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Version 4.3

QF 23(a) Version 4.3 16/03/2016

WASTE COLLECTION PERMIT APPLICATION FORM

Guidance Notes & Application Form For Both New & Review Waste Collection Permit Applications

Applicant Name:

Telephone Number:

Postal Address:

FORM 1

IN ADDITION TO THIS FORM, PLEASE ENSURE TO COMPLETE AND INCLUDE:

FORM 2: Waste Codes Table (Excel File)

FORM 3: Supplementary Questions (applicable for specific waste types only, see Question 5.4 of this form)

FORM 4: Household Kerbside Waste Service and Vehicles Table (Excel File)

ALL FORMS ARE AVAILABLE TO DOWNLOAD FROM www.nwcpo.ie

IMPORTANT Please note this application form is continuously updated. If this form has not recently been received or downloaded, you are advised to contact the National Waste Collection Permit Office to confirm that this is the most recent version.

Please be aware that information supplied in this application, including supporting documentation, will be put on public display and open to inspection by any person. Following the application process your application may be made available under the Freedom of Information Act 2014

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Checklist of Information to be Supplied with Application

INFORMATION REQUIRED: QUESTION INCLUDED

One fully completed application form ONLY. All questions to be completed or marked “not applicable”.

All

Confirmation of payment of application fee e.g.: receipt number/copy of EFT payment.

1.3

An original Statutory Declaration form (Appendix 1). Signed by either sole trader, each partner or director where applicable.

4.6

Completed Waste Codes Table (Excel file – please download from www.nwcpo.ie) One electronic copy to be submitted.

5.4

Appendix 6 completed for each facility that is intended to be used in connection with the waste collection activity.

5.6

A copy of the Vehicle Registration Certificate for each vehicle. 5.8

A copy of current Tax Clearance Certificate from Irish Revenue. 6.4

An original Financial Declaration form (Appendix 3). 6.4

An original Motor Insurance Declaration form (Appendix 4). 6.5

An original Public Liability Insurance Declaration form (Appendix 5).

6.5

For new applications: A copy of the relevant page from the newspaper(s) in which notice(s) have been published. (Template in Appendix 2).

Appendix 2

IF APPLICABLE PROVIDE THE FOLLOWING: QUESTION INCLUDED

A copy of Notice from nominated authority instigating a review. 3.2

A copy of Certificate of Registration of Trade Name. 4.3

A copy of the printout from the Companies Registration Office detailing the Company Directors.

4.6

A copy of the applicant’s Certificate of Incorporation issued by the Companies Registration Office.

4.6

Supplementary Questions as may be required. 5.5

For Household Kerbside Waste Form 4 (excel spreadsheet of proposed household waste collection service and vehicles).

Supplementary Q.5

A Draft Customer Charter (For Household Kerbside Waste Only) Supplementary

Q.5

FP2 form for the export of waste outside of the Island of Ireland (Port of export).

5.7

A copy of the documentation specified by the NWCPO for the leasing of vehicles or the sub-contracting of waste collection.

5.8

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IF APPLICABLE PROVIDE THE FOLLOWING: (Continued...) QUESTION INCLUDED

Details of any court hearing, case, nature of the offence and any penalty or requirements imposed by the court.

6.1

Where the applicant is a sole trader or partnership, include details of any such conviction where any relevant person or partner was at any time within the last 10 years prior to this application, a director, manager, company secretary or similar officer for a company.

6.1

Fees payable from 16th January 2016

Application Fees:

Fee amount paid: €

Payment type: (cheque, EFT, cash)

Electronic Funds Transfer reference number, where applicable:

NEWSPAPER CHECKLIST

IMPORTANT INFORMATION Applicants are hereby advised that in accordance with Article 6 (1)(b) of the Waste Management

(Collection Permit) Regulations 2007-2016 the NWCPO may now publish notification of the intention to make an application on the website of the NWCPO, www.nwcpo.ie

Applicants wishing to avail of this option, rather than having their public notice published in a newspaper, are advised to contact the NWCPO.

“APPLICATION TO OFFALY COUNTY COUNCIL AS NATIONAL WASTE COLLECTION PERMIT OFFICE (NWCPO), FOR A WASTE COLLECTION PERMIT RELATING TO A WASTE COLLECTION ACTIVITY OR WASTE COLLECTION ACTIVITIES IN (<<NAME REGION OR REGIONS>>)”

Full name and address of principal place of business of the applicant.

State that the application for a Waste Collection Permit will be made to the NWCPO within 10 working days of the newspaper notice.

Specify the nature of the waste collection activity to which the application relates (or use template as provided in Appendix 2) and the local authority area or areas where the collection activity or activities will be undertaken.

State that a copy of the application will be available for inspection or purchase at the principal offices of the Local Authorities from as soon as is practicable after receipt by the NWCPO.

