Regulation 5
Waste Avoidance and Resource Recovery Levy Regulations 2008
APPLICATION FOR EXEMPTIONS
& INSTRUCTION BOOKLET
Contents of this booklet
Section 1 – Fact sheet on exemptions under regulation 5
Section 2 – How to apply for exemptions
Section 3 – Exemption categories
Section 4 – Approved Forms for applying for exemption(s)
Section 5 – Checklist
2
Section 1 – Fact sheet on exemptions under
regulation 5
Overview
The Waste Avoidance and Resource Recovery Levy Regulations 2008 (Levy Regulations)
apply to:



all waste received at landfill premises in the metropolitan region on or after 1 July
2008; and
all waste collected within the metropolitan region, irrespective of when it is collected,
and received at landfill premises outside the metropolitan region on or after 1 July
2008; and
return periods commencing on or after 1 July 2008.
The landfill levy is intended to discourage waste disposal to landfill and encourage resource
recovery. Regulation 5 contains exemptions from requirements of the Levy Regulations for
certain wastes and circumstances.
Licensees may apply to claim exemptions under regulation 5 of the Levy Regulations from
requirements of the legislation. Section 3 of this booklet lists the exemptions that licensees
of licensed landfills can apply for. To be eligible to be granted an exemption from
requirements of the Levy Regulations, the licensee must meet the criteria set out in the
relevant sub-regulation.
Applying for an exemption
A licensee must fill out the approved forms and provide all the information as required. Each
form provides further information on the type of information that a licensee must submit in
order to apply for an exemption.
An exemption will not be granted if the approved forms are incomplete.
Exemptions should be in place prior to 28 days after the end of the return period to avoid
landfill levy liability arising. To ensure there is sufficient time to provide an approval it is
important that all necessary supporting documents are provided with the application.
Section 2 of this booklet provides further details on applying for exemptions.
Approval or refusal of an application
Regulation 5(4) of the Levy Regulations specifies that the Chief Executive Officer (CEO) of
the DER may:



grant an exemption; or
refuse to grant an exemption; or
grant an exemption subject to conditions or limited to circumstances specified in the
notice; or
3

