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Wylfa Newydd ProjectRadioactive Substances Regulation – Environmental Permit Application: Appendices

Appendix A Completed NRW Application Forms

Wylfa Newydd Project - Radioactive Substances Regulation – Environmental Permit Application Forms

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NRW-RSR-A Version 1, April 2014 page 1 of 6 OFFICIAL – SENSITIVE (when filled in and part of an application relating to sealed sources)

OFFICIAL – SENSITIVE (when filled in and part of an application relating to sealed sources)

Application for an environmental permit for a radioactive substances activity Part RSR-A – About you and your premises

Please read through this part of the form and the Part RSR-A guidance notes before you fill it in. It will take about two hours to fill in this form.

Fill in this part of the form for all applications relating to a radioactive substances activity.

Please keep a copy of this part of the form once you have filled it in for the first time. You will be able to reuse it if you need to apply for a variation or another radioactive substances activity permit.

If you are reusing this part of the form, please highlight any changes you have made to the information you provided previously. You do not need to resubmit any documents (questions 9c, 12, 13) unless something has changed.

For a transfer application, this part of the form should be filled in by the person the permit will be transferred to.

Contents

1 Site reference number 2 About you 3 Applications from an individual 4 Applications from an organisation of individuals 5 Applications from companies or limited liability partnerships (LLPs) 6 Applications from public or other corporate bodies 7 Your address 8 Contact details 9 About the premises 10 Consultation 11 Justification status 12 Your ability as an operator – management systems 13 Existing site contamination 14 How to contact us

1 Site reference number Fill in your site reference number if you know it.

Site reference number

2 About youAre you applying as:

an individual �

Now go to section 3

an organisation of individuals (for example, a partnership) �

Now go to section 4

a registered company or limited liability partnership � Now go to section 5

a public body or other corporate body �

Now go to section 6

3 Applications from an individual3a Please give us the following details

Title (Mr, Mrs, Miss and so on)

First name

Last name

Now go to section 7.

4 Applications from an organisation of individuals

4a Type of organisation (for example, partnership)

4 Applications from an organisation of individuals, continued

4b Details of the organisation

Please give the details of the main representative of the organisation below. Provide details of the other members on a separate sheet and tell us the document reference you have given this sheet.

Document reference


First name

Last name


5 Applications from companies or limited liability partnerships (LLPs)

5a Name of the company or LLP

5b Company/LLP registration number


6 Applications from public or other corporate bodies

6a Type of organisation (for example, NHS trust, university)

6b Name of the organisation

✔

Horizon Nuclear Power Wylfa Limited

06811987



6 Applications from public or other corporate bodies, continued

6c Position of the person who acts as the secretary or clerk of the organisation

7 Your address 7a Your main (registered office) business address

For companies or LLPs this is the address on record at Companies House.

Address

Postcode

Contact numbers, including the area code

Phone

Mobile

Fax

Email

7b Main UK business address if different from above

Address

Postcode


Phone

Mobile

Fax

Email

Position of most senior person at this address

8 Contact details

8a Who can we contact about this application?


First name

Last name

8 Contact details, continued

Address

Postcode


Phone

Mobile

Fax

Email

8b Who can we contact about your radioactive substances activity?


First name

Last name

Address

Postcode


Phone

Mobile

Fax

Email

8c Who can we contact about your billing/invoice?


First name

Last name

Address

Postcode

Sunrise House

1420 Charlton Court

Gloucester Business Park

Gloucester

GL3 4AE

01242 508508

[email protected]

removed for personal confidentiality


Sunrise House

1420 Charlton Court


Gloucester

GL3 4AE


removed_personal_confidentiality



Sunrise House

1420 Charlton Court


Gloucester

GL3 4AE





Sunrise House

1420 Charlton Court


Gloucester

GL3 4AE



8 Contact details, continued


Phone

Mobile

Fax

Email

9 About the premises

9a What is the name and address of the premises where you intend to carry out a radioactive substances activity?If you only keep and use mobile radioactive apparatus, give details of the premises where that apparatus is normally kept when not in use.

