Application for Waste Carrier
Barges
Address:
Telephone:
E-mail:
Environment and Resources Authority
Environmental Permitting Unit
Hexagon House, Spencer Hill,
Marsa. MRS 1441. Malta.
2292 3500
[email protected]
Form Industrial 12.3
Form 1 - Please complete in block letters. The requested information must be completed in full.
Failure to provide adequate information will delay processing of the application.
Date application was received and stamp:
Reference Number:
(For office use only).
(For office use only)
GBR
n
n
n
n
n
Y
Y
Title of application
Registration of Waste Carriers (Barges)
Do you have another application for the same
vessel?
Name of Vessel:
Yes
Official Number:
No
Class of Waste:
1. Changes to personal details of applicant or
contact person
Surnamen
2. Changes to details of company or institution on
behalf of which the application is being made
Name
Address:
Registered Company Name
Address:
Registered Address
Registered Address
Town:
Town:
Postal Code:
Postal Code:
Telephone Number:
Telephone Number:
Fax:
Fax:
Mobile:
Mobile:
E-mail:
E-mail:
ID card number:
Company reg. no:
VAT Number:
VAT Number:
NACE Code:
(VAT number to be included where available).
Application for Waste Carrier-Barges
90.02
Page 1 of 4
3. Further information
Guidance notes:
 Please allow 10 working days for this application to be processed.
3.1 Category of waste to be carried (Kindly choose one category of waste per application form. Please
refer to the guidance note attached for the list of waste within each class.)
Class B1 – Construction and Demolition Waste
Class B2 – Waste Oils
Class B3 – Separated wastes
Class B4 – Other wastes
3.2 In the case of Classes B4 kindly indicate the type of waste in the boxes below:
3.3 General description of vessel
3.4 Registered flag :
3.5 Capacity of the vessel (in tonnes)
3.6 Details of positioning systems available on-board (a Global Positioning System (GPS) is the
minimum requirement)
3.7 Details of systems that allow the remote tracking of the vessel movements. (including codes for
access to tracking system for use by ERA)
Application for Waste Carrier-Barges
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3.8 Details on the category of Hazardous waste the vehicle is designed to transport. (For class B2, B3, &
for B4 if applicable)
3.9 Details of systems that ensure secure containment of wastes including a certificate by a Transport
Malta authorised ship surveyor confirming that all these systems are in good operational conditions
and maintained according to manufacturers’ specifications (For class B2, B3 & for B4 if applicable)
Titles of supplementary forms and documentation to be submitted
3 Photographs of vessel- front, rear and side (showing name clearly)
Copy of the valid certificate by a Transport Malta authorised ship surveyor
(For Class B2, B3 and for B4 if applicable)
Copy of the valid certificate of vessel registration issued by carrier’s flag
Competent Authority (TM)
Insert further documents as applicable
Tick when provided
NB: The Authority may request any additional information it deems necessary to further process
the application.
Application for Waste Carrier-Barges
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Applicant’s declaration
I apply for the environmental registration as indicated above, and declare that, to the best of my knowledge, all the
information contained in this application and on the submitted supplementary forms and documentation is
complete and correct. I also understand that any incomplete, fraudulent or misleading information will
annul the application or permit, and may also incur any relevant penalties. I also declare that I have
read the data protection clause below:
____________________
_______________________________________
_______________
Signed
on behalf of/in my own name (in block letters)
date
PLEASE READ THE FOLLOWING BEFORE SIGNING - 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.
2.
3.
4.
5.
6.
7.
The proper processing of your application, request and/or notice as submitted;
verification of the information provided to our officers;
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;
Establishing, exercising or defending any legal action;
Internal management, research and statistics, systems administration, the development and
improvement of our services;
the protection and promotion of our legitimate interests and the proper conduct of our obligations
arising under any law or statutory instrument; and
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 you fail to fill in any mandatory field, we reserve the right
to refuse the application. 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.
Application for Waste Carrier-Barges
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