Checklist — Permit Renewal

Reference

Applicant Reference

Complete reference details for this renewal checklist.

Applicant / Business Name*

Renewal Type

Current Permit Number*

Current Permit Expiry Date*

Date Prepared

Contact Number

Checklist

5 items required for all renewals.

0/5 completed

Completed Renewal Form (EMA/WDR 5 or EMA/WDR 15) — Signed

Lodge at least 30 days before expiry.

Copy of Current Permit Attached

Evidence of Quarterly Returns Submitted

All returns for current permit period.

No Outstanding Fees, Fines or Enforcement Notices

Renewal Fee Paid — 50% of Permit Fee

Declaration

I confirm all documents listed are attached to this renewal application. Information provided is true and accurate.

Signature of Applicant

Full Name (Print)*

Date*

Signature of Witness

Witness Name*

Date*

Central Division — Suva

WPC Administrator, Dept. of Environment
Levels 1 & 2, Bali Tower, 318 Toorak Road
P.O Box 2109, Suva
📞 (679) 331 1699 | Fax: (679) 331 2879

Western Division — Lautoka

WPC Administrator, Dept. of Environment
Level 1, Peekay Building, Lautoka

📞 (679) 672 4140

Northern Division — Labasa

WPC Administrator, Dept. of Environment
Ground Floor, Local Timber Bldg
Nasekula Street, P.O. Box 485, Labasa
📞 (679) 881 8017 | Fax: (679) 881 8016