Application For A Variation Form - Environmental Management Authority printable pdf download

Application For A Variation Form - Environmental Management Authority

THE NOISE POLLUTION CONTROL RULES, 2001

THE ENVIRONMENTAL MANAGEMENT ACT 2000

APPLICATION FOR A VARIATION

GENERAL INSTRUCTIONS:

This Form shall be completed in duplicate for any event, activity or facility as required in

Rule 9 of the Noise Pollution Control Rules 2001 and as identified as being in excess of

the prescribed standards in the First Schedule and as stated in the Register of Noise

Pollutants. Essential additional information and maps, plans and diagrams may be

included as an appropriately referenced attachment.

To: The Environmental Management Authority

I/We hereby apply for a Variation in accordance with Rule 9 of the Noise Pollution Control Rules 2001.

Signed _____________________________

_________________________________

Applicant/Applicant’s agent/Applicant’s attorney

(PRINT NAME/CORPORATE NAME)

Date

______________

COMPANY STAMP

FOR OFFICIAL USE ONLY

Date received ________________

Received by ___________________

Reference number ___________________

Location

Industrial

Environmentally sensitive area

General

Variation type

Event

Facility

Date(s) of event(s) _________________

_________________

Noise Advisory Council

Yes

Application for omission of information from NVR

Yes

N/A

Application Fee ___________

Receipt no.______________

Date ______________

Application For A Variation Form - Environmental Management Authority