Name

Address

Postcode

National grid reference for the premises For example, ST 12345 67890

9b Is a nuclear site licence under section 1 of the Nuclear Installations Act 1965 needed for the premises?No �

Yes � What is your status?

Licensee (or potential licensee) �

Tenant �

9c Please provide a plan of the site, marking the site boundary in greenThis is not required if you only keep and use mobile radioactive apparatus.

Document reference

10 Consultation

10a Which local authority area are the premises in?Give the name of your local authority

10b Who is the sewerage undertaker for the premises?You do not need to answer this if you only need a standard rules permit, or your premises are on a nuclear licensed site and you do not discharge radioactive waste to public sewer.

Name

11 Justification status

11a Does your work with radioactive materials and/or radioactive waste relate to:11a.1 An existing practice, or work that is not subject to the requirement for justification?

No �

Yes � Go to question 11b

✔

✔

WN0908-HZCON-PAC-REP-00003

Isle of Anglesey County Council

N/A - nuclear licensed site

✔



Wylfa Newydd Power Station

Cemaes Road

Tregele

Anglesey

LL67 0AA

SH 34917 93134



11 Justification status, continued11a.2 A new practice that the Justifying Authority has determined to be justified?

No �

Yes � Give date and reference number of decision (DD/MM/YYYY), then go to section 12

Document reference

11a.3 A practice that is currently being considered by the Justifying Authority?

No �

Yes � Give date and reference number of application (DD/MM/YYYY), then go to section 12

Document reference

11b Nature of practice or work11b.1 Tell us the number and purpose of the practice which applies to your work with radioactive material and/or radioactive waste

See the Government guidance. If there is more than one practice that applies to you, give the information for each one.

Number Purpose

11b.2 If your work is not listed in the Government guidance, tick the appropriate box to show if it involves any of the following:

You use NORM (substances that are naturally radioactive) as a chemical in a laboratory �

You create NORM as a result of producing gas and oil �

You use NORM for some other reason �

The Ministry of Defence (MOD) or the armed forces use radioactive substances on the premises �

A contractor to the MOD uses radioactive substances for military purposes �

Other � Please give details below

11c Associated activitiesTick the appropriate boxes to show which activities associated with the practice(s) are carried out on your premises

Research and development �

Manufacturing products �

Carrying out repairs �

Carrying out maintenance �

Supplying radioactive substances �

Assembling items that include radioactive substances �

Handling radioactive substances �

Testing radioactive substances for quality standards �

✔12/09/2015

SI 2015/209



11c Associated activities, continuedStoring radioactive substances �

Using radioactive substances �

Disposing of waste �

Other � Please give details below

12 Your ability as an operator – management systemsYou do not need to answer this if you only need a standard rules permit or are applying to surrender your permit.

Provide a summary of your management system or, if you are a nuclear site licensee, provide your management prospectus.

Document reference or references

Is your management system accredited?

No �

Yes � Under what scheme or standard?

13 Existing site contaminationTell us about any existing contamination on the premises, if appropriate (see guidance)

Document reference

Now go to

Part RSR-B1 if you are applying for a standard rules permit.

Part RSR-B2 if you are applying for a bespoke permit to carry out a radioactive substances activity involving sealed sources (including waste sealed sources).

Part RSR-B3 if you are applying for a permit to carry out a radioactive substances activity, on a nuclear site, involving radioactive material (open sources) and/or radioactive waste. (Part RSR-B5 may also be necessary.)

Part RSR-B4 if you are applying for a permit to carry out a radioactive substances activity, not on a nuclear site, involving radioactive material (open sources) and/or radioactive waste. (Part RSR-B5 may also be necessary.)

Part RSR-B5 if you are applying for a permit to carry out a radioactive substances activity involving on-site disposal of solid radioactive waste to land.

Part RSR-C2 if you are applying to vary a permit for a radioactive substances activity involving sealed sources (including waste sealed sources).

Part RSR-C3 if you are applying to vary a permit for a radioactive substances activity, on a nuclear site, involving radioactive material (open sources) and/or radioactive waste.

