/ Licence Application Form
SMALL-SCALE SEWERAGE AND WASTEWATER TREATMENT AND DISPOSAL

SMALL-SCALE SEWERAGE AND WASTEWATER TREATMENT AND DISPOSAL

(Total Installed Wastewater Treatment Capacity < 10,000 m3/day)

INSTRUCTIONS

  • Please read the attached General Notes (page 3) prior to completing this form
  • Please submitone hard copy original of the application form and supporting documents together with an electronic copy on CD/ Memory Stick addressed to: Director General, Regulation & Supervision Bureau, P.O. Box 32800, Abu Dhabi, UAE
  1. APPLICANT DETAILS (legal Entity not a Person)

Commercial Name: / Trade Licence #:
Legal Form: / ☐Government Entity / ☐Company / ☐Establishment
☐Local Branch/Subsidiary / ☐Foreign Branch/Subsidiary
Mailing Address in Abu Dhabi Emirate
Building Name/No: / PO Box:
Street/Area:
City: / Fax Number:
Website:

Details of the Legal Representative of the Applicant:

Full Name: / Designation:
Email Address: / Mobile Number:
UAE ID #:

Prime Contact/s Details

Please provide the name, job title/designation, telephone number and e-mail address of the person/s to whom correspondence or queries concerning this application should be directed.

Name / Designation / ContactNumber
(in the UAE) / Email Address
  1. TECHNICAL INFORMATION

How long do you expect to operate the sewerage services? / ☐1 Year / ☐2 Years / ☐3 Years / ☐4 Years / ☐5 Years
When do you expect to commission the systems? (Date)

Details of premises / sites that application is being made for:

Building/Site Type: / ☐Commercial Office / ☐Government Building / ☐Residential Flat / ☐Factory
☐Warehouse / ☐Hotel / ☐Labour Accommodation
☐Low risk trade effluent source (e.g. Restaurant, Kitchen, Laundry) / ☐Others (please specify)
Location/Area:
GPS Location coordinates:
Status of wastewater facility: / ☐Construction to start / ☐Under-construction / ☐Constructed and running
Total Wastewater Treatment Capacity (total installed Capacity) / Cubic-metres per day

If you are applying for more than one location, please fill out the table below:

Location/Area / GPS Location Coordinates / Type of Facility (e.g. labour camp) / Facility Status (e.g. under construction, Constructed...) / Total Wastewater Treatment Capacity
  1. FINANCIAL INFORMATION

Provide details of the:

Capital costs for the design and installation of the sewerage assets (collection system, treatment plant, disposal network)

Collection system (AED) / Treatment plant (AED) / Disposal network (AED)

Estimated annual operating expenditure for the sewerage assets (collection system, treatment plant, disposal network) for 5 years or for the duration of the licence

Year / 20## / 20## / 20## / 20##
Collection
Treatment
Disposal
Total
Estimated cost of decommissioning the sewerage assets, along with confirmation that appropriate provision has been made in
the accounts. (AED)
  1. DECLARATION

I confirm that the information contained in this application is accurate, comprehensive and not misleading. I am aware that under Article 135 of Law No. (2) of 1998 Concerning the Regulation of the Water and Electricity Sector in the Emirate of Abu Dhabi it is an offence to make a statement known to be false in a material manner or calculated to mislead when giving any information or making an application for a licence.

I enclose the licence application fee of:

☐AED 10,000 for a Treatment Capacity up to 100 m3/day, or

☐AED 50,000 for a Treatment Capacity > 100 to 10,000 m3/day

Authorised Signatory

Name: / Signature
Position: / Date:
Document No. : ID/G01/005 (16) / Issue No.02April 2017
/ Licence Application Form
SMALL-SCALE SEWERAGE AND WASTEWATER TREATMENT AND DISPOSAL

GENERAL NOTES

The applicant is required to submit to the Bureaua complete and signed licence application along with the required documents and registration fee. Any application which does not include all of the required information, documentsor registration fee shall be deemed incomplete and may be rejected by the Bureau.