Application Completed By: _______________________ ________________________ Signature BLOCK CAPITALS

http://www.nwcpo.ie/

QF 23(a) Version 4.3 16/03/2016

Table of Contents

Checklist of Information to be Supplied with Application i

1. GUIDANCE NOTES 1

1.1. Introduction 1

1.2. Who Do I Apply To? 1

1.3. Fees Payable from 16th January 2016 2

1.4. Pre-Application Research and Consultation 2

1.5. Guidance on the Application Form and Process 3

1.6. Additional Documentation to be Included 3

1.7. About these Guidance Notes 4

2. APPLICATION GENERAL INFORMATION 5

2.1. Application Type 5

2.2. Consultant / Agent Details 5

2.3. Pre-Application Consultation with the NWCPO 5

3. EXISTING PERMIT HOLDER DETAILS 6

3.1. Existing Permit(s) Held by the Applicant 6

3.2. Reason(s) for the Review of Existing Permits 6

4. ABOUT THE APPLICANT 7

4.1. Applicant’s Correct Legal Entity 7

4.2. Full Name of Applicant(s) 7

4.3. All Business Name(s) (Trade Names) Used, or Proposed to be Used 8

4.4. Applicant(s) Contact Details 8

4.5. The Local Authority Area where the Principal Office is Based 8

4.6. Statutory Declaration 8

4.7. Is the Applicant a Company? 9

4.8. Is the Applicant a Partnership / Joint Applicant / Limited Liability Partnership? 9

5. ABOUT THE WASTE COLLECTION ACTIVITY 10

5.1. Waste Collection Areas 10

5.2. General Waste Activity 11

5.3. Waste Type and Description 11

5.4. Supplementary Questions for Specific Waste Types 12

5.5. Waste Destination Facilities within the Island of Ireland (including Northern Ireland) 13

5.6. Facilities Outside of Ireland – TransFrontier Shipment (TFS) 13

5.7. Waste Collection Vehicles 14

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6. FIT & PROPER PERSON REQUIREMENTS 16

6.1. Relevant Convictions 16

6.2. Regional Waste Plan and/or National Hazardous Waste Management Plan requirements 16

6.3. Technical Competence (Fit and Proper Person) 17

6.4. Record Keeping and Reporting 18

6.5. Financial Commitment Discharge 18

6.6. Insurance Details 19

6.7. Environmental Liability 19

6.8. Revocation of a Waste Collection Permit 19

7. ADDITIONAL INFORMATION 20

Appendix 1 - Statutory Declaration 22

Appendix 2 - Suggested Newspaper Notice Format 23

Appendix 3 - Financial Commitment Discharge Declaration 25

Appendix 4 - Motor Vehicle Insurance Declaration 26

Appendix 5 - Public Liability Insurance Declaration 28

Appendix 6 – Inclusion of an Authorised Waste Facility 30

NWCPO Waste Collection Permit Application Form Version 4.3 Section 1 - Guidance Notes

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1. GUIDANCE NOTES

1.1. Introduction

On the 1st of February 2012, Offaly County Council was designated as the Nominated Authority for the processing of all new Waste Collection Permit applications and Review applications. This single Nominated Authority is known as the National Waste Collection Permit Office (NWCPO). This form is for making an application for a Waste Collection Permit under the Waste Management (Collection Permit) Regulations S.I. No. 820 of 2007 as amended (hereafter referred to as the Regulations). This application form can be used to apply for a:

New/Review single Local Authority Area waste collection permit; or

New/Review single region waste collection permit; or

New/Review multi region waste collection permit.

The application form and other relevant documents are available to download from the NWCPO web site www.nwcpo.ie.

In order to make the application process as efficient as possible, it may be necessary for the NWCPO

to contact the applicant or a representative for the applicant while processing the application. The

application contact person must have a good knowledge of the application form and the detail

within. For this reason it is recommended that the application contact person should be the person

who has completed the application form and any relevant supporting information.

NOTE: An application for the review of a waste collection permit granted under the 2007 Regulations (as amended) must be made no later than 60 working days before the expiry date of the permit, if it is to remain in force.

1.2. Who Do I Apply To?

All Waste Collection Permit applications and Waste Collection Permit Review applications made on or after the 1st of February 2012 must be made to the National Waste Collection Permit Office.

NATIONAL WASTE COLLECTION PERMIT OFFICE - CONTACT DETAILS

Address

NWCPO Offaly County Council Áras an Chontae Charleville Road Tullamore Co. Offaly

Telephone 057 9357428

Website www.nwcpo.ie

E-mail [email protected]

Twitter @NWCPO



mailto:[email protected]


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1.3. Fees Payable from 16th January 2016

New Application Fees Review Fees

Single Local Authority Area Permit

€1,000 €500

Single-Region Permit €2,000 €1,000

Multi-Region Permit €2,000 per region, up to a maximum charge of €5,000 for all three regions.

€2,500

All Interim Reviews**

N/a

Calculation applied: (Applicable review fee/5 years)*No. of full years completed on permit cycle

All Transfer applications

€500

**Interim Review Fee Calculator: Applicable review fee €__________ / 5 years = € ___________X ____________ No. of full years completed on permit cycle

= Fee Payable € __________

PLEASE NOTE ALL FEES CALCULATED ARE SUBJECT TO APPROVAL BY THE NWCPO. IF YOU REQUIRE CLARIFICATION ON FEES PAYABLE PLEASE EMAIL YOUR QUERY TO [email protected].

Payment Method Instruction

Credit Transfer or Direct Lodgement

Lodge to Offaly County Council’s Bank Account:

Bank of Ireland, Bridge Street, Tullamore, Co. Offaly. Sort Code: 90-19-09 Account Number: 48640672 IBAN: IE64BOFI90190948640672 IBIC: BOFIIE2D

Please quote code 05190026 and include applicant name. Postal Money Order or Bank Drafts

Crossed and made payable to Offaly County Council.

Cash, Cheque, Credit or Debit Card

Pay at the Cash Office in Offaly County Council, or pay with credit or debit card, over the phone. Phone Offaly County Council on 057 9346800.