Part RSR-C4 if you are applying to vary a permit for a radioactive substances activity, not on a nuclear site, involving radioactive material (open sources) and/or radioactive waste.

Part RSR-C5 if you are applying to vary the conditions of a permit relating to on-site disposal of solid radioactive waste to land.

Part RSR-D2 if you are applying to transfer a permit for a radioactive substances activity involving sealed sources (including waste sealed sources).

Part RSR-D3 if you are applying to transfer a permit for a radioactive substances activity involving radioactive material (open sources) and/or radioactive waste (including on-site disposal of radioactive waste).

Part RSR-E2 if you are applying to surrender a permit for a radioactive substances activity involving sealed sources (including waste sealed sources).

Part RSR-E4 if you are applying to surrender a permit for a radioactive substances activity, involving radioactive material (open sources) and/or radioactive waste (including on-site disposal of radioactive waste).

You will also need to complete part RSR-F.

WD03.01.03-S5-NL-REP-00002

✔ ISO 14001:2004

N/A



14 How to contact us If you need help filling in this form, please contact the person who sent it to you or contact us as shown below.

Phone: 0300 065 3000 Email: [email protected] Website: www.naturalresourceswales.gov.uk

Feedback(You don’t have to answer this part of the form, but it will help us improve our forms if you do.)

We want to make our forms easy to fill in and our guidance notes easy to understand. Please use the space below to give us any comments you may have about this form or the guidance notes that came with it.

How long did it take you to fill in this form?

We will use your feedback to improve our forms and guidance notes, and to tell the Government how regulations could be made simpler.

OFFICIAL – SENS ITIVE (when filled in and part of an application relating to sealed sources)

NRW‐EP‐RSR‐B3 Version 1, December 2015 page 1 of 5

Application for an environmental permit

Part RSR‐B3 – New bespoke radioactive substances activity permit (nuclear site – open sources and radioactive waste)

Please read through this part of the form and the part RSR‐B3 guidance notes before you fill it in.

It will take about 3 hours to fill in this form.

If you are applying for a new bespoke permit for a radioactive substances activity involving open sources and/or radioactive waste on a nuclear site, fill in this part of the form, together with parts RSR‐A and RSR‐F. If you want to make on‐site disposals of solid waste to land, also fill in part RSR‐B5.

For security reasons, do not refer to sealed sources on this part of the form. There is a separate part (RSR‐B2) for radioactive substances activities involving sealed sources.

If your application relates to a nuclear power station that has

been through the generic design assessment (GDA) process,

you must clearly identify:

any information that is different from thatprovided for GDA;

Where you have addressed any GDA issues andassessment findings related to the GDA statementof design acceptability.

Contents

1 Other applications

2 About the activities

3 Operating techniques

4 Disposal of radioactive waste

5 Monitoring

6 Radiological assessment

7 Receipt of radioactive waste

8 Radioactive material

9 Mobile radioactive apparatus (environmental

studies)

10 How to contact us

1 Other applications Have you recently made, or do you intend to make, an application for an environmental permit to operate a regulated facility,

other than a radioactive substances activity, on the premises?

No ☐

Yes ☒

2 About the activities

2a What activities are you applying for? Tick the relevant boxes in Table 1 to show which radioactive substances activities you are applying for.

Table 1 – radioactive substances activities

Schedule 23 Part 2

paragraph reference Description

11(2)(a) Keep or use radioactive material on premises used for the purposes of an undertaking ☐

11(2)(b) Dispose of radioactive waste on or from premises used for the purposes of an undertaking ☒

11(4)(a) Receive radioactive waste for the purposes of disposing of it ☐

11(5)(b) Keep or use mobile radioactive apparatus for releasing quantities of radioactive material into the

environment or introducing such material into organisms ☐



2b Is a submission to the European Commission under Article 37 of the Euratom treaty required for these

activities?

No ☐

Yes ☒

(If yes, what is its status?)

