Application For Registration To Carry Out An Activity

Form 7 - Application For Registration To Carry Out An Activity Described By Section 192E of the Public Health Act

1- Name *

2- Business Address *

3- Registered Address (if different)

4 - Can you please give details of your telephone number, fax number or email code.

Phone Number *

Email Address *

5- What prescribed activity do you propose to pursue? (tick as appropriate) *

collecting or transporting waste on a professional basis

arranging as dealers or brokers for the disposal or recovery of waste on behalf of another person.

6- How do you intend to carry out your prescribed activity? Please note the methods to be used for each type of activity. *

7- What categories of waste products do you intend to deal with? *

8- What environmental health protection measures do you propose to take? Please give full details of the technology, machinery, hardware or software you intend to use. *

9- What quantities of waste do you estimate you shall be dealing with? *

Date *

Applicant will be required to sign application form prior to document being issued by the Agency.

I certify that the information contained in this Application is true to the best of my knowledge and belief. *

Yes

* obligatory fields