Form LPD1: Application for deployment
Application for deployment
SR2010No4 Mobile plant for landspreading (land treatment
resulting in agricultural or ecological benefit)
SR2010No5 Mobile plant for reclamation, restoration or improvement of land
SR2010No6 Mobile plant for landspreading of sewage sludge
Bespoke mobile plant permit for landspreading or land reclamation
The Environmental Permitting (England and Wales) Regulations 2010
Please read through this form and the guidance
notes that came with it before you fill this form in.
Please write clearly in the answer spaces.
This form may only be used for deployments for the
landspreading of waste where the operator holds a permit
referring to any of the following standard rules:
•
•
•
•
SR2010No4 Mobile plant for landspreading (land
treatment resulting in agricultural or ecological benefit);
SR2010No5 Use of mobile plant for land reclamation,
restoration or improvement of land;
SR2010No6 Mobile plant for landspreading of sewage
sludge; or a
Bespoke mobile plant permit for landspreading or land
reclamation.
Please tick one box to indicate under which
standard rules set (facility type) or bespoke permit
this deployment is taking place
SR2010No4 Mobile plant for landspreading (land
treatment resulting in benefit).
F
SR2010No5 Mobile plant for reclamation, restoration or
improvement of land
F
SR2010No6 Mobile plant for landspreading of sewage
sludge
F
Bespoke mobile plant permit for landspreading or land
reclamation
Contents
Section A Your organisation
A1 Contact details
A2 Your permit details
Section B Deployment details
B1 Risk assessment
B2 About the waste
B3 About the land to be treated
B4 Occupancy details
B5 Storage of waste
B6 Supporting documents
B7 Payment
Section C Confidentiality and national security
Section D Declaration
Section E How to contact us
Section A Your organisation
A1 Contact details, continued
A1 Contact details
A1.4 Contact details for this deployment
application
A1.1
Your customer number, if applicable
Customer number
A1.2
Discussions before your application
If you have had discussions with us before your application
please give the reference or details on a separate sheet. Tell us
below the reference you have given this extra sheet.
F
Please give details of the person we can speak to about the
information supplied with this form.
Title (Mr, Mrs, Miss and so on)
First name
Last name
Name of company or organisation, if appropriate
Pre-application reference
Address
A1.3 Submitting more than one deployment for the
same area of land
You may spread more than 10 waste streams on the same area
of land provided you submit further fully completed
deployment forms listing the additional wastes. Your benefit
statement must take into account the total benefit to the land
of all wastes to be spread.
If you are submitting more than one deployment for this area of
land please tell us in the box below. For example ‘this
deployment is one of three’.
Postcode
Contact numbers, including the area code
Phone
Fax
Mobile
LPD1 Version 1, August 2011
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Form LPD1: Application for deployment
A1 Contact details, continued
A2 Your permit details, continued
Email
Contact numbers, including the area code
Phone
Fax
Mobile
A1.5 Please indicate your preferred method of
correspondence?
Email
Email
F
Phone
F
A2 Your permit details
A2.3
A2.1 Permit under which this deployment is taking
place
This is the person who will be responsible for compliance with
the permit for this deployment (see the guidance notes for
further details).
Title (Mr, Mrs, Miss and so on)
Permit number
Nominated competent person
First name
A2.2
Name of permit holder (operator)
Last name
Title (Mr, Mrs, Miss and so on)
Name of company or organisation, if appropriate
First name
Last name
Address
Name of company or organisation, if appropriate
Address
Postcode
Contact numbers, including the area code
Phone
Postcode
Fax
Mobile
Email
Section B Deployment details
B1 Risk assessment
B1.1
Which risk band does the activity fall within?
Please tick the relevant box below to indicate which risk band your activity falls within. This is a combination of waste types and
proximity to sensitive receptors.
Table B1.1 Risk banding
Higher risk location
Within 500 m of a European site, Ramsar and/or
SSSI; and/or SPZ 2 (a site specific risk
assessment must be submitted in all cases)
Lower risk location
Outside 500 m of a European site, Ramsar
and/or SSSI; and/or SPZ 2
SR2010No4 List A wastes
(Lower risk)
Low risk deployment
F
Medium risk (2) deployment
F
SR2010No4 List B wastes
(Higher risk)
Medium risk (1) deployment
F
High risk deployment
F
SR2010No5 and SR2010No6
(Any waste listed)
Medium risk (1) deployment
F
High risk deployment
F
Bespoke mobile plant permit
Low risk deployment
LPD1 Version 1, August 2011
F
Medium risk deployment
F
High risk deployment
F
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Form LPD1: Application for deployment
B1 Risk assessment, continued
Once you have selected the risk band your activity falls within, please see the form guidance that tells you what additional
information you need to send with the form.
You will also use this risk banding to help you work out the fee you need to send with your deployment application in section B7.
B1.2
Additional information on sensitive receptors
If you have identified that you are within an SPZ 2 and/or 500m of a European site, Ramsar or SSSI you must submit a site specific
risk assessment showing how you intend to prevent any harm to those receptors.