1.4. Pre-Application Research and Consultation

A pre-application consultation or discussion with the NWCPO may be undertaken before a formal submission of any of the above types of applications. These are primarily undertaken by telephone with one of the members of the NWCPO team.



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Prior to contacting the NWCPO for a pre-application consultation, the applicant is advised to identify the areas of the form which they require further guidance on. The applicant will get more benefit from the process if they prepare the form in advance. It is also recommended that the applicant familiarise themselves with the following, prior to completing the application:

The Waste Management Act, 1996, Waste Regulations and Bye-Laws e.g. Waste Presentation Bye-Laws, Skip Bye-Laws.

The List of Waste code book and the process for assigning waste codes.

It is a requirement that the applicant familiarise themselves with the relevant Waste Management Plan/s for the region or regions and the National Hazardous Waste Management Plan if it is proposed to collect hazardous waste. Waste Management Plans are available to download from all local authority websites. The National Hazardous Waste Management Plan produced by the EPA, is available at www.epa.ie.

1.5. Guidance on the Application Form and Process

The contents of an application (new and review) and the information to accompany an application are specified in Articles 6 and 7 of the Regulations. This form has been designed in accordance with these articles. The application form is designed in such a way as to set out questions in a structured manner and not in the order presented in the Regulations. Certain sections in this application form may not be relevant to every application, or applicant. However, the applicant should look carefully through the complete form and provide all relevant information. If any question is considered 'not applicable’ this should be clearly stated. Additional attachments may be required to support the application. Attachments should be clearly numbered, titled and paginated and must contain the required information as set out in the application form. Where attachments are required they are detailed in the question. For the NWCPO to be satisfied that a valid application has been submitted or to make a decision on the application, further information may be requested from the applicant. This may delay the application process and is likely where insufficient information has been submitted. A decision in relation to an application for a waste collection permit will be made within:

40 working days from the date of receipt of a valid application, or

40 working days from the date of receipt of further information or particulars, or

25 working days from the date of receipt of any submission received

Whichever period is the longest.

1.6. Additional Documentation to be Included

Documents and information which must be supplied with the application are detailed throughout the application form and are summarised for convenience as a checklist on pages (i) and (ii) of this application form. Any applicant who does not submit all of the relevant documents will be contacted by the NWCPO to supply the missing documents within a set timescale.

http://www.epa.ie/


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New applicants must advertise the proposed waste collection activity as outlined in Appendix 2. Please ensure that a copy of the page of the newspaper notice is attached to the application.

The applicant is required to submit details in relation to the waste types and quantities that will be collected as per Question 5.4 of this application. The Waste Codes Table (FORM 2), (Excel spreadsheet) is available to download from www.nwcpo.ie. This must be completed and submitted electronically.

The applicant must complete the Supplementary Questions (FORM 3) for specific waste type’s e.g. household kerbside waste, bulky waste, Waste Electronic and Electrical Equipment. These supplementary questions may not be applicable to all applicants. See Question 5.5.

1.7. About these Guidance Notes

This application form and attachments do not purport to be, and should not be considered a legal interpretation of the provisions and requirements of the Waste Management (Collection Permit) Regulations, 2007 as amended. While every effort has been made to ensure the accuracy of the material contained in this application form, the NWCPO assumes no responsibility and gives no guarantees; undertakings or warranties concerning the accuracy, completeness or up-to-date nature of the information provided herein and does not accept any liability whatsoever arising from any errors or omissions.


NWCPO Waste Collection Permit Application Form Version 4.3 Section 2 – Application General Information

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2. APPLICATION GENERAL INFORMATION

2.1. Application Type

Please tick () the relevant box to which this application applies and complete the fee calculator (Only one box may be ticked).

NEW WASTE COLLECTION PERMIT Complete all sections excluding Section 3

REVIEW OF A WASTE COLLECTION PERMIT OR PERMITS Complete all sections

INTERIM REVIEW OF A WASTE COLLECTION PERMIT (please note interim review fee calculator section 1.3)

Complete all sections (unless otherwise agreed with the NWCPO)

2.2. Consultant / Agent Details

Has the applicant a Consultant / Agent acting on their behalf? Yes No

Please provide details of an appropriate contact or representative of the applicant.

Contact Name

Address

Telephone

Email

Should all correspondence be sent to the agent’s address? (where applicable)

Yes No

NOTE: If the answer is ‘No’, all correspondence will be sent to the applicant’s address.

2.3. Pre-Application Consultation with the NWCPO

Has the applicant had any form of consultation with the NWCPO in relation to the application?

Yes No

If ‘Yes’ please provide the following details:

Contact Name in NWCPO

Date of Pre-Application Consultation

NWCPO Waste Collection Permit Application Form Version 4.3 Section 3 – Existing Permit Holder Details

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3. EXISTING PERMIT HOLDER DETAILS

3.1. Existing Permit(s) Held by the Applicant

If the applicant is the holder of existing waste collection permit(s), please complete the table below.

Nominated Authority / Granted By Waste Collection Permit Number

3.2. Reason(s) for the Review of Existing Permits

Where a permit holder is applying for a review of their Waste Collection Permit, explain the reason(s) for review (continue on separate sheet if necessary). If a review has been initiated by the

NWCPO, please attach a copy of the notice initiating the review. Attached

NOTE:

When an application for a review has been submitted due to a significant change in nature, focus or extent of waste collection activity, the NWCPO may determine that a new application is warranted, e.g. commencing the collection of household kerbside waste or adding a new waste region(s) to the waste collection activity.

