please print this form and post it on completion. We will deal with most applications within 20 working days. You also need to send a signed form ‘Landfill site operators application to operate Revenue Scotland’s water discount scheme for waste producers’ from each receiving landfill site operator indicating that they are willing to operate an agreed discount. It should be noted that formal authorisation is provided to the landfill site operator. About the waste producer Is the application for renewal of a previously approved scheme? Yes – please provide details of your SLfT water discount reference SLfT water discount reference number (if applicable) No Applicant/Company name Address Line 1 1 Line 2 Line 3 (optional) Postcode Telephone Number About the waste for which water discounting is required Choose all boxes that apply The water has been added for transportation for disposal; The water has been used for the extraction of minerals; The water has arisen or been added (or both) in the course of an industrial process; or the material is the residue from the treatment of effluent or sewage by a water treatment works; and none of any of the above material is a liquid waste and banned from landfill. Tell us what type of waste is produced? 2 Tell us how this waste was produced? Tell us how and why water was added? Tell us the water content of the waste as it arrives at the landfill site (please provide evidence to support this)? Water content in the waste % Is there naturally occurring water? Yes No If yes – what is the naturally occurring water content ? % What is the added water content? % 3 Have you carried out treatment to the waste to reduce or remove water content? Yes No If yes – tell us about this treatment? If no- Tell us the reason treatment to reduce or remove water was not possible? Tell us the date that disposals will start at this site, or the date you want your agreement to start from? Please send us documentation to support this application List all relevant documentation which you are sending to support this application, including: - details of how and why water is added; - details of water reduction or removal or why this is not possible; and 4 - analysis of the waste 5 The landfill sites PART 2 Give the details of the site(s) which will be receiving the waste covered by the SLfT water discounting agreement. The landfill site operator will be able to give you the information. Important You will need to provide separate details for each landfill site and attach to your application. Landfill site no. ( ) (please number as appropriate) Trading name of the site operator SLfT registration number Site address Line 1 Line 2 Line 3 (optional) Postcode 6 Does the Landfill site operator have a separate mailing address? Yes No If yes, please provide details Line 1 Line 2 Line 3 (optional) Postcode (complete pages 6&7 for each additional nominated Landfill site and attach to this application). Tell us about the type of waste which will be sent to this site? Give an estimate of the weight in tonnes which will be sent to this site annually. 7 Declaration The information I have given on this form and in the accompanying documents is complete and accurate to the best of my knowledge and belief. I will tell Revenue Scotland immediately if my circumstances or plans change in any way that affects the answers I have given on this form. When you have printed this form, please sign and date it in the appropriate boxes Signature 8