hereby apply for (check one)
a licence to transport hazardous waste within the Province of British Columbia.
a revision of a licence (number LT...............).
a renewal of a licence (number LT...............).
| Copyright (c) Queen's Printer, Victoria, British Columbia, Canada | Licence Disclaimer |
| This archived regulation consolidation is current to December 3, 2004 and includes changes enacted and in force by that date. For the most current information, click here. |
Schedule 5
[en. B.C. Reg. 132/92, s. 37; am. B.C. Reg. 319/2004, ss. 2 and 46.]
Initial Generator Registration
THIS FORM IS AN INITIAL GENERATOR REGISTRATION REPORT
MADE UNDER SECTION 43 (1) OR (2) OF THE
HAZARDOUS WASTE REGULATION
Instructions: PLEASE PRINT
(1) Complete a separate form if there are more than one generation sites or management sites.
(2) Send Copies 1 and 2 to: The Director of Waste Management responsible for the hazardous waste generation site.
(3) Retain Copy 3 for your records
1. GENERATOR:
...............................................................................................................................................................
Name of Generator:
...............................................................................................................................................................
Address: (Full Postal Mailing Address) City Province Country Postal Code
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Note: |
If the generator is a company in British Columbia the registered company name and address must be provided. Enter the corporate name or, if a partnership or proprietorship, the name of the principal(s). If the generator intends to carry on business under a separate name or style, this should also be entered. |
2. HAZARDOUS WASTE DESCRIPTION [see notes below]
Physical State | Waste Identification | Quantity | Units | Handling Code | Generation Code | |||
Name of Waste | Pin | TDG Class | Now in storage | Produced/ 30-day | ||||
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NOTES:
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Physical State: |
L = Liquid; S = Solid; G = Gas; X = sludge. |
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Waste Identification: |
Name of Waste: (a) TDG Regulations classified Hazardous Wastes - enter PIN, TDG Class and waste name in accordance with TDG Regulations, (b) hazardous wastes not regulated by TDGR: enter "N/A" for PIN and TDG Class, use defined hazardous waste name. |
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Quantity: |
Now in storage: Amount currently on site, excluding any amounts in "temporary storage". |
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Produced/30-day period: |
estimate of amount produced. |
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Units: |
Use metric, litres or kilograms (L or kg). |
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Handling codes: |
01 storage; 02 thermal treatment; 03 chemical treatment; 04 physical treatment; 05 biological treatment; 06 landfill; 07 recycled; 08 other, please specify....................; 09 landfarming; 10 off site management. |
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Generation Codes: |
A = generated one time only; B = generated intermittently; C = generated continuously. |
3. BUSINESS GENERATING HAZARDOUS WASTE:
...............................................................................................................................................................
3a. General Business Type (Sawmill, Restaurant, Petroleum Refinery, etc.)
...............................................................................................................................................................
3b. Source or actual process generating the Hazardous Waste. (e.g. TCMTB spray booth)
...............................................................................................................................................................
3c. Address of HAZARDOUS WASTE GENERATION SITE: City Prov Postal Code
...............................................................................................................................................................
3d. (Please state full Company Name if Hazardous Waste is being Managed by a Company other than as stated in section 1 above.)
...............................................................................................................................................................
Address of HAZARDOUS WASTE MANAGEMENT SITE: City Prov Postal Code
4. CERTIFICATION:
I certify that the information provided on this form is correct and complete.
...............................................................................................................................................................
PRINT NAME SIGNATURE DATE (Y/M/D) TELEPHONE NUMBER
FOR MINISTRY USE ONLY:
Region: LM ......... VI ......... TN .......... CA .......... OP ......... OK .......... SK .......... KO ..........
Location coordinates of Present Hazardous Waste Generation Site are
Latitude:........Deg. .........Min. .........Sec. Longitude: ........Deg. .........Min. .........Sec.
Standard Industrial Classification Code: ..............................
SPWASTE: ENTRY #: ......... DATE: ......... INITIALS: .......... BCG#: ..........