In draft ☐

Submitted to DBEIS (or successor) ☒ (Please provide date of submission in the box below DD/MM/YYYY)

10/10/2017

Opinion received ☐ (Please provide date of opinion in the box below DD/MM/YYYY)

2c Provide a technical description of your activities

Document reference

WN0908‐HZCON‐PAC‐REP‐00003

3 Operating techniques Describe how you manage the production, discharge and disposal of radioactive waste to protect the environment and to

optimise the protection of people

Document reference

HNP‐S3‐DA‐REP‐00013

4 Disposal of radioactive waste

4a Provide quantitative estimates for normal operation of

discharges of gaseous and aqueous radioactive wastes

arisings of combustible waste and disposals by on‐site or off‐site

incineration

arisings of other radioactive wastes (by category and disposal route (if

any))

Document reference


4b Provide your proposed limits for

gaseous discharges

aqueous discharges

disposal of combustible waste by on‐site incineration

Document reference




5 Monitoring

5a Provide a description of the sampling arrangements, techniques and systems for measurement and assessment

of discharges and disposals of radioactive waste

Document reference


5b Provide a description of your environmental monitoring programme

Document reference


6 Radiological assessment

6a Provide a prospective dose assessment at the proposed limits for discharges and for any on‐site disposal

(such as incineration but not on‐site disposal of solid waste to land)

Document reference


6b Provide an assessment of the impact of the radioactive discharges and on‐site disposals on non‐human species

Document reference


6c Provide an assessment of the impact on people and non‐human species of the environmental studies

(only answer this question if you are applying for an activity described in Schedule 23, Part 2, paragraph 11(5)(b))

Document reference

N/A

7 Receipt of radioactive waste Provide details of the origin, nature and quantity of each waste stream to be accepted onto the premises, and how you will

manage and dispose of it (tell us if you may receive waste as a result of your participation in the National Arrangements for

Incidents involving Radioactivity or in a Radsafe incident response ‐ no further details are required for such waste)

Document reference

WN0908‐HZCON‐PAC‐REP‐00003 – only for participation in the National Arrangements for Incidents involving Radioactivity or

in a Radsafe incident response.



8 Radioactive material Only answer this question if you are a tenant applying for an activity described in Schedule 23, Part 2, paragraph 11(2)(a)

involving unsealed sources.

Fill in Table 2 with details of the radioactive material that you will keep or use on the premises.

Table 2 – radioactive material on the premises

Radionuclide Maximum amount

(see note 1) Units (becquerels or

multiples thereof)

Estimated usage per

month Units (becquerels or

multiples thereof)

Note 1 This is the maximum amount on the premises at any one time.

9 Mobile radioactive apparatus for environmental studies Only answer this question if you are applying for an activity described in Schedule 23, Part 2, paragraph 11(5)(b).

Fill in Table 3 with details of the radioactive material that you will use for environmental studies.

Table 3 – radioactive material for environmental studies

Radionuclide Maximum amount

(see note 1) Units (becquerels or

multiples thereof)

Maximum daily

release Units (becquerels or

multiples thereof)

Note 1 This is the total radioactivity of the specified radionuclide to be used for the environmental study

Now fill in part RSR‐F.



10 How to contact us If you need help filling in this form, please contact the person who sent it to you or contact us as shown below. Phone: 0300 065 3000 Email: [email protected] Website: www.naturalresourceswales.gov.uk

Application for an environmental permit: (radioactive substances activity) Part RSR-F – Charges and declarations

Form: EPR Part F1 Page 1 of 8 NRW Version 1, July 2016 OFFICIAL – SENSITIVE (when filled in and part of an application relating to sealed sources)

Please read through this part of the form and the part RSR-F guidance notes before you fill it in.

Fill in this part for all applications for a radioactive substances activity.

If you need help filling in this form, please contact the person who sent it to you or contact us as shown below. Phone: 0300 065 3000 Email: [email protected] Website: www.naturalresourceswales.gov.uk

Contents 1 Permit type 2 Working out charges 3 Payment 4 The Data Protection Act 1998 5 Confidentiality and national security 6 Declaration 7 Application checklist 8 Where to send your application 9 How to contact us

1 Permit type

If your application relates to permit type G or H (and is not an application for transfer or surrender) provide a copy of your calculations showing how you determined the permit type.