Continue on separate sheets if necessary. Document(s) Reference:

NWCPO Waste Collection Permit Application Form Version 4.3 Section 4 – About The Applicant

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4. ABOUT THE APPLICANT

4.1. Applicant’s Correct Legal Entity

Applicant(s) must be a legal entity. Please tick () the relevant type: (Only one box may be ticked).

Sole Trader

Partnership (including LLP)

Limited Company (LTD)

Designated Activity Company (DAC)

Unlimited Company (UC)

Company Limited by Guarantee (CLG)

4.2. Full Name of Applicant(s)

Applicant(s) must be a legal entity (sole trader, partnership or company (body corporate)). In the case of joint applicants, identify the principal applicant.

Name(s)

Name(s)

NOTE:

The name provided above (4.2), is the name the permit will be issued under. The full name of the applicant must be consistent throughout the application form including newspaper notice (where applicable).

If the applicant is applying as a company, it is important to include the suffix e.g. the word ‘Limited’ or ‘Ltd’ throughout the application form, including newspaper notice (where applicable).

Inconsistent use of the applicant name / legal entity will result in the application being deemed invalid.


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4.3. All Business Name(s) (Trade Names) Used, or Proposed to be Used

Business Name (Trade Name)

Business Name (Trade Name)

Attach a copy of the Certificate of Registration of Business Name from the Companies Registration Office. ATTACHED

4.4. Applicant(s) Contact Details

Please supply the address of the principal place of business, the telephone number, fax and email address of the applicant. If the business is a partnership, please supply the name and address of the principal partner.

Contact Name

Address

Telephone

Fax

Email*

*A valid email address must be provided with the application.

NOTE: The above information (excluding contact name) will be provided on the Public Register at www.nwcpo.ie and the applicant’s Waste Collection Permit.

4.5. The Local Authority Area where the Principal Office is Based

Please state which Local Authority Area the principal place of business is based within.

Local Authority Area (e.g. Dublin City Council)

4.6. Statutory Declaration

A Statutory Declaration must accompany the application in the format provided in Appendix 1.

To be signed by the applicant, each partner in the case of a partnership, each director in the case of a company. To be witnessed by a Solicitor/Commissioner of Oaths/Notary Public/Peace Commissioner/Garda Síochána.

ATTACHED


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4.7. Is the Applicant a Company?

Attach a copy of the Certificate of Incorporation for the company. ATTACHED

Attach a copy of the company printout from the Companies Registration Office detailing the company director(s) and other similar officers. ATTACHED

NOTE: In the case of a company, please be advised that an original Statutory Declaration is required for each director (Appendix 1).

Address of Registered Office of the Company:

Address

CRO Number

4.8. Is the Applicant a Partnership / Joint Applicant / Limited Liability

Partnership?

If the applicant is a partnership, please list the name(s) and address(es) of all other partners.

Name & Address

Name & Address

Name & Address

Name & Address

Name & Address

NOTE: In the case of a partnership, please be advised that an original Statutory Declaration is required for each partner (Appendix 1).

NWCPO Waste Collection Permit Application Form Version 4.3 Section 5 – About The Waste Collection Activity

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5. ABOUT THE WASTE COLLECTION ACTIVITY

5.1. Waste Collection Areas

Please tick () the relevant Local Authority Area(s) where the applicant proposes to collect waste. Regional groupings below are as per the Waste Management (Collection Permit) Regulations, 2007 as amended.

LOCAL AUTHORITY

All Local Authorities

CONNACHT ULSTER REGION

Cavan County Council

Donegal County Council

Galway City Council

Galway County Council

Sligo County Council

Leitrim County Council

Mayo County Council

Roscommon County Council

Monaghan County Council

EASTERN & MIDLANDS REGION

Dun Laoghaire-Rathdown

Fingal County Council

Longford County Council

Westmeath County Council

Kildare County Council

Offaly County Council

Louth County Council

Laois County Council

Meath County Council

Wicklow County Council

South Dublin County Council

Dublin City Council

SOUTHERN REGION

Carlow County Council

Cork County Council

Clare County Council

Kerry County Council

Kilkenny County Council

Tipperary County Council

Wexford County Council

Limerick City and County

Council

Waterford City and County

Council

Cork City Council


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5.2. General Waste Activity

Please outline the proposed waste activity:

Continue on separate sheets if necessary.

NOTE: For new applications, please ensure that a copy of the page of the newspaper notice is attached to the application. See Appendix 2.

5.3. Waste Type and Description

Please complete the Waste Codes Table to accompany this application (FORM 2 - Excel spreadsheet available to download at www.nwcpo.ie). This table must be completed electronically and must be completed by all applicants. Applicants must provide details of the Collection Area (Local Authority Area), Waste Description, Type of Service and Destination Facilities by completing the Waste Codes Table. The applicant may need to refer to the List of Waste Code Book which can be downloaded from www.nwcpo.ie. A separate Excel Spreadsheet (FORM 4) is required for applicants proposing to collect household kerbside waste (routine household bin collections). See Question 5.5 and Supplementary Question 6.

