EHS ENP-03
ENF-03b
GROUNDWATER DISCHARGE PERMIT APPLICATION FORM
Property Developer
Construction Contractor
Name
:
Name
:
Address
:
Address
:
Authorized Representative of the Property Developer
Authorized Representative of the Construction Contractor
Name
:
Name
:
Address
:
Address
:
Proposed Groundwater Disposal
Method
Discharge to Open Sea
On-site Recycling & Re-use
Discharge to Storm Water Line
Off-site Recycling & Re-use
Discharge to Temporary Constructed Pond
(please check the appropriate box
and give details when necessary)
Other (please describe)
Proposed Groundwater Treatment
Method(s)
Sediment Settlement
Ion Exchange
Oil Separator
Filtration
(please check a box to indicate
the proposed method of treatment
prior to discharge)
Screening / Grit Removal
Other Methods of Water Treatment
Temporary Construction Dewatering
Permanent Site Dewatering
Operations that will apply to the
site
Site / Groundwater Remediation
Other (please describe)
Date of Initial Dewatering
:
Date of Dewatering Completion
:
Groundwater Laboratory Analysis Report from Accredited Third Party
Laboratory (http://www.dac.dm.ae)
Documents to be submitted
Actual Location Map – showing the dewatering and discharge locations
Others (if any; as required)
1
REVISION: 00
July 2010
Note: Please refer to www.ehss.ae to ensure that this document is current and applicable
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