For more information on risk-assessment please look at the accompanying guidance and TGN 8.01.
Please tick the box indicating which risk-assessment you have submitted:
I have attached a site-specific risk-assessment as the
deployment is within and SPZ 2 and/or 500m of a European site,
Ramsar or SSSI. I have also addressed risks to other receptors in
the risk assessment
F
I am not within an SPZ 2 and/or 500 m of a European site,
Ramsar or SSSI but have addressed risks to other receptors in
my benefit statement
F
I have a bespoke permit and I have attached a site-specific risk
assessment
F
B2 About the waste
B2.1
Please list all the individual waste streams being spread under this deployment
Table B2.1 Summary of wastes being spread
LoW Code
Description of waste
Physical form
Producer of the waste
Total amount to be
spread (tonnes)
Example: 03 03 05
De-inked paper
Sludge
Smith’s Newsprint
500
1
2
3
4
5
6
7
8
9
10
B3 About the land to be treated
B3.1
Please give details of the main address of the land to be treated
Address
Postcode
B3.2
Please indicate the type of land to be treated
Agricultural land
F
Non-agricultural land
F
LPD1 Version 1, August 2011
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Form LPD1: Application for deployment
B3 About the land to be treated, continued
B3.3
Please give details of the parcels of land to be treated
Please fill in table B3.3 below. The total area to be treated must be no more than 50 hectares.
Table B3.3 Details of land to be treated
Field name/number/ref
Size (hectares)
Grid reference (centre of fields)
Waste type(s) to be spread (LoW)
1
2
3
4
5
6
7
8
9
10
B3.4
Previous land treatment
Has land been treated with other wastes, sewage sludge, slurries or manures etc. in the last 12 months?
Yes F Please fill in table B3.4 below. You must take them into account in your benefit statement.
No F Please go to section B4
Table B3.4 Details of previous land treatment
Field name/number/ref
Type of waste etc. spread in last
12 months
Person or company
etc. who spread the
waste
Quantity spread
per hectare
(tonnes)
Example: East Field
Digested Sewage Sludge cake
Eastern Waters
20
Deployment or other
reference if
applicable/known
1
2
3
4
5
6
7
8
9
10
B4 Occupancy details
B4.1
Yes F
No F
Are you the occupier of the land?
Please go to section B5
Please give the details of the landowner or main occupier (e.g. tenant). If there is more than one occupant for the area
covered by this deployment please give the details in a separate document.
Title (Mr, Mrs, Miss and so on)
First name
Last name
Name of company or organisation, if appropriate
Position
LPD1 Version 1, August 2011
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Form LPD1: Application for deployment
B4 Occupancy details, continued
Address
Postcode
Contact numbers, including the area code
Phone
Fax
Mobile
Email
B4.2
Yes F
No F
Do you have the consent of the occupants to carry out the activity?
Please go to section B5
Please give details below why you can carry out this operation without the consent of the occupier
B5 Storage of waste
B5.1
Are you storing waste in connection with this deployment?
Yes F Please fill in table B5.1 below
No F Please go to section B6
In table 5.1 below please give the location of your storage facility, or facilities if you are planning to use more than one.
No more than 3,000 tonnes of waste to be spread under this deployment may be stored at any one time either at one or multiple
storage facilities.
Table B5.1 Location of storage facility or facilities
Grid reference (12-figure)
Waste type and method of storage
Quantity stored at any one time (tonnes)
1
2
3
4
5
6
7
8
9
10
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Form LPD1: Application for deployment
B6 Supporting documents
B7 Payment, continued
If you don’t provide us with all the information we need, we
won’t be able to assess your proposal and the application may
be rejected.
Please write the name of your company and your permit
reference number on the back of your cheque or postal order.
Please tick and fill in as appropriate, or enter N/A if not
applicable.
We will not accept cheques with a future date on them.
Paying by credit or debit card
Location map (required for all deployments)
Document references
F
Benefit statement (required for all deployments)
Document references
F
Waste analysis (required for all deployments)
Document references
F
Receiving soil analysis (required for all deployments)
Document references
F
Site-specific risk assessment (in accordance with B1.2)
Document references
F
Additional information
Please list documents and any references
F
If you are paying by credit or debit card, please fill in the
separate form CC1. We will destroy your card details once we
have processed your payment. We can accept payments by
Visa, MasterCard or Maestro card only.
Paying by electronic transfer
Applying for a mobile plant deployment in Wales?
If you choose to pay by electronic transfer and you are applying
for a mobile plant deployment in the EA Wales region, you will
need to use the following information to make your payment.
Company name:
Environment Agency Wales
Company address:
PO Box 663, Cardiff, CF24 0TP
Bank:
Barclays Bank Plc
Address:
15 Queen Square, Bristol,
BS1 4NP
Sort code:
20-13-42
Account number:
00440108
Payment reference number: xxxxxxxxxxxxxx
You should also email your payment details and permit
reference number to [email protected]
or fax it to 02920 466 404.