For your assistance, sample rows have been completed in the Waste Codes Table. Please delete these rows before completion. ATTACHED



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5.4. Supplementary Questions for Specific Waste Types

The following waste types have specific requirements in waste policy and/or legislation. Please identify if the proposed waste activity includes any or all by ticking the relevant boxes. The applicant is advised to refer to the List of Waste Code Book which may be downloaded from www.nwcpo.ie. NB: If the applicant has selected any of these specific waste types or codes, the relevant Supplementary Question(s) in FORM 3 must be submitted. The Supplementary Questions (FORM 3) is available to download from www.nwcpo.ie.

NOTE:

Should an existing permit holder decide to expand their business and include any of these waste types post grant (where they were not on the original permit), this will require a permit review.

Where household waste was not previously included on a permit, this cannot be added through the review process, a new application is required.

Specific Waste Type List of Waste Codes Supp.

Question Tick

Batteries and Accumulators

16 06 01*, 16 06 02*, 16 06 03*, 16 06 04, 16 06 05, 16 06 06*, 20 01 33*, 20 01 34

1

Bulky Waste (Skip hire, household clear-outs) 20 03 07 2

Commercial and Industrial (Non Production) Waste (door to door kerbside and packaging)

Codes from Chapter 15 (Packaging) and 20

(commercial kerbside) 3

Hazardous & Non Hazardous End of Life Vehicles (E.L.V.’s)

16 01 04* and 16 01 06 4

Hazardous Waste Any List of Waste code

with an asterisk (*) 5

Household Kerbside Waste Code 20 03 01 or

20 01 08 from households

6

Sludges/Slurries and Septic Tank Waste

02 01 01, 02 01 03, 02 02 01, 02 02 04, 02 03 01, 02 03 05, 02 04 03, 02 05 02, 02 06 03, 02 07 05, 19 08 05, 19 09 02, 20 03 04, 20 03 06

7

Waste Electrical and Electronic Equipment (WEEE)

09 01 10, 09 01 11*, 09 01 12, 16 02 09*,

16 02 10*, 16 02 11*, 16 02 12*, 16 02 13*, 16 02 14, 16 02 15*, 16 02 16, 20 01 21*, 20 01 23, 20 01 35*,

20 01 36

8

Waste Tyres 16 01 03 9




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5.5. Waste Destination Facilities within the Island of Ireland (including

Northern Ireland)

The NWCPO needs to be satisfied that for any and all waste types that the applicant proposes to collect, that authorised waste facilities are available for the deposition of the waste material. These authorised waste facilities will then be included as an appendix on any permit granted. Appendix 6 must be completed for each facility by both the applicant and the receiving facility.

The use of sludge in agriculture is exempt from waste facility authorisation; however it must have a Nutrient Management Plan (NMP). Where the waste being collected is sludge for use in agriculture, and its destination is a landbank please provide evidence that an NMP is in existence for the proposed landbank(s) and that the plan(s) has / have been approved by the relevant Local Authority or the EPA. See also Supplementary Question 7.

5.6. Facilities Outside of Ireland – TransFrontier Shipment (TFS)

The transport of waste outside the Republic of Ireland (including to Northern Ireland) has additional regulatory requirements. It is advisable to contact the National Transfrontier Shipment Office (National TFS Office) at Dublin City Council (01 222 4411/4601 or email [email protected]). If the applicant proposes to use a waste facility outside the state, the following documentation is required for the Waste Collection Permit Application:

For facilities in Northern Ireland a completed Appendix 6 is required.

For the export of waste off the Island of Ireland, Ports of Export will be included on relevant permits rather than end destination facilities. To include a Port of Export on a waste collection permit please submit a completed FP2 Form for the “Inclusion of a Port for Export” with this application.

NOTE:

FP2 forms must be dated within 6 months of the application being submitted and be signed by a Broker or Originator (Producer) of the waste for export. The form is available to download at www.nwcpo.ie.

ATTACHED

NOTE: Appendix 6 must be dated within 6 months of the application being submitted and be signed by a Facility Manager or equivalent appointed person(s).

ATTACHED




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NOTE:

Facilities outside of Ireland Continued:

The transport of waste by a haulier to the port for export is subject to the provisions of Regulation (EC) 1013/2006 on shipments of waste, and the Waste Management (Shipments of Waste) Regulations, 2007.

Hauliers must be authorised to collect and transport the waste specified in a TFS notification or described in an Annex VII document to the port (contact the National Transfrontier Shipment Office (NTFSO) at Dublin City Council for further information).

Waste shipments start from the time the waste consignment is transported by the haulier from the waste facility or site of origin to the port and must be accompanied by the TFS documents.

The notifier shall provide to the NTFSO:

o Details of the carrier nominated in the notification,

o Evidence that the carrier is authorised to collect the specified waste types, & evidence that the carrier is authorised to transport the waste to the port of export indicated in the notification.

5.7. Waste Collection Vehicles

Does the applicant currently have vehicles for waste collection? Yes No

If ‘yes’, please provide the following details. (Continue on separate sheet if necessary).

Vehicle Registration

Number

Vehicle Type

Household Kerbside

Waste Collection

Vehicle Yes/No

Owned/Leased or Owner Driver

Copy of Vehicle

Registration Certificate Included


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Vehicle Registration

Number

Vehicle Type

Household Kerbside

Waste Collection

Vehicle Yes/No

Owned/Leased or Owner Driver

Copy of Vehicle

Registration Certificate Included

Vehicle Registration Certificates must be attached for each vehicle and must be in the exact name of the applicant.