revoke an exemption.
The CEO will provide written notice of the decision. If an exemption is granted, an exemption
notice outlining the decision and conditions of the exemption will be issued to the licensee.
The licensee is required to meet all the conditions in the exemption notice. If a condition is
breached, the exemption ceases to have effect.
The exemption, if granted, applies to the exemption period as stated in the exemption notice.
The CEO may grant more than one exemption in an exemption notice.
If the CEO refuses an application for exemption or has imposed conditions or limitations that
the licensee objects to, the licensee may apply to the State Administrative Tribunal (SAT) for
a review of that decision.
The contact information for SAT is:
12 St Georges Terrace
PERTH WA 6000
GPO Box U1991
PERTH WA 6845
Telephone: 08 9219 3111
Toll-free: 1300 306 017
Facsimile: 08 9325 5099
www.sat.justice.wa.gov.au
Further information and other resources
A copy of the Levy Regulations can be found on the Western Australia State Law Publisher
website at: www.slp.wa.gov.au
The other waste avoidance legislation, Waste Avoidance and Resource Recovery Act 2007,
Waste Avoidance and Resource Recovery Regulations 2008 and Waste Avoidance and
Resource Recovery Levy Act 2007, can also be found on the website.
4
Section 2 – How to apply for exemptions
Overview
This section contains instructions on how to apply for exemptions.
Instructions
1. Read the information in Section 1 prior to completing the relevant forms.
2. Follow the instructions in this section of the booklet (Section 2) when completing the
approved forms.
3. Complete the Applicant / licensee details application form on page 7 with your (the
applicant’s) details and details of the licensed premises in relation to which exemptions
are being claimed.
4. There are 10 Approved application for exemption forms within this booklet. Fill in the
relevant forms. You may apply for more than one exemption in one return period. Only
complete the forms relevant to the exemptions that you are applying for.
5. Attach all the information and documents that are required for each exemption that you
have applied for. Information is provided on each form on what should be attached.
6. Complete and sign the declaration in Applicant / licensee details application form on
page 7. Failure to sign the form as the licensee of the landfill facility may mean the
application is not considered complete and may increase processing time.
7. Print out the Applicant / licensee details application form and the relevant completed
application for exemption forms, if using the electronic version.
8. Take a photocopy of the completed forms and the attached information and documents
that you will submit to DER for your records.
9. Send the completed forms and all required information:
By post to:
Director General
Department of Environment Regulation
Locked Bag 33
Cloisters Square PERTH WA 6850
ATTENTION: MANAGER, WASTE MANAGEMENT BRANCH
OR
In person or by courier to:
Reception
Department of Environment Regulation
Level 4, 168 St Georges Terrace
5
PERTH
ATTENTION: MANAGER, WASTE MANAGEMENT BRANCH
Section 3 – Exemption Categories
Overview
Regulation 5 of the Levy Regulations contains the following exemptions, with wording to the
general effect:
Regulation
Category of exemption
Regulation 5(1)(a)
Uncontaminated soil or other clean fill that is used for final cover
Regulation 5(1)(b)
Waste that is not disposed of to landfill but collected and stored at a landfill
for reuse, reprocessing, recycling or use in energy recovery
Regulation 5(1)(c)
Waste removed from an orphan site as defined in Section 32 of the
Contaminated Sites Act 2003 by a public authority to mitigate or prevent a
risk of harm to human health or the environment.
Regulation 5(1)(d)
Hazardous waste (that is, waste that poses an immediate risk of harm to
human health or the environment) reasonably removed by a public
authority
Regulation 5(1)(e)
Waste resulting from a natural disaster that cannot reasonably be reused,
reprocessed, recycled or used in energy recovery
Regulation 5(1)(f)
Waste deposited on a shoreline by the action of water that is removed by a
public authority to mitigate or prevent a risk of harm to human health or the
environment and cannot be reused, reprocessed, recycled or used in
energy recovery
Regulation 5(1)(g)
Waste used for construction or maintenance work carried out on the
licensed landfill
Regulation 5(1)(h)
Waste used for cover as required by a closure notice issued under the
Environmental Protection Act 1986
Regulation 5(2)
An exemption to weigh waste on a weighbridge
Regulation 5(3)
An exemption from conducting and lodging a survey if no waste is received
at a landfill during a return period
Complete each form for the exemption you wish to apply for. You may apply for more than
one exemption in one return period or for one financial year.
6
Section 4 – Application for Exemption(s)
Overview
This application for exemption booklet contains the following approved forms necessary to
apply for Regulation 5 exemptions from the landfill levy:
Regulation
Application located
I am applying for (tick box)
at page
Applicant details
7
□
Regulation 5(1)(a)
8
□
Regulation 5(1)(b)
10
□
Regulation 5(1)(c)
12
□
Regulation 5(1)(d)
14
□
Regulation 5(1)(e)
16
□
Regulation 5(1)(f)
18
□
Regulation 5(1)(g)
21
□
Regulation 5(1)(h)
23
□
Regulation 5(2)
25
□
Regulation 5(3)
27
□
Complete each form for the exemption you wish to apply for. You may apply for more than
one exemption in one return period or for one financial year.
Attach all relevant documents referenced in the application(s) to this booklet.
If you run out of space in an application attach extra pages as required, to this booklet.
7
8
APPROVED FORM – Application for Exemption
Office use only
Details of licensee
WARR Officer
Licensee name
Postal Address
Date received
Accepted as complete
Licensee ABN
Company ACN
Departmental reference
DER Licence Number
Name of landfill facility
Address of facility as per
licence
Contact Details
Contact name
Position
Contact telephone
number
Mobile number
Email address
Signed by the licensee
applicant
Deliver in person or by courier to:
Postal address:
Director General
Locked Bag 33
Department of Environment Regulation
Cloisters Square PERTH WA 6850
Level 4, 168 St Georges Terrace
PERTH WA 6000
ATTENTION: MANAGER, WASTE MANAGEMENT BRANCH
APPROVED FORM – Application for Exemption
9
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(a)
IMPORTANT: Complete this form if you are applying for an exemption under regulation
5(1)(a) from the Levy Regulations in respect of the following category of waste:
uncontaminated soil or other clean fill that –
(i)
is, or is to be, used after the completion of landfill operations to cover, to a
depth of up to 500 mm, waste disposed of on the premises; and
(ii) was accepted by the licensee at no charge.
Fit-for-purpose waste (being uncontaminated soil or other clean fill) used for final cover on a
landfill may be exempt from the Levy Regulations under regulation 5(1)(a). The definition of
“clean fill” is defined in the Landfill Waste Classification and Waste Definitions 1996 (as
amended). The waste must be accepted at no charge.
When applying to claim an exemption under regulation 5(1)(a), licensees are to apply for one
financial year, as the waste suitable for the sub-regulation’s purpose is likely to be received
and accepted on a continuous basis.
I am applying for an exemption
under regulation 5(1)(a) of the Levy
Regulations for the following
financial year:
Total quantity of waste needed for
final cover for the landfill
Financial year 20___ / ___
1 JULY 20___
TO
30 JUNE 20___
m3 / tonnes
[Delete one]
The quantity of waste exempted cannot
exceed the amount required to cover the
landfill cell(s) to a maximum depth of
500mm.
APPROVED FORM – Application for exemption under regulation 5(1)(a)
10
How did you arrive at the above
figure?
Please provide details of calculation or
methodology on how you arrived at the
above number. Attach further reports
and/or documentation if required.
In total, how much waste have you
claimed for exemption under this
category?
m3 / tonnes
[Delete one]
This is the amount of waste that you
have already claimed exemption on in
previous return periods.
m3 / tonnes
What is the quantity of waste you are
applying for in this exemption
application?
[Delete one]
Attachments required
No attachments required
APPROVED FORM – Application for exemption under regulation 5(1)(a)
11
APPROVED FORM – Application for exemption under regulation 5(1)(a)
12
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(b)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(b) of the Levy Regulations:
Waste that is not disposed of to landfill but is collected and stored at a licensed
landfill for reuse, reprocessing, recycling or use in energy recovery
The exempted waste must meet the below criteria below:



The exempt waste is reused, reprocessed, recycled or used in energy recovery as an
alternative to being disposed to landfill;
The exempt waste is stockpiled in a designated area and not disposed to landfill (i.e. if
the waste is buried or ‘disposed of to landfill’, the levy applies);
The exempt waste is removed from the landfill facility within the exemption period unless
otherwise stated.
If the waste is not recycled or otherwise removed from the licensed premises in an approved
manner before the expiry of the exemption period, the licensee must pay the levy on the
waste within 2 weeks of the end of the exemption period (see regulation 5(7) of the Levy
Regulations). However, regulation 5(8) of the Levy Regulations provides for DER to refund
the levy paid on the exempted waste if the waste is recycled or otherwise removed in an
approved matter within 12 months after the end of the exemption period. Records will be
required to substantiate claims for the refund.
This exemption does not apply to category 63 landfills (inert landfills).
I am applying for an
exemption under
regulation 5(1)(b) of the
Levy Regulations for a
period of:
One financial year
1 JULY 20___
–
30 JUNE 20___
Reuse
Description of the waste
Reprocessing
Recycling
tonnes
Maximum quantity of
waste to be exempted
[Delete one]
Energy recovery
techniques
[Circle one]
APPROVED FORM – Application for exemption under regulation 5(1)(b)
13
Reuse
Description of the waste
Reprocessing
Recycling
tonnes
Maximum quantity of
waste to be exempted
[Delete one]
Energy recovery
techniques
[Circle one]
Reuse
Description of the waste
Reprocessing
Recycling
tonnes
Maximum quantity of
waste to be exempted
[Delete one]
Energy recovery
techniques
[Circle one]
You may add to this table by attaching further information to the back of this form.
Attachments required
No attachments required
APPROVED FORM – Application for exemption under regulation 5(1)(b)
14
APPROVED FORM – Application for exemption under regulation 5(1)(b)
15
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(c)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(c) of the Levy Regulations:
Waste reasonably removed from an orphan site as defined in the Contaminated
Sites Act 2003 section 32 by a public authority to mitigate or prevent a risk of harm
to human health or the environment
□
I am applying for an exemption
under regulation 5(1)(c) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box.
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Name of public authority
Name of company transporting the
waste on behalf of the public
authority
APPROVED FORM – Application for exemption under regulation 5(1)(c)
16
m3 / tonnes
Quantity of waste to be exempted
[Delete one]
Location of the orphan site
Estimated time for the waste to be
removed from orphan site and
disposed to landfill
Why is the waste a risk of harm to
human health or to the environment?
Provide chemical analysis results and/or
other details of the contaminants from a
NATA accredited laboratory to show
how they pose a risk to human health
and the environment.
Attachments required
Please attached the following document as supporting information to your application for an
exemption under regulation 5(1)(c) of the Levy Regulations:


