Environment And Resources Authority

Environmental management and monitoring services

Address: / Hexagon House, Spencer Hill, Marsa MRS 1441
Email: /
Telephone: / 22923500
/

1. Contact details

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Details of applicant or contact person:

Surname / Name
ID card number:

Address:

Registered Address
Town:
Postal Code:
Telephone Number:
Fax:
Mobile:
E-mail:

Details of company or institution on behalf of which the form is being filled:

Registered Company Name (if applicable)

Accreditation:

Indicate which (if applicable) and provide supporting documentation
Company registration number:
VAT number:

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Applicant’s declaration

I declare that, to the best of my knowledge, all the information contained in this form and supporting documentation is correct.

______

Signed On behalf of/in my own name (in block letters) Date

PLEASE ALSO READ THE DATA PROTECTION CLAUSE AT THE END OF THIS DOCUMENT BEFORE SIGNING.

2. Environmental management and monitoring services provided

Please indicate the services provided by yourself or your company. Any of the sections filled must be accompanied by the respective attachment.

Service / Tick ()
if provided / Attachment
Number
Stack emissions monitoring / 1
Water sampling and analysis / 2
Land monitoring / 3
Noise monitoring / 4
Certification of vehicles / 5
Certification of containment (e.g. settling pits, retention tanks, bunds) for impermeability / 6
Risk assessment / 7
Dispersion modelling / 8
Others (please specify) / 9
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Notes:

(1)Waste brokers are required to register with ERA and therefore should not submit this questionnaire.

(2)Waste management facilitiesrequire a waste management permit from ERAand therefore should not submit this questionnaire. Please contact Mark O’Neill(email: , tel: 2292 3500) to obtain details on how to apply.

3. What to do next

Please fill in the attachment(s) according to the service provided (as ticked in Section 2). Where the service is subcontracted, details of the person carrying out the service must be given.Additional rows may be added as necessary.

Attachment 1: Stack emissions monitoring

Note: This relates to emissions from point sources, not ambient air monitoring.

Parameter monitored
(e.g. NOx, SO2, dust) / Standard methodology used (EN or ISO standards preferred) / Emission point (e.g. scrubber, boiler) / Detection limit
(include units) / Is this company accredited for this test?
Yes  No 
Yes  No 
Yes  No 

Person(s) carrying out the monitoring (a separate table is to be filled for each person carrying out the above monitoring):

Name
Qualifications (degrees and higher): please list
Warrants (if any): please give warrant number

Attachment 2: Water sampling and analysis

Parameter monitored / Standard methodology used (EN or ISO standards preferred) / Detection limit
(include units) / Is this company accredited for this test?
Yes  No 
Yes  No 
Yes  No 

Person(s) carrying out the monitoring (a separate table is to be filled for each person carrying out sampling and/or analysis):

Name
Qualifications (degrees and higher): please list
Warrants (if any): please give warrant number

Attachment 3: Land monitoring

Parameter monitored / Standard methodology used (EN or ISO standards preferred) / Detection limit
(include units) / Is this company accredited for this test?
Yes  No 
Yes  No 
Yes  No 

Person(s) carrying out the monitoring (a separate table is to be filled for each person carrying out the above monitoring):

Name
Qualifications (degrees and higher): please list
Warrants (if any): please give warrant number

Attachment 4: Noise monitoring

Standard methodology used (EN or ISO preferred)
Is this company accredited for this test? / Yes  No 

Person(s) carrying out the monitoring (a separate table is to be filled for each person carrying out the above monitoring):

Name
Qualifications (degrees and higher): please list
Warrants (if any): please give warrant number

Attachment 5: Certification of vehicles

Notes:

(1)Only warranted engineers should fill this form.

(2)For applications from companies, please give details of each engineer carrying out such certification.

Name of engineer
Qualifications (degrees and higher): please list
Warrant number

Attachment 6: Certification of containment (e.g. settling pits, retention tanks, bunds) for impermeability

Notes:

(1)Only warranted engineers should fill this form.

(2)For applications from companies, please give details of each engineer carrying out such certification.

Name of engineer
Qualifications (degrees and higher): please list
Warrant number
Standard used for testing (EN or ISO preferred)

Attachment 7: Risk assessment

Note: The applicant must be able to carry out a risk assessment which covers environmentally relevant aspects (including, for example, fires, spills and other environmental incidents).

Name
Qualifications (degrees and higher): please list
Warrant number (if any)
Accreditation (if any): Indicate which

Attachment 8: Dispersion modelling

Medium (e.g. air, marine, sediment)
Model used
Parameters able to be modelled (e.g. NOx, dust)
Accreditation (if any): Indicate which

Person(s) carrying out the modelling (a separate table is to be filled for each person):

Name
Qualifications (degrees and higher): please list
Warrants (if any): please give warrant number
DATA PROTECTION CLAUSE

In terms of the Data Protection Act (Chapter 440 of the Laws of Malta), we will process any personal and/or sensitive data supplied on/in this application, request or notification form or subsequently supplied by yourself, whether orally or in writing, for all or any of the following:

  1. The proper processing of your application, request and/or notice as submitted;
  2. Preventing, detecting and/or prosecuting fraud and any other criminal activity which the Authority is bound to report and/or act upon whilst meeting any other specific legal or regulatory obligations;
  3. Establishing, exercising or defending any legal action;
  4. Internal management, research and statistics, systems administration, the development and improvement of our services;
  5. The protection and promotion of our legitimate interests and the proper conduct of our obligations arising under any law or statutory instrument; and
  6. To make public the necessary information as specified in the relevant law and/or instrument.

Relevant data will be disclosed or shared as appropriate with all our employees and with other third parties if pertinent to any of the purposes listed above.

Every field on the form is mandatory. Should any field be inapplicable to your particular circumstances please mark that field with the letters “N/A”.

You have the right to require that we provide you with access to your personal data as well as the right to rectify, or, in appropriate circumstances, erase/edit any inaccurate, incomplete or immaterial personal data which is being processed. However, you are required to inform us immediately of any alterations relating to your personal data which we are processing.

By signing this form, you confirm that you are giving your explicit consent, in terms of the Data Protection Act, on behalf of yourself and all the other persons specified in this form for the Authority to process your respective personal information as outlined above and you confirm that you have brought this Data Protection notice to the attention of these other persons and obtained their respective consents.

We undertake to implement appropriate measures and safeguards for the purpose of protecting the confidentiality, integrity and availability of all data processed.

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