Supplementary VOC Application Form

Environment and ResourcesAuthority

Supplementaryform for Environmental Permit Application -Solvents VOC-Emissions installations

Please complete in block letters. The requested information must be completed in full. Failure to provide adequate information will delay processing of the application.

Companies falling within scope of S S.L.549.79, Limitation of Emissions of Volatile Organic Compounds Regulations, are obliged to fill in this application form and submit it in conjunction with the application form for an environmental permit. As this permit is applicable to companies in a range of activities some of the questions may not be relevant to a specific enterprise, in which case “N/A” should be inserted. ERAreserves the right to request additional information and clarifications during the processing of the permit application, including supporting documentation for the data submitted.If two or more activities within scope (L.N 12 of 2013) are carried out in the installation, an application form is to be completed and submitted for each activity.

The Environment and Resources Authority (ERA) should be provided with one (1) hard copy of the application form as well as one (1) copy in digital format. A signed copy of the form must be posted to ERA at the above address, together with the application for an environmental permit and supporting documentation. Please complete the form by typing or with block letters. Incomplete forms will result in delays in the processing of the application.

2.1 Activity to be permitted – Please tick main & sub category where applicable:

Dry Cleaning

Printing

Heatset web offset

Publication Rotogravure

Other Rotogravure (not Publication)

Flexography

Rotary screen

Rotary screen on cardboard/textile

Laminating activity

Varnishing activity

Wood impregnation

Wood and plastic lamination

Manufacture of pharmaceuticals

Manufacture of coating preperations/varnishes/inks/adhesives

Footwear manufacture

Rubber conversion

Vegetable oil and animal fat extraction; Vegetable oil refining

Surface cleaning (of products)

Vehicle coating and refinishing

Coating of new cars

Coating of trailers/semi-trailers

Coating of new trucks/vans/buses

Coating of truck cabins

Winding wire coating

Coil coating

Adhesive coating

Coating of wooden surfaces

Coating of leather

Other coating

Metal

Plastic

Textiles/fabric

Film/paper

Other coating:______

2.2Technical details of the installation

2.2.1Please provide a brief description of the installation and equipment used to carry out the activity indicated in section 2.1. For standalone industrial units (such as Dry-cleaning machines & printing presses), the Make, Name/Model No. And Serial No. Should be quoted. A schematic plan of the installation may also be included.

2.2.2Is the installation equipped with a waste gas stack for VOC emissions? YES/NO

If YES, are any other gas volumes added to the emissions (for coolingor dilution purposes) before they are emitted to the environment? YES/NO

2.2.3Is the installation equipped with any VOC-abatement technology? YES/NO

If YES,

a)What typeof technology is used?......

b)What emissions does it treat?......

c)When was the equipment installed? ____/____/______

d)Is the average hourly rate of emissions after abatement more than 10kg/h TOC (Total Organic Carbon) YES/NO

e)Are emissions monitored and measured after abatement? YES/NO

If YES, please give details on the methodology, frequency of measurement and monitoring equipment used:

2.2.4Is there a plan to install new/additional VOC-abatement technology? YES/NO

If YES, please give details on the type of technology and timeframe for installation:

2.2.5What measures are in place/planned to minimise VOC emissions during start-up and shutdown?

2.2.6Supplementary information for installations already in operation:

a)Start date of operation of the installation: ____/____/______

b)Date of legal registration of the installation:____/____/______

3.1Annual maximum solvent consumption in the installation as tonnes VOC

Consumption in year 201X in tonnes VOCs/year = Stock 1 Jan 201X + Purchase in 201X – Stock 31 Dec 201X – Sent offsite in 201X for reuse

3.2Does the installation recover solvents for reuse? YES/NO

If YES, please explain briefly the type of reuse (onsite/offsite, use of recovered solvent):

3.3Is waste containing solvents stored on site for export/disposal? YES/NO

Please note that waste solvents must be disposed of at sites authorised by MEPA to receive such waste.

3.4Is the installation’s solvent consumption expected to increase in the near future? YES/NO

4.1Does the activity make use of solvents that due to their content of VOCs, are assigned any of the Risk Phrases / Hazard Statements listed below? YES/NO

If YES, please mark which risk phrase/phrases:

4.2Please list these ‘risk / hazardous products’ and the quantity used.

4.3What is the sum of the risk / hazardous compounds emitted (mass flow in grammes/hour), without taking into consideration the diluting effect of any gas volumes added (e.g. for dilution or cooling purposes)?

• R40 + R68 (i.e. H341 + H351)halogenated compounds :______g/hr

(Note: Not applicable for Dry-cleaning)

• R45 + R46 + R49 + R60 + R61 (i.e. H340 + H350 + H350i + H360D + H360F)compounds : ______g/hr

4.4Are the emissions of hazardous VOCs regularly monitored? YES/NO

If YES, please give details on the methodology, frequency of measurement and monitoring equipment used:

4.4Is there a substitution plan for the substances/preperations carrying the risk phrases R45, R46, R49, R60 and R61 (or hazard statementsH340, H350, H350i, H360D and/or H360F)? YES/NO

If YES, please attach plan. Document Ref. No. ______

5.1Preferred Compliance Option

Waste gas emission limit values and fugitive emission values

Total emission limit values

Reduction Scheme(for Printing and Coating activities, except Winding wire coating and Coating of leather)

Request for derogation (as per Regulation 6(3) (a) or (b) of L.N. 12 of 2013). Please attach supporting documentation. (In case emissions from the installation do not pose significant risks to human health or the environment) Document Ref. No. ______

5.2Two or More Activities

Is any other activity listed in section 2.1 carried out in the installation? YES/NO

If YES,

a)Which activity/activities?......

b)Does the solvent consumption exceed the threshold in Schedule II of L.N. 12 of 2013? YES/NO

5.3Additional Comments

Applicant’s Declaration:

I submit this Supplementary VOC application form in accordance with S.L.549.79, and declare that, to the best of my knowledge, all the information contained in this application and on any attached documentation is correct.

Definitions

Volatile organic compound or VOC means any organic compound having at 293.15K a vapour pressure of 0.01kPa or more, or having a corresponding volatility under the particular conditions of use.

Organic solvent means any VOC which is used alone or in combination with other agents, and without undergoing a chemical change, to dissolve raw materials, products or waste materials, or is used as a cleaning agent to dissolve contaminants, or as a dissolver, or as a dispersion medium, or as a viscosity adjuster, or as a surface tension adjuster, or a plasticiser, or as a preservative.

Start-up and shut-down operations shall mean operations whilst bringing an activity, an equipment item or a tank into or out of service or into or out of an idling state. Regularly oscillating activity phases are not to be considered as start-ups and shut-downs.

Installation means a stationary technical unit where one or more activities falling within the scope of the regulations are carried out, and any other directly associated activities which have a technical connection with the activities carried out on that site and which could have an effect on emissions.

Sectors (activity installations) are according to Schedule I of S.L.549.79. These can be viewed on

Solvent consumption thresholds are according to Schedule II of S.L.549.79. These can be viewed on

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