SPCW: ENTRY #: .......... DATE: .......... INITIALS: ..........
[en. B.C. Reg. 132/92, s. 37; am. B.C. Reg. 319/2004, ss. 2 and 46.]
Generator Registration Update
THIS FORM REPLACES / RENEWS / UPDATES THE FOLLOWING HAZARDOUS WASTE INFORMATION REPORTED ON THE PREVIOUS GENERATOR REGISTRATION REPORT,
DATED....................(Y/M/D) BY: .............................. (CERTIFICATION NAME) FOR BCG: .....................
PLEASE PRINT
(1) Complete this form if there are any changes in the Hazardous Waste Quantity, Generation Site, or Management Site, from the Initial Registration.
(2) Send Copies 1 and 2 to: The Regional Waste Manager responsible for the hazardous waste generation site.
(3) Retain Copy 3 for your records.
1. GENERATOR:
..............................................................................................................................................................
Name of Generator:
..............................................................................................................................................................
Address: (Full Postal Mailing Address) City Province Country Postal Code
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Note: |
If the generator is a company in British Columbia the registered company name and address must be provided. Enter the corporate name or, if a partnership or proprietorship, the name of the principal(s). If the generator intends to carry on business under a separate name or style, this should also be entered. |
2. HAZARDOUS WASTE DESCRIPTION [see notes below] FORMERLY:
Physical State | Waste Identification | Quantity | Units | Handling Code | Generation Code | |||
Name of Waste | Pin | TDG Class | Now in storage | Produced/ 30-day | ||||
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b) |
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PRESENTLY:
Physical State | Waste Identification | Quantity | Units | Handling Code | Generation Code | |||
Name of Waste | Pin | TDG Class | Now in storage | Produced/ 30-day | ||||
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b) |
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d) |
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e) |
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NOTES:
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Physical State: |
L = Liquid; S = Solid; G = Gas; X = sludge. |
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Waste Identification: |
Name of Waste: (a) TDG Regulations classified Hazardous Wastes - enter PIN, TDG Class and waste name in accordance with TDG Regulations, (b) hazardous wastes not regulated by TDGR: enter "N/A" for PIN and TDG Class, use defined hazardous waste name. |
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Quantity: |
Now in storage: Amount currently on site, excluding any amounts in "temporary storage". |
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Produced/30-day period: |
estimate of amount produced. |
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Units: |
Use metric, litres or kilograms (L or kg). |
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Handling codes: |
01 storage; 02 thermal treatment; 03 chemical treatment; 04 physical treatment; 05 biological treatment; 06 landfill; 07 recycled; 08 other, please specify....................; 09 landfarming; 10 off site management. |
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Generation Codes: |
A = generated one time only; B = generated intermittently; C = generated continuously. |
3. BUSINESS GENERATING HAZARDOUS WASTE:
..............................................................................................................................................................
3a. General Business Type (Sawmill, Restaurant, Petroleum Refinery, etc.)
..............................................................................................................................................................
3b. Source or actual process generating the Hazardous Waste.
3c. ADDRESS OF HAZARDOUS WASTE GENERATION SITE:
..............................................................................................................................................................
FORMER Address of Hazardous Waste Generation Site: City Prov Postal Code
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PRESENT Address of Hazardous Waste Generation Site: City Prov Postal Code
..............................................................................................................................................................
3d. Please state full Company Name if Hazardous Waste is being Managed by a Company other than as stated in section 1 above.
..............................................................................................................................................................
FORMER Address of Hazardous Waste Management Site: City Prov Postal Code
..............................................................................................................................................................
PRESENT Address of Hazardous Waste Management Site: City Prov Postal Code
4. CERTIFICATION:
I certify that the information provided on this form is correct and complete.
..............................................................................................................................................................
PRINT NAME SIGNATURE DATE(Y/M/D) TELEPHONE NUMBER
FOR MINISTRY USE ONLY:
Region: LM ......... VI ......... TN .......... CA .......... OP ......... OK .......... SK .......... KO ..........
