Download Construction and deconstruction sites

Department of Markets and Consumer Protection
Port Health and Public Protection – Pollution Team
City of London, PO Box 270, Guildhall, London EC2P 2EJ
Tel No: 020 7606 3030
Fax No: 020 7332 1316
Out of Hours Contact No: 020 7606 3030
SITE HOURS VARIATION REQUEST SHEET
This form must be completed and faxed to the Pollution Team on the above number at least 5 days
before the activities are to take place. The site hours requested can only be worked if approval is
given and this form is countersigned by relevant Environmental Health Officer(s).
Date:
Company:
Company Contact:
Company Contact for
Operation:
Site Name and Address:
Direct Number:
Fax Number:
Operation(s)including
on site:
location
Date of operation(s)
Proposed Working hours:
Company contact(s) for
operation(s):
Details of operation(s):
Reasons for the
operation(s):
Plant and/or tools used:
Predicted noise levels at sensitive
location1
Location
High
Medium
Low
Mitigation measures to minimise
high and medium levels of noise:
1
Criteria for predicted noise levels
Operations that involve frequent mechanical impact, large numbers of plant and/or are continuous for
High
30 to 60 min. in every 1 hour.
Operations that involve manual impact noise, movement of plant (e.g. excavation, movement of
Medium
materials etc) and/or are continuous for 10 to 25 min. in every 1 hour.
Little or no perceptible noise above background levels at receptor, manual activities, limited plant
Low
and/or are continuous for up to 10 min. in every 1 hour.
Residents and businesses
likely to be affected.
e.g. addresses, site maps etc.
Notification method
Proposed. (copies of written
communications
to be included)
For Environmental Health use:
Variation Number:
Variation Granted: YES/NO (delete as appropriate)
If YES, any additional comment/specific conditions:
If NO, please provide brief details/reasons:
Name:
Signature:
Environmental Health Officer
Date: