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PROCEDURE FOR GETTING NOC FROM THE DISTRICT MAGISTRATE &

COLLECTOR AND EXPLOSIVE LICNECE FROM THE JOINT CHIEF


CONTROLLER OF EXPLOSIVES, SOUTH CIRCLE, EGMORE, CHENNAI - FOR
INSTALLATION OF PETROLEUM CLASS B (HSD & SKO) INSTALLATION

The Disgtrict Magistrate & Collector,


__________________ distrtict
State

Sub: Installation of Petroleum Class B – Issue of NOC for Petroleum Class B Installation at S
No.___________________, ______________________Village, ________________
Mandal, ________________________ district

Dear Sir,

We are pleased to inform you that we are putting up a new cement plant at S No.
_______________________________________Village___________________ Mandal
__________________, ______________________ district.

Since we have a huge requirement for HSD for own/contracted vehicles, we propose to go in
for installation of Petroleum Class B at S.No. ___________________________
___________________ Village, ___________________ Mandal, ____________ district. M/s.
Indian Oil Corporation Limited, ______________________, have consented to provide the
facilities required in this connection.

We are enclosing herewith the following:

1. 6 copies of the lay out drawings showing the location of the HSD consumer pump
facility
2. Form No.IX duly filled in

We request you to kindly arrange to issue NOC at the earliest.

Thanking you,

Yours faithfully,

(NAME)
DESIGNATION
(AUTHORIZED SIGNATORY)

Encl: as above

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CUSTOMER’S LETTER HEAD

REF NO,
DATE:

The Joint Chief Controller of Explosives,


Marshalls Road, Egmore,
Chennai 400 006

Sub: Installation of Petroleum Class B – HSD Consumer Depot at S. No. ___________,


______________ Village, __________________Mandal ____________________District
Andhra Pradesh - Approval Requested

Dear Sir,

We propose to go in for installation of Petroleum Class B- HSD at S.


No.__________________, ____________________Village, ________________ Mandal,
Kurnool district. M/s. Indian Oil Corporation Limited, _________________________, have
consented to provide the facilities required in this connection.

We are enclosing herewith the following:

1. 3 copies of the lay out drawings showing the location of the HSD consumer
facility
2. Form No.IX duly filled in
3. A demand draft for Rs.400/- (rupees Four Hundred only) on Nagp;ur drawn in
favour of Joint Chief Controller of Explosives, Chennai towards scrutiny fee

We request you to kindly accord approval at the earliest.

Thanking you,

Yours faithfully,

(AUTHORIZED SIGNATORY)

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Encl: as above
DD No.__________ Dated ________________of (Govt Banks only) drawn on Chennai

FORM IX
(See rules 143, 147,148 and 156)
Application for a grant/amendment/renewal/transfer of a licence to import and store
petroleum

Documents listed below must be enclosed with this application, if it is for the
grant of a licence in Forms XIV, XV, XVI or in Special Form

The replies to be given in this Column

1. Applicant’s Name : ________ CONSTRUCTIONS LIMITED

Applicant’s calling : S NO. VILLAGE


MANDAL, DIST. A.P
Applicant’s full
Postal Address : S NO. VILLAGE
___________ MANDAL, DIST. A.P

2. Situation of the premises where Petroleum is to be stored

State : ANDHRA PRADESH


District : DISTRICT
Town and village : S NO. VILLAGE
Police Station : ______________ P.S
Nearest railway station : ______________ RS

3. Quantity (in litres) of petroleum proposed to be imported and stored :

(i) Petroleum Class A : NOT APPLICABLE


(a) In bulk : NOT APPLICABLE
(b) Not in bulk : NOT APPLICABLE
I Total : NOT APPLICABLE

(ii) Petroleum Class B :


(a) In bulk : 40,000 LITERS
(b) Not in bulk : NOT APPLICABLE
I Total : 40,000 LITERS

(iii) Petroleum Class C : NOT APPLICABLE

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(a) In bulk : NOT APPLICBALE
(b) Not in bulk : NOT APPLICBALE
I Total : NOT APPLICABLE

Total of all classes of Petroleum: 40,000 LITERS

4. Quantity in litres of petroleum already stored in the premises:

(i) Petroleum Class A : NOT APPLICABLE


(a) In bulk : NOT APPLICABLE
(b) Not in bulk : NOT APPLICABLE
I Total : NOT APPLICABLE

(ii) Petroleum Class B


(a) In bulk : NOT APPLICABLE
(b) Not in bulk : NOT APPLICABLE
I Total : NOT APPLICABLE

(iii) Petroleum Class C : NOT APPLICABLE


(a) In bulk : NOT APPLICABLE
(b) Not in bulk : NOT APPLICABLE
I Total : NOT APPLICABLE

Total of all classes of Petroleum 40,000 LITERS

5. Number of licence held for the premises and the Full name of the holder of the
licence : NONE

I hereby declare that the statements made above have been checked up by
me and are true and I undertake to abide by the terms and conditions Of the
licence which will be granted to me.

Signature and designation of the applicant.


Date of application

Notes.
1. Where the application is made on behalf of a company, the name and
address of the company and the name of the manager or agent should be
given and the application should be signed by him. Every change in the
name of the manager or agent shall be forthwith intimated to, and his
specimen signature filed with, the licensing authority.
2. “In bulk” means in tanks or receptacles exceeding 1,000 litres in capacity
“Not in bulk” means in approved containers not exceeding 1,000 litres in
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capacity.

DATE:___________
The Joint Chief Controller of Explosives,
Marshalls Road, Egmore,
Chennai 400 006

Sub: Specimen Signature of Persons authorized to sign the Correspondence addressed to Jt CCE South
Circle Chennai - Installation of Petroleum Class B – HSD Consumer Pump at S.
No.______________________Village,________ Mandal, _____ District Andhra Pradesh - Reg

Dear Sir,

This is to inform you that we are the Chairman/Managing Director/Director of


M/s._________________________H No._________________________________ . we have
located our hot mix plant/crusher/project site at Sy. No.
_________________________________________ _____________ District Andhra Pradesh.

Following officers of our company are the authorized persons to sign the correspondence
addressed to Jt. Chief Controller of Explosives, South Circle, Egmore, Chennai in connection
with the HSD consumer pump at Sy. No._____________________________ district, A.P:

S No. Name of the OFFICIAL DESIGNATION Signature

Thanking you,

Yours faithfully,
For _______________________

XXXXX
DIRECTOR

Encl. Partnership Deed

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