Application Form - RENEWAL of LICENCE (August 2016)

application form [SECTION 55]

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PART 1: THE WASTE LICENSING APPLICATION PROCESS

1. LICENSING APPLICATION FOR WASTE ACTIVITIES PROCESS EXPLAINED:

1.1 This form must be used to apply for the Renewal and Transfer of a waste licence or permit.

1.2 This form is current as of 01 April 2014. It is the responsibility of the Applicant / EAP to ascertain whether subsequent versions of the form have been published or produced by the competent authority. It is the applicant’s responsibility to download the current version of the application form from the website of the Department at http://www.gdard.gov.za.

1.3 Three copies of this form (i.e. one copy with original signatures and two copies of the original) must be submitted at the offices of the relevant competent authority as detailed below prior or simultaneously with the submission of the Draft Basic Assessment Report or the Draft Scoping Report.

1.4 One hard copy and two CD’s of draft reports must be submitted to the relevant Competent Authority for review and comments.

1.5 The application must be typed within the spaces provided in the form. The sizes of the spaces provided are not necessarily indicative of the amount of information to be provided. Spaces are provided in tabular format and will extend automatically when each space is filled with typing.

1.6 The applicant must clearly mark confidential sections of the information submitted in the application form and supporting documents. Unless protected by law, all information filled in on this application will become public information on receipt by the competent authority. Any interested and affected party should be provided with the information contained in this application on request, during any stage of the application process.

1.7 The applicant must fill in all relevant sections of this form. Incomplete applications will not be processed. The applicant will be notified of the missing information in the acknowledgement letter that will be sent within 10 days of receipt of the application.

1.8 Incomplete applications may be returned to the applicant for revision.

1.9 Sections in the form that do not apply to the applicant must be marked “not applicable”. However, the use of the phrase “not applicable” in the form must be done with circumspection. Should it be done in respect of material information required by the competent authority for assessing the application, it may result in the rejection of the application as provided for in the Regulations.

1.10 Where applicable black out the boxes that are not applicable in the form.

1.11 All application forms must be signed as stipulated in the form. Applications that are not signed or completed accordingly will not be considered.

1.12 No faxed or e-mailed applications will be accepted. Only hand delivered or posted applications will be accepted.

1.13 Unless protected by law, all information filled in on this application will become public information on receipt by the competent authority. Any interested and affected party should be provided with the information contained in this application on request, during any stage of the application process.

1.14 Proof of payment must accompany this application. The application will not be processed without proof of payment unless one of the exclusions provided for in the Fee Regulations, 2014 is applicable AND such information in part 2 of this application form has been confirmed by this Department.

1. DEPARTMENTAL DETAILS

Postal Address

Gauteng Department of Agriculture and Rural Development

Attention: Deputy Director: Strategic Administrative Unit of the Sustainable Utilization of the Environment (SUE) Branch

P. O. Box 8769

Johannesburg

2000

Physical Address

Administrative Unit of the Sustainable Utilisation of the Environment (SUE) Branch

Ground floor, Diamond Building, 11 Diagonal Street

Johannesburg

Queries should be directed to the Strategic Administrative Unit at:

Administrative Unit telephone number (011) 240 3051/3052

Administrative Unit fax number (011) 240 3055

Departmental central telephone number (011) 240 2500

View the Department’s website at http://www.gdard.gov.za for the latest version of the documents

Application for Waste Management Licence in terms of NEM: Waste Act, 2008 (Act No. 59 of 2008)

Proof of payment must accompany this application. The application will not be processed without proof of payment unless one of the exclusions provided for in the fee Regulations is applicable AND such information in the exclusion section of this application form has been confirmed by this Department.

1. FEES

Gauteng Department of Agriculture and Rural Development’ details for the payment of application feesGauteng Department of Agriculture and Rural Development’ details for the payment of application fees

EXCLUSIONS

An applicant is excluded from paying fees if:

• The activity entails the rehabilitation of wetlands;
• The activity is a community based project funded by a government grant; or
• The applicant is an organ of state.