The Bureau will undergo a detailed evaluation of the application to determine the prospective licensee’s financial, managerial and technical competence to hold a licence. The Bureau will endeavour to perform this assessment in-house; however, some applications may require external consultancy advice. Should this be required, these external costs will be recharged to the applicant in the form of an Evaluation Fee as per The Current Scale of Charges published on the Bureau’s website (

A notice of intention to grant a licence will be published on the Bureau’s website. The notice period is for a minimum of 28 days. Once the Bureau is satisfied that an applicant is competent to hold a licence, and no objections to the notice are received, a licence will be issued to the applicant and its activities will be regulated in accordance with the licence conditions.

Depending on the nature and complexity of an application, the overall assessment and licensing process may take 30 working days.

For further information, please visit our website:

REGISTRATION FEES & METHOD OF PAYMENTS

Treatment Capacity / Fees (AED)
☐up to 100 m3/d / 10,000/-
☐ >100 to 10,000 m3/d / 50,000/-

Payments are to be made in favour of theBureauvia wire transfer or cheque as detailed below:

Wire Transfer:

Account Name: Regulation & Supervision Bureau

Account Number:015-695-8679

IBAN Number: AE410350000000156958679

Bank Name: National Bank of Abu Dhabi

Branch: Corniche Branch

Address:Abu Dhabi – UAE

Cheque:

Please make non-negotiable cheques payable to“Regulation & Supervision Bureau”.

Once the licence is issued, the licensee will be required to pay Annual Fees to the Bureau as per the Current Scale of Charges.

REQUIRED DOCUMENTS

Your application should be supported by the following documents:

Tick / Required Documents
☐ / Complete and signed application form
☐ / Registration fee
☐ / UAE ID and passport copies of the applicant Legal Representative
☐ / Power of Attorney/Delegation of the authorised signatory and his/her UAE ID and passport copies (if not the Legal Representative)
☐ / Third Party Liability Insurance (copy) (if not available to be provided within 30 days from the issuance of the RSB licence)
☐ / Any permits issued by the municipality (if applicable)
☐ / Copy of the Land Lease Agreement or property deed of each site where the regulated activities will be undertaken.
☐ / Company’s logo (JPEG, TIFF, BMP, PNG formats)
☐ / Copy of the relevant legislation establishing the government entity (if applicant is a Government Entity)
☐ / Copy of a valid trade licence (for companies and establishments)
TECHNICAL REQUIREMENTS
☐ / location map showing the collection and disposal catchments and the treatment works
☐ / Compliance sheet with the Small Scale “Wastewater Flow Monitoring Guide”
☐ / An engineering drawing of the collection system including any trade effluent (café, restaurant, laundry…) discharges connected to the system
☐ / Compliance sheet with Chapter 7 and 16 of Abu Dhabi Uniform Plumping Code 2009 (only applicable for Greywater Recycling Systems)
☐ / A Schematic flow diagram showing the collection, treatment and disposal systems at the site (See Annex 1 for example)
☐ / Process & Instrumentation Drawings (PID) of the treatment plant along with supporting technical data sheets
☐ / Recycled Water & Biosolids Quality Management Plan (RW&B QMP) as per template available on our website
☐ / A reference list highlighting the experience for each contractor involved in the design, installation and operation
☐ / A detailed organisational chart highlighting the team responsible for operating and maintaining the wastewater systems (collection, treatment and disposal)
☐ / A list of procedures related to the operation and maintenance of the entire wastewater system.
FINANCIAL REQUIREMENTS
☐ / Audited financial statements for the Applicant for the last (most recent) year and the company’s comments on auditor concerns, if any, raised in the audit reportOR
☐ / A Letter of Guarantee/Support for the Applicant (see template) from the parent company(acceptable only from a local parent) if applicant’s own financial statements are not availableOR
☐ / Bank guarantee equal to estimate annual OPEX from a local bank in case the Applicant does not provide its own or parent company financial statements or expects that the Bureau may not be satisfied with the applicant/parent financial strength (see template )
HEALTH, SAFETY & ENVIRONMENT REQUIREMENTS
☐ / HSE Management System (approved by OSHAD or other International Organization)
☐ / HSE Policy, and Emergency Response Plan
☐ / Site-Risk assessment for high risk jobs including the jobs under the licence
☐ / HSE Training certificates for the O&M team members related to the operation of Sewerage Services OR
☐ / undertaking that a suitable HSE and Technical training will be provided for the proposed O&M team members
Document No. : ID/G01/005 (16) / Issue No.02April 2017

ANNEX 1

SAMPLE SCHEMATIC DIAGRAM