IPPC Form A: Application for a permit, variation, transfer or surrender
ID Card No
Building Entry Point Name
Form IPPC Part A – application for a permit, variation, transfer or surrender(For Environment & Resources Authority Use Only)
Name assigned to installation
Application for a permit, variation, transfer or surrenderIntegrated Pollution Prevention and Control (IPPC)Industrial Emissions (IPPC) Regulations 2013
Introduction to Part AUse this form if you are sending an application to the ERA under the Industrial Emissions (IPPC) Regulations, 2013.The form is to be used for applications made in respect of both ‘installations’ and ‘mobile plant’ (and in the rest of the form, the term ‘installation’ also covers ‘mobile plant’ where appropriate).
Before you start to fill in this formThere may be two or more operators in a single installation. Each operator will need a permit, each obtained by a separate application. Your applications will principally relate to the part of the installation under your control, but will also need to include some information on the rest of the installation. This will help us to assess the operation of the whole installation. The term “installation”, when used in this application form (and elsewhere) may refer to either the whole or part of the installation, depending on the nature of the information we are seeking to obtain.
Which parts of the form to fill inThe form is in five parts but we usually only send you the parts you need to fill in. Everyone has to fill in Part A, and prepare and sign a covering letter at the end of their application.The other parts you need to fill in depends on the type of application you are making:• To apply for a new permit – fill in Parts A and B;• To vary an existing permit – fill in Parts A and C;• To transfer all or part of an existing permit to someone else – fill in Parts A and D. This should be a joint application by the transferor and the transferee;• To surrender all or part of an existing permit – fill in Parts A and E.
Other documents we need to seeThere are a number of other documents you will need to send us with your application. Each time a request for documents is made in the application form you will need to record a document reference number for the document or documents that you are submitting in the box provided on the form for this purpose.Please also mark the document(s) clearly with this reference number and either the application reference number if you know it or your existing permit number. If you do not have either of these, please use the name of the installation.
If you know your Application Reference Number, please enter it into the box below
Using continuation sheetsIn the case of questions required to be answered on the application form itself, please use a continuation sheet if you need extra space; but please indicate clearly on the form that you have done so by stating a document reference number for that continuation sheet. Please also mark the continuation sheet itself clearly with the information referred to above.
CopiesPlease submit 1 hard copy and 1 soft copy of the application form and all supporting information. A soft copy of the application form must also be submitted to the consultees identified in Regulation 19(2) of Legal Notice 10 of 2013. A signed delivery note must be enclosed with the application to ERA.
If you need help and adviceWe have made the application form as straightforward as possible, but please get in touch with us on tel: 2292 3500 or email: firstname.lastname@example.org if you need any advice on how to set out the information we need.
A1 About your application
A1.1 What type of application are you making?
A1.2 Name of the installation
Please tell us if this name is:
A1.3 Please give the address of the site of the installation, and a map or plan showing the site of the installation and the location of the installation on the site
A1.4 Give details of any existing permit(s) for the installation.Please give details of any applicable waste management licences, planning permits, environmental permits or sewer discharge permits. Include permit number(s), type(s) and date(s) of issue, and submit copies.
A2 Authorised contacts
It will help us to have someone who we can contact directly with any questions about your application. The person you name should have the authority to act on your behalf.
A2.1 Who can we contact about your application?This could be an agent rather than the operator.
A2.2 Operational contactIf different to the above, please identify the person we should contact to discuss operational matters on an ongoing basis.
A3 About the operator
Please provide the information requested below about the ‘operator’, which means:• for applications for a new permit – the person whoit is proposed will have control over the installation in accordance with the permit (if granted),• for applications for a variation, transfer or surrender – the person who currently has control over the installation in accordance with the permit.If you are applying for a transfer, we will ask for more information relating to the proposed new operator (transferee) in Part D.
Legal status of operatorA3.1 Is the operator an individual, a group of individuals, a partnership or a company/corporate body?
Individual applicantsA3.2 Please give us the following details.
Where more than one person is applying (other than as a partnership) we need details of each person.Continue on separate sheets if necessary.
ID Card No.
Trading/business name (if any)
Now go to question A4, What to do next.
Applications from partnershipsA3.3 Who is applying?
We can only issue permits to named individuals, not to a partnership name. We therefore need details of each person in the partnership.Continue on separate sheets if necessary.
Principal place of business
A3.4 Please give us the following details about the partnership.
Name of partnership (if there is one)
Companies or other corporate applicantsA3.5 Please gives us the following details.
Full name of company or corporate body
Trading/business name (if different)
Registered office address
Company registration number
Date of formation of company
For applications from companies, please provide a copy of the certificate of incorporation or registration and any certificates of subsequent name changes.
Document reference number
For applications from other corporate bodies, please provide evidence of status.
A3.6 Is the operator a subsidiary of a holding company?
If yes, name of ultimate holding company
Principal office address (if different)
A4 What to do nextNow you need to fill in the other Parts of this form available online.If you are applying for