Applicants are required to tick the appropriate box below to indicate that either proof of payment is attached or that, in the

applicant’s view, an exclusion applies. Proof and a motivation for exclusions must be provided.

Proof attached

Exclusion applies

FEE AMOUNT

PART 2: background information

1. Details relating to the Waste Management Licence

A certified copy of the waste management licence must be attached to this application.

2. Details of the holder of the waste management licence

3. Details of the environmental assessment practitioner

In terms of Section 55 (4) of NEM: WA, if the environment or the rights or interests of other parties are likely to be adversely affected, the licensing authority must, before deciding the application, request the applicant to conduct a consultation process that may be appropriate in the circumstances to bring the application for renewal of a waste management licence to the attention of relevant organs of state, interested persons and the public

4. Details of landowner

Please duplicate the above section in instances where there is more than one landowner. Consent use form in Addendum 1 must be filled if the applicant is not landowner or person in control of the land where the development will / is taking place. Further, the above section must be duplicated in instances where there is more than one landowner.

PART 3: RENEWAL APPLIED FOR AND REQUIRED INFORMATION

1. Environmental impacts

1.1Describe any negative environmental impacts that may occur if the application for renewal is granted. Information on any increases in air emissions, waste generation, discharges to water and impacts of the natural or cultural environment must be included.

If there is insufficient space in the table above, the table may be expanded if being completed electronically, or attach an extra page.

1.2 Describe any negative environmental impacts that may occur if the application is not granted.

If there is insufficient space in the table above, the table may be expanded if being completed electronically, or attach and extra page and tick the box.

1.3Describe any positive environmental impacts that may occur if the application for renewal is granted. Information on any reduction in the ecological footprint, air emissions, waste generation and discharges to water must be included.

If there is insufficient space in the table above the table may be expanded if being completed electronically, or attach and extra page and tick the box.

1. 4 The following documents and reports must be attached as part of the application:

a) A report demonstrating that the applicant has been complying with the

1. current waste management licence conditions and;
2. current waste management licence requirements.

b) Waste impact report indicating

1. positive environmental impacts and the enhancement thereof and;
2. negative environmental impacts and the mitigation thereof.

c) Proof of notification of relevant organs of state as required by NEM:WA Section 47 (2)

d) Proof of notification of interested and affected parties (I&APs) as required by NEM:WA Section 47 (2)

e) Proof of consultation process as required by NEM:WA Section 47 (3) and (4) i.e .inclusive of :

1. A publication of a notice in at least two local newspapers;
2. A participation report with comments from I&APs.

1. Authorisation from other Government Departments

Are any permissions, licences or other authorisations required from any other departments before the requested renewals can be granted?

If yes, please complete the table below.

1. Rights and interests of other parties

Will the rights or interests of other parties be adversely affected by the granting of the application for renewal?

If yes, please describe the parties who may be affected and the manner is which they may be affected in the space below.

If no, describe why other parties will not be adversely affected in the space below.

1. Competence To Operate Site

It is imperative that the holder of the waste license is a fit person in terms of section 59 of the NEMWA (59 of 2008). To assess the holder’s competence to operate the site, please disclose the following:

Legal compliance

Technical competence

Details of applicant’s experience and qualification along with that of relevant employees must be summarised as shown in the table below:

Financial Provisions

Provide a plan of estimated expenditure for the following:

Signature of Applicant

Name of company:

Date:

PART 4: CONSENT USE AND DECLARATIONS

ADDENDUM 1

4.1 CONSENT USE

Consent in terms of Regulation 39 of the 2014 NEMA EIA Regulations by the landowner or person in control of the land that the proposed activity/ies may be undertaken on the land in question

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When to use this form

Note: This form must be completed when an application for amendment in terms of the 2014 NEMA EIA Regulations is submitted where the proposed amendment will impact on the activity undertaken/to be undertaken on the land or if the amendment relates to the transfer of rights and obligations.

Notes for completing and submitting this form

(1) This form is current as of December 2014. It is the responsibility of the applicant to ascertain whether subsequent versions of the form have been released by the Department.

(2) This form must be attached to the application form for amendment.

