Fillable WAIROA DISTRICT COUNCIL (Wairoa District Council New Zealand)

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WAIROA DISTRICT COUNCIL (Wairoa District Council New Zealand)

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The WAIROA DISTRICT COUNCIL (Wairoa District Council New Zealand) form is 3 pages long and contains:

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  • 21 check-boxes
  • 33 other fields

Country of origin: NEW-ZEALAND
File type: PDF

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1
WAIROA DISTRICT COUNCIL
P +64 6 838 7309
F +64 6 838 8874
E customerservices@wairoadc.govt.nz
W www.wairoadc.govt.nz
p PO Box 54, Wairoa 4160, Hawke’s Bay
A Coronation Square, Queen Street, Wairoa
APPLICATION FOR CONSENT TO DISCHARGE TRADE WASTE TO THE SEWER
APPLICATION FOR CONSENT TO DISCHARGE TRADE WASTE TO THE SEWER
Application for consent to discharge trade waste into the wastewater system, complying with the Trade Waste & Wastewater
Bylaw 2012.
If you are unsure whether you have to apply for a consent or not, contact our Trade Waste Oicer on (06) 838 7309 who can
help you identify sources of Trade Waste and the right pre-treatment.
Aer your application has been assessed our Trade Waste Oicer will contact you to arrange a site visit. Following this, you
may be required to take any or all of the following steps (this varies from site to site):
• install appropriate, or make changes to, existing pre-treatment equipment.
• enter into maintenance and service contracts for your pre-treatment equipment.
• commence a programme of monitoring of your Trade Waste discharge.
Applicant Details
Full Name
Postal Address
Post Code
Email Address
Phone Number
Company Details
Trade Name
Physical Address
Post Code
Email Address
Phone Number
Correspondence Details (if you are acting on behalf of the Applicant, e.g. agent)
Full Name
Company Name
Postal Address
Post Code
Email Address
Phone Number
Please answer all questions fully.
2APPLICATION FOR CONSENT TO DISCHARGE TRADE WASTE TO THE SEWER
Discharge Details
This application relates to (please tick)
Proposed New Discharge
Temporary Discharge
Renewal of a Consent
Variation to an Existing Consent (please specify)
Is there any existing pre-treatment (e.g. grease trap or oil & grit interceptor) at the premises?
Yes
No
If Yes, please provide details about the pre-treatment (type, size, frequency of maintenance etc.)
Please tick which of the following connections are at the premises.
Council Wastewater Network
Council Stormwater Network
Council Water Supply
Other source of water (please specify)
Main trade activity (please tick)
Food Premises
Process/Manufacturing
Healthcare
Hair & Beauty Services
Veterinary Clinic
Laundromat/Dry Cleaners
Tanker
Leachate/Landll Wastes
Commercial Swimming Pool
Printer
School/Educational Facility
Service Station/Mechanical Workshop
Other (please specify)
Please describe processes and main trade activity.
3APPLICATION FOR CONSENT TO DISCHARGE TRADE WASTE TO THE SEWER
Application & Declaration
The Council relies on the information contained in this application being complete and accurate. The Applicant must take
all reasonable steps to ensure that it is complete and accurate and accepts responsibility for information in this
application being so.
I hereby request consent to discharge Trade Waste to the sewers in keeping with the terms of the Trade Waste & Wastewater
Bylaw 2012 and I certify that to the best of my knowledge and belief the information given in this application is complete and
accurate.
Signed by (or as authorised Agent of) the Applicant
Full name of person lodging this form
Date
WDC Oice Use Only
Application received on
Site Visit Booked on
Site Visit Undertaken on
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WAIROA DISTRICT COUNCIL (Wairoa District Council New Zealand)

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Completed 7 February 2021

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