Reference N/A – nuclear licensed site

2 Working out charges

2a Is your application for a variation to change a fixed condition registration to a standard rules permit?

Yes ☐ Answer question 2e, then go to section 4 (there is no charge)

No ☒

2b Is your application for an administrative variation only?

Yes ☐ Go to section 4 (there is no charge)

No ☒

2c Does your application relate to a radioactive substances activity on a nuclear licensed site?

Yes ☒ Go to section 4 (we will charge you on a time and materials basis)

No ☐

2d Does your application relate to the disposal of solid low-level radioactive waste (including high-volume

Yes ☐ Go to section 4 (we will charge you on a time and materials basis)

No ☐ Fill in the table below

RSR Permit type (see note 1) Application type (see note 2) Charges due (£) (see note 3)

Note 1: A – H as described in the charging scheme guidance.

Note 2: New, variation, transfer or surrender.

Note 3: As specified in the charging scheme guidance. Please print or copy this page as confirmation of the

Form: RSR Part F1 Page 2 of 8 NRW Version 2, January 2017 OFFICIAL – SENSITIVE (when filled in and part of an application relating to sealed sources)

application charge payable and for use in raising the payment. We will not be sending you an invoice to cover this charge.

2e If your permit type is A, is each source you hold a gaseous tritium light device?

Yes ☐ (this does not affect the application fee but may affect your subsistence charge)

No ☐

2f If you are claiming the reduced fee for a ‘minor technical’ variation (permit types D, G and H only), give your reasons

Explanation

2g If you are claiming the reduced fee for a surrender application (permit types G and H only), give your reasons

Explanation

3 Payment

Important: The fields below are mandatory. If you do not complete this section in full your application will be treated as ‘not received’ and may be sent back to you.

In order for us to process your application, please ensure you answer all questions correctly.

3a How do you want to pay?

Tick an option below to show how you will pay.

Electronic transfer (for example, BACS) ☐ Go to section 3b

Credit or Debit card ☐ Go to section 3c

Cheque ☐ Go to section 3d

Postal order ☐ Go to section 3d

3b Paying by electronic transfer

If you choose to pay by electronic transfer use the following information to make your payment.

Company name: Natural Resources Wales

Company address: Income Dept., PO BOX 663, Cardiff, CF24 0TP

Bank: RBS

Address: National Westminster Bank Plc, 2 ½ Devonshire Square, London, EC2M 4BA

Sort code: 60-70-80

Account number: 10014438


Reference number

You can use any reference number but we prefer the number to be ‘EPR’ followed by the first nine letters of your organisation name followed by a four-digit number.

For example, for a company named Joe Bloggs Ltd, the reference number might be EPRJOEBLOGGS0001. (Remember you can use any four-digit number at the end.)

The reference number you will provide will appear on our bank statements so we can check your payment. We may need to contact your bank to make sure the reference number is quoted correctly.

You should also email your payment details and payment reference number to [email protected] / [email protected] or fax it to 0300 065 3001 and enter it in the space provided below.

Amount paid

Applicant name

Payee name (if different from above)

Date paid (DD/MM/YYYY)

BACS reference

Making payments from outside the UK

These details have changed. If you are making your payment from outside the United Kingdom (which must be received in sterling), our IBAN number is GB70 NWBK6070 8010 0144 38 and our SWIFT/BIC number is NWBKGB2L.

If you do not quote your payment reference number, there may be a delay in processing your payment and application.

3c Paying by credit or debit card

If you are paying by credit or debit card, please fill in the separate form CC1.

You can download this from our website or you can ask for one of our customer service providers to send one by post. We will destroy your card details once we have processed your payment. We can accept payments by Visa, MasterCard or Maestro UK card only.

3d Paying by cheque or postal order

You should make cheques or postal orders payable to Natural Resources Wales and they should be marked ‘A/c Payee’.

We will not accept post-dated cheques (cheques with a future date written on them).

