Tire Permit Application
Tire Permit Application GOVERNMENT OF THE U.S. VIRGIN ISLANDS DEPARTMENT OF PLANNING & NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION (340) 773-1082 / 774-3320 SPECIAL SOLID WASTE PERMIT TO COLLECT/STORE WASTE TIRE Pursuant to the Solid & Hazardous Waste Management Act 19 V.I.C. {1557 et. seq.} and the Rules and Regulations promulgated thereunder, the owners or operators of a qualifying waste tire collection center, small processing facility or shredding, chopping, or cutting equipment are required to submit the following information to DPNR Status of Operation: Type of Operation: __ Existing __ Waste Tire Collection Center __ Proposed __ Small Processing Facility __ Shredding, Chopping, or Cutting Equipment __ Other: _____________________________ Waste Tire Collection Centers and Small Processing Facilities must provide the following facility information: Facility Name: ___________________________________________________________________________________________________________ Street Address: ________________________________________ City:______________________________________ …
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Tire Permit Application GOVERNMENT OF THE U.S. VIRGIN ISLANDS DEPARTMENT OF PLANNING & NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION (340) 773-1082 / 774-3320 SPECIAL SOLID WASTE PERMIT TO COLLECT/STORE WASTE TIRE Pursuant to the Solid & Hazardous Waste Management Act 19 V.I.C. {1557 et. seq.} and the Rules and Regulations promulgated thereunder, the owners or operators of a qualifying waste tire collection center, small processing facility or shredding, chopping, or cutting equipment are required to submit the following information to DPNR Status of Operation: Type of Operation: __ Existing __ Waste Tire Collection Center __ Proposed __ Small Processing Facility __ Shredding, Chopping, or Cutting Equipment __ Other: _____________________________ Waste Tire Collection Centers and Small Processing Facilities must provide the following facility information: Facility Name: ___________________________________________________________________________________________________________ Street Address: ________________________________________ City:_______________________________________ Zip:__________________ Name of Operator: ____________________________________________________________ Telephone Number: ___________________________ Operator Address:________________________________________City:______________________________________ Zip:__________________ Name of Property Owner (if different):____________________________________________ Telephone Number:___________________________ Operator Address:________________________________________City:______________________________________ Zip:__________________ Parcel Identification Number________________________________ Date Operation Began:_______________________________________ Quantities of Waste Tires Quantities of Waste Tire Quantities of Waste Tire Received Per Month: Stored On-site: Processed Per Month _________________tires ____________________tires ____________________tires DPNR use only: Payment Type ____ Check ____Cash Date Received__________________ Receipt No.__________ Permit No._____________________ Date Issued__________ Tire Permit Application Describe in sufficient detail how and where the waste tires, processed tires, and residuals from processing will be disposed: ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ Required Attachments: a. Certificate of Inspection from the VI Fire Services CERTIFICATION: I certify, to the best of my knowledge and belief, that the information provided in this application is true and accurate. ___________________________________________ _______________________________________________ ____________ Signature of Authorized Representative Name of Authorized Representative (Print or type) Date