Matamata-Piako District Council

Application for Trade Waste Discharge

Section A: General Information

Company/Premise Details

Legal Name:*

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Trade Name:*

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Occupier/Discharger:*

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Physical Address: *

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Postal Address (if different):

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Postcode:*

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Postcode:

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Email:*

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Phone Number:*

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Fax Number:

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This application relates to:

This application relates to:*

Temporary dischargeProposed new dischargeRenewal of a consentVariation to an existing consent Invalid Input

Nature of variation:*

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Council connections (tick all that apply):*

Council wastewater networkCouncil stormwater networkCouncil water supplyOther source of water Invalid Input

Please specify:*

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Description of main trade activity:

Description of main trade activity:*

Food premisesProcess/manufacturingHealthcareHair and beauty servicesService station/car washLaundromat/dry cleanersTankerLeachate/landfill wastesOther Invalid Input

Please specify:*

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Describe processes and main trade activity:*

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Please upload site drainage plans showing process areas, trade waste drains, domestic wastewater drains, stormwater drains, pre-treatment device location, flow measuring devices, sampling point and water meter(s):*

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Section B: Nature of the trade waste

General characteristics of trade waste

Does the discharge meet the permitted characteristics specified in Schedule 1 of the bylaw?*

YesNo Invalid Input

If No, please refer to Section 4 of the Trade Waste Bylaw and provide all the necessary information to address all the items specified in the section. Please upload the additional information in the 'supporting information' upload field at the end of this section.

Operational days/discharge hours

Days operating:*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday Invalid Input

Hours of operation:*

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Trade waste discharge volume

Discharge volume*

Continuous dischargeBatch discharge Invalid Input

Maximum daily discharge volume (m3/day):*

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Maximum instantaneous flow rate (litres/second):*

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Batch discharge volume (m3):*

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Frequency of batch discharge:*

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Trade waste discharge volume flow measurement

Proposed method of flow measurement:*

Permanent installation of Council-approved waste flow measuring equipmentBased on water usage as measured by a Council meter Invalid Input

Proposed water loss factor:*

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Note: attach supporting information regarding the calculation of the water loss factor in the 'supporting information' upload field at the end of this section.

Process and pollutants

List any substances which are stored, used and/or generated on the premise (e.g. chemicals, oil solvents, waste products, etc.):*

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Attach Material Safety Data Sheets (MSDS) in the 'supporting information' upload field at the end of this section if necessary.

Describe mitigation measures employed to prevent accidental spillages of these substances from entering the public sewer or stormwater system:*

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Attach additional information in the 'supporting information' upload field at the end of this section if necessary.

Supporting information for this section:

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Section C: Pre-treatment systems

Proposed/existing pre-treatment devices

Proposed/existing pre-treatment devices*

ScreensGrease removal systemFlow balanceFirst-flush diversionpH adjustmentAmalgam separatorChemical/biological treatmentOil and grit interceptorBalance/holding tankComplex filtration systemOther Invalid Input

Please specify:*

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Specification of pre-treatment systems

Attach specification of proposed/existing pre-treatment devices in the 'supporting information' upload field at the end of this section.

Type:*

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Make/model:*

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Size (litres):*

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Pre-treatment servicing

Contractor:*

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Contact phone number: *

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Frequency of service:*

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Section D: Liquid waste removal from site

List all liquid wastes removed from site:*

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Contractor:*

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Contact phone number: *

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Frequency:*

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Section E: Reducing liquid and solid waste

List all waste (liquid and solidwastes) minimisation and cleaner production initiatives that will be implemented in the premise:*

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Attach further information in the 'supporting information' upload field at the end of this section if necessary.

Section F: Health and safety

Is there an induction required?*

YesNo Invalid Input

Health and safety (induction requirements, hazard registers, PPE requirements, etc.) requirement(s) for Council staff prior to entering site:*

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Management Plan

As part of your application you must submit a trade waste management plan. Download and fill out this template and upload it in the supporting documentation field below.

Supporting information for these sections:

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Go to the next page to complete your application.

Please note: The Council Trade Waste Bylaws and Local Government Act 2002 allow the following:

All Authorised Officers or Authorised Agents of the Council, or any analysts, may enter any premise believed to be discharging trade waste at any time in order to determine any characteristics of any actual or potential discharge by:

Taking readings or measurements
Carrying out site inspection audits; and/or
Taking samples for testing, of any solids, liquid or gaseous material or any combination or mixture of such materials.

Payment

You will be invoiced for the cost of the application.

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Signature

Please confirm that:*

I am duly authorised to make this applicationI believe that all the information contained in this application is true and correct Invalid Input

You must check both boxes.

Full name:*

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Position:*

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Date:*

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