Private Bag 9023 | Whangarei 0148 | New Zealand
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12/58296 August 2012
Application under the Trade Waste Bylaw of Whangarei District Council
dry cleaning and laundry wastes
Office use
Date received
File no
Consent no
Issuing officer
Details of business (trade waste producer)
Name of business
Street address
Postal address
Phone no
Nature of activity generating trade waste
Name and address of applicant (if different from above)
Name
Address
Phone no
Details of trade waste discharge
Type of application
Proposed discharge Existing discharge with no consent
Consent renewal
Consent number
Variation of existing discharge
Type of variation
12/58296 August 2012
Composition of waste
Are solvents used Yes No
If yes (please specify)
Please include relevant MSD sheets and management plan controlling use and disposal of this material
Volume and rate of discharge
Average daily volume (m
3
)
Maximum flow rate (L/sec)
Daily/seasonal variation (if any)
Proposed method of flow measurement:
Calibrated meter (e.g. mains/internal supply) Manufacturer specification Other (please specify)
Volume and rate of discharge
Is there a pre-treatment system (e.g. filter or similar) Yes No
If yes (please specify)
Diameter of sewer being discharged into
Attach plan/sketch of the drainage layout for premises. Include details of:
i Any pre-treatment systems and management plans for their operation
ii Reservoirs or impounding areas to which wastes could be diverted in an emergency
Additional information
Please include any supporting information you may have, i.e. existing certification relevant to industry,
relevant management plans, etc.
Compliance statement (to be completed by executive representative of registered company)
The discharge referred to in this application complies with all conditions of the Trade Waste Bylaw 2012. The
discharge does not contain any substances which are specifically prohibited under Schedule 1B of the Trade
Waste Bylaw 2012. I understand that under Section 4.10 of this bylaw, failure to limit trade waste discharges
to within the parameters specified in Whangarei District Council’s Trade Waste Consent or Special
Agreement issued under this bylaw can be reasonable grounds for cancellation of this consent.
Signature
Name (please print)
Designation
Business name
Date
Application checklist
All sections completed
Yes No
Analysis attached
Yes No
Drainage plan/sketch attached
Yes No
Application signed
Yes No
NB: Application fee(s) apply.
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