Commission Decision of 20 November 2008 defining a format for the submission of the information by Member States in accordance with Article 7(4)(b)(iii) of the Regulation (EC) No 850/2004 of the European Parliament and of the Council (notified under document number C(2008) 6917) (Text with EEA relevance) (2009/63/EC)

ANNEX Items to be notified pursuant to Article 7(4)(b)(iii) of Regulation (EC) No 850/2004

1. Authorisation of the exemption:

1.1. Name of the competent authority:

1.2. Address of the competent authority:

1.3. Authorisation identification number:

1.4. Date of the permission:

1.5. Authorisation holder (company name):

1.6. Authorisation holder address:

2. General description of waste:

2.1. Six digit code as laid down in Commission Decision 2000/532/EC(1) as amended:

2.2. Waste name as laid down in Decision 2000/532/EC as amended:

2.3. Approved amount in tonnes:

2.4. POP(s) substance(2) and concentration exceeding the limit laid down in Annex IV:

3. Description of treatment technology:

3.1. Pre-treatment required: yes/no(3)

namely: solidification(3)/stabilisation(3)/

other pre-treatment methods(3):

3.2. Final storage:

Salt mine(3)/safe, deep, underground, hard rock formations(3)/hazardous waste landfill(3)

3.3. Name of final storage site:

3.4. Address of final storage site:

4. Summary of justification of environmental preferability of the management compared with the destruction or irreversible transformation of the POPs content in the waste (e.g. addressing the emissions of POPs, other emissions and risks or uncertainties of the operation):

5. Website address or other reference where to find more information on the authorisation and the justification of the exemption, if available:

(1)

OJ L 226, 6.9.2000, p. 3.

(2)

Name in accordance with the substance name laid down in Annex IV.

(3)

Cross out the wrong answer(s).