"Application Form Requesting Approval of a Source (Land-Based Aquaculture)" - New Brunswick, Canada

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Download "Application Form Requesting Approval of a Source (Land-Based Aquaculture)" - New Brunswick, Canada

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DEPARTMENT OF ENVIRONMENT
APPLICATION FORM REQUESTING APPROVAL OF A SOURCE
(LAND-BASED AQUACULTURE)
Water Quality Regulation – Clean Environment Act
I.
APPLICATION FOR:
A.
Construction/ Modification
Operation
B.
Facility type and capacity:
Fresh water tank culture
Maximum Biomass:
kg
Fresh water pond culture
Maximum number of fish:
Salt water – pump ashore Maximum Biomass:
kg
C.
All species reared: ________________________________________
II.
COMPANY INFORMATION:
Legal Name: _______________________________________________________________________________
Common Name: ____________________________________________________________________________
Address (including civic no.): _________________________________________________________________
Mailing Address (if different from above): _______________________________________________________
Phone: _______________________ Fax: _______________________
III.
APPLICANT’S INFORMATION:
Name:
Position: ______________________________________
Department Name: ___________________________ Office Name: __________________________________
Address (including civic no.): _________________________________________________________________
Mailing Address (if different from above): _______________________________________________________
Phone: __________________ ext. ______ Fax: __________________ E-mail: ________________________
Existing Approval No. (if any): ___________________
Page 1 of 6
DEPARTMENT OF ENVIRONMENT
APPLICATION FORM REQUESTING APPROVAL OF A SOURCE
(LAND-BASED AQUACULTURE)
Water Quality Regulation – Clean Environment Act
I.
APPLICATION FOR:
A.
Construction/ Modification
Operation
B.
Facility type and capacity:
Fresh water tank culture
Maximum Biomass:
kg
Fresh water pond culture
Maximum number of fish:
Salt water – pump ashore Maximum Biomass:
kg
C.
All species reared: ________________________________________
II.
COMPANY INFORMATION:
Legal Name: _______________________________________________________________________________
Common Name: ____________________________________________________________________________
Address (including civic no.): _________________________________________________________________
Mailing Address (if different from above): _______________________________________________________
Phone: _______________________ Fax: _______________________
III.
APPLICANT’S INFORMATION:
Name:
Position: ______________________________________
Department Name: ___________________________ Office Name: __________________________________
Address (including civic no.): _________________________________________________________________
Mailing Address (if different from above): _______________________________________________________
Phone: __________________ ext. ______ Fax: __________________ E-mail: ________________________
Existing Approval No. (if any): ___________________
Page 1 of 6
CONTACT INFORMATION:
IV.
Name (if different from above):
Position: _____________________
Department Name: ____________________________ Office Name: _________________________________
Address (including civic no.): ________________________________________________________________
Mailing Address (if different from above): ______________________________________________________
Phone:
ext. ______ Fax: ___________________ E-mail: ________________________
SOURCE INFORMATON
V.
Location of Facility: ________________________________________________________________________
Geographic Coordinates of Source: ____________________________________________________________
________________________________________________________________________________________
Parcel Identification # (PID): _________________________
Expected Date of Operation or Construction (if applicable): _____________________________
Description of Source: i) Approval to Construct/ Modify -- complete “Supporting Form A”
ii) Approval to Operate -- complete “Supporting Form B”
***This application will not be considered without the completion of the appropriate Supporting Form A or B****
Note: Business plans and other corporate financial information need not be submitted with this application.
I certify that the information in this application and supporting documents is correct to the best of my knowledge and belief and I
consent to the collection, use and disclosure of the information contained herein.
…………………………...…….…….
……………………………………………………
Applicant’s Signature
Date
Page 2 of 6
F O R M
A
SUPPORTING INFORMATION
(Request for an Approval to Construct a New, or Modify an Existing, Land-Based Aquaculture
Facility)
The following information is required prior to issuing an Approval for the construction of a new, or the
modification of an existing, land-based aquaculture facility. Please attach sheets as required.
1. Site layout diagram with scaled drawings indicating the proposed locations of all new structures,
including:
Buildings
Wells
Pipelines
Tanks
Ponds
Other construction features that may result in site disturbance
The site layout diagram should also indicate the locations of these features in relation to any nearby
water bodies, access roads, and any pre-existing site development features.
2. Topographic map indicating the site location in relation to surrounding property owners, neighbouring
residences and wells.
3. List all proposed surface and groundwater supplies for the facility, and the proposed withdrawal rate
for each.
4. Describe the proposed rearing structures (eg. number of tanks, size of tanks, total rearing volume of
the facility).
5. Does the facility include water reuse or water recirculation technology? What is the anticipated
recirculation rate?
6. What is the maximum stocking level for the facility, both in terms of maximum number of fish reared,
average size of fish at peak production, and total biomass of fish at peak capacity?
7. List all species to be reared at the facility and all life stages that each will achieve while held at the
facility.
8. What is the anticipated maximum feeding rate (kg/day)?
9. What effluent treatment system(s) are employed? Provide details of filter capacity (i.e. litres/minute)
mesh sizes, pond retention time, polymers/flocculants utilized etc. The dimensions and design of any
settling ponds should also be provided.
10. Provide the names of the facilities that have agreed to accept the fish waste (sludge and moribund
fish) from this facility, or detail any alternate disposal plans.
Page 3 of 6
11. Provide a list of all chemicals including, but not limited to: pesticides, antibiotics, therapeutants, water
treatment chemicals, petroleum products, and disinfectants that may be used during the operation of
the facility.
12. To what water body will the final effluent discharge? Describe the discharge structure(s) in terms of
location, composition, and construction techniques for putting them in place. What is the expected
minimum dilution rate of the effluent in the receiving water?
13. What is the nearest downstream receptor?
14. Should an Approval be issued, how long is the construction period expected to last?
15. Please include any additional information about the facility that you feel is necessary to understand the
environmental impacts (real or perceived) from this proposed facility.
Page 4 of 6
F O R M
B
SUPPORTING INFORMATION
(Request for an Approval to Operate an Existing, Land-Based Aquaculture Facility)
The following information is required prior to issuing an Approval for the operation of an existing, land-based
aquaculture facility. Please attach sheets as required.
1. Site layout diagram with scaled drawings indicating the locations of all structures, including:
Buildings
Wells
Pipelines
Tanks
Ponds
The site layout diagram should also indicate the locations of these features in relation to any nearby
water bodies, and access roads.
2. Topographic map indicating the site location in relation to surrounding property owners, neighbouring
residences and wells.
3. List all surface and groundwater supplies for the facility, and the withdrawal rate for each.
4. Describe the rearing structures (e.g. number of tanks, size of tanks, total rearing volume of the facility).
5. Does the facility include water reuse or water recirculation technology? What is the recirculation rate?
6. What is the maximum stocking level for the facility, both in terms of maximum number of fish reared for
fish in pond culture, average size of fish at peak production, and maximum total biomass of fish at
peak capacity for tank culture operations?
7. List all species reared at the facility and all life stages that each will achieve while held at the facility.
8. What is the maximum feeding rate (kg/day)?
9. What effluent treatment system(s) are employed? Provide details of filter capacity (i.e. litres/minute)
mesh sizes, pond retention time, polymers/flocculants utilized etc. The dimensions and design of any
settling ponds should also be provided.
10. Provide the names of the facilities that have agreed to accept the fish waste (sludge and moribund
fish) from this facility, or detail any alternate disposal plans.
Page 5 of 6