Application Form - Business Licence Finder

HAZARDOUS WASTE (REGULATION OF EXPORTS AND IMPORTS) ACT 1989
APPLICATION FORM
COMPLETE ALL BOXES. DO NOT PROVIDE ATTACHMENTS UNLESS REQUESTED OR THERE IS INSUFFICIENT SPACE.
Detailed advice on completing all the permit application forms can be obtained from
the Department of Sustainability, Environment, Water, Population and Communities
Please call 1800 803 772 or e-mail [email protected] to find out whether you have the latest editions.
Office use only:
1 Application for:
Export Permit
Import Permit
2 Identity and suitability of applicant
a) Applicant’s name and street address:
Transit Permit
Notification Number
Applicant’s postal address (if different):
b) Contact person:
Telephone:
Facsimile:
Mobile:
E-mail:
c) Australian Business Number/Australian Company Number:
d) If the company is a corporation, please list the name of each director, or attach a copy of the most recent annual report.
e) Please attach sufficient information on the applicant’s financial situation in order for the Department of the Environment and Heritage to
assess financial viability
(balance sheet and financial statements from the most recent annual report).
f) Has the applicant or any of the applicant’s directors (if any) ever been found guilty of an offence under Australian (Commonwealth, State or
Territory) or other (eg, overseas) environmental law? If yes, please provide details.
Yes
No
g) Are there any other environmental or health matters, including planning, development and community issues, relevant to the application?
If yes, please provide details.
Yes
No
3
Please attach copies of contracts or chains of contracts in place to demonstrate ownership and continuous control over the movement of the
waste, starting with the notifier and terminating with the recovery/disposal facility.
4
Please attach evidence that the applicant has appropriate insurance (certificate of currency or a copy of the insurance policy).
5
Export only: Are there alternative disposal/recovery options available in Australia? If so, explain why these are not suitable in this
instance.
6
What customs code will be used to identify the material? (you may need to contact Australian Customs Service or a customs broker for
advice).
7
Please provide a comprehensive description of the disposal operation including:
(a) Description of disposal process;
(b) Transportation proposed, including any safety or environment issues to be addressed;
(c) Packaging and storage of material; and
(d) What wastes/residues will be generated by the recovery process.
8
Basel export permits only: If you are intending to export hazardous waste to a non-OECD country that is party to the Basel Convention, you
will need to provide information in line with the requirements set out in the current Information Paper on Environmentally Sound
Management of Hazardous Waste.
9
Please provide any other information which you consider relevant to this application.
10 I certify that all information provided as part of this application is complete and correct to my knowledge.
Signature of applicant __________________________ Date _______________ Name and position _________________________________
To be completed by small businesses with less than twenty employees
Please provide an estimate of the time taken to complete this form, the notification form and the movement tracking form.
Include
 The time actually spent reading the instructions, working on the questions and obtaining the information.
 The time spent by all employees in collecting and providing this information.
Hours
Minutes