HomeMy WebLinkAboutInv# HM-12910-23 - BOARD OF COUNTY COMMISSIONERS - 11/15/2024/ Resilient Environment Department
BK%�MRD ENVIRONMENTAL PERMITTING DIVISION
/ 1 AI1 North University Drive, Mailbox 201, Plantation, Florida 33324
I V I 1 PHONE: 954-519-1483 FAX 954-519-1412
License Renewal Notice and Application
Hazardous Material Manaqement Facilitv License: HM-12910-23
October 15, 2024
Operator/Licensee:
Fernando Rodriguez, Public Services Director
City of Dania Beach
100 W DANIA BCH BLVD
Dania Beach, FL 33004
Update Licensee Information Here: (Only Changes)
Attention:
Operator:
Mailing Address:
City: State: _ Zip:
Email:
Facility: City of Dania Beach Lift Station #3 License Expiration: January 31, 2025
1200 SE 2ND AVE Renewal License Fee: $320.00
Dania Beach, FL 33004
The facility's Hazardous Materials License expiration date is: January 31, 2025.
Renew online!
To Renew (Term - 2 years)
Online: 1) Logon to: https:Hdi2epp.broward.org/HazmatRenewal/Login.aspx
2) Sign in using CAPSLOCK to enter the license number, and use as password: 78302948
3) Verify/update (if needed) license information and make payment by credit card.
OR Expired licenses cannot be renewed online.
By Mail: 1) Review all current license information and update if necessary.
2) Sign and date this form.
3) Make a check for the renewal fee payable to Broward County Board of County Commissioners.
4) Mail signed form and payment by check to the above address.
Current Information: (Verify)
Nature of activity: Non -Residential Building with Diesel Generator
# of employees engaged in activity: 1
Contact name and title: Fernando Rodriguez, Public Services Direc
Contact phone: (954) 924-6802 Facility phone: (954) 924-3740
Contact email: frodriquez@daniabeachfl.gov
DEP Site ID: None
Is the facility on a septic system? No
Waste stream: Batteries
Intormation Here:
of activity:
of employees engaged in activity: -
ew contact: Title:
phone: Facility phone:
Contact email:
DEP Site ID:
Is the facility on a septic system?
Waste stream:
Applicant Certification:
The undersigned certifies that the statements made in this application are correct and complete to his or her knowledge and belief, and
understands that false or misleading statements may result in denial or revocation of a license and/or civil action including assessment of a
civil penalty as prescribed in Chapter 27 of the Broward County Code of Ordinances. The undersigned further agrees to comply with the
provisions of the Broward County Code of Ordinances, Chapter 27. In particular, as specified in Section 27-8, reasonable entry shall be
provided to RED personnel for the purpose of inspection and testing to determine compliance.
Failure to renew the license prior to the above ►ioted expiration date may result in enforcement action that carries a civil penalty.
Authorized signature: Dincer Akin Ozavdin, RE Date:
Deputy Public services Director/City Engineer
Please print name: Title:
To obtain additional information or assistance, contact Valerie Phipps at (954) 519-1203, by email at vphipps@broward.org
or visit our website at www.broward.org/consumer
A., + ilty Board of County Commissioners