Atlantic Used Oil Management Association - Processor registration application

Processor registration application form
****** IMPORTANT NOTICE ******

Before completing the processors registration application form, please make sure you have the following documents in PDF format: Civil and Environment Insurance Certificate, government issued operation permit(s) and completed, signed and initialed Processor Agreement(s). A separate Processor Agreement is required for each province for which you seek registration as a processor. The Processor Agreements are available on the "Processor" tab of our website's "Partners" page. All above mentioned documents must be attached to the processor registration form.
Company legal name:*
Address*

Street address

Street address (line 2)

City Province/State

Postal/Zip Code
Phone number to display on website*

Area CodePhone #
Extension (if any)

Contact Person*
Title*
Contact person email address*
Provide contact person's email address
Contact phone number*

Area codePhone #
Extension (if any)

In which of the following provinces were the Atlantic Used Oil Management Association products that your company will be processing collected?*

New BrunswickNewfoundland & LabradorNova ScotiaPrince Edward Island
Important: You are required to register as a processor for each province where the collector picked up the products delivered to you.

Please indicate the address of your facility(ies) where Atlantic Used Oil Management Association products are being or will be processed. (List all addresses that apply)*
Attach all government issued permit(s) or certificate(s) of approval for each aforementionned facility where Atlantic Used Oil Management Association products will be processed.*

Attach your file(s)
You can attach more than one file Cancelof
Does your company have a municipal permit for the installations where you will process Atlantic Used Oil Management Association products?*

YesNo
Attach a copy of your municipal permit*

Attach your file(s)
You can attach more than one file Cancelof
For each facility, briefly describe your current spill prevention and containment measures (e.g. berm(s) or other confinement unit(s), regular inspections of storage units, proximity of absorbants, etc.)*
For each location, briefly explain what the provincial or federal requirements are in order to store and process the products for which you are registering with Atlantic Used Oil Management Association.*
For any of your locations, are you required to produce a report to local government authorities?*

YesNon
For each facility, specify which type(s) of report(s), and the frequency at which you are required to produce such report(s).*

For each aforementionned facility, when was the last inspection by the local government authority in regards to activities for which you are registering with Atlantic Used Oil Management Association? Specify the location of the inspected facility(ies), the month and year of inspection.*
Over the last two years, has your company received any infraction notice from local government authorities regarding a facility whose activities are related to Atlantic Used Oil Management Association products?*

YesNo
Attach a copy of your infraction notice(s).*

Attach your file(s)
You can attach more than one file Cancelof
For each infraction notice your company has received, briefly explain what measures were implemented to correct the situation. *

Each provincial Atlantic Used Oil Management Association registration requires its own signed and initialized Processors Agreement. All Processors Agreements are available on their respective provincial program's website, in the "Processors" tab of the "Partners" tab.
Please attach your signed and initialized NB Processors Agreement below.*

Attach your file

Cancelof
Please attach your signed and initialized NL Processors Agreement below.*

Attach your file

Cancelof
Please attach your signed and initialized NS Processors Agreement below.*

Attach your file

Cancelof
Please attach your signed and initialized PE Processors Agreement below.*

Attach your file

Cancelof
Attach you civil and environmental insurance certificate(s)*

Attach your file(s)
You can attach more than one file Cancelof

Which of the following products do you wish to register as a Atlantic Used Oil Management Association processor for?*

USED OILUSED ANTIFREEZE (GLYCOL)USED FILTERSUSED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS*USED AEROSOL CONTAINERS**
*Diesel exhaust fluid containers are only applicable in Prince Edward Island and Nova Scotia.

**In New Brunswick and Newfoundland & Labrador, only lubricants and break cleaner aerosol containers are applicable; In Prince Edward Island and Nova Scotia, only lubricants and automotive parts cleaner aerosol containers are applicable.

