Form Tceq 0 0481 – Fill Out and Use This PDF

TEXAS COMMISSION ON ENVIRONMENTAL QUALITY

MUNICIPAL SOLID WASTE REGISTRATION TEAM

APPLICATION TO REGISTER OR RENEW REGISTRATION AS A

TRANSPORTER OF MUNICIPAL SLUDGE(S) AND SIMILAR WASTES

Please type or print all information. All registered transporters must submit an Annual Summary Report (ASR) and pay an annual transporter fee. All ASRs must be submitted and annual transporter fees paid prior to registration renewal. Completed applications may not be submitted via fax. Applications for renewal are due by June 15 of the year the registration expires. Any administrative changes to the registration information must be made on the TCEQ Core Data Form (TCEQ 10400).

Are there any outstanding fees or penalties due to the TCEQ from this owner? If yes, provide the amount $____________;

nature of the fee or penalty _______________________________; and the identifying account number _____________________.

The registration form will not be processed until all delinquent fees and/or penalties owed to the TCEQ are paid.

TCEQ Customer Number: CNTCEQ Regulated Entity Number: RN

A. REGISTRATION INFORMATION
Please check the appropriate box.	G New	!
				To Be Assigned
	G Renew	!
			Current Registration No.

B.LEGAL BUSINESS NAME INFORMATION

1.How are you operating your business? Check one.

			Individual		City Government
			Other		County Government
			Partnership		Local Government
			Corporation		State Government
			Other Government		Federal Government
2.					3.
	Individual/Legal Business Name (Corporation, Business							Tax Identification Number or Filing Number
	or other Legal Entity, i.e. municipality/local authority)
								(Do Not Include Social Security Numbers)
	Regulated Entity Name or Doing Business As (DBA)

C. ADDRESS INFORMATION

Please provide a physical address for the place of business and the mailing address for correspondence. A Post Office Box may not be listed as a physical address.

__________________________________________________			___________________________________________
Physical Address			Mailing Address
__________________________________________________			___________________________________________
City	State	Zip	City	State	Zip
(______)___________________(_______)________________			___________________________________________
Daytime Telephone Number	Fax Number		Contact Person

___________________________________________

E-mail Address

TCEQ -0 0481 (04/15/2010) Transporter Registration Application

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In accordance with 30 TAC §312.145(b)(4), registered transporters must submit an ASR by July 1 of each year covering June 1 of the previous year to May 31 of the current year even if no waste was transported during reporting period. A final ASR must be submitted upon cancellation of operation during any portion of the reporting year. Each transporter is required to pay an annual transporter fee ranging from $100 to $500, based on the volume of transported waste reported on the ASR. If no waste was transported, the minimum fee of $100 will be assessed. Cancellation does not exempt a registered transporter from submitting an ASR or paying an annual transporter fee. If a completed ASR is not submitted by July 1, the $500.00 maximum fee will be assessed. If these requirements are not met, penalties could be assessed pursuant to 30 TAC §312.150.

I. CANCELLATION OF REGISTRATION

In accordance with 30 TAC §312.142(d), a registered transporter must submit a written notification of cancellation to the TCEQ within fifteen (15) days of the decision to cease operation. All required fees and the final ASR must be submitted at that time.

J. SIGNATURE / NOTARY

An application submitted under the business type of INDIVIDUAL must be signed by that individual. A person signing an application on behalf of the applicant must provide a letter of authorization signed by the applicant. In the case of a PARTNERSHIP, the application must be signed by a general partner. In the case of a MUNICIPAL, STATE, FEDERAL or other public facility, the application must be signed by a principal executive officer, a ranking elected official or another duly authorized employee. An application submitted by a CORPORATION must be signed by a principal executive officer of at least the level of vice - president or by his duly authorized representative, if such representative is responsible for the overall transportation activity. An application signed by a person other than vice-president or above must provide a letter of authorization, signed by an executive officer of at least the level of vice - president. In all cases, the person signing the form must be authorized to do so by the applicant.

I,

(Printed name of applicant)

Title

certify under penalty of law that all information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for falsification of information, including the possibility of fine, imprisonment for violations, and revocation of this registration.