In the case of sub-contractors / leased vehicles, further documentation is required (VR2/VR3 forms). These are available to download from www.nwcpo.ie

Further details on vehicles used for the collection of household kerbside waste are requested in FORM 4 (excel spreadsheet of proposed household waste collection service and vehicles).

NWCPO Waste Collection Permit Application Form Version 4.3 Section 6 – Fit & Proper Person Requirements

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6. FIT & PROPER PERSON REQUIREMENTS

6.1. Relevant Convictions

Has the applicant, including in the case of a company and/or any officer of that company, been convicted in the District Court of an offence, prescribed under Section 32(1) or Section 55(8) of the Waste Management Act 1996 or on indictment of an offence under Waste Management Act 1996, the Environmental Protection Agency Acts 1992 and 2003, the Local Government (Water Pollution) Acts 1977 to 2007 or the Air Pollution Act 1987 and 2011?

Yes No

Has the applicant, including in the case of a company and/or any officer of that company, been convicted in the District Court of any offence, prescribed under Article 21 of the Waste Collection Permit Regulations, 2007 as amended within the period of 10 years prior to the making of this application?

Yes No

If ‘yes’, please include a supplementary sheet detailing the court hearing, the case, nature of the offence and any penalty or requirements imposed by the court. Where there is more than one offence to be considered, please use a separate sheet for each offence.

ATTACHED

Where the applicant is a sole trader or partnership, include details of any such conviction where any relevant person or partner was at any time within the last 10 years prior to this application, a director, manager, company secretary or similar officer for a company.

ATTACHED

6.2. Regional Waste Plan and/or National Hazardous Waste Management

Plan requirements

Please confirm that the applicant has familiarised themselves with the relevant Regional Waste Plans and Hazardous Waste Management Plan relative to the proposed activity.

Yes


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6.3. Technical Competence (Fit and Proper Person)

Please detail the applicant’s technical knowledge and / or qualifications relevant to the collection of waste (continue on a separate sheet if necessary). Does the applicant have waste related qualifications? If ‘Yes’, please provide details below.

Waste Related Qualifications:

Does the applicant have relevant experience? If ‘Yes’, please provide details below.

Relevant Experience:

Other (complete if necessary):

Document(s) Reference:

Yes No

Yes No


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6.4. Record Keeping and Reporting

Please outline how the applicant as a permit holder proposes to:

1) Maintain records of waste collection activities 2) Prepare an Annual Return of the source, type, weight and destination of the waste collected.

Where a third party will be maintaining records and/or completing the Annual Return on behalf of the applicant/permit holder, please outline this proposed arrangement.

6.5. Financial Commitment Discharge

All applicants are required to make a signed declaration stating their financial ability to properly carry out waste handling and waste collection in a manner that will not cause environmental pollution or breach environmental standards. Please attach the following:

Financial Declaration - Appendix 3

A copy of the applicant’s current Tax Clearance Certificate issued by Irish Revenue

ATTACHED

ATTACHED

NOTE: For applicants’ resident outside the Republic of Ireland, a Tax Clearance Certificate must be obtained from Irish Revenue. Failure to submit a current Tax Clearance Certificate will result in an invalid application.


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6.6. Insurance Details

Please complete the insurance declaration documents contained in Appendix 4 and Appendix 5.

These insurance declarations require that the applicant confirms that a sufficient insurance cover is in place for the proposed waste collection activity and include:

A limit of indemnity of €6.5 million.

An indemnity to Offaly County Council (as Nominated Authority on behalf of all Local Authorities in the Republic of Ireland).

ATTACHED

6.7. Environmental Liability

It is advised to investigate if Environmental Liabilities Insurance is appropriate for the proposed waste collection activity. While this is not a current requirement of the waste collection permit application process, it may be in the future.

6.8. Revocation of a Waste Collection Permit

Has the applicant had a waste collection permit revoked other than where a permit was surrendered?

Yes No

NWCPO Waste Collection Permit Application Form Version 4.3 Section 7 – Additional Information

20 QF 23(a) Version 4.3 16/03/2016

7. Additional Information

If there is additional information which the applicant feels may be required or beneficial to the NWCPO in making its decision or any information identified during pre-application consultation, this should be included here. If there are any outstanding documents to be submitted that were not available when submitting the application, please outline here.

Document(s) Reference:

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APPENDICES

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Appendix 1 - Statutory Declaration

ORIGINAL, STAMPED DOCUMENT TO BE SUBMITTED

I declare that the information given in the application

by1 ____________________________________________________________________________

of2 ____________________________________________________________________________

for the purpose of obtaining a waste collection permit is correct, and that no information which is required to be included in the said application has been omitted. I make this solemn declaration conscientiously believing the same to be true and by virtue of the Statutory Declarations Act 1938. I authorise OFFALY COUNTY COUNCIL as the NATIONAL WASTE COLLECTION PERMIT OFFICE to make any enquiries from official sources as it may consider necessary for the purpose of determining this application and, pursuant to Section 8 of the Data Protection Act 1988, I consent to the disclosure of details of convictions for relevant offences specified under Article 21 of the Waste Management (Collection Permit) Regulations 2007.

Signature (s)3: Name: (block capitals)

....................................................................... .....................................................................

...................................................................... .....................................................................

....................................................................... .....................................................................

....................................................................... ......................................................................

Declared before me at4 ......................................................... this ............................... day of

............., 20 ....................

Signature of Witness: .....................................................................................................................

Occupation: ................................................................. Date: .......................................................

