EHS ENP-03
ENF-03a
ENVIRONMENTAL PERMIT APPLICATION FORM
Type of Permit Application (please tick the appropriate box/es)
Harbor / Open Sea Discharge Permit
Air Emission Permit
Irrigation Permit
General Information
Name of the Company
:
Type of Activity
:
Plot Location Number/s
:
Free Zone License No.
Contact Person
Date of Expiry :
:
Designation :
Email Address
:
Contact Nos.
:
:
1
REVISION: 00
July 2010
Note: Please refer to www.ehss.ae to ensure that this document is current and applicable
Page 1 of 4
EHS ENP-03
ENF-03a
Air Emission Permit
Combustion Source
Volatile Organics Source
Sources of Air Emission
Process Source
Number of Emission Source/s
Type of Air Emission
Discharge
Continuous
Batch
Number of Hours Operated in a
Year
Type of Fuel Used
% Sulfur of Fuel
Combustion Source
Previous Year Fuel Consumption
Fuel Storage Capacity
Fuel Storage Type
Documents to be submitted
Stack Emission Analysis Report from accredited third party
laboratory (http://www.dac.dm.ae)
Fuel Analysis Report from fuel supplier (if applicable)
Others (if any; as required)
Minimum parameters to be tested for each type of emission sources
(others can be added as required by EHS – Environment Department)
Carbon Monoxide, Nitrogen Oxides, Sulfur Dioxide,
Combustion Source
Total Particulate Matter
Minimum parameters shall be based on the type of raw materials
Process Source
input
Volatile Organics Source
Total Volatile Organic Compounds, Total Particulate Matter
2
REVISION: 00
July 2010
Note: Please refer to www.ehss.ae to ensure that this document is current and applicable
Page 2 of 4
EHS ENP-03
ENF-03a
Harbor / Open Sea Discharge Permit
Discharge Outfall Location
Harbor Water
Open Sea
Type of Treatment Process
Rated Capacity of Treatment
Facility
Industrial
Description of Waste Type
Domestic
Others (please specify)
Method for Collection /
Storage of Waste
Type of Treated Effluent
Discharge
Continuous
Maximum Quantity of
Discharged Treated Effluent
Batch
m3 / day
JAFZA Manhole ID No.
(Location of Discharge)
Documents to be submitted
Treated Water Analysis Report from accredited third party
laboratory (http://www.dac.dm.ae)
Others (if any; as required)
3
REVISION: 00
July 2010
Note: Please refer to www.ehss.ae to ensure that this document is current and applicable
Page 3 of 4
EHS ENP-03
ENF-03a
Irrigation Permit
Source of Irrigation Water
Type of Treatment Process
Quantity of Irrigation Water
Discharge
m3
Number/s of Irrigation Water
Storage Tank/s
Capacity of each of Irrigation
Water Storage Tank/s
Documents to be submitted
Irrigation Water Analysis Report from accredited third party
laboratory (http://www.dac.dm.ae)
Others (if any; as required)
4
REVISION: 00
July 2010
Note: Please refer to www.ehss.ae to ensure that this document is current and applicable
Page 4 of 4