(3) Unless protected by law, all information contained in the form will become public information.

CONTACT INFORMATION

CONSENT

1.I/we the undersigned (insert the name/s of the owner/s of the land) ______

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of identity number/registration number (insert the owner/s ID number/s or the registration number of the legal entity)

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am/ are the registered owner/s of the property (insert description of the property/ies and title deed numbers)

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located at (insert physical address or a brief description of the location of the property)

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2.I/ we hereby give consent to the applicant /person to whom the rights are to be transferred (insert the name/s of the applicant/person/s)

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of identity number/registration number (insert the owner/s ID number/s or the registration number of the legal entity)

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to undertake the following activity(ies) on the property (insert a brief description of the project and identified activity(ies) in question and amendment that will be applied for):

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Signature of land owner/person in control of the land or authorised representative ______

Name of authorised person if the landowner is a legal entity ______

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Date

ADDENDUM 2

4.2 DECLARATIONS

4.2.1 DECLARATIONS OF AN ENVIRONMENTAL ASSESSMENT PRACTITIONER

The independent Environmental Assessment Practitioner

I, ______, declare under oath that I –

• act as the independent environmental assessment practitioner in this application for "[insert project title]" ;
• do not have and will not have any financial interest in the undertaking of the activity, other than remuneration for work performed in terms of the Environmental Impact Assessment Regulations, 2014;
• have and will not have vested interest in the proposed activity proceeding;
• have no, and will not engage in, conflicting interests in the undertaking of the activity;
• undertake to disclose, to the competent authority, any material information that have or may have the potential to influence the decision of the competent authority or the objectivity of any report, plan or document required in terms of the Environmental Impact Assessment Regulations, 2014;
• will ensure that information containing all relevant facts in respect of the application is distributed or made available to interested and affected parties and the public and that participation by interested and affected parties is facilitated in such a manner that all interested and affected parties will be provided with a reasonable opportunity to participate and to provide comments on documents that are produced to support the application;
• will ensure that the comments of all interested and affected parties are considered and recorded in reports that are submitted to the competent authority in respect of the application, provided that comments that are made by interested and affected parties in respect of a final report that will be submitted to the competent authority may be attached to the report without further amendment to the report;
• will keep a register of all interested and affected parties that participated in a public participation process; and
• will provide the competent authority with access to all information at my disposal regarding the application, whether such information is favourable to the applicant or not.

Signature of Environmental Assessment Practitioner

Name of company:

Date:

Signature of the Commissioner of Oaths

Full Name

Designation

Physical Address

Date

Official stamp (Above)

4.2.2 DECLARATIONS OF AN APPLICANT

The Applicant

I, ______declare under oath that I -

• am, or represent, the applicant in this application for "[insert project title]" ;
• appointed the environmental assessment practitioner as indicated above to act as the independent environmental assessment practitioner for this application;
• will provide the environmental assessment practitioner and the competent authority with access to all information at my disposal that is relevant to the application;
• will be responsible for the costs incurred in complying with the Environmental Impact Assessment Regulations, 2014, including but not limited to –

(i) costs incurred in connection with the appointment of the environmental assessment practitioner or any person contracted by the environmental assessment practitioner;

(ii)costs incurred in respect of the undertaking of any process required in terms of the regulations;

(iii)costs in respect of any fee prescribed by the Minister in respect of the Regulations;

(iv)costs in respect of specialist reviews, if the competent authority decides to recover costs; and

(v)the provision of security to ensure compliance with conditions attached to an environmental authorisation, should it be required by the competent authority;

• will ensure that the environmental assessment practitioner is competent to comply with the requirements of these Regulations;
• am responsible for complying with the conditions of any waste management licence issued by the competent authority;
• hereby indemnify, the government of the Republic, the competent authority and all its officers, agents and employees, from any liability arising out of the content of any report, any procedure or any action for which the applicant or environmental assessment practitioner is responsible in terms of these Regulations; and
• will not hold the competent authority responsible for any costs that may be incurred by the applicant in proceeding with an activity prior to an appeal being decided in terms of these Regulations.

Signature of Applicant