Fill - Free fillable Form 1: Operating Licence / Construction Permit Application PDF form

Operating Licence / Construction Permit

Application Form

The Environmental Authority

P.O. Box HM 834, Hamilton HM CX, Bermuda. Phone: 239 2303

Application for a Construction Permit ; Operating Licence ; or Both for each Controlled Plant

APPLICANT’S:

NAME(S):

COMPANY:

MAILING ADDRESS:

Number Street (or PO Box Number) Parish Postal Code

Phone (day): Phone (eve): Email:

Complete this section if you are acting on behalf of the owner. (NOTE: section above must be fully completed):

AGENT’S:

NAME: COMPANY:

MAILING ADDRESS:

Number Street (or PO Box Number) Parish Postal Code

Phone 1: Phone 2: Email:

If you would like a copy of the Operating Licence Certificate that is mailed to the applicant please tick this box:

PROPOSED LOCATION OF CONTROLLED PLANT:

HOUSE/COMPANY/ORGANISATION NAME:

ADDRESS:

Number Street Parish Postal Code

Assessment Number: OS Map No/Grid Ref:

(supplied by office)

Planning Application submitted: Yes: No: Planning Application Number:

TYPE OF CONTROLLED PLANT

Manufacturer: Model:

Proposed Installation Date: Plant Capacity:

Types/Amounts of Emissions to Air:

Air Pollution Control Devices Installed:

Other Types of Emissions from Plant:

Daily Times of Operation: Total Hours of Operation (Hrs/Month):

Stack Height: Above Ground Level (m): Above Building Eaves (m):

Chemicals Used (Type / Amounts per yr):

Nominated Operator/Maintainer (Yes/No/Name):

Please attach additional information where possible: Site Plan: Manufacturers Information:

Rated capacity (b-kW): US EPA/CFR Tier Rating:

Fuel Type: Proposed Sulphur Content of Fuel:

1RLVH0RGHOOLQJ,QFOXGHG<1: Exhaust Silencer Grade:

Rated Noise Level at  metre (dBA): With Silencer: Without Silencer:

OFFICE USE: 89100.8457

Construction Permit # CP Fee ($200/plant):

Operating Licence #

Fee

(

$90/

plant):

Validation No. Date:

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April 2018

SEWAGE TREATMENT PLANTS:

Type of Sewage Treatment Plant:

Type of Screening/Pre-Treatment:

Frequency of Removal (vol./month): Screenings: Sludge:

Estimated Flow: Black water (igpd): Grey water (igpd):

Other Waste Waters (Type / igpd):

Designed Dissolved Oxygen

(ppm): Air Flow Rate (m

/hr):

Grease Trap (Type / Capacity):

A Water Right application is required for disposal of treated water to borehole. Water Right applied for Yes: No:

Design range of dissolved oxygen within aerobic stage of the sewage treatment process (if applicable).

I am the owner of the Controlled Plant: I am the Agent* for the Controlled Plant:

I am the owner of the site where the Controlled Plant will be operated:

Name: __________________________ Signature: ____________________ Date: ___________

*If the application form is signed by anyone other than the owner of the controlled plant (e.g. an agent), this application

must be accompanied by a letter signed by the owner stating that he/she is aware that the application is being made.

Information on Construction Permit & Operating Licence Applications

This application is only for an Operating Licence of a Controlled Plant in compliance with the requirements of

the Clean Air Act 1991. Before an Operating Licence (i.e. this form) can be granted a Construction Permit

(i.e. also this form) is required to locate the Controlled Plant at a particular site. A separate application to

the Department of Planning for planning permission and a building permit for the use and operation of the

controlled plant must be submitted to and approved by the Development Applications Board prior to any use

and operation of the controlled plant in compliance with the Development and Planning Act 1974 and the

Building Act 1988. Required approvals from other appropriate Government Departments must also be secured

prior to the operation of the plant.

Please submit the completed form together with the application fees at the top right of this form per plant to

the PO Box above or to the Department of Environment & Natural Resources, Botanical Gardens, 169 South

Road, Paget DV-04. Cheques should be made payable to the Accountant General. Alternatively, payment

may be made at the Cashiers, Ground Floor, Government Administration Building, 30 Parliament Street,

Hamilton HM 12.

Types of Controlled Plants legislated under the Clean Air Act 1991:

(a) a facility for the manufacture of –

(i) asphalt or ready-mixed concrete; or

(ii) chemical, stone, clay, glass, cement or lime products or fertilisers or animal by-products;

(b) a facility for the production or processing of metal or of organic or inorganic chemicals, or for the

processing of wood or wood products;

(d) a facility for the treatment or disposal of sewage;

(e) a facility for the drying of hay or forage, or for the production of compost;

(f) a facility which generates electricity or steam;

(g) an incinerator;

(ga) a facility for the spray painting of vehicles or machinery;

(gb) a facility for the dry cleaning of apparel;

(gc) a facility using non-portable internal combustion engines (excluding motor vehicle engines) such as

compressors and gas or diesel powered pumps.

(h) a facility for the storage, treatment or disposal of hazardous materials (as defined in regulations);

(i) a facility for burning, or a pyre consisting of, prohibited debris (as defined in regulations);

(j) any other thing declared by regulations to be a controlled plant for the purposes of this Act.

If You Have Any Queries

Please contact Patricia Hollis (239-2303), Dr Shaun Lavis (239-2318) or Dr Geoffrey Smith (239-2356) for further

information or email PollutionControl@gov.bm or visit www.gov.bm for forms and legislation.

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Fillable Form 1: Operating Licence / Construction Permit Application

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