This is an application to vary a premises-based activity licence issued under the Protection of the Environment Operations Act 1997 Act’). (‘POEO A variation includes the substitution, omission or amendment of an existing condition, or attaching a new condition to a licence. If a licence holder wishes to seek a variation to licence conditions, this is the application form to fill in. The form provides for the following scenarios: undertaking a new scheduled activity or ceasing a scheduled activity deleting an activity covered by a water licence or adding a new activity to be covered by the licence changing the scale/capacity of an activity extending a scheduled development works licence to cover the next stage of the development works or converting it to a scheduled activity licence adding an environmental improvement program any other variations. To complete this form you may need the Guide to licensing prepared by the Environment Protection Authority (EPA) and available at and/or Waste Classification Guidelines which are available at . If you need help filling out the form, please contact your nearest EPA office from the list at the end of this form. Once completed and signed, the form should be sent to your nearest EPA office (as indicated at the end of this form). Licence to be varied Licence to be varied Licence number Name of current licence holder(s) Full name(s) of licence holder(s) ACN /ABN ACN: ABN: (if applicable) Changes to scheduled activities If you have stopped undertaking a scheduled activity that is covered by your current licence, or propose to commence a new scheduled activity, you should advise the EPA. For more details on changing your activity type, please refer to the Guide to licensing. EPA’s Adding a new scheduled activity Write down the short descriptions of the categories of scheduled activity you would like added to the licence for your premises. These are listed in Schedule 1 of the POEO Act available at . Description of scheduled activities Please attach extra page(s) if more space is needed.
This is an application to vary a premises-based activity licence issued under the Protection of the Environment Operations Act 1997 (‘POEO Act’). A variation includes the substitution, omission or amendment of an existing condition, or attaching a new condition to a licence. If a licence holder wishes to seek a variation to licence conditions, this is the application form to fill in. The form provides for the following scenarios: undertaking a new scheduled activity or ceasing a scheduled activity deleting an activity covered by a water licence or adding a new activity to be covered by the licence changing the scale/capacity of an activity extending a scheduled development works licence to cover the next stage of the development works or converting it to a scheduled activity licence adding an environmental improvement program any other variations. To complete this form you may need the Guide to licensing prepared by the Environment Protection Authority (EPA) and available at and/or Waste Classification Guidelines which are available at . If you need help filling out the form, please contact your nearest EPA office from the list at the end of this form. Once completed and signed, the form should be sent to your nearest EPA office (as indicated at the end of this form). Licence to be varied Licence to be varied Licence number Name of current licence holder(s) Full name(s) of licence holder(s) ACN /ABN (if applicable) ACN: ABN: Changes to scheduled activities If you have stopped undertaking a scheduled activity that is covered by your current licence, or propose to commence a new scheduled activity, you should advise the EPA. For more details on changing your activity type, please refer to the EPA’s Guide to licensing. Adding a new scheduled activity Write down the short descriptions of the categories of scheduled activity you would like added to the licence for your premises. These are listed in Schedule 1 of the POEO Act available at . Description of scheduled activities Please attach extra page(s) if more space is needed.
poeolicencevary_premises.docx