EDD.1.F.

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Revision 2, 01 December 2016

Republic of the Philippines

PHILIPPINE ECONOMIC ZONE AUTHORITY
Building 5, DOE-PNOC Complex, Energy Drive, 34th Street, Boniface Global City, Tausig City
Trunk Line No. 551-3451 Loc. 213 & 214 / Telefax No. 551-3440/E-mail Add: edd@peza.gov.ph

SCRAP BUYER'S REGISTRATION FORM

1. APPLICANT

Company/Enterprise Name : EULOGIA CONSUMER GOODS TRADING

TIN No. : 387-099-384-00000
Business Address : ROUTE 217 , TUCOP DINALUPIHAN BATAAN R03
Owner/President/CEO : NORMAN DANIEL Signature :
HIPOLITO GASPAR
Telephone No. : (02) 254-5665 Mobile No. : 0948-346-4580
Fax No. : N/A E-mail Add: eulogiaconsumergoodstrading@gmail.com

2. ORIGINAL COPIES OF THE FOLLOWING CERTIFICATES, PERMITS AND OTHER DOCUMENTS PERTINENT TO SCRAP-BUYING OPERATIONS WITH ONE (1)
CERTIFIED TRUE COPY Certificate No. Date Issued
2024-0000002761 February 22, 2024
Current Mayor's Permit (with corresponding Official Receipt)
DENR Certificate of Non-Coverage (CNC) for buyers of scrap CNC-OL-R03-2024-02-00766
materials not containing toxic / hazardous matters; or February 21, 2024
DENR Environmental Compliance Certificate (ECC) for buyers of
scrap materials containing toxic and hazardous waste
DENR Certificate of No Violation
(relative to the ECC if issued more than one year)
Permit to Transport for scrap buyers withdrawing and transporting
scrap materials containing toxic and hazardous waste
Business Registration
(i.e. SEC Registration or DTI Business Name Certificate of Registration) 5772501 February 06, 2024
Previous Certificate of Scrap Buyer's Registration, if any
(original copy)
Anti-Graft Certificate (Notarized)

3. TYPES OF SCRAP MATERIALS COVERED BY SCRAP-BUYER'S OPERATIONS

Types of Materials: Enumerate clearly the nature of the scrap materials and their intended uses.
Ceramic Example 1: Plastic drums for re-use.
Paper Example 2: Rejected printed circuit boards for recovery of usable parts and components.
Glass Example 3: Cotton, acrylic and wool yarns for stuffing toys and pillows and other uses.
Plastic
Wood
Textile
Rubber
Leather
Chemical
Metal
Aluminum
Copper
Iron/Steel
Lead
Tin
Zinc
Others

4. ACKNOWLEDGMENT

Application/Order of Payment Issuance

Date Received : Registration Certificate No. :
Amount Paid : Date Issued :
O. R. No. : Received by :
Received by :