Newfoundland and Labrador - Processor registration application form

Processors registration application form

Newfoundland and Labrador
******* IMPORTANT NOTICE *******

Before completing the Processors registration application form, please make sure you have completed, signed and initialed each page of the Processors Agreement and that you have the following documents in PDF format: your initialed Processors Agreement, your Civil and Environment Insurance Certificate and Government issued Operation permit(s) (if applicable). All above mentioned documents must be attached to the following processors registration form.

Company legal name*
Address*

Street Address

Street Address (line 2)

City Province/State

Postal Code

Telephone*

Area codePhone number
Extension

Contact Name*
Title*
Contact's email address*

Confirmation EmailConfirm the contact person's email address

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.)*
When was your last inspection by the government authority having jurisdiction in Newfoundland and Labrador (or the equivalent government authority if you are located outside the province of Newfoundland and Labrador) concerning the activities for which you are registering with Atlantic Used Oil Management Association (Newfoundland & Labrador)? Specify the location of the inspected facility(ies), the month and year of inspection.*
Over the last two years, has your company received an infraction notice from the government authority having jurisdiction in Newfoundland and Labrador (or the equivalent government authority if you are located outside of Newfoundland and Labrador) regarding a processing facility whose activities are related to Atlantic Used Oil Management Association (Newfoundland & Labrador)'s 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. *

What is the location of the facility(ies) where you process the products for which you are registering to Atlantic Used Oil Management Association (Newfoundland & Labrador)? (select all that applies)*

In Newfoundland and LabradorOutside of Newfoundland and Labrador

Indicate the address of your Newfoundland and Labrador facility(ies) whose activities are related to the products for which you are registering to Atlantic Used Oil Management Association (Newfoundland & Labrador). *
Attach the permit(s) or certificate(s) for every Newfoundland and Labrador facility where you perform activities related to Atlantic Used Oil Management Association (Newfoundland & Labrador) products. *

Attach your file(s)
You can attach more than one file Cancelof
Are you required to produce a report to the government authority having jurisdiction in Newfoundland and Labrador for your hazardous waste treatment/processing installations in Newfoundland and Labrador?*

YesNo
Specify which type(s) of report(s), for which facility(ies), and the frequency at which you are required to produce such report(s). *

Indicate the address of your facility(ies) outside of Newfoundland and Labrador whose activities are related to the products for which you are registering with Atlantic Used Oil Management Association (Newfoundland & Labrador). *
For every facility(ies) outisde of Newfoundland and Labrador, briefly explain what are the province or state requirements in order to treat/process the products for which you are registering with Atlantic Used Oil Management Association (Newfoundland & Labrador). *
Do you have a permit or certificate for your facility(ies) outside of Newfoundland and Labrador where you process products for which you are registering with Atlantic Used Oil Management Association (Newfoundland & Labrador)?*

YesNo
Attach the permit(s) or certificate(s) for every facility outside of Newfoundland and Labrador where you perform activities related to Atlantic Used Oil Management Association (Newfoundland & Labrador) products. *

Attach your file(s)
You can attach more than one file Cancelof
Are you required to produce a report to local government authorities for your hazardous waste treatment/processing installations outside of Newfoundland and Labrador?*

YesNo
Specify which type(s) of report(s), for which facility(ies), and the frequency at which you are required to produce such report(s). *

Does your company have municipal permits for its facilities where will be processed the products for which you are registering with Atlantic Used Oil Management Association (Newfoundland & Labrador)?*

YesNo
Attach a copy of your municipal permit(s). *

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

Civil and environmental insurance certificate*

Attach your file(s)
You can attach more than one file Cancelof
Processor's Agreement signed and initialized on every page*

Attach your file(s)

Cancelof

Would you like to register as a USED OILS processor?*

YesNo
From the list below, select which option(s) best describes the purpose of your USED OILS processing activities.*

Energy recoveryRegenerationRerefinery

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

YesNo
Briefly explain your quality control procedures for the USED OILS 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 processing USED OILS for RE-REFINERY?*
List the address of each facility where you process USED OILS for RE-REFINERY and specify the maximum storage capacity for each facility.*
Briefly describe the installations and equipments utilized for the RE-REFINERY of USED OILS. *
Specify the average storage period before processing. *
Do you exercise quality control of the USED OILS received from the collectors?*

YesNo
Briefly explain your quality control procedures for the USED OILS 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?*

Would you like to register as a USED ANTIFREEZE processor?*

YesNo

How long has your company been processing USED ANTIFREEZE? *
List the address of each facility where you process USED ANTIFREEZE and specify the maximum storage capacity for each facility.*
Specify the average storage period before processing. *
Which method do you use to measure the water percentage and what quantities are you sampling for this verification process?*
Briefly describe installations and equipments utilized for the processing of USED ANTIFREEZE. *
Do you exercise quality control of the USED ANTIFREEZE received from the collectors?*

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

YesNo
Which method are you using to verify the product's quality after processing?*

Conductivity lower than 1000ASTM D7713ASTM E1177Other
What is the end product's use and to whom is it shipped?*

Would you like to register as a USED FILTERS processor?*

YesNo

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 the USED FILTER batches received from each collectors.*
Briefly specify the sampling method used and the analysis performed on the processed USED FILTERS to ensure they meet all required criterias.*
Specify the average storage period before processing. *
How are the extracted oils (generated by the processing of USED FILTERS) disposed of? *
What is the end product's use and to whom is it shipped?*

Would you like to register as a USED OIL AND ANTIFREEZE CONTAINERS processor?*

YesNo

How long has your company been processing USED OIL AND ANTIFREEZE CONTAINERS?*
List the address of each facility where you process USED OIL AND ANTIFREEZE CONTAINERS and specify the maximum storage capacity for each facility.*
Briefly describe installations and equipments utilized for the processing of USED OIL AND ANTIFREEZE CONTAINERS. *
Briefly explain how you keep track the USED OIL AND ANTIFREEZE CONTAINER batches received from each collectors.*
Briefly specify the sampling method used and the analysis performed on the processed USED OIL AND ANTIFREEZE 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 AND ANTIFREEZE CONTAINERS) 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

Would you like to register as a USED AEROSOL CONTAINERS (lubricants and brake cleaners only) processor?*

YesNo

How long has your company been processing USED AEROSOL CONTAINERS (lubricants and brake cleaners only)?*
List the address of each facility where you process USED AEROSOL CONTAINERS (lubricants and brake cleaners only) and specify the maximum storage capacity for each facility.*
Briefly describe installations and equipments utilized for the processing of USED AEROSOL CONTAINERS (lubricants and brake cleaners). *
Briefly explain how you keep track the USED AEROSOL CONTAINER (lubricants and brake cleaners only) batches received from each collectors.*
Briefly specify the sampling method used and the analysis performed on the processed USED AEROSOL CONTAINERS (lubricants and brake cleaners only) 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:

Processors registration application form