Signature						Date:
SUBSCRIBED AND SWORN to before me by the above person on this			day of			, (Year)

(Seal Here)	Notary Public
	__________________________________________________County, Texas
My Commission Expires on:______________________________

For questions you may contact the agency at (512) 239-3695. Please mail the check or money order for the vehicle sticker fee payment and the completed application to the following address:

Texas Commission on Environmental Quality

Cashier’s Office (MC-214)

P. O. Box 13088

Austin, Texas 78711-3088

**PLEASE NOTE APPLICATIONS WILL NOT BE ACCEPTED WITHOUT STICKER FEE

PAYMENT IN THE FORM OF CHECK OR MONEY ORDER**

If you have questions on how to fill out this form or about the Sludge Transporter program, please contact us at 512/239-3695. Individuals are entitled to request and review their personal information that the agency gathers on its forms. They may also have any errors in their information corrected. To review such information, contact us at 512/239-3282. Any administrative changes must be made on the TCEQ Core Data Form (TCEQ 10400).

TCEQ -0 0481 (04/15/2010) Transporter Registration Application

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TEXAS COMMISSION ON ENVIRONMENTAL QUALITY

INSTRUCTIONS TO REGISTER AS A TRANSPORTER OF MUNICIPAL

SLUDGE AND SIMILAR WASTES

Outstanding Fees: Check if any fees or penalties are due to the TCEQ for any program regulated by the TCEQ. Provide the amount due, the type of the fee or penalty (i.e. PST, sludge hauler) and the identifying account, permit, registration or CN number. Note: the registration form will NOT be processed until all delinquent fees and/or penalties owed to the TCEQ are paid.

ITEM A. REGISTRATION INFORMATION: If you are currently registered and you would like to renew your registration, please provide your current registration number. If you have never registered as a sludge hauler before, leave both lines blank.

ITEM B. LEGAL BUSINESS NAME INFORMATION: Please provide your legal business name and the Regulated Entity Name (the name you will use on the truck). See TCEQ Form number 10400 Instructions for an explanation of each business type. Please be aware, as per the Texas Business Corporation Act Annotated Article 2.45 (Vernon Supplement 1996), a corporation that is delinquent in franchise tax “may not be granted a permit or license by the state agency or any agency of the state.” All state tax requirements must be satisfied before a registration can be issued.

ITEM C. ADDRESS INFORMATION: Please provide both the physical address for the place of business and a mailing address for correspondence purposes. Also provide a telephone number and a contact name.

ITEM D. DISPOSAL FACILITY INFORMATION: For each of the waste types your business will be transporting, indicate at least one disposal facility where you will be depositing that waste type. Please be aware that this registration only covers the waste types listed. Waste may only be taken to facilities authorized by the TCEQ. Legal disposal facilities must have permission from the TCEQ in the form of a permit, registration, or other acceptable authorization to accept the given waste. Regardless of the type of authorization, each facility will have a state-issued identification number. Use this number on the application. Some examples include (where the “#” equals any number):

Wastewater Treatment Plant: WQ 1####-0##

Sanitary Landfill: ## or ### or ####

Type V Grease/Grit Facility: #### or 40###

Beneficial Land Application Site: 710### or 730###

ITEM E. TRANSPORTATION ACROSS STATE LINES: If you will be using an out-of-state disposal facility or will be transporting waste from another state to Texas for disposal, please submit copies of your authorization(s) that allow transportation and/or disposal of waste in another state(s), including the state in which the office or place of business is located. See Title 30 Texas Administrative Code (TAC) §312.149.

ITEM F. COUNTY OF LOCATION: Indicate the county in which your business is located.

ITEM G. VEHICLES & FEES: Please list all motorized vehicles in this section. Vehicles that transport waste or pull trailers are required to have a TCEQ authorization sticker. If a vehicle is a power unit only, the capacity is to be left blank. Roll-off boxes and trailers do not need to be listed. Authorization stickers are ten dollars ($10.00) each. Please enclose payment with first time applications and amendments. All payments must be in the form of a personal check, money order, or cashier check made payable to the: Texas Commission on Environmental Quality or TCEQ.

ITEM H. ACKNOWLEDGMENT OF FEES: Explains program fees, reporting requirements, and billing process.

ITEM I. CANCELLATION AND AMENDMENT OF REGISTRATION: Cancellations and Amendments must be received within 15 days of the status change. You will receive a document from the TCEQ indicating your new status.

ITEM J. SIGNATURE AND NOTARY: Be sure the application is signed by the appropriate individual in charge of the registration. The Notary Public’s seal of office must clearly show the name of the Notary Public and the date the Notary Public’s commission expires. The Notary Public shall authenticate all official acts with the seal of office. (Texas Government Code Subsection 406.013) A Notary Public is only required for an initial registration application. A Notary Public is not required for a renewal application.

TCEQ -0 0481 (04/15/2010) Transporter Registration Application

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