WARNING: ANY PERSON WHO GIVES FALSE OR MISLEADING INFORMATION FOR THE PURPOSE OF OBTAINING A WASTE COLLECTION PERMIT RENDERS THEMSELVES LIABLE TO SEVERE PENALTIES.

1 Insert full name of the applicant (legal entity)i.e Sole Trader / Partnership / Company. 2 Insert address of the principal place of business. 3 To be signed by the applicant, each partner in the case of a partnership, each director in the case of a company. 4 To be witnessed by a Solicitor/Commissioner of Oaths/Notary Public/Peace Commissioner/Garda Síochána.

NWCPO Waste Collection Permit Application Form Version 4.3 Appendix 2

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Appendix 2 - Suggested Newspaper Notice Format

(Only in the case of a new application for a single or multi-regional waste collection permit)

IMPORTANT INFORMATION Applicants are hereby advised that in accordance with Article 6 (1)(b) of the Waste Management

(Collection Permit) Regulations 2007-2016 the NWCPO may now publish notification of the intention to make an application on the website of the NWCPO, www.nwcpo.ie

Applicants wishing to avail of this option, rather than having their public notice published in a newspaper, are advised to contact the NWCPO.

NOTE :

For new applicants: please ensure that a copy of the page of the newspaper notice is attached to the application and submitted within 10 working days of the notice appearing in the paper. For review applicants: where a newspaper notice is deemed to be required, a template will be provided by the NWCPO. An incorrect newspaper notice will result in an invalid application and the applicant having to re-advertise at additional cost and time.

APPLICATION TO OFFALY COUNTY

COUNCIL AS THE NATIONAL WASTE

COLLECTION PERMIT OFFICE (NWCPO)

FOR A WASTE COLLECTION PERMIT

RELATING TO A WASTE COLLECTION

ACTIVITY OR WASTE COLLECTION

ACTIVITIES IN <<NAME OF RELEVANT

REGION or REGIONS (see Note 1)>>.

<<Applicant’s full name (legal entity) & address of

principal place of business>> will be making an

application to the NWCPO, within ten working days

from the date of this notice, for a waste collection

permit to collect waste which may include hazardous

& non-hazardous, commercial, industrial, household,

construction & demolition waste, sludges, slurries &

septic tank waste and other wastes in <<state name of

local authority area or areas (see Note 2)>>.

A copy of the application will, as soon as is

practicable after receipt by the NWCPO be available

for inspection and for purchase at the principal offices

of the local authority area or areas listed above.



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THE FOLLOWING NEWSPAPERS CIRCULATE IN ALL LOCAL AUTHORITY AREAS:

The Irish Independent

The Irish Times

The Irish Sun

The Irish Star

The Irish Daily Mail Proof of circulation should be requested for all other newspapers Where some newspapers circulate in the majority of areas e.g. the Irish Examiner, or Evening Herald, then a combination of this paper plus a local paper will be acceptable. NOTE 1: The Regions are:

The Connacht Ulster Region

The Eastern & Midlands Region

The Southern Region This can be worded for example as:

The Eastern & Midlands Region, or

All Regions, or

The Connacht Ulster Region & The Southern Region

NOTE 2: The Local Authority areas are: The Connacht Ulster region consists of the administrative areas of Cavan, Donegal, Galway, Leitrim, Mayo, Monaghan, Roscommon, and Sligo County Councils and Galway City Council. The Eastern & Midlands Region consists of the administrative areas of Dun LaoghaireRathdown, Fingal, Longford, Westmeath, Kildare, Offaly, Louth, Laois, Meath, Wicklow and South Dublin County Councils and Dublin City Council. The Southern Region consists of the administrative areas of Carlow, Cork, Clare, Kerry, Kilkenny, Tipperary and Wexford County Councils, Limerick City and County Council, Waterford City and County Council and Cork City Council. Or, for Multi-regional applications including all Local Authority Areas;

All City and County Council Areas. All Local Authority areas where the applicant proposes to collect waste must be included in the newspaper notice to be deemed as a valid notice.

Applicants are advised to seek advice in relation to their newspaper notice from the NWCPO. A newspaper notice will not be pre-approved and will only be validated by the office following the submission of a complete application. It is further advised to use the Newspaper Notice Checklist on Page ii.

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Appendix 3 - Financial Commitment Discharge Declaration

ORIGINAL, STAMPED DOCUMENT TO BE SUBMITTED

(To be completed by a financial representative of the applicant, e.g. Company Accountant or Bank Manager or Finance Director/Manager etc.)

This document must be completed to satisfy the NWCPO that the applicant meets the full definition

of a ‘fit and proper person’ as defined in Article 4 of the Waste Management (Collection Permit)

Regulations, 2007 as amended.

Please note that under Article 17(3) the NWCPO shall not grant a waste collection permit unless it is

satisfied that the applicant is a fit and proper person.

All applicants are required to make a signed declaration stating their financial ability to properly

carry out waste handling and waste collection in a manner that will not cause environmental

pollution or breach environmental standards.

FINANCIAL DECLARATION

It is my opinion that the applicant (Name) ____________________________________________ , based on his/her/the company’s current financial circumstances, is in a position to meet current financial commitments and liabilities.