Copy of orphan site confirmation as per section 32 of the Contaminated Sites Act
2003.
Chemical analysis results and/or other documents from a NATA accredited
laboratory on the waste to prove that the contaminants pose a risk to human
health and the environment.
APPROVED FORM – Application for exemption under regulation 5(1)(c)
17
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(d)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(d) of the Levy Regulations:
Hazardous waste reasonably removed by a public authority
The intention of this exemption includes, but is not limited to, reducing the cost to public
authorities of dealing with illegal dumping of waste that poses an immediate risk of harm to
human health or the environment, such as asbestos, where the waste cannot be dealt with in
any other manner except to be disposed of to landfill, in order to facilitate timely clean up.
□
I am applying for an exemption
under regulation 5(1)(d) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box.
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Name of public authority
Name of company transporting the
waste on behalf of the public
authority
APPROVED FORM – Application for exemption under regulation 5(1)(d)
18
m3 / tonnes
Quantity of waste to be exempted
[Delete one]
Description of hazardous waste
Reasons for disposal to landfill
Provide reasons why the waste cannot
be dealt with in any other manner except
disposal to landfill.
Why is the waste a risk of harm to
human health or to the environment?
Provide chemical analysis result and/or
other details of the contaminants from a
NATA accredited laboratory to show
how they pose a risk to human health
and the environment.
Attachments required
Please attached the following documents as supporting information to your application for an
exemption under regulation 5(1)(d) of the Levy Regulations:

Where relevant, chemical analysis result and/or other documents from a NATA
accredited laboratory to prove that the waste poses a risk to human health and the
environment.
APPROVED FORM – Application for exemption under regulation 5(1)(d)
19
APPROVED FORM – Application for exemption under regulation 5(1)(d)
20
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(e)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(e) of the Levy Regulations:
Waste resulting from storm, fire, flood or other natural disaster that cannot
reasonably be reused, reprocessed, recycled or used in energy recovery
□
I am applying for an exemption
under regulation 5(1)(e) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box.
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Detail of natural disaster
Provide the date(s) and type of natural
disaster that generated the waste e.g.
fire, storm flood etc.
Name of public authority or company
or person removing the waste
APPROVED FORM – Application for exemption under regulation 5(1)(e)
21
Name of company transporting the
waste on behalf of the public
authority
Description of waste
m3 / tonnes
Quantity of waste to be exempted
[Delete one]
Reasons for disposal to landfill
Provide reasons why the waste cannot
reasonably be reused, reprocessed,
recycled or used in energy recovery.
Attachments required
No attachments required
APPROVED FORM – Application for exemption under regulation 5(1)(e)
22
APPROVED FORM – Application for exemption under regulation 5(1)(e)
23
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(f)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(f) of the Levy Regulations:
Waste that –
(i)
(ii)
(iii)
is deposited on a shoreline by the action of water; and
is reasonably removed from the shoreline by a public authority to
mitigate or prevent a risk of harm to human health or the environment;
and
cannot reasonably be reused, reprocessed, recycled or used in energy
recovery.
□
I am applying for an exemption
under regulation 5(1)(f) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box.
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Name of public authority
Name of company transporting the
waste on behalf of the public
authority
APPROVED FORM – Application for exemption under regulation 5(1)(f)
24
Was the waste deposited on a
shoreline by the action of water?
□
Yes
□
No
Location of shoreline where the
waste was deposited
Details on how the waste was
generated
Description of waste
m3 / tonnes
Quantity of waste to be exempted
[Delete one]
Why is the waste a risk of harm to
human health or to the environment?
Where applicable, provide chemical
analysis results and/or other details of
the contaminants, from a NATA
accredited laboratory, to show how they
pose a risk to human health and the
environment.
APPROVED FORM – Application for exemption under regulation 5(1)(f)
25
Reasons for disposal to landfill
Provide reasons why the waste cannot
reasonably be reused, reprocessed,
recycled or used in energy recovery.
Attachments required
Please attached the following documents as supporting information to your application for an
exemption under regulation 5(1)(f) of the Levy Regulations:

