DEP Form 62-701.900(24) "Waste Tire Small Processing Facility Permit Application" - Florida

What Is DEP Form 62-701.900(24)?

This is a legal form that was released by the Florida Department of Environmental Protection - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 6, 2010;
  • The latest edition provided by the Florida Department of Environmental Protection;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DEP Form 62-701.900(24) by clicking the link below or browse more documents and templates provided by the Florida Department of Environmental Protection.

ADVERTISEMENT
ADVERTISEMENT

Download DEP Form 62-701.900(24) "Waste Tire Small Processing Facility Permit Application" - Florida

Download PDF

Fill PDF online

Rate (4.3 / 5) 28 votes
Page background image
DEP Form #: 62-701.900(24)
Department of
Form Title: Waste Tire Small Processing Facility Permit
Application
Environmental Protection
Effective Date: January 6, 2010
Bob Martinez Center
DEP Application No.
_____________________
2600 Blair Stone Road
(Completed by DEP)
Tallahassee, Florida 32399-2400
WASTE TIRE SMALL PROCESSING FACILITY PERMIT APPLICATION
A Small Waste Tire Processing Facility Permit allows up to 1,500 waste tires to be stored at the facility at any one
time and allows up to 1,500 waste tires to be processed during any 30 day period. If these quantities are exceeded,
a Waste Tire Processing Facility Permit is required.
Permit No.
Renewal 
Modification 
Existing unpermitted facility 
Proposed new facility 
Part I-General Information:
A.
Applicant Information:
1. Applicant Name:
2. Applicant Street Address:
3. City:
County:
Zip:
4. Applicant Mailing Address:
5. City:
County:
Zip:
6. Contact person:
Phone: (
)
FEID No:
7. Have any enforcement actions been taken by the Department against the applicant relating to the operation of
any solid waste management facility in this state? This includes any Complaint, Notice of Violation, or revocation
of a permit or registration, as well as any Consent Order in which a violation of Department rules is admitted. It
does not include a Warning Letter, Warning Notice, Notice of Noncompliance, or other similar document which
does not constitute agency action.
Yes
No
If yes, attach a history and description of the enforcement actions.
B.
Facility Information:
1. Facility Name:
2. Facility Street Address (Main Entrance):
3. City:
County:
Zip:
4. Facility Mailing Address:
5. City:
State:
Zip:
6. Contact Person:
Phone:
(
)
Facility Location Coordinates:
7. Section:
Township:
Range:
8. Latitude:
Longitude:
9. Anticipated date for starting construction
and for completion of construction
10. Anticipated date for receipt of tires
and for start of processing
Mail completed form to
the appropriate District office
listed below
Northwest District
Northeast District
Central District
Southwest District
South District
Southeast District
160 Government Center
7825 Baymeadows Way, Ste. 200 B
3319 Maguire Blvd., Ste. 232
13051 N. Telecom Pky
2295 Victoria Ave., Ste. 364
400 North Congress Ave.
Pensacola, FL 32501-5794
Jacksonville, FL 32256-7590
Orlando, FL 32803-3767
Temple Terrace, FL
Fort Myers, FL 33902-2549
West Palm Beach, FL 33401
850-595-8360
904-807-3300
407-894-7555
813-632-7600
239-332-6975
561-681-6600
Page 1 of 3
DEP Form #: 62-701.900(24)
Department of
Form Title: Waste Tire Small Processing Facility Permit
Application
Environmental Protection
Effective Date: January 6, 2010
Bob Martinez Center
DEP Application No.
_____________________
2600 Blair Stone Road
(Completed by DEP)
Tallahassee, Florida 32399-2400
WASTE TIRE SMALL PROCESSING FACILITY PERMIT APPLICATION
A Small Waste Tire Processing Facility Permit allows up to 1,500 waste tires to be stored at the facility at any one
time and allows up to 1,500 waste tires to be processed during any 30 day period. If these quantities are exceeded,
a Waste Tire Processing Facility Permit is required.
Permit No.
Renewal 
Modification 
Existing unpermitted facility 
Proposed new facility 
Part I-General Information:
A.
