FORM VIII Application for the grant/amendment/renewal ...

1 FORM VIII Application for the grant/amendment/renewal /transfer of a licence to Transport petroleum Class A/B in bulk on land for fuelling of aircraft, heavy vehicles/machineries and stationery equipment by a mechanically propelled vehicle, viz., Refueller Documents Listed below must be submitted with this Application The replies to be given in this column 1 Applicant s name and full postal address 2 Particulars of the vehicle in which petroleum is proposed to be transported for on-site fuelling of aircraft, heavy vehicles/machineries and stationery equipment. (i) Make and model (ii)Engine Number (iii)Chassis Number (iv)Registration Number (v)ULW and RLW (vi)Date upto which the vehicle is registered (vii)Name and full postal address of the registered owner (viii)No. of compartments and certified capacity in kiloliters of each compartment.

2 Compartment No. 1 2 3 4 5 6 7 Total capacity in kiloliters Capacity in KL. (ix)Class or classes of petroleum proposed to be transported in the vehicle described above. (x)Number and date of approval of the design drawing of the vehicle by the Chief Controller. 3 Does the tank vehicle described above fully conform to the requirements laid down in Third Schedule of the petroleum Rules 2002 and the design drawings approved by the Chief Controller. 4 Full postal address of the place where the vehicle will be normally stationed. 5 Full postal address and licence number of the installation where the vehicle shall be loaded. In case of service station number and date of the letter under which the specifically prepared loading area attached to the service station has been approved. 6 Name and full postal address of users and of the place where the vehicle normally will be transporting petroleum Class A/B for the purpose of the site refueling of aircrafts, heavy vehicles/machineries, stationery /equipments.

3 Particulars of heavy vehicle, which are proposed to be refueled by the vehicle. I /We declare that the particulars given above have been checked up by me/us and are correct. I/We undertake of transport petroleum by the vehicle, particulars of which are given according with the provision of the petroleum Act 1934, and the rules framed thereunder and any other law or rules for the time being in force. I/We understand that any contravention of the said Act and the rules framed thereunder is punishable for the first offence with simple imprisonment which may extend to one month, or with fine which may extend to one thousand rupees, or with fine which may extend to five thousand rupees, or with both. Signature of the applicant To be filled in duly signed by the recognized engineer.

4 I certified that the vehicle, the particulars of which are given in Part A of this form, has been examined and tested by me and found to be fully conforming to the particulars shown in approved drawing dated .. Complying with the requirements laid down in the Third Schedule to the petroleum Rules, 2002. Name .. Recognized Full postal Documents required to be submitted with this Application copies of drawing approved under sub-rule 3 of rule 63 amount if licence fee to be paid in the manner specified in rule 13 licence (only in case of renewal/amendment) copies of site plan showing area of operation (only in case vehicle is used for on-site fuelling of the heavy vehicle/machineries and stationary equipments) of heavy vehicle/machineries and stationary equipments whose tanks require filling/replacement copies of the plan of the premises approved for loading the vehicle under rule 76(1).

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