Declaration of classified institutions Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1- Information and Nature of Activities 1-2 Latin Social Name:1-3 Arabic Company Name:1-4 Legal status:2. Classified Installations (Executive Decree No. 07-144 of May 19, 2007 establishing the nomenclature of classified installations for environmental protection)2-1 Authorization: 2-2 Classification of Classified Establishments:2-3 Secondary School Rankings 2-4 Category Establishment:2-5 Number of employees:2-6 Work Rhythm:2-7 Date of commissioning:2-8 Authorization References:2-10 Date of Issuance of the Authorization 3. Exceptional Operating Authorization Exceptional Authorization:YesnonSpecial Date:Exceptional Authorization Number:4. Installation LocationDistrict:Municipality:Municipality:Address :Geographic coordinates: FirstLastDisplay radius:5. Information Contacts• Tel ꞉• Fax ꞉• Email• site web꞉6. Information Fiscale• Commercial register: Article Number (ART):Tax identification number (NIF):Statistical Identification (NIS):Establishment ManagerName :First name :Date of birth :Place of birth:Nationality :In terms of quality: ManagerNatural personContact details:Email :Tel :Part number:• Date of: • Date of: Date:Date: Environmental DelegateName :First name :Date of birth : : réel꞉ : Place of birth:Nationality :In terms of quality:ManagerNatural personContact details:Email :Tel :Part number:• Date of:• Date of: Date:Date: 8- Atmospheric Emissions (Executive Decree No. 06-138 of April 15, 2006 regulating the emission into the atmosphere of gases, fumes, vapors, liquid or solid particles, as well as the conditions under which their control is exercised)PollutantQuantityUnit6- Solid/liquid waste (Executive Decree No. 06-104 of February 28, 2006 establishing the nomenclature of waste, including special hazardous waste)Description of the wasteWaste Code (according to Executive Decree No. 06-104) *Quantity Generated (T/YEAR)Waste class AMISSDWaste Type and ConsistencySolidliquidpastyTransport Authorization7- Industrial Discharges (Executive Decree No. 06-141 of April 19, 2006 defining the limit values for industrial liquid effluent discharges)• Total debit ꞉• Industrial throughputSanitary flow rate ꞉• Existence of a collection network ꞉YesNonExistence of a wastewater treatment plantYesNon• Type of wastewater treatment plant ꞉IndividualCollectiveWastewater treatment plant status.FunctionalNot functionalPartially functional• Year of commissioningProcessed flow ꞉Purification capacity ꞉Theoretical purification efficiency ꞉Actual purification efficiency ꞉Method of effluent disposal Method of effluent disposalIndustrial zone sanitation network• Municipal sewer system• Directly into the natural environmentOldSebkhaLacsMoreChottOthers9- Consumption 9-1 Power Source Type• Urban networks ꞉• Surface waters ꞉• Underground networks ^WellForageSource9-2 Type of Consumption Water consumption (m3/year) (Proceedings)Water consumption (m3/year) (Washing and cleaning)Water consumption (m3/year) (Domestic/Sanitary)Water consumption (m3/year) (Fire-fighting water)Water consumption (m3/year) (Cooling)Water consumption (m3/year) (Demineralization)Water consumption (m3/year) (• Other to be specified)9-3 Energy ConsumptionNatural gas Nm3Electricity kWhGasoil m3Other 9-4 Material ConsumptionMaterial typeQuantity ConsumedQuantity StoredUnitStorage conditions Send