You will be processing USED OIL originating from which of the following province(s)?*

New BrunswickNewfoundland & LabradorNova ScotiaPrince Edward Island
Which of the following options best describe your USED OIL processing operations.*

Energy recoveryRerefiningRegeneration

How long has your company been processing USED OIL for ENERGY RECOVERY?*
List the address of each facility where you process USED OIL for ENERGY RECOVERY purposes and specify the maximum storage capacity for each facility.*
Briefly describe the installations and equipments for USED OIL ENERGY RECOVERY.*
Specify the average storing period before processing.*
Is your combustion equipment in compliance the applicable provincial Regulation?*

YesNo
Are you benifiting from a vested right for your combustion equipment?*

YesNo
How do you ensure the quality of the USED OIL received from the collectors and intended for ENERGY RECOVERY meet the standards for burning set forth by the applicable provincial regulation?*
Are the supply tank and the burner tank flange equipped with a sampling system?*

YesNo
Are USED OIL analysis performed by an accredited laboratory?*

YesNo

How long has your company been processing USED OIL for REGENERATION?*
List the address of each facility where you process USED OIL for REGENERATION purposes and specify the maximum storage capacity for each facility.*
Briefly describe the installations and equipments utilized for the REGENERATION of USED OIL.*
Specify the average storing period before processing.*
Do you exercise quality control of the USED OIL received from collectors?*

YesNo
Briefly explain your quality control procedures for the USED OIL received from the collectors.*
Do you require analysis performed by an accredited laboratory?*

YesNo
What is the end product's use and to whom is it shipped?*

How long has your company been RE-REFINING USED OIL?*
List the address of each facility where you RE-REFINE USED OIL and specify the maximum storage capacity for each facility.*
Briefly describe the installations and equipments utilized for the RE-REFINERY of USED OIL. *
Specify the average storage period before processing. *
Do you exercise quality control of the USED OIL received from the collectors?*

YesNo
Briefly explain your quality control procedures for the USED OIL received from the collectors. *
Do you require analysis performed by an accredited laboratory?*

YesNo
What is the end product's use and to whom is it shipped?*

You will be processing USED FILTERS originating from which of the following province(s)?*

New BrunswickNewfoundland & LabradorNova ScotiaPrince Edward Island
How long has your company been processing USED FILTERS?*
List the address of each facility where you process USED FILTERS and specify the maximum storage capacity for each facility.*
Briefly describe installations and equipments utilized for the processing of USED FILTERS. *
Briefly explain how you keep track of the USED FILTER batches received from each collector.*
Specify the average storage period before processing.*
How is the extracted oil (generated by the processing of USED FILTERS) treated/disposed of? *
What is the end product's use and to whom is it shipped?*

You will be processing USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS* originating from which of the following province(s)?*

New BrunswickNewfoundland & LabradorNova ScotiaPrince Edward Island
*Diesel exhaust fluid containers are only applicable in Prince Edward Island and Nova Scotia.
How long has your company been processing USED OIL, ANTIFREEZE CONTAINERS and DIESEL EXHAUST FLUID CONTAINERS?*
List the address of each facility where you process USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS and specify the maximum storage capacity for each facility.*
Briefly describe installations and equipments utilized for the processing of USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS.*
Briefly explain how you keep track of the USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS batches received from each collector.*
Briefly specify the sampling method used and the analysis performed on the processed USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS to ensure they meet all required criterias.*
Specify the average storage period before processing.*
How is the oily water generated by the processing of USED OIL, ANTIFREEZE and DIESEL EXHAUST FLUID CONTAINERS treated/disposed of?*
What is the end product's use and to whom is it shipped?*

Would you like to receive payments by cheque or electronic funds transfer (EFT)? - For processors of plastic containers only*

ChequeEFT
Please attach a void cheque in order to get EFT*

Attach your file

Cancelof

You will be processing USED AEROSOL CONTAINERS** originating from which of the following province(s)?*

New BrunswickNewfoundland & LabradorNova ScotiaPrince Edward Island
**In New Brunswick and Newfoundland & Labrador, only lubricants and break cleaner aerosol containers are applicable.
In Prince Edward Island and Nova Scotia, only lubricants and automotive parts cleaner aerosol containers are applicable.
How long has your company been processing USED AEROSOL CONTAINERS?*
List the address of each facility where you process USED AEROSOL CONTAINERS and specify the maximum storage capacity for each facility.*
Briefly describe installations and equipments utilized for the processing of USED AEROSOL CONTAINERS.*
Briefly explain how you keep track of the USED AEROSOL CONTAINER batches received from each collector.*
Briefly specify the sampling method used and the analysis performed on the processed USED AEROSOL CONTAINERS to ensure they meet all required criterias.*
Specify the average storage period before processing.*
What is the end product's use and to whom is it shipped?*

Signatory Name*
Signatory title*
I, {signatoryName}, {signatoryTitle}, declare I am duly authorized for this purpose and certify that the information provided on this form is accurate.
Signature*

Clear
Signature*

I confirm this signature
Date*

an MoisJour
Date
Should be Empty:

Processor registration application form