If you are making your payment from outside the United
Kingdom, it must be in sterling. Our IBAN number is GB42
BARC2013 4200 4401 08 and our SWIFTBIC number is BARC
GB22.
BACS reference
Applying for a mobile plant deployment in England?
If you choose to pay by electronic transfer and you are applying
for a mobile plant deployment for another (English) region, you
will need to use the following information to make your
payment.
B7 Payment
Tick below to show how you will make the payment.
Cheque
Postal order
Credit or debit card
Electronic transfer (for example, BACS)
How to pay
Paying by cheque, postal order or cash
Cheque details
Cheque made payable to
Cheque number
Amount
£
You should make cheques or postal orders payable to
‘Environment Agency’ or ‘Environment Agency Wales’ as
appropriate and make sure they have ‘A/c Payee’ written
across them if it is not already printed on.
LPD1 Version 1, August 2011
F
F
F
F
Company name:
Company address:
Environment Agency
Income Dept 311, PO Box 263,
Peterborough, PE2 8YD
Bank:
Barclays Bank Plc
Address:
15 Queen Square, Bristol,
BS1 4NP
Sort code:
20-13-42
Account number:
20744646
Payment reference number: xxxxxxxxxxxxxx
You should also email your payment details and permit
reference number to [email protected] or
fax it to 01733 464 892.
If you are making your payment from outside the United
Kingdom, it must be in sterling. Our IBAN number is GB42
BARC2013 4220 7446 46 and our SWIFTBIC number is BARC
GB22.
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Form LPD1: Application for deployment
Section C The Data Protection Act 1998
We, the Environment Agency, will process the information you
provide so that we can:
•
•
deal with your application;
make sure you keep to the conditions of the licence,
permit or registration;
• process renewals; and
• keep the public registers up to date.
We may also process or release the information to:
• offer you documents or services relating to environmental
matters;
• consult the public, public organisations and other
organisations (for example, the Health and Safety
Executive, local authorities, the emergency services, the
Department for Environment, Food and Rural Affairs) on
environmental issues;
• carry out research and development work on
environmental issues;
• provide information from the public register to anyone who
asks;
• prevent anyone from breaking environmental law,
investigate cases where environmental law may have been
broken, and take any action that is needed;
• assess whether customers are satisfied with our service,
and to improve our service; and
• respond to requests for information under the Freedom of
Information Act 2000 and the Environmental Information
Regulations 2004 (if the Data Protection Act allows).
We may pass the information on to our agents or
representatives to do these things for us.
Section D Confidentiality and national
security, continued
Only tick the box below if you are certain that you wish to
claim confidentiality for your application. This may delay your
application.
Please treat the information in my application as
confidential
F
Tick the box below if you have written to the Secretary of State
or Welsh ministers to claim national security for your
application.
I attach a letter stating that I have written to the Secretary
of State or Welsh ministers explaining why my information
should not be included on the public register for national
security reasons
Section E Declaration
If you knowingly or carelessly make a statement that is
false or misleading to help you obtain a mobile plant
deployment (for yourself or anyone else), you may be
committing an offence under the Environmental Permitting
(England and Wales) Regulations 2010.
I declare that the information in this application is true to
the best of my knowledge and belief. I understand that this
application may be refused or approval withdrawn if I give
false or incomplete information.
If you deliberately make a statement that is false or
misleading in order to get approval you may be
prosecuted.
Tick this box to confirm that you understand and agree
with the declaration above
Section D Confidentiality and national
security
If you do not tick the box above we will not be
able to process your application.
We will normally put all the information in your application on a
public register of environmental information. However, we may
not include certain information in the public register if this is in
the interests of national security, or because the information is
confidential.
Section F How to contact us
You can ask for information to be made confidential by
enclosing a letter with your application giving your reasons. If
we agree with your request, we will tell you and not include the
information in the public register. If we do not agree with your
request, we will let you know how to appeal against our
decision, or you can withdraw your application.
You can tell the Secretary of State that you believe including
information on a public register would not be in the interests of
national security. You must enclose a letter with your
application telling us that you have told the Secretary of State
and you must still include the information in your application.
We will not include the information in the public register unless
the Secretary of State decides that it should be included.
F
F
If you need help filling in this form, please contact the person
who sent you it or contact us as shown below.
General enquiries and customer service line: 03708 506 506
(Monday to Friday, 8am to 6pm)
Incident hotline: 0800 80 70 60
Floodline: 0845 988 1188
Textphone: 03702 422 549 (Monday to Friday, 8am to 6pm)
Email: [email protected]
Website: www.environment-agency.gov.uk
If you are happy with our service, please tell us. It helps us to
identify good practice and encourages our staff. If you’re not
happy with our service, please tell us how we can improve it.
Please tell us if you need information in a
different language or format (for example, in
large print) so we can keep in touch with you
more easily.
For Environment Agency use only
Date received (DD/MM/YYYY)
Our reference number
Payment received?
No F
Yes F Amount received
£
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