Where applicable, chemical analysis result and/or other documents from a NATA
accredited laboratory to prove that the waste poses a risk to human health and the
environment.
APPROVED FORM – Application for exemption under regulation 5(1)(f)
26
APPROVED FORM – Application for exemption under regulation 5(1)(f)
27
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(g)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(g) of the Levy Regulations:
Waste used for construction or maintenance work carried out on the licensed
landfill if –
(i)
(ii)
the amount of waste is specified in advance in a plan prepared by a
registered builder or an engineer; and
no charge is made by the licensee for accepting the waste.
The construction or maintenance work referred to in the regulation refers to work to construct
or maintain structures necessary for the operation of the landfill, for example internal roads
and hardstands. The application for this exemption, along with all supporting documentation,
should be submitted not less than 28 days before commencing the construction or
maintenance work.
□
I am applying for an exemption
under regulation 5(1)(g) of the Levy
Regulations for the return period of:
One financial year
□
1 JULY 20___
–
30 JUNE 20___
OR
Tick the relevant boxes.
□
One return period
□
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
APPROVED FORM – Application for exemption under regulation 5(1)(g)
28
Is the construction or maintenance
work necessary for the operation of
the landfill?
□
Yes
□
No
Nature of construction or
maintenance work
Description of the waste used for the
purpose of this exemption
m3 / tonnes
Quantity of waste to be exempted as
specified in the accompanying plan
prepared by a registered builder or
engineer
[Delete one]
Attachments required
Please attached the following documents as supporting information to your application for an
exemption under regulation 5(1)(g) of the Levy Regulations:

A plan of the construction or maintenance work prepared by a registered builder
or engineer.
The plan should include the details of the registered builder or engineer along with a
copy of the registration certificate and the amount of waste required for the construction
or maintenance work.
Plans may include:
1. Diagrams and cross-sections for easy reference; and
2. Maps of the facility’s proposed works.

Evidence to show that the material to be used is/will be accepted free of charge.
APPROVED FORM – Application for exemption under regulation 5(1)(g)
29
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(1)(h)
IMPORTANT: Complete this section if you are applying for exemptions under regulation
5(1)(h) of the Levy Regulations:
Waste used for cover on the licensed landfill if –
(i)
(ii)
a closure notice has been given in respect of the licensed landfill under
the Environmental Protection Act 1986 section 68A(2); and
the waste is used as required by the closure notice.
□
I am applying for an exemption
under regulation 5(1)(h) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box.
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Reference number:
Closure notice details
Date issued:
Quantity of waste to be exempted
m3 / tonnes
The quantity of waste exempted cannot
[Delete one]
exceed the amount required in the
closure notice.
APPROVED FORM – Application for exemption under regulation 5(1)(h)
30
Attachments required
Please attach the following documents as supporting information to your application for an
exemption under regulation 5(1)(h) of the Levy Regulations:

A copy of the closure notice issued under section 68A(2) of the Environmental
Protection Act 1986.
The plan should include the details of the registered builder or engineer along with a
copy of the registration certificate and the amount of waste required to comply with the
closure notice orders.
APPROVED FORM – Application for exemption under regulation 5(1)(h)
31
APPROVED FORM – Application for exemption under regulation 5(1)(h)
32
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(2)
IMPORTANT: Complete this section if you are applying for exemptions under regulation 5(2)
of the Levy Regulations:
A licensee may by application in the approved form claim an exemption from
the requirement under regulation 8 to weigh waste on a weighbridge.
Putrescible landfill facilities (category 64 and 65 landfills) with a weighbridge are required to
weigh waste on the weighbridge at the time of delivery in order to calculate the amount of
levy payable every return period.
Regulation 5(2) provides for DER to grant an exemption to weigh waste received at category
64 or 65 landfill premises on a weighbridge. Examples of when this exemption may be
granted are:



The weighbridge becomes inoperable or compromised, due to unforeseen
circumstances, such as accidental truck collision.
The weighbridge breaks down or data from the weighbridge is compromised.
The inoperable weighbridge cannot be repaired or rectified immediately.
This exemption is assessed on a case by case basis.
This exemption does not apply to category 63 landfills (inert landfills).
I am applying for an exemption
under regulation 5(2) of the Levy
Regulations for the return period(s)
of:
□
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box(es).
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
APPROVED FORM – Application for exemption under regulation 5(2)
33
Why and how did the weighbridge become inoperable?
Provide details on plans to repair or replace the weighbridge.
What is the expected timeframe to
repair or replace the weighbridge?
Attachments required
No attachments required
APPROVED FORM – Application for exemption under regulation 5(2)
34
APPROVED FORM – Application for exemption under regulation 5(2)
35
APPROVED FORM – Application for Exemption
Application for exemption under regulation 5(3)
IMPORTANT: Complete this section if you are applying for exemptions under regulation 5(3)
of the Levy Regulations:
A licensee of a category 63 licensed landfill may by application in an approved
form claim an exemption from the requirements of regulation 10(5) and (6) in
respect of a return period if no waste has been disposed of to landfill on the
licensed landfill.
Inert landfill facilities (category 63 landfills) are required to undertake volumetric surveys of
the landfill in order to calculate the amount of levy payable every return period.
Regulation 5(3) provides for DER to grant an exemption to conduct volumetric surveys if no
waste has been disposed of to landfill in a particular return period. The licensee must apply
for the exemption PRIOR to the due date for submitting the levy return and payments for a
return period. The levy is payable by a licensee not later than 28 days after the end of a
return period.
This exemption is assessed on a case by case basis. The licensee can only apply for this
exemption for one return period at a time.
APPROVED FORM – Application for exemption under regulation 5(3)
36
□
I am applying for an exemption
under regulation 5(2) of the Levy
Regulations for the return period of:
Quarter 3, 20___
1 July to 30 September
□
Quarter 4, 20___
1 October to 31 December
Tick the relevant box(es).
□
Quarter 1, 20___
1 January to 31 March
□
Quarter 2, 20___
1 April to 30 June
Was waste disposed of to landfill on
the premises?
□
Yes
□
No
APPROVED FORM – Application for exemption under regulation 5(3)
37
APPROVED FORM – Application for exemption under regulation 5(3)
38
Section 5 – Checklist
□
Complete the Applicant / licensee details application form on page 7 and the
relevant approved application for exemption forms attached to this booklet. Only
complete the forms for those exemptions for which you wish to apply. Incomplete
forms may increase processing time, or may be returned.
□
Tick the box(es) next to the exemption(s) you are applying for in the Applicant /
licensee details and declaration form and sign the declaration.
□
Ensure relevant documents are attached to the back of the application for exemption
form/s where required as supporting evidence for sub-regulations:
□
Regulation 5(1)(a):
No attachment required
□
Regulation 5(1)(b):
No attachment required
□
Regulation 5(1)(c):
Attach copy of orphan site confirmation as per section 32 of the Contaminated
Sites Act 2003
Attach a chemical analysis result and/or other documents from a NATA
accredited laboratory that proves that the waste poses a risk of harm to the
environment or human health
□
Regulation 5(1)(d):
Attach a chemical analysis result and/or other documents from a NATA
accredited laboratory that proves that the waste poses an immediate risk of
harm to the environment or human health
□
Regulation 5(1)(e):
No attachment required
□
Regulation 5(1)(f):
Attach (if applicable) a chemical analysis result and/or other documents from
a NATA accredited laboratory that proves that the waste poses a risk of harm
to the environment or human health
□
Regulation 5(1)(g):
Attach plan of construction or maintenance work prepared by registered
builder or engineer
Attach copy of builder’s or engineer’s registration certificate
39
□
Regulation 5(1)(h):
Attach copy of closure notice issued under section 68A(2) of the
Environmental Protection Act 1986
□
Regulation 5(2):
No attachment required
□
Regulation 5(3):
No attachment required
□
Take a photocopy of your application and any attachments for your records.
Provide the original forms and required attachments to DER either:
□
By post to:
Director General
Department of Environment Regulation
Locked Bag 33
Cloisters Square PERTH WA 6850
ATTENTION: MANAGER, WASTE MANAGEMENT BRANCH
OR
□
In person or by courier to:
Reception
Department of Environment Regulation
Level 4, 168 St Georges Terrace PERTH
ATTENTION: MANAGER, WASTE MANAGEMENT BRANCH