Applicant Information:
1. Applicant Name:
2. Applicant Street Address:
3. City:
County:
Zip:
4. Applicant Mailing Address:
5. City:
County:
Zip:
6. Contact person:
Phone: (
)
FEID No:
7. Have any enforcement actions been taken by the Department against the applicant relating to the operation of
any solid waste management facility in this state? This includes any Complaint, Notice of Violation, or revocation
of a permit or registration, as well as any Consent Order in which a violation of Department rules is admitted. It
does not include a Warning Letter, Warning Notice, Notice of Noncompliance, or other similar document which
does not constitute agency action.
Yes
No
If yes, attach a history and description of the enforcement actions.
B.
Facility Information:
1. Facility Name:
2. Facility Street Address (Main Entrance):
3. City:
County:
Zip:
4. Facility Mailing Address:
5. City:
State:
Zip:
6. Contact Person:
Phone:
(
)
Facility Location Coordinates:
7. Section:
Township:
Range:
8. Latitude:
Longitude:
9. Anticipated date for starting construction
and for completion of construction
10. Anticipated date for receipt of tires
and for start of processing
Mail completed form to
the appropriate District office
listed below
Northwest District
Northeast District
Central District
Southwest District
South District
Southeast District
160 Government Center
7825 Baymeadows Way, Ste. 200 B
3319 Maguire Blvd., Ste. 232
13051 N. Telecom Pky
2295 Victoria Ave., Ste. 364
400 North Congress Ave.
Pensacola, FL 32501-5794
Jacksonville, FL 32256-7590
Orlando, FL 32803-3767
Temple Terrace, FL
Fort Myers, FL 33902-2549
West Palm Beach, FL 33401
850-595-8360
904-807-3300
407-894-7555
813-632-7600
239-332-6975
561-681-6600
Page 1 of 3
C.
Land Owner Information (if different from applicant):
1. Owner's name:
2. Land owner's mailing address:
3. City:
State:
Zip:
4. Authorized Agent:
Agent's phone
(
)
5. Current lease expires:
D.
Facility Operator Information (if different from applicant):
1. Operator's name:
2. Operator's mailing address:
3. City:
State:
Zip:
4. Contact person:
Phone: (
)
E.
Preparer of Application:
1. Name of person preparing application:
2. Mailing address:
3. City:
State:
Zip:
4. Phone: (
)
5. Affiliation with facility:
Part II Operations:
A.
Describe the process and products and how storage will be maintained in compliance with 62-711.540, F.A.C.:
Describe the equipment (other than the hand held equipment) used for processing waste tires. This description
B.
shall include the make, model, and hourly capacity of each piece of equipment:
C.
Describe the waste from the process, the amount of waste expected from 1,500 tires, and how and where it will
be disposed of:
DEP FORM 62-701.900(24)
Effective January 6, 2010
Page 2 of 3
Part III Attachments:
Please attach the following information to this application:
A plot plan of the small processing facility showing:
A.
1. Boundaries of the area being permitted, easements, and rights of way
2. All wetlands and water bodies in or within 200 feet of this area.
3. The storage areas for whole tires, processed tires and processing waste.
4. The processing area.
5. All structures including buildings, fences, roadways, stormwater control devices, and water wells.
A copy of a fire safety survey of the small processing facility.
B.
C.
A copy of the emergency preparedness manual.
A letter from the landowner (if different from applicant) authorizing use of the land as a small waste tire
D.
processing facility.
E.
A check for the application fee.
Note: the record keeping requirements of 62-711.530(4) apply to small processing facilities. Quarterly reports
to the Department are required by 62-711.530(5),F.A.C.
Part IV Certification:
To the best of my knowledge and belief, I certify the information provided in this application is true, accurate, and
correct. I have attached all documents and/or authorizations that are required.
Print Name of Authorized Agent
Signature of Authorized Agent
Date
DEP FORM 62-701.900(24)
Effective January 6, 2010
Page 3 of 3
Page of 3