Cheque/ postal order number

Amount paid

4 The Data Protection Act 1998

We, the Natural Resources Body for Wales (hereafter “Natural Resources Wales”), will process the information you provide so that we can: • deal with your application;• make sure you keep to the conditions of the licence, permit or registration;• process renewals; and• keep the public registers up to date.We may also process or release the information to:• offer you documents or services relating to environmental matters;• consult the public, public organisations and other organisations (for example, the Health and Safety

Executive, local authorities, the emergency services, the Department for Environment, Food and RuralAffairs) on environmental issues;

mailto:[email protected]

mailto:[email protected]


• carry out research and development work on environmental issues;• provide information from the public register to anyone who asks;• prevent anyone from breaking environmental law, investigate cases where environmental law may have

been broken, and take any action that is needed;• assess whether customers are satisfied with our service, and to improve our service; and• respond to requests for information under the Freedom of Information Act 2000 and the Environmental

Information Regulations 2004 (if the Data Protection Act allows). We may pass the information on to ouragents or representatives to do these things for us.

5 Confidentiality and national security

We will normally put all the information in your application on a public register of environmental information.

However, we may not include certain information in the public register if this is in the interests of national security, or because the information is confidential

Confidentiality

You can ask for information to be made confidential by enclosing a letter with your application giving your reasons.

If we agree with your request, we will tell you and not include the information in the public register. If we do not agree with your request, we will let you know how to appeal against our decision, or you can withdraw your application.

Only tick the box below if you wish to claim confidentiality for your application.

Please treat the information in my application as confidential ☐

Tick the box to confirm you have provided evidence to support your confidentiality claim and give us the document reference, below.

☐

Document reference N/A

National security

You can tell the Welsh Ministers that you believe including information on a public register would not be in the interests of national security. You must enclose a letter with your application telling us that you have told the Welsh Ministers and you must still include the information in your application. We will not include the information in the public register unless the Welsh Ministers decide that it should be included.

Note: All applications relating to sealed sources are automatically subject to national security restrictions – only tick the box if there is some other reason for claiming national security.

I believe that including my information in the public register would not be in the interests of national security.

☐

Tick the box to confirm you have provided evidence to support your national security claim and give us the document reference, below.

☐

Document reference N/A

6 Application checklist (you must fill in this section)

Tell us about the supporting evidence and information you have sent with this application.

Application fee – only applicable if you have completed the table in question 2d

You must submit the correct application fee in line with our current charging scheme.

Tick the box to say you have included the correct fee. ☐

List all the documents you have included in Table 1. Please see the guidance notes for examples on how to complete the checklist.

If the relevant information for a question forms part of a larger document, please specify the relevant section(s) of the document. This will speed up the process of checking your application and making decisions.

If necessary, continue on a separate sheet and tell us the reference you have given the document below.


Document reference Wylfa Newydd Project, Radioactive Substances Regulation – Environmental Permit Application / WN0908-HZCON-PAC-REP-00003

Table 1 – application checklist

Question reference Document title/ reference Document section

A correlation between the requirements of the NRW application forms and the information presented in WN0908-HZCON-PAC-REP-00003 are set out in Table 1.2

Wylfa Newydd Project, Radioactive Substances Regulation – Environmental Permit Application / WN0908-HZCON-PAC-REP-00003

Section 1.7 – Table 1.2

7 Declaration

You must read this section before making the declaration and sending your form to us.

For transfer applications - Both you and the person receiving the permit must make the declaration.

Section 7c must be completed by the current holder and Section 7d must be completed by the proposed new holder.

A relevant person should make the declaration. You must be a relevant person or have the authority of a relevant person to sign this application on their behalf.

Relevant people means each applicant, and in the case of a company, a director, manager, company secretary or any similar officer or employee listed on current appointments in Companies House. In the case of a Limited Liability Partnership (LLP), it includes any partner. If the permit holder is an organisation of individuals, each individual (or individual trustee) must complete the declaration.

To simplify and speed up the application process we recommend that the declaration is filled in by an officer of a company or one of the partners in a Limited Liability Partnership (LLP).