Signature: __________________________________________________

Name (Block Capitals): _______________________________________

Position or Title: ____________________________________________

Financial Institution (if applicable): _____________________________

Date: ______________________________________________________

WARNING: IT IS AN OFFENCE UNDER ARTICLE 36 (1) OF THE WASTE MANAGEMENT (COLLECTION PERMIT) REGULATIONS 2007, AS AMENDED, FOR ANY PERSON TO PROVIDE FALSE OR MISLEADING INFORMATION FOR THE PURPOSES OF OBTAINING A WASTE COLLECTION PERMIT.

OFFICIAL STAMP


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Appendix 4 - Motor Vehicle Insurance Declaration

ORIGINAL, STAMPED DOCUMENT TO BE SUBMITTED (To be completed by the applicant’s insurance company/insurance broker)


of a ‘fit and proper person’ as interpreted in Article 4 of the Waste Management (Collection Permit)


Please note that under Article 17(3) (c) the National Waste Collection Permit Office shall not grant a

waste collection permit unless it is satisfied that the applicant is a fit and proper person.

MOTOR VEHICLE INSURANCE DECLARATION

I confirm that the applicant (Name) _________________________________________________

______________________________________________________________________________

has a Motor Vehicle Insurance Policy covering the use of all vehicle(s) registration(s)

______________________________________ (if fleet policy state ‘fleet policy’) in relation to their

activities identified in Table 1 below, which are the subject matter of the Waste Collection Permit

application including:

A Third Party Property Damage Limit of €6.5m. Yes No

An indemnity to Offaly County Council (as Nominated Authority on

behalf of all Local Authorities in the Republic of Ireland),

Yes No

Policy No.: _____________________ Expiry Date of Policy: __________________

Insurer: _________________________________________________________________

TABLE 1

Batteries and Accumulators Hazardous Waste

Bulky Waste Household Kerbside Waste

Commercial and Industrial (Non Production) Waste (door to door

kerbside and packaging) Sludges/Slurries and Septic Tank Waste

Construction and Demolition Waste Waste Electrical and Electronic Equipment

Hazardous & Non-Hazardous End of Life Vehicles

Waste Tyres


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MOTOR VEHICLE INSURANCE DECLARATION (Continued)

Signature: ....................................................................................................

Name (Block Capitals): ...............................................................................

Position or Title: .........................................................................................

Insurance Broker or Company: ..................................................................

Date: ............................................................................................................

ADDITIONAL COMMENTS:


OFFICIAL STAMP


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Appendix 5 - Public Liability Insurance Declaration

ORIGINAL, STAMPED DOCUMENT TO BE SUBMITTED (To be completed by the applicant’s insurance company/insurance broker)


of a ‘fit and proper person’ as interpreted in Article 4 of the Waste Management (Collection Permit)


Please note that under Article 17(3) (c) the National Waste Collection Permit Office shall not grant a

waste collection permit unless it is satisfied that the applicant is a fit and proper person.

PUBLIC LIABILITY INSURANCE DECLARATION

I confirm that the applicant (Name) __________________________________________________

_______________________________________________________________________________

has a Public Liability Insurance Policy covering their activities, identified in Table 1 below, which are

the subject matter of the Waste Collection Permit application, including:

Limit of indemnity of at least €6.5m any one occurrence, including

sudden/unforeseen pollution risks. Yes No

An indemnity to Offaly County Council (as Nominated Authority on

behalf of all Local Authorities in the Republic of Ireland). Yes No

Does Policy include Irish Law Jurisdiction? (only relevant if insured is

based outside ROI) Yes No

Policy No.: _____________________ Expiry Date of Policy: __________________

Insurer: _________________________________________________________________

TABLE 1

Batteries and Accumulators Hazardous Waste

Bulky Waste Household Kerbside Waste

Commercial and Industrial (Non Production) Waste (door to door

kerbside and packaging) Sludges/Slurries and Septic Tank Waste

Construction and Demolition Waste Waste Electrical and Electronic Equipment

Hazardous & Non-Hazardous End of Life Vehicles

Waste Tyres


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PUBLIC LIABILITY INSURANCE DECLARATION (Continued)

Signature: ....................................................................................................

Name (Block Capitals): ...............................................................................

Position or Title: .........................................................................................

Insurance Broker or Company: ..................................................................

Date: ............................................................................................................

ADDITIONAL COMMENTS:


OFFICIAL STAMP


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Appendix 6 – Inclusion of an Authorised Waste Facility To be completed by the applicant and the authorised waste facility

APPLICANT DETAILS

Name of Applicant:

Address:

DETAILS OF THE AUTHORISED WASTE FACILITY TO BE ADDED (All of these details must be supplied)

Facility Name:

Facility Authorisation Reference Number:

Facility Permit Expiry Date:

LIST OF WASTE CODES THAT WILL BE DISPOSED / RECOVERED AT THE AUTHORISED WASTE FACILITY BY THE WASTE COLLECTION PERMIT HOLDER*

(All of these details must be supplied) List of Waste

Code Corresponding Waste Description Detailed Waste Description for Codes ending in ‘99’

*please use additional sheet if necessary.

AUTHORISED WASTE FACILITY PERMIT HOLDER DECLARATION

I declare that the information I have provided to the Permit Holder is correct and that this facility is authorised to accept the waste types listed.

Signed:

Print Name:

Position/Title: (where applicable)

Date

COMPLETED FORMS SHOULD BE POSTED TO:

NWCPO, Offaly County Council, Áras an Chontae, Charleville Rd, Tullamore, Co. Offaly.

Ph: 05793 57428 Fax: 05793 29230 Email: [email protected] Web: www.nwcpo.ie