Location coordinates of Present Hazardous Waste Generation Site are
Latitude: ........Deg. .........Min. .........Sec. Longitude: ........Deg. .........Min. .........Sec.
Standard Industrial Classification Code: ..............................
SUPPLEMENTARY REPORT: ARCHIVE REPORT:
BCG#: ......... ENTRY: ......... BCG#: ......... ENTRY: .........
SPWASTE: ........ DATE: ........ INITIALS: ........ SPWASTE: ........ DATE ........ INITIALS: ........
SPCW: ........ DATE: ........ INITIALS: ........ SPCW: .......... DATE: .......... INITIALS: ..........
ADDITION YES: .......... NO: .......... DELETION: YES: .......... NO: ..........
REPLACES BCG: ........../ ......... REPLACED BY BCG: ........../ ..........
[en. B.C. Reg. 132/92, s. 37; am. B.C. Regs. 109/2002, s. 1; 319/2004, ss. 2 and 46.]
|
CREST |
Province of British Columbia |
Ministry of Water, Land and Air Protection |
File No. ............... (office use only)
APPLICATION FOR A LICENCE TO TRANSPORT HAZARDOUS WASTE
UNDER PROVISIONS OF THE
ENVIRONMENTAL MANAGEMENT ACT
1. I/We, .....................................................................................................................................................
(Full name, if a company, British Columbia registered name)
of ...........................................................................................................................................................
(Address) (City) (Province) (Postal Code)
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hereby apply for (check one) |
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2. This undertaking relates to the transportation of: (check those that apply)
biomedical wastes
inorganic wastes
waste batteries
contaminated soil
lab packs
waste pesticides
corrosive wastes
paint waste
waste petroleum products
dry cleaning wastes
waste asbestos
waste solvents
PCBs
other (please specify) .............................................
by vehicles dispatched from an operation located at (Address) .......................................
............................................................... (City) ............................................................
(Province)........................ (Postal Code).........................
3. Those vehicles used to transport hazardous waste are described as follows (Please attach a current owner's certificate of insurance for each vehicle):
| Vehicle | Licence | Province or State | Net Load Capacity | Load Type | Liability Insurance Coverage |
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(Continue on reverse side if necessary.)
Note: If applying for a licence revision or renewal, list only the changes to the current Licence
4. Liability insurance provided by ..............................(Name of insurance company/carrier — not agent) is carried by the applicant on each vehicle.
5. I ..............................(print name) certify that I am aware of the requirements of the Hazardous Waste Regulation as related to the transportation of hazardous waste.
Date of Application ...................(Y/M/D)
Telephone (
)...................(Area code - Number)
..........................................(Print name of applicant) ............................(Signature of applicant)
FOR OFFICE USE ONLY:
Region: LM ......... VI ......... TN .......... CA .......... OK ......... OP .......... SK .......... KO ..........
[REVERSE]
(Continued from face side.)
3. Those vehicles used to transport hazardous waste are described as follows:
| Vehicle | Licence | Province or State | Net Load Capacity | Load Type (i.e. bags, bulk, barrels, roll off, tank, etc.) | Liability Insurance Coverage $ |
(h) |
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(j) |
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(l) |
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Return completed application forms with a copy of proof of insurance and vehicle registration to:
Director of Waste Management
PO Box 9342 Stn Prov Govt
Victoria, B.C.
V8W
9M1
(located at 2975 Jutland Road, Victoria, B.C.)
[en. B.C. Reg. 132/92, s. 37; am. B.C. Reg 109/2002, s. 1]
[en. B.C. Reg. 132/92, s. 37; am. B.C. Reg. 319/2004, ss. 2 and 46.]
[en. B.C. Reg. 132/92, s. 37; am. B.C. Regs. 109/2002, s. 1; 319/2004, s. 2.]
[en. B.C. Reg. 132/92, s. 37; am. B.C. Regs. 109/2002, s. 1; 319/2004, s. 2.]
Copyright (c) 2004: Queen's Printer, Victoria, British Columbia, Canada