If you wish a manager, employee or consultant etc. to sign the declaration on behalf of a relevant person, we will need written confirmation from a relevant person; that is, an officer of the company, a partner in the LLP or the individual, confirming that the person has the authority to fill in the declaration.

If you are joint permit holders you should each fill in your own declaration. We have provided extra spaces for this below. Please send in a separate sheet with your application if you need more room for signatories.

Where the operator is the subject of any insolvency procedure, the declaration must be filled in by the official receiver/appointed insolvency practitioner.

7a Are you signing the form on behalf of a relevant person?

If you are not a relevant person, but want to sign the application on their behalf, you must include confirmation that you can do this.

I have included written confirmation from a relevant person to confirm I can sign on their behalf.

7b Does your application include a standard facility?

D

If your application includes a standard facility, you also need to confirm that you are able to meet all relevant criteria of the standard rule set/sets for which you are applying.

I confirm that my standard facility will fully meet the rules that I have applied for.

7c Declaration

If you're transferring the permit, the current holder or holders should sign this section of the declaration, and the proposed new holder or holders of the permit should sign the declaration in section 7d.

D

If you knowingly or recklessly make a statement which is false or misleading to help you get an environmental permit (for yourself or another person), you are committing an offence under the Environmental Permitting (England and Wales) Regulations 2016. I declare that the information in this application is true to the best of my knowledge and belief. I understand that this application may be refused or approval withdrawn if I give false or incomplete information.

I understand that if I knowingly or recklessly make a false or misleading statement:

• I may be prosecuted; and

• if convicted, I may have to pay a fine and/or go to prison.

By signing below, you are confirming that you understand and agree with the declaration above.

Title jMr

First name I Carl

Last name I Devlin

On behalf of (if relevant)

Today's date I 1011012017

If you knowingly or recklessly make a statement which is false or misleading to help you get an environmental permit (for yourself or another person), you are committing an offence under the Environmental Permitting (England and Wales) Regulations 2016. I declare that the information in this application is true to the best of my knowledge and belief. I understand that this application may be refused or approval withdrawn if I give false or incomplete information.





Title �--------------� �' ------�

First name

Last name


Today's date

Form: RSR Part F1 Page 6 of 8 NRW Version 2, January 2017 OFFICIAL - SENSITIVE (when filled in and part of an application relating to sealed sources)


7d Declaration for the person or persons receiving the permit (transfers only)

The persons ‘receiving the permit’ is the proposed new permit holder.

Note: If you cannot trace a person or persons holding the permit you may be able to transfer the permit without their declaration (in section 7d above). Please contact us to discuss this and supply evidence in your application to confirm you are unable to trace one or all of the permit holders.

If you knowingly or recklessly make a statement which is false or misleading to help you get an environmental permit (for yourself or another person), you are committing an offence under the Environmental Permitting (England and Wales) Regulations 2016.

I declare that the information in this application is true to the best of my knowledge and belief. I understand that this application may be refused or approval withdrawn if I give false or incomplete information.





Title

First name

Last name


Today’s date

If you knowingly or recklessly make a statement which is false or misleading to help you get an environmental permit (for yourself or another person), you are committing an offence under the Environmental Permitting (England and Wales) Regulations 2016.

I declare that the information in this application is true to the best of my knowledge and belief. I understand that this application may be refused or approval withdrawn if I give false or incomplete information.





Title

First name

Last name


Today’s date

8 Where to send your application

If your application relates to sealed radioactive sources:

You must send all parts of your completed application form and supporting documents by post, to:


Permitting team leader (Regulated Industry), Natural Resources Wales, 5th Floor, Cambria House, 29 Newport Road, Cardiff, CF24 0TP

If your application does not relate to sealed radioactive sources:

You may send the application by post, to the address above. Or you can email it to: [email protected]

Horizon Nuclear Power Sunrise House 1420 Charlton Court Gloucester Business Park Gloucester, GL3 4AE

T +44 (0)1242 508508

www.horizonnuclearpower.com

CONTACT US:

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