________________________________________________________

Enquiries: JM Mabuza Cell: 082 577 3415 Email: jmmabuza@mpg.gov.za

REGISTRATION FORM

TRANSPORTER OF WASTE FOR GAIN IN TERMS OF REGULATION 5 (I) OF THE SOUTH AFRICAN
WASTE INFORMATION SYSTEM REGULATIONS.
FOR OFFICE USE ONLY
Date Application Form
Received:
Outcome of Evaluation of the Accepted Not accepted (provide
application form reasons)
DARDLEA Registration
Number:

NB: THIS REGISTRATION FORM NEEDS TO BE COMPLETED FULLY AND ANY FALSE
INFORMATION PROVIDED WILL INVALIDATE THE APPLICATION AND RESULT IN
REJECTION OF THE APPLICATION.

SECTION A: DETAILS OF THE OWNER OF THE WASTE MANAGEMENT ACTIVITY:

The following contact information will be used to create the Central Registry User for the site. All notifications
pertaining to the facility will be sent to this person.
*
First Name
Matevhutevhu Phineas
*
Surname:
Maphaha
*
ID Number: 7705105872086
*
Email:
maphahamp@gmail.com

The registration form for Waste Transportation must be submitted to: Deputy Director: Pollution and Waste Management,
Department Of Agriculture Rural Development Land and Environmental Affairs , Cnr Rosemead and Ryan Street, Klipfontein
Witbank,1050.
E-mail: jmmabuza@mpg.gov.za cell: 0825773415
 *
Cell phone
072 2256790
Telephone Number
* P. O. Box 14295
Postal Address: MIddelburg
1050
Physical Address * 21 Jukskei Street
Aerorand
Middelburg
SECTION B: COMPANY INFORMATION
Company Name: * Haya Group Pty LTD
Company Telephone number: * 072 2256790
VAT Registration Number (if * 4830294577
applicable):
Municipality : * Steve Tshwete
Province: * Mpumalanga
Physical Address: Street or Erf * Shale 13
* P.O. Box 14295
Physical Address: City MIddelburg
1050
* Shale 13
Physical Address: Postal Code: Middelburg
1050
SECTION C: WASTE TYPE BEING TRANSPORTED
Please select and tick the waste type being transported and specify the name of waste for SAWIS reporting
underneath: Coal, Oil, Sludge Contaminated soil and Rags
* When did the activity commence, if commencement has taken place?
2023 07 01

GENERAL WASTE HAZARDOUS WASTE X

Coal
Oil

The registration form for Waste Transportation must be submitted to: Deputy Director: Pollution and Waste Management,
Department Of Agriculture Rural Development Land and Environmental Affairs , Cnr Rosemead and Ryan Street, Klipfontein
Witbank,1050.
E-mail: jmmabuza@mpg.gov.za cell: 0825773415
 Sludge
Contaminated soil
Rags

SECTION D: SOURCE OF WASTE INFORMATION:

Source from which waste comes * Coal Laboratory
from
*
Quantities of Waste transported 12 tons
* Holfontein
Final Destination:

Type of Transportation: * Trucks

Municipality: * Steve Tshwete
Province: * Middelburg
Frequency:(Daily/ Weekly/ * Weekly
Monthly)

SECTION E: THE OWNER OF THE WASTE MANAGEMENT ACTIVITY/FACILITY/ INSTITUTION.

I, __________________________________ hereby declare that I have read the completed registration form
and hereby confirm that the information provided is to the best of my knowledge true and correct.

Furthermore, I declare that I am fully aware of my responsibilities in terms of the National Environmental
Management: Waste Act, 2008 (Act 59 of 2008) and failure to comply with these requirements may constitute
an offence in terms of the National Environmental Management: Waste Act, 2008 (Act 59 of 2008).

Full names :_______________________________________________

Designation :_______________________________________________

Signature: _________________________(duly authorised to sign on behalf of Owner of the Activity /Facility)

Date:_____________________ Place: ____________________________

Signature of the Commissioner of Oaths:

Date:

Designation:

The registration form for Waste Transportation must be submitted to: Deputy Director: Pollution and Waste Management,
Department Of Agriculture Rural Development Land and Environmental Affairs , Cnr Rosemead and Ryan Street, Klipfontein
Witbank,1050.
E-mail: jmmabuza@mpg.gov.za cell: 0825773415
 Official stamp (Above)

The registration form for Waste Transportation must be submitted to: Deputy Director: Pollution and Waste Management,
Department Of Agriculture Rural Development Land and Environmental Affairs , Cnr Rosemead and Ryan Street, Klipfontein
Witbank,1050.
E-mail: jmmabuza@mpg.gov.za cell: 0825773415