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Republic of the Philippines

DEPARTMENT OF ENERGY
(Kagawaran ng Enerhiya)

DEPARTMENT CIRCULAR NO. DCO2J - Ol- 0o2q

GUIDELINES ON NOTICES AND REPORTORIAL REQUIREMENTS PURSUANT TO


THE DOWNSTREAM OIL INDUSTRY DEREGULATION ACT

Pursuant to Republic Act 8479, otherwise known as the "Downstream Oil Industry Deregulation
Act of 1998," and its IRR, and for the consistent and effective monitoring of the activities of the
Downstream Oil Participants, the DOE hereby adopts this Guidelines on Notices and Reportorial
Requirements for the Philippine Downstream Oil Industry.

Rule I
General Provisions

Section 1. Scope and Application.

This Circular shall apply to all Refiners, Importers, Bulk Distributors, Terminal
Operators/Lessors, Bunker Traders, Haulers and Own Users of Crude Oil and Finished
Petroleum Products as well as all Blenders, Marketers and Own Users of Base Oils and
Lubricating Products under the Philippine Downstream Oil Industry.

Section 2. Definition of Terms.

a. Base Oil - refers to an oil with typical boiling range of 390 degree C to 600 degree C,
obtained from petroleum by refining, or of synthetic origin, serving as the raw materials
for the blending and production of Lubricating Products;

b. Basel Convention - refers to the international accord which governs the trade or
movement of hazardous and toxic waste across borders;

c. Blender - refers to any person, natural or juridical, engaged in the importation of Base
Oils, production of Lubricating Products and sale of both Lubricating Products and Base
Oils to consumers;

d. Bulk Distributor - refers to any person, natural or juridical, who is a non-importer and
non-refiner but engaged in bulk distribution and/or retail of locally purchased Finished
Petroleum Products sourced from Importer or Refiner;

e. Bunker Trader - refers to any person, natural or juridical, engaged in the in bunkering
which is the activity of supplying fuel for use by ships and includes the shipboard
logistics of loading fuel and distributing it among available bunker tanks;

f. Crude Oil - refers to the oil in its natural state before the same has been refined or
otherwise treated, but excluding water, bottoms, sediments and foreign substances;

g. DOE - refers to the Department of Energy created under Republic Act No. 7638, as
amended;

h. DOI - refers to Downstream Oil Industry which is engaged in the business of importing
and refining Crude Oil as well as exporting, storing, bunkering, hauling, marketing,
refilling and retailing of Finished Petroleum Products;

Energy Center, Rizal Drive cor. 34th Street, Bonifacio Global City, Taguig City, Philippines 1632
Tel. No. (Trunkline) (632) 479-2900;
Website: hltp://www.doe.gov.ph; E-mail: infodoe.gov.ph
DOI Participant - refers to any person, natural or juridical, engaged in any business
activity of the Downstream Oil Industry. Specifically, it refers to any of the following:
Refiner, Importer, Bulk Distributor, Terminal Operator/lessor, Bunker Trader, Hauler,
Own User of Crude Oil and Finished Petroleum Products as well as Blender, Marketer
and Own User of Base Oils and Lubricating Products which shall each notify to 01MB its
intended activity for the issuance of acknowledgement as a participant of the Philippine
DOT;

J. Finished Petroleum Product - refers to a product formed in the course of refining crude
petroleum through distillation, cracking, solvent refining and chemical treatment coming
out as primary stocks from the refinery such as, but not limited to: diesel, gasoline,
kerosene, fuel oil, aviation fuel, liquefied petroleum gas (LPG), naphtha, lubricants,
solvent, waxes and petrolatums, asphalts, bitumens, coke and refinery sludges, or such
refinery petroleum fractions which have not undergone any process or treatment as to
produce separate chemically-defined compounds in a pure or commercially pure state
and to which various substances may have been added to render them suitable for
particular uses: Provided, That the resultant product contains not less than fifty percent
(5 0%) by weight of such petroleum products;

k. Hauler - refers to any person, natural or juridical, engaged in the transport of finished
petroleum products, whether in bulk or packed form, from the Importer, Refiner, and
Bulk Distributor down to Retailer through a network of transport facilities;

1. Importer - refers to any person, natural or juridical, engaged in importing Crude Oil for
refining andlor Finished Petroleum Products for the purpose of bulk distribution. An
Importer may likewise engage in other business activities of the DOT;

m. Liquid Petroleum Products — refer to Crude Oil and Finished Petroleum Products except
Lubes Products;

n. Lubes Products — refer to Base Oils and Lubricating Products;

o. Lubricating Product — refers to any substance that controls friction, heat and wear by the
introduction of a friction-reducing film between moving surfaces in contact;

p. Marketer - refers to any person, natural or juridical, engaged in the importation or local
purchase and selling of Lubricating Products to consumers;

q. 01MB - refers to the Oil Industry Management Bureau of the DOE;

r. Own User - refers to any person, natural or juridical, engaged in the importation of Crude
Oil, Finished Petroleum Products, Base Oils and Lubricating Products for own
consumption;

s. Refiner - refers to a DOI Biofuel Participant engaged in refining Gasoline or Diesel for
sale in the Philippines. Refiners may opt to supplement its inventory by directly
importing Gasoline or Diesel. It may, in addition, import Bioethanol for sale to other
Refiners, Importers or Own Users; and

t. Terminal Operator/Lessor - refers to any person, natural or juridical, engaged in the


business activity of operating for own use or leasing of storage facilities to DOI
participants.

Page 2 of 5
Rule II
Notices and Reportorial Requirements

Section 3. Notices.

The issuance of the 01MB acknowledgment letter to the following notices below shall be
consistent with the procedure and timeline reflected in the Citizen's Charter of 01MB and the
corresponding required information, documentary requirements and reminders or instructions
reflected in the specified annexes below:

a. Notice to Engage in the Downstream Oil Industry Business - Liquid Petroleum Products
(Annexes A, A-i, A-2, A-3 and A-4);

b. Notice to Engage in the Downstream Oil Industry Business - Hauling Services (Annexes
B, B-i and B-2);
c. Notice to Engage in the Downstream Oil Industry Business — Lubes Products (Annexes
C, C-i and C-2);

d. Notice to Import for Sale or Own Use — Liquid Petroleum Products (Annex D);
e. Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol (Annex
E); and

f. Notice to Import for Sale or Own Use — Lubes Products (Annex F).

Section 4. Reportorial Requirements.

For proper monitoring and reconciliation of data, each DOI Participant shall submit to the 01MB
the enumerated reports below as applicable. The submission of these reports shall be consistent
with the procedure and timeline reflected in the Citizen's Charter of 01MB and the
corresponding required information, documentary requirements and reminders or instructions
reflected in the specified annexes below:

a. Monthly Reports.

a. i. Monthly Report on Finished Petroleum Products Supply and Demand Summary


(Annex MR-A SUMM-FPP);

a.2. Monthly Report on Crude Oil and Finished Petroleum Products Ending Inventory
(Annex MR-B);

a.3. Monthly Report on Finished Petroleum Products Imports (Annex MR-C);

a.4. Monthly Report on Finished Petroleum Products Exports (Annex MR-D);

a.5. Monthly Report on Domestic/Local Purchase of Finished Petroleum Products from


Importer, Refiner or Bulk Distributor (Annex MR-E);

a.6. Monthly Report on Crude Oil Supply and Demand Summary (Annex MR-F SUMM-
CO);

a.7. Monthly Report on Crude Oil Imports (Annex MR-G);

a.8. Monthly Report on Crude Oil Exports (Annex MR-H);

a.9. Monthly Report on Refining Input and Finished Product Production (Annex MR-I);

Page 3of5
a. 10. Monthly Report on Total Domestic/Local Sales by Region, Trade, Sub-sector,
Product and Customer (Annex MR-J); and

a. 11. Monthly Report on Base Oils and Lubricating Products Supply and Demand
Summary (Annex MR-K SUMM- BOLP).

b. Quarterly Reports.

b. 1. Quarterly Update Report on Terminal and Blending Operations (Annex QR - A).

c. Annual Reports.

c. 1. Annual Update Report on Hydro Skimming Yields (Annex AR-A);

c.2. Annual Update Report on Company Profile (Annex AR-B);

c.3. Annual Update Report on Refinery Profile (Annex AR-C);

c.4. Annual Update Report on Import Terminal! Depot Profile (Annex AR- D); and

c.5. Annual Update Report on Projected Annual Supply and Demand Balance for the
Next Five (5) Years (Annex AR-E).

d. Special Reports.

d. 1. Maintenance Shutdown Notification Report (Annex SR-A);

d.2. Maintenance Shutdown Monthly Progress Report (Annex SR-Al);

d.3. Calamity or Emergency Damage Assessment and Daily Progress Report (Annex SR-
B);

d.4. Oil Spill Notification Report (Annex SR-C); and

d.5. Weekly Oil Spill Progress Report (Annex SR-Cl).

Rule III
Transitory Provisions

Section 5. Transition Period.

The DO! Participant shall be given the following transition period on the use and submission of
the notices and reports:

a. The use of the new formats for notices and monthly reports shall be implemented on the
second month following the month when this Department Circular took effect; and

b. The use of the new formats for the quarterly reports shall be implemented on the next
quarter following the quarter when this Department Circular took effect.

Section 6. Use of Online and Digitized Platform of Submission.

The DO! Participant shall comply with the use of an online and digitized submission platform
when the 01MB implements the same subject to the conduct of a corresponding training and roll-
out program. This transition to the use of an online and digitized platform is consistent with the
overall goal of implementing a digitized data management system for the benefit of both the
Government arid the DOI Sector.

Page 4 of 5
Rule IV
Final Provisions

Section 7. Prohibited Acts, Fines and Penalties.

1. Failure to comply with the submission of notices and reports in this Circular shall cause
both the suspension of the acknowledgement as DOT Participant pursuant to Section 5,
Chapter II of the Downstream Oil Industry Deregulation Act of 1998 and the
Accreditation as a DOI Biofuel Participant or cancellation for continued non-compliance
thereby suspending or cancelling, respectively, the further processing of any application
or request to the DOE in relation to its DO1 operations;

2. The DOE may further recommend to the Department of Interior and Local Government
and the concerned Local Government Unit the suspension or revocation of the business
permit of the non-compliant DOT Participant; and

3. The following administrative fines shall be applied, on a per violation basis, for the
following:

a. Operating without, or with a suspended


or cancelled acknowledgement as
DOT Participant — Php 100,000.00
b. Non-submission of a notice to import — Php 75,000.00
c. Late submission of a notice to import — Php 50,000.00
d. Non-submission of a report —Php 75,000.00
e. Late submission of a report —Php 50,000.00

The initiation of an administrative action andlor the imposition of any administrative fine against
any DO! Participant shall be without prejudice to the filing of criminal action against such
person or persons responsible pursuant to Republic Act No. 8479.

Section 8. Separability Clause.

Should any provision of this Department Circular be subsequently declared invalid or


unconstitutional, such parts not affected thereby shall remain in full force and effect.

Section 9. Repealing Clause.

All other rules and regulations or parts thereof, which are inconsistent with this Circular are
hereby repealed or modified accordingly.

Section 10. Effectivity.

This Department Circular shall take effect fifteen (15) days following its complete publication in
two (2) newspapers of general circulation and submission of a copy to the University of the
Philippines Law Center-Office of the National Administrative Register (UPLC-ONAR).

Done this of SEP 1 62021 , 2021 in Bonifacio Global City, Taguig City, Metro
Manila.

S- retary
Ropoblic or e Phhllppi000
DEPARTMPNT OF ENGRGY
IN REPLYING PLO. CITE:

DOE-AGC-21 00551
Il
Page 5 of 5
Annex A
July 2021

Notice to Engage in the Downstream Oil Industry Business - Liquid Petroleum Products

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd Floor, PNOC Building 5
Energy Center, Rizal Drive,
Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with the Department Circular No. , we wish to inform you of this
notice to engage in the Downstream Oil Industry Business with the following details below:

A. Company Details (Applicant)

1. Business Name
2. Address
3. Telephone Number
4. Email Address
5. DO! participant classification Refiner ()
Importer )
Bulk Distributor ()
Terminal operator/lessor ()
Bunker Trader ()
Own User ()

6. Type of Products Involved

B. Supporting Documentary Requirements

Please refer to the attached documents in compliance with Annexes A-I, A-2, A-3 and A-4.

Very truly yours,

Name, designation & signature of applicant or


authorized representative

Reminder/ Instructions:

I. Submit this application form with complete documentary attachments to 01MB for the issuance of the required
acknowledgment before the start of commercial operation;
2. Pay the application fee based on the Order of Payment if submission of application is complete;
3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application; and
4. For Notice to Engage in the Downstream Oil Industry Business - Hauling Services, please refer to the requirements
in Annex B, B-I, and B-2.

Page 1 of2
Annex A
Notice to Engage in the Downstream Oil Industry Business - Liquid Petroleum Products
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


CITY/MUNICIPALTY OF ) S.S

BEFORE ME, a Notary Public for and in the City/Municipality of , this day
of 20, personally appeared presenting his/her identification, to wit:

Name Competent Evidence of Date & Place of Issue


Identity

known to me and to me known to be the same person who executed and voluntarily signed the foregoing
application, which he/she acknowledged before me as his/her own free and voluntary act and deed, and
with full authority to sign in that capacity.

This application consisting of ( ) original copy/ies submitted to 01MB with complete


attachment, duly signed by the applicant.

IN WITNESS WHEREOF, I have hereto set my hand on the day, year and place above the written.

NOTARY PUBLIC

Doc No.
Page No.
Book No.
Series of 20

Page 2 of2
Annex A
Notice to Engage in the Downstream Oil Industry Business - Liquid Petroleum Products
Department of Energy Annex A-I
Oil Industry Management Bureau (01MB) July 2021

CHECKUST OF REQUEMENTS

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - UQUU) FETROLUEM PRODUCTS

Company Name / Address: Contact Details (email and tel 1)):

Prepared By: Approved By:

(Position and Signature over Printed Name I (Position and Signature over Printed Name)
REQUIREMENTS SUBNI1TrED (Y/N)
I. Application Form — Annex A (For all st'cs of bn.oingcs activity)
2. Checklist of Requirements — Annex A-I iFur all ttpe.c of business c,cl,rlll)
3. Company Profile Form — Annex A-2 (For all types sj'husincss act: vi tj')
4. Refinery Profile Form — Annex A-3 (Far Refiner)
5 Import Terminal! Depot Profile Form — Annex A-I (For all (spec of business activity)
6. Attached Supporting Documents:
6.1. Supporting Documents for Refiner. Iniporter. Bunker Trader or Own User
6.1.1. Executive briefer of operation;
1,1.2. Business Regtsnation for the applied business activity from the Securities and Exchange Commission or Department of Trade and Industry (iihich.-rc'r is ipplicable;
Sc. [.3. Securities and Exchange Commissioit Articles of Incorporation (II applicable)

6.1.4. Business/Mayor's Pemtit for the applied business activity from the concerned city or municipality;
6.1.5. Certificate of Accreditation as Importer front the Bureau of Customs;
6.1.6. Bureau of Internal Revenue (BIR) Permits:
6.1.6.1. BIR Registration for the applied busittess acltvirv.
6.1.6.2. Permit to import Petroleum Products subject to Excise Tax;
6.1.6.3. Permit to Operate storage facilitv/ies.
6.1.7 Chemical Control Order (CCO) for Importation of aviation gas from the Environmental Management Bureau.
6.2. Supporting documents for Bulk Distributor
6.2.1. Executive briefer of operation;
1,2.2. Busintess Registration for the applied business activity from the Securities and Exchange Commission or Department of Trade and Industry (li'hiclics'er vs appliccthlej:
6.2.3. Secunties and Exchange Commission Articles of Incorporation (if app/ira/tie)
6.2.4. Business/Mayor's Permil for the applied business activity front the concerned city or municipality;
6.2.5. BIR Registialion for the applied business activity: and
6.2.6. BIR Permit to Operate storage faciliiy!ies. (if applicable)
6.3. Supporting documents for Terminal Operator/Lessor
6.3,1. Executive briefer of operation;
6.3.2. Bustness Registration for the applied business activtry from the Securities and Exchange Commission or Department of Trade said Industry (whichever is applicabirt;
6.3.3. Secunties and Exchange Conmmission Articles of Incorporation (i/applicable)
6.3.4. Business/Mayor's Pennil for the applied business activity from the concerned city or municipality; and
6.3.5. BIR Registration for the applied business acrivitv.

Page I of2
Department of Energy Annex A-I
Oil Industry Management Bureau (01MB) July 2021

CHECKLIST OF REQUIREMENTS

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID PETROLUEM PRODUCTS

Company Name /Address: Contact Details (email and tel II)

Prepared By: Approved B':

(Position and Signature over Printed Namel Position and Signature over Pnnted Name)
REQUIREMENTS SUBhflrrED (YIN)
6.4. Additional supporting documents lithe office building. storage and blending facility are constructed by the applicant
6.4.1 Site. reflitery, terminal, storage and blending facility layout plan with sufficient descnption and supported bvblueprint copy with legend:
64.2. Fire prevention and response manual,
6.4.3. Oil and.'or Finished Petroleum Product onshore (land) spill prevention and response nianuat;
6.4.4. Oil and.'or Finished Petroleum Product offshore Iwater) spill prevention and response manual:
6.4.5. Envirotunentat Compliance Certificate of the site, office building, storage and bleodiog facility from the Departnaem of Environoseot and Natural Resources;
6.4.6. Fire Safety Inspection Certificate for the office building, storage and blending facility from the Bureau of Fire Protection:
6.4.7. Occupancy Pennit for the office building, storage and blending facility front the ctty or itsunictpahty: and
6.4.8. Pertnrt to Operate unfired pressure vessel per tank for LPG business from the Department of Labor and Employeaent;
6.5. Additional Supporting Documents if the office building, storage and blending facility, transport s'eliicle or vessel are leased by the applicant
6.5.1. Lease AgreementlContract with the owner of the site, office, storage and blending facilities:
6.5.2. Lease Agreement'Contract with the owner of the transport vehicle which iso duly acknowledged DO! participant engaged in battling services;
6.5.3. Lease AgreeioentfConwact with the owner of the transport vessel which is a duly acknowledged DOl participant engaged in hauling services:
6.5.4. Site, refinery, terminal, storage and blending facility layout plan with sufficient description and supported by blueprint copy with legetid:
trS.5. Fire prevention and response manual;
6.5.6. Oil and/or Finished Petrnleuau Product onshore (land) spill prevention and response manual;
6.5.7. Oil and/or Finished Peeroleinn Product offshore (water) spill prevention and response manual;
6.5.8. Environmental Compliance Certificate of the site, office building, storage and blending facility from the Department of Environment and Natural Resources:
6.5.9. Fire Safety Inspection Certificate for the office building, storage and blending facility from the Bureau of Fun Protection:
6.5.10. Occupancy Permit for the office building, storage and blending facility from the concerned city or muntctpahty: and
6.5.11. Permit to Operate unfired pressure vessel per tank for LPG business from the Department of Labor and Employment;
6.6. Company Secretary's Certificate for authorized representative and signatory: and
6.7. Proof ofPasment of Application Fee.

Reminder/Instructions:

1.Stibnait one (I) Certified True Copy of all the required supporting documents:
2. The Applicant toast also apply for the accreditation as Downsu'eam Oil lrtdrisny Biofliel Participant ander the DOE DC No. 2021-06-0014 if engaged in importation for sale or own use of Gasoline or Diesel in compliance so the Biofuels Act:
3. TheApplicant shall be issued likewise with Standards Conipljaitce Certificate if engaged in refinhtg, importation, bulk distribution and terniamal operation of Liquefied Petroleum Gas (LPG)in couispltanee to DOE DC No. 2014- 01-000!;
4. For Notice to Engage in the Downstream Oil Industry Business - Hauling Services. please refer to the requireuteals as Annex B, B-I, rout B-2: and
5. lithe applicant lenses a third-party hauling servires. die owner operator of the transport vessel nod/or vehicle shall be the one to comply with the requirements for Notice to Engage iii the Dosvnstreaun Oil Industry Business - Hauling Services.

Page 2 of 2
Department of Energy Anne's A-2
Oil Industry Management Bureau (01MB) July2021

COMPANY PROFILE

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID PETROLUEM PRODUCTS

Company Name i Address: Contact Details (email and tel

Prepared By: Approved By:

(Position and Signature over Printed Name (Position and Signature over Printed Name)
L COMPANY BACKGROUND
Company Name:
Business Address:
Landline: E-mail Address:
President/CEO'
Type of Ownership: ( 1 Single Proprietorship ( ) Partnership ) Corporation
I
Registered Partnerslacorporator:
Name Nationality

*acici rolls as necessary


Executive Management Organizational Stricture'
Name Position

ad1 iroc s as necessary


Description of the Organizational Structure: (attach Organizational Structure and indicate ttunsber of staff' employees)

II. DESCRIPTION OF BUSINESS PORTFOLIO


Background

History of operations and ittvestments in the Philippines

Expansiott Program/s

Product:

Product Source: (lli,llt local and abroad)


Name of supplier Location where the product will be soruced

add rout's as necessary


List of Buyers Market Area (scope or urea coverage where the products will be marketed or distributed)
Name of contpany Business Address

add roll' s as necessary

Page 1 of3
Annex A-2
Department of Energy
July 2021
Oil Industi Management Bureau (01MB)

COMPANY PROFILE

NOTICE TO ENGAGE IN ThE DOWNSTREAPl OIL INDUSTRY BUSINESS - LIQUID PETROLUEM PRODUCTS

Company Name / Address: Contact Details (email and tel 0):

Prepared By: Approved By:

(Position and Signature over Printed Name) (Position and Signature over Printed Name)
IlL FACILITIES
1. Refinery - Attach Annex AS - Refiner Profile
2. Import Temsitial / Depot - Attach Annex A4 - Tennit al;Depot Profile (/hr each jbciliti')
3. LPG Refilling Plant! Marketer! Dealer! Retail Outlets and Liquid Fuel Retail Otitliets
Location ot Address Certificate of Compliance Standard Compliance Valtd Utitil
Type of Facility Nanse Na. Certificate No.
- Province Municipality/City Baranggay Street
- Region (For Liquid Fuels) (For LPGi (dd/osm,yyyy)

Company Owned and Operated


LPG Refilling Plant
LPG Marketer
LPG Dealer
LPG Retail Outlet
Liquid Fuel Retail Outlet
5 add too sos necessary
Company Owned but Priva e Operated
LPG Refilling Plant
LPG iclarketer
LPG Dealer
LPG Retail Outlet
Liquid Fuel Retail Outlet
*add role s ics ,terestary

Private Owned and Operated


LPG Refilling Plant
LPG Marketer
LPG Dealer
LPG Retail Outlet
Liquid Fuel Retail Outlet
*adj miii as neressarr

Page 2 of 3
Department of Energy Annex A-2
Oil lnduttry Management Bureau (01MB) July 2021

COMPANY PROFILE

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID PETROLCEM PRODUCTS

Company Name / Address: Contact Details (email and tel #1:

Prepared By: Approved By:

(Position and Signature over Printed Name) (Position and Signature over Printed Name)
IV. COST OF INVESTMENT
Details Cost in Philippine Peso Number of Manpower Requirement
Refinery
Import Terminal
Depot Terminal
Distribution Faciliues
LPG Refilling Plant
LPG Marketer
LPG Retail Outlet
Liquid Fuel Retail Outlet
Operational Cost
T07>1L
Note: Please attached detailed fact sheet of the individual details of investment and the required manpower. The information us this matrix is a requirement for the preparation of the DOI investment data sheet in the Philippine Energy Plan and the subsequent endorsement to the 301.
V. PLANNED INVESTMENT FOR THE NEXT FIVE YEARS
Details Cost in Philippine Peso Number of Manpower Requirement
Rufinery
Import Terminal
Depot Terminal
Dtstiibotion Facilities
LPG Refilling Plant
LPG Marketet
LPG Retail Outlet
Liquid Fuel Retail Outlet
Operational Cost
T(Yi:4L
Note: Please attached detailed fact sheet of the individual details of investment and the i-eqs ired manpower. The information in this manix is a requirement for the preparation of the 001 investment data sheet iu the Philippine Ettergy Plan and the subsequent endorsement to the 801.
Other Observations/Infonnation:

Page 3 of3
Department of Energy Annex A-3
Oil Industry Management Bureau (01MB) July 2021

REFINERY PROFILE

NOTICE TO ENGAGE IN TIlE DOWNSTREAM OIL INDUSTRY BUSINESS - LiQUID FETROLUEM PRODUCTS

Company Name Address: Contact Details (email and tel 0):

Prepared By: Approved By:

(Position and Signature over Printed Nasne (Position and Signature over Printed Name
I. COMPANY PROFILE
Facility Name:
Address(Location: Longitude:
Date Commissioned: Latitude:
Date of Start of Operation:
Cost Of Investment (Phil:
II. EXECUTIVE MANAGEMENT ORGANIZATIONAL STRUCTURE
Name Position

*odt j roil' s as necessary


III. PROCESS UNITS AND TURNAROUND SCHEDULE
(a) Units (b) C apacitve (c) % Service Factor (d) TomarouitdiShutdown Schedule°
(MBSD) (eve). cumarotmd) (dl) Date (d2lNo. of Days (d3) Reason

add run sax nrcrssars'


IV. PRODUCT PROCESSING CAPABILITY PARTICULARS
Ia) Products!Process Utsit tb) % of Feeds* Ic) Product Capnciry (MBCD)
L Product #1 )pls. sperify)
Process Unit 01 (pls. specify)
Process Unit #2 (pis'. specify')
Process Unit #3 (pis. specify)
2. Product 02 (pis. specify)
Process Unit #1 1pls. specify)
Process Unit #2 (pls. specify)
Process Unit 03 (pls specify)
3. Product #3 (p15. specify)
Process Unit (I) (plc. specify)
Process Unit 02 )pls. specif')
Process Unit #3 (pls. specify)
°add rust' 5 05 necessary (per pro duct per process unit)

Page I of2
Department of Energy Anaes A-3
Oil Indusii Management Bureau (01MB) July 2021

REFINERY PROFILE

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID FETROLUEM PRODUCTS

Company Name IAddress: Contact Details (entail and tel #1:

Prepared By: Approved By

(Position and Signature over Printed Name (Position and Signature over Printed Name)
V. REFINERY STORAGE CAPACITIES
1. CRUDE OIL 11(L)
Products Working Capacity lexcl, heels) Design Capacity

*JJ as necessary
2. INTERMEDIATE STOCK (1(L)
Products Working Capacity cxci. heels) Design Capacity

add rotc s as necessary


3. FINISHED PRODUCT (1(L)
Products Working Capacity (excL heels) Design Capacity

iJJ rotc s as necessary


Other Observations/information:

Page 2 of 2
Department of Energy Annex A4
Oil Industry Management Bureau (01MB) July 2Q21

IMPORT TERMINAL I DEPOT PROFILE

NOTICE TO ENGAGE IN TIlE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID PETROLUEM PRODUCTS

Company Name! Address: Contact Details email and tel 0):

Prepared By Approved By:

(Position and Sigitature over Printed Name) (Position and Sintiature over Printed Nattie)
I. COMPANY PROFILE
Facility Name:
Address / Locatioo
Longitude: Latitude:
Iota] Lot Area (mt): Facilit Layout: (p/s attach s-ho/Op/an!
Type of Facilit: ( (Import Terminal ( I Depot ( ) Warehouse
Type of Operation: Ownership:
By its own ( I Company ownedfoperated
I Rationalized I I By contract
with whom: with whom:
I ) Joint Operation valid until:
with whom:
Cost of investment (PhP):
Date Commissioned Date of Start of Operation:
B. EXECUTIVE MANAGEMENT ORGANIZATIONAL STRUCTURE
Name: Position

*a jd nor .v as ;icressan
UI. SUPPLY. RECEIVtNG, MARKETING AND DISTRIBUTION
SUPPLY
a. lmportatiott:
Source Product Frequency (daily'weekly/motsthlv( Volume (KLI

odd roir .5 0.5 necu'.csarO'


b. Local Purchase:
Company Product Frequency ldaily!weekly/mnonthlv) Votuttie (KL)

rout sax necr'xearl


REPLENISHMENT
Product Mode Frequency (dailyiweeklyimottchly) Volume (hit

adi1 roil S as nuri.usarj


AREA COVERAGE
Product Mode Frequency (daily/weekly/monthly) Clients I Area Coverage

add nor S a.s nccrr.sarl

Page I o13
Department of Energy Annex A-4
Oil Industry Management Bureau (01MB) 2021

IMPORT TERMINAL I DEPOT PROFILE

NOTICE TO ENGAGE IN TILE DOWNSTREAM OIL INDUSTRY BUSINESS - UQUII) PETROLIFEM PRODUCTS

Company Name! Address: Contact Details (email and tel I):

Prepared By Approved By:

(Position and Signature over Printed Name') (Position and Siunature over Printed Name)
IV. TANK LISTING
Tank III 7isnk 02 Tank #3 7#mk #4
Tank ID No.
Product Tpe
Capacity (desiun), K!
Capacity (working), KL
Thruput )KLCD(
Date last cleaned (ddjmm/vvvv)
Date due for repainting (dd/nun/vv)
Type of Leak Detection System employed
Type of Corrosion / Cathodic Protection employed
Type of Over-fill Protection! Alarm employed
Tank Grounding (YIN) -
STATUS
(YIN) Operational (Y/N) Operational (YIN) Operational (YIN) Operational
(YIN) Back-up tanks (YIN') Buck-up tanks (Y.N( Back-up tanks (YiN) Back-up tanks
(Y/N) For dismantling disposal Y/N) For dismantling / disposal (Y/N) For dismantling disposal (YIN) For distnatmtling I disposal
Reason's:
Penod indicate specific dates for dismantling):
I Y/N For repair / rehabilitation (YIN) For repair: rehabmbtation — (Y/N) For repair I rehabilitation (Y/N) For repair. rehabilitation
Reusonls:
Period (indicate specific dates for repair/rehabl:
Con of repair, Php:
(Y/N) Available for lease (YIN) Available for lease (YIN) Available for lease (YIN) Available for lease
Available period lindicate specific dates for lease):
Cast of leasing, Php:
(YIN) For other use (Y/N') For other use (Y/N) For other use (YIN) For other use

Specify:
°lf therm' arc' more than/our (4) saorage tanks, please use another sheet

Page 2 of)
Department of Energy Annex A—I

Oil Industry Management Bureau (01MB) July 2021

IMPORT TERMINAL I DEPOT PROFILE

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIQUID PETROLUEM PRODUCTS

Company Name ! Address: Contact Details email and tel #1:

Prepared By Approved By:

(Position and Siguature over Printed Natnel (Position and Signature over Printed Name)
V. FACILITIES
Findings
Particulars Remarks
Yes No
Blending ( ) EIO ( B2 ( ) Both
Manual
In-Line
Provision of port or receiving line
Tank truck loading rack )TTLR) or Gantry
Tank truck grotmdinr
Oil Water Separator
Generator Set
for Back-up Power
for Fire pump
Fire Protection prevention
Water Tank Capaciw:
Extinguisher
Safety Shower and Eve Wash Station (3m-15m from the hard(
Entergencv Shutdown System
Emergettcv Evacuanoo Area
Gil Spill Containment Apparatus
0tth applicable to depots located in coasral anno'
Other Observations'lnforntation:

Page 3 of 3
Annex B
July 2021

Notice to Engage in the Downstream Oil Industry Business - Hauling Services

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd Floor, PNOC Building 5

Energy Center, Rizal Drive,


Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with the Department Circular No. , we wish to inform you that our
company would like to submit our notice to engage in the Downstream Oil Industry as Hauling Services
with the following details below:

A. Company Details (Applicant)

I. Business Name
2. Address
3. Telephone Number
4. Email Address

B. Supporting Documentary Requirements

Please refer to the attached documents in compliance with Annexes B-I and B-2.

Vemy truly yours,

Name, designation & signature of applicant or


authorized representative

Reminder! Instructions:

1. Submit this application form with complete documentary attachments to 01MB for the issuance of the required
acknowledgment before the start of commercial operation;
2. Pay the application fee based on the Order of Payment if submission of application is complete; and
3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application.

Page 1 of2
Annex B
Notice to Engage in the Downstream Oil Industry Business - Hauling Services
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES


CITY/MUNICIPALTY OF )S.S

BEFORE ME, a Notary Public for and in the City/Municipality of , this day
of 20_, personally appeared presenting his/her identification, to wit:

Na me Competent Evidence of Date & Place of Issue


Identity

known to me and to me known to be the same person who executed and voluntarily signed the foregoing
application, which he/she acknowledged before me as his/her own free and voluntary act and deed, and
with full authority to sign in that capacity.

This application consisting of ( ) original copy/ies submitted to 01MB with complete


attachment, duly signed by the applicant.

IN WITNESS WHEREOF, I have hereto set my hand on the day, year and place above the written.

NOTARY PUBLIC

Doc No.
Page No.
Book No.
Series of 20

Page 2 of 2
Annex B
Notice to Engage in the Downstream Oil Industry Business - Hauling Services
Department of Energy Annex B-I
Oil Indnstiy Management Bureau (01MB) July 2021

CHECWST OF REQUIREMENTS

NOTICE TO ENGAGE hN THE DOWNSTREAM OIL INDUSTRY BUSINESS - I3AUUNG SERVICES

Company Name.' Address: Contact Details (entail and tel #1:

Prepared By: Approved By:

(Position and Signature over Printed Name I (Position and Signature over Printed Name)
REQUIREMENTS SUBMIrfED (YIN)
1. Application Fonts - Annex B
2. Checklist of Requirements - Annex B-I
3. Company Profile Form - Annex B-2
4. Attached Supporting Documents:
4.1. Executive briefer of operation;
4.2. Business Registration for the applied business activity Born the Securities and Exchange Commission or Department of Trade atid Industry (irhrrhri'er is oppliculrlrj:
4.3, Securities and Exchange Commission Articles of Incorporation (if appitcobk'i
4.4. Business/Mayor's Permit for the applied business activity from the concerned city or municipality;
4.5. Bureau of lniemal Revenue Registration for the applied bstsiness activity:
4.6. Official Receipt atid Certificate of Registration per transport vehicle from the Land Tmnsportattois Office:
4.7. Conveyance Permit per transport vehicle from the Bureau of Fire Protection:
4.S. Calibration Certificate per transport vehicle from the Deparunent of Science and Technology:
4.9. Rogittiy and Safety Certificairs per transport vessel from the Maritime lndussry Autbonty;
4.10. Accrediiatiotr Certificate per transport vessel from the Philippine Ports Authority;
4.11, Fire prevention and response manual for taassport sehicle:
4.12. Fire preventiots and response manual for tansport vessel:
4.13. Oil and/or Finished Petroleum Product and Biofsmel onshore (lundi spill prevention and response manual,
4.14. Oil aatdior Finished Petroleum Product and Biofuel offiliore (water) spill prevention and response plan:
4.15. Company Secretarys Certificate for Authorized Representative and Signatory; and
4.16. Proof of Payment of Application Fee.

Reminder/ Instructians:

1. Submit one I I) Certified True Copy of all the required supporting documents:

Page 1 of 1
Department of Energy Annex B-2
Oil Industry Management Bureau (01MB) July2021

COMPANY PROFILE

NOTICE TO ENGAGE IN THE DOWNSTREAM OiL INDUSTRY BUSINESS - HAULING SERVICES

Company Name I Address: Contact Details (email and tel 0):

Prepared By: Approved By:

(Position and Signature over Printed Name (Position and Signature over Prtnted Name)
1. COMPANY BACKGROUND
Company Name:
Business Address:
Landlure E-mail Address:
President/CEO:
Type of Ownership: ) ) Single Proprietorship 1 1 Partnership ( ) Corporation
Registered Partners/Incorporator:
Name Nationality

'add rots .s 0.5 flrccs.sory


Description of the Organizational Structure: (attach Organizational Structure and indicate number of staff employees)

IL BUSINESS PLAN
Background

Ilistory of operations and investments in the Philippines

Expansion Prograinio

Product:

Product Source: (ho/h local and abroad)


Name of supplier Location where the product will be sourced

'add rots a as necessart


List of Buyers I Market Area (scope or area coverage where the products will be marketed or distributed)
Name of company Business Address

a as ,tec-estarr

Page I of2
Department of Energy Annex B-2
Oil Industry Management Bureau (01MB) July 2021

COMPANY PROFILE

NO110E TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - HAULING SERVICES

Company Name I Address; Contact Details (email and tel 0);

Prepared By; Approved By;

(Position and Signature over Printed Name I I Postnotr and Signature over Printed Name)
101. DISTRIBUTION FACILITY/IRS
Land Transport
Depamiment of Sciencr and Technology
Latrd Transportation Office Registration Bureau of Fire Protection Conveyance Permit
Vehicle Type Capacity Calibration Certificate
Product
(i.eIank truck.' lorry!trailer) I In KL) Cortflcate Registration
Official Receipt No. Issued Date Valid Until Issued Date Valid Until Issued Date Valid Until
No.

r,n .c as ncn.tsary
Maritime Transport

Mantune Industry Authorit't Philippine Ports Authority Accreditation


Capucttx
Name of Vessel Product
(In KLl
Registration Cemficate No. Safety Certificate No. Issued Date Valid Until Issued Date Valid Until

a as nt'cccsa,y
IV. COST OF INVESTMENT
Details Cost in Philippine Peso
Distribution Facilities
Operational Cost
TOTAL

Page 2 of 2
Annex C
July 2021

Notice to Engage in the Downstream Oil Industry Business — Lubes Products

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd
Floor, PNOC Building 5
Energy Center, Rizal Drive,
Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with the Department Circular No. , we wish to inform you of this
notice to engage in the lubes business with the following details below:

A. Company Details (Applicant)

1. Business Name
2. Address
3. Telephone Number
4. Email Address
5. Lube Business Activity
(Blender, Marketer or Own User)

B. Supporting Documentary Requirements

Please refer to the attached documents in compliance with Annexes C-i and C-2.

Very truly yours,

Name, designation & signature of applicant or


authorized representative

Reminder! Instructions:

I. Submit this application form with complete documentary attachments to 01MB for the issuance of the required
acknowledgment before the start of conirnercial operation;
2. Pay the application fee based on the Oider of Payment if submission of application is complete; and
3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application.

Page 1 of2
Annex C
Notice to Engage in the Downstream Oil Industry Business — Lubes Products
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )


CITY/MUNICIPALTY OF )S.S

BEFORE ME, a Notary Public for and in the City/Municipality of this day
of 20, personally appeared presenting his/her identification, to wit:

Na me Competent Evidence of Date & Place of Issue


Identity

known to me and to me known to be the same person who executed and voluntarily signed the foregoing
application, which he/she acknowledged before me as his/her own free and voluntary act and deed, and
with full authority to sign in that capacity.

This application consisting of ( ) original copy/ies submitted to 01MB with complete


attachment, duly signed by the applicant.

IN WITNESS WHEREOF, I have hereto set my hand on the day, year and place above the written.

NOTARY PUBLIC

Doc No.
Page No.
Book No.
Series of 20

Page 2 of 2
Annex C
Notice to Engage in the Downstream Oil Industry Business — Lubes Products
Department of Energy
July 2021
Oil Itsdustr Management Bureau OIMB(

CHECKLIST OF REQUIREMENTS

NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LURES PRODUCTS

Company Name; Address Contact Details (email and tel 6):

Prepared By: Approved By:

(Position and Signature over Printed Name) (Position and Signature over Printed Name)
REQUIREMENTS SUBMITFED (YIN)

1.Application Form - Annex C


2. Check]ist of Requirements - Annex C-i
3. Company Profile Form — Annex C-2
4. Attached Supporting Documents:
4.1. Executive briefer of operation;
-(.2. Business Registration for the applied business activity from the Securities and Exchange Commission or Department of Trade and Industay (w/awhec'er s.c applicablel:
4.3. Securities and Exchange Commission Articles of Inrorporatioti ( if aj'plicnhlct
4.4. BusinessiMayor's Permit fur the applied business activity from the concerned city or muaticipaltty
4.5. Certificate of Accreditation as Importer from the Bureau of Customs: and
4.6. EIR Registration for the Applied Business Activtt'v.
4.7. Additinnal supporting documents if the production plant and storage facility are constructed by the applicant
4.7.1. Site, plant and storge facility layout plan with sufficient description and supported byblueprttrt copy with legend:
4.7.2 Fire prevention and response ittannal.
4.7.3. Litbes onshore (land) spill prevennon and response manual:
4.7.4. Lubes offshore (water) spill prevention and response ntanual:
4.7.5. Occupancy Permit for the production plan) and storage facility frotn the Cttv or Municipality;
4.7.6. Fire Safety Inspection Certificate for the production plant and storage facilit from the Bureau of Fire Protection.
4.7.7. Environmental Consptiance Certificate of the site, office building, storge and blending facility front the Department of Environment
4.8. .&ddiliunnl Supporting Documents if the Production Plant and Storage are leased by the Applicant
4.8,1. Lease AgreementlContract with the osvner of the site, office building, plant and storage facility:
4.8.2. Site, plant and storge facility layout plan with sufficient description and supported by bluepnist copy with legend:
4.8.3. Fire prevention and response manual:
4 8 4. Lathes onshore (land) spill prevention and response manual:
4.8.5. Lubes offshore twateti spill prevention and response inunual:
48.6. Occupancy Permit for the production plant and storage facility from the City or Municipality:
4.8.7. Fire Safety Inspection Certificate for the production plant and storage facility from the Bureau of Fire Protecuots:
4.8.8. Environmental Compliance Certificate of the site, office building. storge and blending factliry frotn the Department of Envirounsent
4.9. Cnitspany Secretars Certificate for Authorized Representative and Signatory: and
4.10. Proof of Payment of Application Fee.

Reminder/Instructions:

1. Submit one (I) Certified True Copy of all the required supporting documents:

Page I of 1
Department of Energy Aiuiex C-2
Oil Industry Manatrement Bureau (01MB) July 2021

COM1ANY PROFILE

NOTICE TO ENCAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LIJBES PRODUCTS

Company Name IAddress Contart Details (email and tel dl:

Prepared By: Approved By:

(Position and Signature over Printed Name I (Position and Signature over Printed Name)
L COMPANY BACKGROUND
Company Name:
Business Address:
Landitne: E-mail Address:
President/CEO:
Type of Ownership: ( ) Single Proprietorship ) ) Partnership ( Corporation
IL BUSINESS PLAN
1. Description:
a. PrnpcssedActhrn' h's related to juliet hztsitirsx
N Pn,diict TsTes
c. Product Source
Name of supplier/s Locatioe where the product will be sourced/ittsported

°add a,,' sos necessarY


LII. FACILITIES
t. Production Plant
Rermsnal Location or Address Process Units Capacity in Thousand Liters (KL)

•add toss as ,tccess'on'


2. Storage
Regsonal/Location or Address Products to be stored

°add sos,' as necessary


V. COST OF INVESTMENT
Detatls Cost to Philippme Peso Number of Manpower Requirement
Blending Facility
Storage Tanks
Warehouse
Other Ancillary Facilities
Operattotsal Cost
TOTAL
Note: Please attached detailed fact sheet of the individsial details of investment and the required manpower. The information in this matrix is a requirement for the preparation of the DOl investment dam sheet in the Philippine Energy Plan mid the subsequent endorsement to the BOl.

Page 1 of 1
Annex D
July 2021

Notice to Import for Sale or Own Use — Liquid Petroleum Products

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd Floor, PNOC Building 5

Energy Center, Rizal Drive,


Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with tile Department Circular No. ,please be informed of this notice
to import with details as follows:

A. Company Details (Applicant)

1. Company Name! Business Name


2. Address
3. Contact Number
4. Email Address

B. Details of Shipment

1. Purpose (For Sale or Own Use)


2. Type of Product
3. Description (if applicable)
4. Quantity
5. Unit
6. Percent Tolerance
7. Name of Supplier
8. Source
9. Loadport
10. Estimated Loading Date
From
To
11. Estimated Arrival Date
From
To
12. Discharge Port
Region
Province
Municipality
Add ress
13. Vessel Name

C. Estimated Price

1. FOB ($/KL or $!CBM)


2. Insurance cost ($/KL or $ICBM)
3. Freight cost ($/KL or $/CI3M)
Page 1 of2
Annex D
Notice to Import for Sale or Own Use — Liquid Petroleum Products
D. Attached Documentary Req uirements

1. Certified true copy of the Proforma Invoice;


2. Certified True Copy of Certificate of Quality;
3. EMB/DENR clearance pursuant to RA 6969, otherwise known as "Toxic Substances,
1-lazardous and Nuclear Wastes Control Act of 1 990" in accordance with the Basel Convention,
if importing the following products:
a. Aviation Gas
b. Slop/used water, sludges and similar petroleum products/by-products
4. Material Safety Data Sheet (MSDS) indicating the petroleum weight percentage content, if
importing petroleum-based solvents.

Very truly yours,

Name, designation & signature of applicant or


authorized representative

Reminders! Instructions:

I. Submit this application form with complete documentary attachments to 01MB before (late of arrival;
2. Pay the application fee based on the Order of Payment if submission of application is complete; and
3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application.

Page 2 of 2
Annex D
Notice to Import for Sale or Own Use — Liquid Petroleum Products
Annex E
July 2021

Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd Floor, PNOC Building 5

Energy Center, Rizal Drive,


Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with the Department Circular No. , please be informed of this notice
to import with details as follows:

A. Company Details (Applicant)

1. Business Name
2. Address
3. Telephone Number
4. Email Address

B. Details of Shipment

1. Type of Product
2. Quantity of cargo (in KL)
3. Supplier
4. Loadport
5. Estimated Date of Loading (ETL)
6. Estimated Date of Arrival (ETA)
7. Disport
8. Name of Transporter

C. Estimated Price

1. FOB ($/KL or $/CBM)


2. Insurance cost ($/KL or $/CBM)
3. Freight cost ($/KL or $/CBM)

Page 1 of2
Annex E
Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol
D. Attached Documentary Requirements

II. Certified true copy of the Proforma Invoice;


2. Certified True Copy of Certificate of Quality;
3. Material Safety Data Sheet (MSDS) indicating the petroleum weight percentage content, if
importing petroleum-based sol vents; and
4. Airway Bill/Bill of Lading.

Very truly yours,

Name, designation & signature of applicant or


authorized representative

Reminders! Instructions:

1. Submit this application form with complete documentary attachments to 01MB before date of arrival;
2. Pay the application fee based on the Order of Payment if submission of application is complete; and
3. Issuance of acknowledgenient shall be not later than seven (7) working days from receipt of application.

Page 2 of 2
Annex E
Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol
Annex F
July 2021

Notice to Import for Sale or Own Use Lubes Products

Date

OIL INDUSTRY MANAGEMENT BUREAU


DEPARTMENT OF ENERGY
3rd Floor, PNOC Building 5

Energy Center, Rizal Drive,


Fort Bonifacio, Taguig City

Attention:

Director

Dear Sir/Madam

In compliance with the Department Circular No. , please be informed that we are
notifying our application for importation as follows:

A. Company Details (Applicant)

1. Business Name
2. Address
3. Telephone Number
4. Email Address
5. Lube Business Activity
(Blender, Marketer or Own User)

B. Details of Shipment

1. Purpose (For Sale or Own Use)


2. Type of Product (Base Oil or
Lubricating Product)
3. Name of Product
4. Packaging per product
5. Quantity of cargo
a. Lube oils in liters
b. Greases in kilograms
c. Other lubricating products
6. Supplier
7. Loadport
8. Estimated Loading Date (ELD)
9. Estimated Arrival Date (EAD)
10. Discharge Port
11. VesselName
12. Voyage Number

C. Estimated Price

1. Estimated Price per Unit ($/li, $/kg)


2. Pricing Term (CFR, FOB, etc.)

Page 1 of2
Annex F
Notice to Import for Sale or Own Use — Lubes Products
D. Attached Documentary Requirements

1. Proforma Invoice or Commercial Invoice;


2. Product brochure! bulletin; and
3. Material Safety Data Sheet (MSDS).

Very truly yours,

Name, designation & signature of applicant or


authorized representative

Reminders! Instructions:

1. Submit this application form with complete docuinenmaiy attachments to 01MB before date of arrival;
2. Pay the application fee based on the Order of Payment if submission of application is complete; and
3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application.

Page 2 of 2
Annex F
Notice to Import for Sale or Own Use — Lubes Products
Department of Energy Annex MR-A (SUMM-FPP
Oil Industry Management Bureau (01MB) July 2021

REFINER, IMPORTER. BULK DISTRIBUTOR. BUNKER TRADER OR OWN USER

MONTHLY REPORT ON FINISHED PETROLEUM PRODUCTS SUPPLY AND DEMAND SUMMARY

Company Name Address: Contact Details (email and tel #1: Covered Mouth:

Prepared By: Approved By Deadline of Submission:

(Position and Sinaturc over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of she succeeding month
A B C D E F G H I J
J
SUPPLY WITHDRAWAL

BEGINNING
REFINERY
INVENTORY DOMESTICLOCAL DOMESTICtOCAL
IMPORTS PRODUCTiON TOTAL AVAILABLE EXPORT TOTAL ENDING INVENTORY
PETROLEUM PRODUCTS (KL) (On Hand or In- Country PURCHASE SALES O\VN USE
(Actual Quantity in (Net ReEnery Output Per SUPPLY (Actual Quantity in WITHDRAWAL (E - 1)
Ending Inventory in (Actual Quantity in (Actual Sales in ANNEX CONSUMPTION
ANNEX MR-C) Product in ANNEX MR- (A+B+C+D) ANNEX MR-D) (F+G±H)
ANNEX laiR-B- previous ANNEX MR-E) MR-J)
I)
motsth)

GASOLINE
Gasoline unbiended with biofuel
Gasoline blended with biofuel
DIESEL
Diesel unbiended with biofuel
Diesel blended with biofisel
FUEL OIL
AVTURBO!JET-Al
KEROSENE
LPG
AVIATION GAS
N APl-ITHA,TOPS
ASPI-IALTS/BITUMEN
1-IYDRO SOLVENT
MIXED XYLENE
PROPYLENE
TOLUENE
BENZENE
PETCOKE
SULPHUR
CME
ETHANOL
OTHER PRODUCTS (p1s specify)

Page 1 of I
Annex MR-B
Deparmient of Energy
July 2021
Oil lisdusoy Management Bureau (1MB)

IMPORTER. REFINER, BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER

MONTHLY REPORT ON CRUDE OIL AND FINISHED PETROLEIrM PRODUCTS ENDING INVENTORY

Compan) Name / Address: Contact Details (email and let II): Covered Month:

Prepared 3r- Approved By Deadline of Submission:

(Position and Signature over Printed Name) (Position and Signature over Printed Naiad Not later than the 20th calendar day of the succeedingnionlh

ON HAND OR IN- COUNTRY TOTAL AVAILABLE


individual Finished IN TRANSIT INVENTORY
Depot Location ENDING INVENTORY (Already loaded within the covered month) INVENTORY
Product Ave Daily (Basis for MIR Compliance) Supply Coverage
Storage Capacity
Finished Petroleum Product Demand Areas
\'ol (1(L)
for the past sin months Vol (KL( Total Days
Vol (1(L) Days Supply \'ol (1(L) Days Supply
City ETL ETA Vessel Supply
Name Reon Province
Municipality (Al (D) ID/A)
(BI (B/Al (C) (C/A)
GASOLINE
Gasoline unhlended with biotuel
Gasoline blended with biofuel
DIESEL
Diesel unblended with biofuei
Diesel blended with biofuel
FUEL OIL
A\TL!RBOJET.At
KEROSENE
LPG
A-'lATION GAS
NAPRTH,OjTOPS
ASPHALTSfBITUMEN
HYDRO SOLVENT -
MIXED XYLENE
PROPYLENE
TOLUENE
BENZENE
PETCOKE
SULPHUR
CME
ETHANOL
OTHER PRODUCTS (phi, specify)

Page 1 of2
Deparonent of Energy Annev MR-B
Oil Indusny Management Bureau (01MB) July 2021

E11PORTER, REFINER. BULK DISTRIBUTOR. BUNKER TRADER OR OWN USER

MONTHLY REPORT ON CRUDE OIL AND FINISHED PETROLEUM PRODUCTS ENDING INVENTORY

Conspan Name / Address: Contact Details (email and tel I): Covered Month:

Prepared B: Approved B Deadline of Submission:

Position and Signature over Printed Name) (Position and Signature over Printed Name Not later than the 20th calendar day of the succeeding month

ON I-LAND OR IN-COUNTRY
IN TRANSIT INVENTORY TOTAL AVAILABLE
Depot Location weighted Ave. of Individual Finished ENDING INVENTORY
(Already loaded within the covered month) INVENTORY
Crude Type Storage Capacity Product Daily Demand (Basis for MIR Cnmpliance
Vol EL) for the past six months
(A) \'ol IKL) Days Supply Vol (EL) Days Supply Vol (EL) Total Days
City': Vessel Supply
Name Region Province ETL ETA
Municipality (D) (D/A)
(B) (B/A) (C) (C/A)

Remiaderflnstrurtion:

- Covered Inventory - refers to the following inventory as of end of the month on a per depot, per location, and perproduct basis: (a) On hand or In- country stocks mid (b) Import tn-n-aaisit volume already loaded within the covered period:
2. Average Daily Demand - refers to the average daily sales for the past six (6) mouths in thousand liters per calendar day KLCD(: and
3. Days Supply - refers to the equivalent number of days of in-counu-v ending inventory aaidIor in transit inventor,' divided by the average daily demand.

Page 2 of 2
Department of Energy Annes MR-C
Oil Industry Management Bureau (01MB) Jul3 2021

IMPORTER. REFINER. BUNKER TRADER OR OWN USER

MONTHLY REPORT ON FINISHED PETROLEUM PRODUCTS IMJ'ORTS

Company Narue / Address: Contact Details (email and tel B): Covered Month:

Prepared B Approved By: Deadline of Submission:

(Position and Signature over Printed Name (Position and Signature overPrinted Name) Not later than the 20th calendar day of the succeeding month
SHIPMENT PARTICULARS
Importer Depot Location 01MB TRACKING CODE DETAILS AS STATED TN APPLIED IMPORT NOTICE DETAILS AS SEEN IN SUBMITTED POST-IMPORTATION DOCUMENTS
r

ACTUAL PRiCE
Estmsaled Pri'.eprrn
e t DISPORT
PRODUCT DISPORT US$'KL or MT)
Ci ty/ tlnnicipahity

cUSS:

Courtly Source
o

Loading Date

A rrival Dale
LoadilIg Date
Estimated. ' Actual

S upplier
Province

Qtv. SAD
Name

.' Qtv. . p

Commercial
Invoice No.
Invoice No,

Province
Profornia
-n B -n 5 5 No.
5

FOB
FOB
z 'vlajorTpe B' (1.J) B ° (KL)
— -. B '. P
B

GASOLINE
DIESEL
FUEL OIL
AVTURBO/JET-A I
KEROSENE
LPG
AVIATION GAS
NAPHTHA'rOPS
ASPHALTS/BITL MEN
HYDRO SOLVENT
MIXED XVLENE
PROPYLENE
TOLUENE
BENZENE
PETCOKE
SULPHUR
CME
ETI-IA3'IOL
OTHER PRODUCTS Ipis. specify)

Reminder/Instruction:

This report shall have the followiag attachments:


I. Certified one copy of Bill of Lading;
2. Certified true copy of Commercial Invoice;
3. Certified true copy of fully processed BOC Single Administmtive Document or SAD: and
4. Certified true copy of the Certificate of Quality tested at the Ioadportsource tank in compliance with the Philippine National Standards and submitted by the seller.

Page 1 of I
Deparrment of Energy Annex MR-D
Oil Indusov Management Bureau (01MB) July 2021

IMPORTER, REFINER. BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER

MONTHLY REPORT ON FINISHED PETROLEUM PRODUCTS EXPORTS

Company Name Address: Contact Details (email and tel ): Covered Month:

Prepared By Approved By: Deadline of Submission

(Position and Signature over Printed Name (Position and Signature over Printed Namel Not later than the 20th calendar day of the succeedine mouth
SHIPMENT PARTICULARS
Exporter Depot Location FOB Price
- - product — Actual Quantity (KL) Country of Destination Buyer Vessel Date Lsaded Loadport
Name Retion Province CitviMumcipahtv CUSS .'LL or MT(
GASOUNE
DIESEL
FUEL OIL
AVTIJRBO!JET-Al
KEROSENE
LPG
AVIATION GAS
NAPl{rHAT0PS
ASPHALTS/BITUMEN
HYDRO SOLVENT
MIXED XYLENE
PROPYLENE
TOLUENE
BENZENE
PETCOKE
SULPHUR
OTHER PRODUCTS (pin. specifi'l

Reminder/Instruction:

This report shall have the following attaclunents:


1. Certified true copy of Bill of Lading; and
2. Certified true copy of Commercial Invoice.

Page 1 of I
Deparnuent of Energy Annex MR-E
Oil Indusn-v Management Bureau (01MB) July 2021

IMPORTER. REFINER. BULK DISTRIBUTOR, BUNKER TRADER OR OWT' USER

MONTHLY REPORT ON DOMESTIC/LOCAL PURCHASE OF FINISHED PETROLEUM PRODUCTS FROM IMPORTER, REFINER OR BULK DISTRIBUTOR

Contpan1 Name I Address: Contact Details (email and tel 9): Covered Month:

Prepared By Approved By: Deadline of Submission:

Position and Signature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of the succeeding month
Buyer Depot Location Supplier Depot Location (3ASOL NE (NI) DIESEL (NI) LPO (EL)

SOLVENTS
AVTVRBO /
KEROSENE

Els. Speci fy
Blended with Unblended with -n

IIYDR()/

OThERS
>

JET-Al
Blended with Biofuel Unblended with Biofuel

Province

(KL1
(KL

(KL)
z B-. 9. Biofuel Biofuel ,-<
am Ox B am Bar >
mm above 97R0N 5RON OIRON above 7R0N 95R0N OIRON 0.005% 0.3% 0.005% 0.3% 2 E

97 RON mm. ntin. mm. 97 RON mitt. win. mitt. Sulfur Sulfur Sulfur SLL(ftlr

TOTAL —

Reminder/Instruction:

This report shall have the following attachntent:


I. Cerolled a-ne copy of Commercial Invoice.

Page 1 of I
AIWOX MR-F (SUMM-CO)
DeparOnent of Energy
July2021
Oil Industry Management Bureau (01MB)

REFINER

MONTHLY REPORT ON CRUDE OIL SUPPLY AND DEMAND SUMMARY

Company Name Address: Contact Details (email and tel #1: Covered Month:

Prepared By Approved By: Deadline of Submission

(Position and Siianire over Printed Name) (Position and Signanue over Printed Name) Not later than the 20th calendar day of the succeeding month
A B C D E F 0
SUPPLY WITHDRAWAL

Depot Location Crude Oil import Refining Lisput


Beginning Inventory Export TOTAL
Crude Type (On Hand or In- Country (Actual Quantity in Annex Total Crude Oil Supply (Actual Quantity in Ending Inventors
(Actual Quantity in WITHDRAWAL
Ending Inventory in ANNEX MR-U) (A +B) Annex MR-I) (C-F)
Annex MR-H) (D+E)
Name Region Province City/Mumcipalitv MR-B- previous nsottth)

Page 1 of I
Department of Energy' Annex MR-G
Oil Industry Management Bureau )OIMB) July 2021

REFINER

MONTHLY REPORT ON CRUDE OIL IMPORTS

Company Name ! Address: Contact Details (email and tel d): Covered Month:

Prepared By: Approved By: Deadline of Submission:

(Position and Signature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of the succeeding month
SHIPMENT PARTICULARS
Importer Depot Location 01MB TRACKING CODE DETAILS AS STATED TN APPLIED IMPORT NOTICE DETAILS AS SEEN IN SUBMITTED POsT-IMPORTATiON DOCUMENTS
Estimated Price per unit ACTUAL PRICE
Crude Type
(USS; KL(
City/Munici pality

(USS: KL)

(Munici pality /

Loadin g Date
I-

A rrival Date
Estimated o Actual -a

Provi nce)

Supplier
Cotuttry

B!LNo
Suppli er

Disport

Region
SAD

Oceutt Lass
.3 —

aria aU
P MajorSpecific -'5 - S

FOB
FOB
Type Type (KL)
I (KL1
I: U

Reminder;Instruction:

Tlsi5 report shalt have the following attachments:


Certified true copy of Bill of Ladmg;
2. Certified true copy of Commerctal Invoice: and
S. Copy of fully processed DOC Single Administrative Document or SAD.

Page 1 of I
DeparOnent of Energy Annex MR-H
Oil Industry Management Bureau (01MB) July 2021

REFENER

MONTELY REPORT ON CRUDE OIL EXPORTS

Company Name I Address: Contact Details (email aod tel F): Covered Month:

Prepared By Approved By- Deadline of Submission

(Position and Signature over Pnnted Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of the succeeding month
SHIPMENT PARTICULARS
Exporter Depot Location
Actual Quantity FOB Price
Name Crude Type Countty of Destination Buyer Vessel Date Loaded Loadpori
Region Provtnce Citv'Municipa)itv (KU (USSKL)

TOTAL

Reminder/ Instruction:

This report shall hare the following attachments for each shipment:
- Bill of Lading: and
2. Commercial Invoice.

Page 1 of I
Departinentof Energy Annex MR-I
Oil Industry Management Bureau (01MB) July 2021

REFINER

MONTHLY REPORT ON REFINING INPUT AND FINISHED PRODUCT PRODUCTION

Company Name 'Address: Contact Details (entail and tel hi: Covered Month:

Prepared By: Approved By: Deadline of Submission:

(Position and Signature over Printed Namet IPosition and Signature over Printed Name) Not later than the 20th calendar day of the succeeding
I. INPUT
A. REFINING INPUT
Actual Volume utilized Projection for the first following month Projection for the second following month Projection for the third following month
Crude Input per Type

Sub-Total
B. IMPORTED FEEDSTOCK AND BIOFUEL BLENDING COMPONENT INPUT
Imported Feedstock?EthanoL'CME Blendino Components Actual Volume utilized Projection for the first following mouth Projection for the second following mouth Projection for the third following month

Sub-Total
TOTAL INrUT=(A +B)
II. REFINING PRODUCTION
C. Finished Petroleum Product Actual Volume Produced Projection for the first following month Projection for the second following month Protection for the third followutto month

Solo-Total
D Intemuecloame Components Actual Volsune Produced Projection for the first following month Projection for the second following month Projection for the third following month

Sub-Total
TOTAL PRODUCTION ( C±D)
III. REFINERY FUEL OWN USE & LOSS/GAIN PER PRODUCT
E. Refinery Own Used Fuel Actual Volume utilized Projection for the first following month Projection for the second following month Protection for the third following month

F. Refinery Loss/Gain Actual Volume of (Loss(/ Gain Projection for the first following tnonlh Projection for the second following ntonth Projecnon for the third following month

NET REFINERY OUTPUT PER PRODttCT(Total Refining Production ±1- Total Refinery Use & Loss/Gain)

Page 1 of I
Department of Enemy Annex MR-i
Oil Industry Management Bureau (01MB) July 2021

IMPORTER. REFINEL BULK DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTICILOCAL SALES BY REGION. TRADE, SUB-SECTOR, PRODUCT AND CUSTOMER

Company Name I Address: Contact Details (entail and tel #) Covered Month:

Prepared By Approved By: Deadlinc of Submission

(Position and Signature over Printed Name (Position and Signature over Printed Name) Nor later than the 20th calendar day of the succeeding month
VOLUME OF PRODUCT SOLD (KL
DEPOT SOURCE BUYER DETArLS LPG
GASOLINE
f

RE EU RMATE
Blended wilts Unbietuled with

Nois A utonsoti se

SOLVENTS

NAPI ITt IA /
AVTURBO'
KEROSENE

PI s. Specif y
Blended with Biofuel Unblended with Biofuel . 'O -

HYDRO /

OTt tEES
I

Automotive
0

JE t -Al
TRADE - Biofuel Biofuel -

REGION

ICIPALITY /
lPAL1TY I
NAME

CITY
CiTY

SALES 9 9
above 97 RON 95 RON 91 RON above 97 RON 95 RON 91 RON 0.005% 03% 0.005% 0.3%
97 RON mm. rain. mitt. 97 RON rain. rain. nun. Sulfur Sulfur Sulfur Sulfur

I. Tran partamion and storage (Liquid Petroleum Products Auto-LPG)


1.1. Railway Transport

1.2 Road Trausport


1.2.1. Uquid Petroleum Products Retail Outlet - Company Brand
I I I I I I I I I
I I I I I I I I I - L
1.2.2. Liquid Petroleum Products Retail Outlet - lndependentIWhite Station

I I I -
(.2 3 Liquid Petroleum Produrts Retail Outlet - Garage based I Endoser)

1.3. Water Transport

1.4. °irTranmon (Domestic)

1.5. Warehoasing!Storage

2. Industrial (Liquid Petroleum Products / LPG)


2.1. Manufacturing
2.1.1. Manufacture of Food Products

2.1.2. Manufacture of Beverages

2.1.3. Mant facture of Tobacco Products -

Page 1 of6
Department of Energy Annex MR-i
Oil Industry Manaoenient Bureau (01MB) July 2021

IMPORTER. REFINER, BULK DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTIC/LOCAL SALES BY REGION, TRADE, SUB-SECTOR, PRODUCT AND CUSTOMER

Company Name Address: Contact Details (email and tel 0) Covered Month:

Prepared B Approved By: Deadline of Submission

(Position and Signature over 'rioted Namct (Position and Signarure over Printed Name) Not laier than the 20th calendar day of the succeeding month
VOLUME OF PRODUCT SOLD (K.L)
DEPOT SOURCE BUYER DETAILS
GASOLINE DIESEL LPG

r
MUNICIPALIIY /

MUNICIPALITY /

REFORMATE
Blended with Unblended with z

AVTURBO !

N APIITIIA /
KEROSENE

P0. SpeciI '


Blended with Biofuel Unblended with Biofuel :1

OTIIERS
PROV1NCE
a - -

JEl -Al
Biofuel

AVGAS
TRADE Biofuel c

REGiON
.< '5
Z ru
CITY

CITY
SALES c
B >
0 Z above 97 RON 95 RON 91 RON above 97R0N 95 RON 91 RON 0.005% 0.3% 0.005% 0.3% 9.
Z ' 0 - 5,
97 RON mm. mm. mitt. 97 RON miii. win. mm. Sulfur Sulfur Sulfur Sulfur

2.1.4. Manufacture of Textiles

2.1.5. Manufacture of Wearing Apparel

2. ta. Manufacture of Leather and Related Prodscts


I - I I I I
I I I .1 I
2.1.7. Manufacture of Wood and of Products ofVsood and Cork. Except Furniture; Manufacture of .Articles of Barnboo,cane, Rattan and the Like; Manufacture of Articles of Straw and Plaiting Materials

2.1.8. Manufacture of Paper and Paper Products

2.1.9. Printing and Reproduction of Recorded Media

2.1.10. Manufacture of Coke and Refmed Petroleum Products

Sit I. vlanufacture of Chemicals and Chemical Products

2.1.12. Manufacture of Basic Pharmaceutical Products and Pharmaceutical Preparations

2.1.13. Manufacture of Rubber and Plastic Products

2.1.14. Manufacture of Other Non-metallic Mineral Products

Page 2 of 6
Department of Energy Annex MR-S
Oil Industry Manonement Bureau (01MB) July 2021

IMPORTER. REFINER. BULK DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTIC/LOCAL SALES BY REGION. TRADE, SUB-SECTOR, PRODUCT AND CUSTOMER

Company Name I Address: Contact Details (email and tel 6) Covered Month:

Prepared By Approved By: Deadline of Subtnission

(Position and Signature over Printed Name) (Position and SiitnattLre over Printed Name) Not later than the 20th calendar day of the succeeding month
VOLUME OF PRODUCT SOLD lKIJ
DEPOT SOURCE BUYER DETAILS LPG
GASOLINE

f
r

REFORMATE
MUNICI PALII V /
Blended wjth Unblended with z

SOLVENTS

NAPIITIIA /

Pis. SpeciI '


Blended with Bioftiel Uablended with Biofuel _

FUEL UI

I-IYI)RO /

OThERS
I7
TRADE Biofuel Biofuel ° >

_________
9 B

CIPALITY /
9
CII V

SALES 9 R >

io
above 97RON PSRON 9IRON above 97R0N 95 RON 91 RON 0.005% 03% 0.005% 0.3% Z — B B.
7 RON rein, mill, mill. 07 RON mill. mill, mill. Sulfur Sulfur Sulfur Sulfur

]
2.1.15. Manufacture of Basic Metals

2.1.16. Manufacture of Fabricated Metal Products Except Machiner and Equ precut

2.117. Manufacture of Computer. Electronic and Optical Products


I I I I I
I I I I I .1
2.1.18. Manufacture of Electrical Equipment

2.I.19 Manufacture of Machinet and Equtpnsent. N.e.c.

2.1.20. Manufacture af Is lotor Vehicles. Trailers and Semi-trailers

2.1.21. Manufacture of Other Transport Equipmetit - -

2.1.22. Manufacture of Fumtture

2.1.22. Other Manufacturing

2.2. Mining and Quarrying

2.3. Constructtou
2.3.1. Construction of Buildings

Page 3 of 6
Department of Energy Aune:s MR-J
Oil Industry Management Bureau (01MB) July 2021

IMPORTER. REFINER. BULI DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTIC/LOCAL SALES BY REGION. TRADES SUB-SECTOR PRODUCT AND CUSTOMER

Company Name / Address: Contact Details (email and tel 0) Covered Month:

Prepared By: Approved By: Deadline of Submission

(Position and Signature over Printed Names (Position and Sienaluire over Printed Name) Not later than tbe 20th calendar day of the ssicceeding month

fl Y1)RO /
VOLUME OF PRODUCT SOLD
DEPOT SOURCE BUYER DETAILS
GASOLINE LPG

L
MUNICIPALI1Y /

MUNICIPALITY /
Blended wtth Unbiended with

SOLVENTS
AVTURHO'
KEROSENE

Pis. Specif y
— Blended with Biofuel Unblended with Biofuel

OTHERS
Biofuel Biofuel >

JEl -Al
TRADE NAME
NAME

CITY

CITY
SALES 9
above 97 RON 95 RON 91 RON above 97 RON 95 RON 91 RON 0.005% 03% 0.005% 0.3% .
97 RON mm. nun. mm. 97 RON mill, win. mm. SulfUr Sulfur Sulfur Sulfur

25.2. Construction of Roads

21,3. Other Construction

2.4. Water Supply


- I I I I I I I I I I I I
I I I I I I I .1
2.5. Sewerage

2.6. Waste Management

2.7. Power Generation


2.7.1. National Power Corporation

2.7.2. Private Power Plants

'1 I I I
2.7.3. Others

3. Commercial (Liquid Petroleum Products LPG)


3.1. LPG for household use (LPG)
3.1.1. LPG Retail Outlet - Company Brand

3.1.2. LPG Refihler - Independent

Page 4 of 6
Department of Energy Annex MR-i
Oil IndustTy Management Bureau (01MB) July 2021

IMPORTER. REFINER, BULK DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTIC/LOCAL SALES BY REGION. TRADE, SUB-SECTOR PRODUCT AND CUSTOMER

Company Name Address: Contact Details (email and tel 6) Covered Month:

Prepared By Approved B: Deadline of Submission

(Position and Smenanire over Printed Namnt (Position and Signature over Printed Naive) Not later than the 20th calendar day of the succeeding month
VOLUME OF PRODUCT SOLD (KLi
DEPOT SOURCE BUYER DETAILS DIESEL LPG I
GASOUNE

MUNICIPALITY I
MUNICIPALII Y /

Blended with Unbletsded with

Non Auloniolive
Z

Pis.
Blended with Bioftiel Unblanded with Biofuel I a

OTJIERS
'5>

AVGAS
Biofael >
PROVINCE

PROVINCE
TRADE Biofuel o lit -< -o 'a
Ha
REGION

SpcciUy
z a -tE

CITY
CII Y

SALES > > " > . I I > E


ro —
above 97 RON 95 RON 91 RON above 97 RON 95 RON 91 RON 0.005% 0.3% 0.005% 0.3% a o I . I
'5 '5 I St
97 RON win. mis. mm. 97 RON win. miii. mm. Sulfur Sulfur Sulfur Sulfur

3.2. Wholesale Trade'Buik Sales


3.2.1. Seller ofOoods

3.2.2. Seller of Services


3.2.2.1. Accommodation and Food Service Activities
I I I I I
J I I I I
3.2.2.2. Information and Communication

3.2.2.3. Financial and Insurance Activities

j1j I
3.2.2.4. Real Estate Activities
I I

3.2.2.5. Professional. Scientific and Technical Activities

I , I - - —
3.2.2.6. Administrative tnd Support Service Activities

3.2.2.7. Education

3.2.2.0. Human blealtlt and Social Work Activities

3.2.2.9. Arts, Entertainment and Recreation

3.2.2. 10. Other Service Activities

PageS of 6
,Asinex MR-i
Department of Energy
July 2021
Oil Industry Management Bureau (01MB)

IMPORTER. REFiNER. BULK DISTRIBUTOR OR BUNKER TRADER

MONTHLY REPORT ON TOTAL DOMESTIC/LOCAL SALES BY REGION. TRADE, SUB-SECTOR • PRODUCT AND CUSTOMER

Company Name! Address: Contact Details (email and tel 0) Covered Month:

Prepared By: Approved By: Deadline of Subtntssion

(Position and Signature over Printed Name i (Position and Sionature over Printed Name) Not later than the 20th calendar day of the succeeding month
VOLUME OF PRODUCT SOLD (1
DEPOT SOURCE BUYER DETAiLS LPG
GASOLINE
f

REFORMATE
MUNICIPALItY /
Blended with Unblended with

Non Autornohive

SOLVENI'S

NAPILTIIA /
- >

ASPIIALTS

EN.
Blended with Bioftiel Unblended with Biofuel

IlYDRO /

OThERS
AVGAS
Biofuel =

PROVINCE
PROVINCE

TRADE Biofuel
REGION

Specify
NAME

CITY
CITY
CIPALITY /

SALES
0b0N above 97 RON 95 RON 91 RON above 97 RON 95 RON 91 RON 0005% 0.3% 0.005% 0.3%
97 RON nun. mm. mm. 97 RON mm. mm. atm. Sulfur Sulfur Sulfur Sulfur

3.3. Philippine Government Agencies and GOCCs

3.4. Foreign Embassies

4. Agriculture. Forest and Fishing - (Liquid Petroleum Products LPG(


4.1. Fishing and Aquaculture

4.2 Agricultural Crops Production


I I I
I I i
4.3. Livestock and Poulti Production

4.4. Forestry and Logging

5. international Sales (Liquid Perrnleuin Productst


5.1. Water TranspsrtiBuitkerittg (lntentacional)

5.2. ir Trans ott (lnternational(

TOTAL (NET OF SUPPLY SALES) - -


6. Sales to another Refiner or Importer (Liquid Petroleum Products / LPG)

GRAND TOTAL
you .s en' ,teressarr
Reminder/Instruction:

I. For detailed definition and description of the tradeisales classif'icatiott. please refer to the PSA- Philippine Standard litdusuial Classificanon (PSICI - https:i/psa.gov.phiclasstficationupsic

Page 6 of 6
Department of Energy Annex MR-K (STJMM-BOLP)
Oil Industry Management Bureau (01MB) July 2021

BLENDER, MARKETER OR OWN-USER

MONTHLY REPORT ON BASE OILS AND LUBRICATING PRODUCTS SUPPLY AND DEMAND SUMMARY

Company Name / Address: Contact Details (email and tel II): Covered Month:

Prepared By Approved By: Deadline of Submission:

(Position and Signature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of the succeeding month
A B C D B F G H I J
SUPPLY WITHDRAWAL

Beginning lnventoty
(Ending Inventory in Domestic/Local TOTAL AVAILABLE Ending Inventory
Importation Production (Blending) Domestic/Local Sales Export Own Use Consumption TOTAL WITHRAWAL
Annex MR-K (SUMM- pamhme SUPPLY
Product Type
BOLP) of previous month)

(Liter or KG) (Liter or KG) (Liter or KG) (Liter or KG) (A + B + C + D) (Liter or KG) (Liter or KG) (Liter or KG) (F+ G + H) (B-I)

A. Automotive Lube Oil


Engine Motor Oil
Gear/Transmission Oil
Motorcycle Oil
Other Automotive Oils
B. Industrial Lube Oil
Hydraulic Oil
Circulating Oil
Turbine Oil
Gear Oil
Cutting Machine Oil
Compressor Oil
Transformer Oil
Other Industrial Oils
C. Aviation Lube Oil
D. Marine Lube Oil
E. Base Oil
Solvent Neutral (SN)
Bright Stock (BS)
Other Base Oils
F. Grease -
Automotive Grease
Industrial Grease
G. Other Lubricating Products

Page 1 of 1
Department of Energy Annex QR-A
Oil Industry Management Bureau (01MB) JulY 2021

TERNINAL OPERATORJLESSOR

QUARTERLY UPDATE REPORT ON TERMiNAL AND BLENDINC OPERATIONS

Company Name Address: Contact Details (email and tel Th: Covered Quarter:

Prepared By Approved Bs': Deadline of Stibotissioss:

(Position and Signature over Printed Name) Position and Sigitatsire over Printed Name) Not later than the 20th calendar day of tlte month after the covered quarter
Duration of Lease Contract Duration of Blending Contract
Lessee Capacit Details mtniddyy(
(nsinldd;vyvv) With Blending
Cost of (easing the Cost of blending Factsheet of the Repair or
Contract for
Status storage tank per liter per Ister Rehabilitation Status
Biofuet
Address Tank Number Product Stored (On 1ease For Repair! Volume (KL( Start End (Thousand FliP) Start End (Thousand PhP( (What. Why. When. Huw and Cost)
Company Noose (Yesi1'o)
For Disinmislingiesc.)

Reminder/ Instruction:

I. Capocit Details should be on a per storage tank and per product basis.

Page 1 of I
Annex AR-A
Deparnuent of Energy
July 2021
Oil Industry Managemenl Bureau (01MB)

REFINER

ANNUAL UPDATE REPORT ON HYDROSKIMMING YIELDS

Cornpnn Name Address: Contact Details (entail and tel dl: Covered Year

Prepared Br Approved By: Deadline of Submission:

Position and Signature over Printed Name) (Position and Signature over Printed Name I Not later than the 20th calendar day of Januars of the succeeding year
YIELDS 1%)
Crude Type API Gravity Naphtha Fuel Oil
- Kerosene Diesel Off Gases Refinety Fuel Loss'Ciaut
Heavy \'trgtn Naphtha Licht \'lretn Naphtha (Reduced Crude)

Page 1 of I
Annex AR-B
Department of Ettergn
July 2021
Oil Industry Mnnagcment Bureau (01MB)

IMPORTER, REFINER. BULK DISTRIBUTOR. TERMINAL OPERATOR OR OWN USER

ANNUAL UPDATE REPORT ON COMPANY PROFILE

Company Name f Address: Contact Details (email and tel ): Covered Year.

Approved By Deadline of Submission


Prepared By

(Position and Sitruature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar rim of January of the succeeding year
I. COM ANY BACKGROUND
Company Name:
Business Address:
Landlitie E-mail Address:
PresidesisiCE0:
I ) Single Proprietorship ( 1 Partnership I ) Corparation
Type of Ownership:
Registered Partners/Incorporator:
Name Nationality

ood roil' a as oeressors'


Executive Manaecment oreanizauonal Structure:
Name Position

1add ens' a as u'ccssary

H. DESCRIPTION OF BUSINESS PORTFOLIO


Background (write a hñef description ofLit)! business acnwts' test

History of opecatioiss and investments in die Plulippmes (from sOot of operanons to present)

Expansion Prograsras

Ill. FACILITIES
I. Refiners' - Attach Annex AR-C (per fiict/iti')
2. Import Terminal / Depot - Attach Annex AR - D (per faei!itt')
3. Distribution Facilities
3.a. Land Transport
Land Transportation Office Registration Bureau of Fire Protection Conveyance Penutt Department of Science and Techtsology

Vehicle Type (i.e.tank Capacity


Plate Number. Product Certificate of \'alid Until Issued Date Valid Until Issued Date Valid Until
truck! lottyitrailer) In KL Official Receipt No. Issued Date
Registration No.

°ocid rent' ,r as ,jecex on'

Page 1 of 3
Departoten! of Energy Annex AR-B
Oil Industry Management Bureau (01MB) July 202!

IMPORTER, REFINER, BULK DISTRIBUTOR, TERMINAL OPERATOR OR OWN USER

ANNUAL UPDATE REPORT ON COMPANY PROFILE

Company Name Address: Cealact Details (email and tel 0) Covered Year:

Prepared By Approved By: Deadline of Submission

(Position and Signature over Printed Name) (Position and Signature over Pritsled Name) Not later than the 20th calendar day of January of the succeedtne year
3.b. Marit/me Transport
MARINA Registration Philippine Ports Authority (Accreditation I
Name of Vessel Product Capacity in KL Charterer issued Date Valid (inn!
Registration Certificate No. Safety Certificate No. Issued Date Valid Until

Winier
I I
Blur/c:
1 I I 1 1
LI'G;
I 1
rinI .c us ,,ere550rr
4. LPG Refilling Plant Marketer! Dealer! Retail Outlets and Liquid Fuel Retail Outlets
Location or Address Standard Compltaasce
Certificate of
Valid Until
Type of Facility Name Compliatice No. Certificate No.
Region Province Municipalirv!Citv Barauggay Street
(For Liquid Fuels) (For LPG)

Company Owned and Operated


LPG Reflllme Plant
LPG Marketer
LPG Dealer
LPG Retail Outlet
Liqitid Fuel Retail Outlet
*a dd row sos necessar,
Company Owned but Private Operated
LPG Refilling Ptunt
LPG Marketer
LPG Dealer
LPG Retail Outlet
Liquid Fuel Retail Outlet
"odd rote s as twcc.ssory
Private Owned mid Operated
LPG Refllliitg Mmst
LPG Marketer
LPG Dealer
LPG Retail Outlet
Liquid Fuel Retail Outlet
nodd row s as necessary

Page 2 of 3
Annes AR-B
Department of Energy
JuI 2021
Oil industry Management Bureau (01MB)

IMPORTER, REFINER. BULK DISTRIBUTOR. TERMINAL OPERATOR OR OWN USER

ANNUAL UPDATE REPORT ON COMPANY PROFILE

Company Name Address: Contact Details (email arid tel h): Covered Year

Prepared By Approved By- Deadline of Submission

(Position and Signature over Printed Name) (Position and Sigiiatiire over Printed Name) Not later than the 20th calendar day of January of the succeeding year
IV. ACCUMULATED COST OF EXISTING INVESTMENT
Details Cast in Philippine Peso Number of Manpower Requirement
Refinery
Iniport Temsuial
Depot Terminal
Distribution Facilities
LPG Refilling Plant
LPG b-tarketer
LPG Retail Outlet
Liquid Fuel Retail Outlet
Operational Cast
TOTAL
Note: Please attached detailed fact sheet of the individual details of investment above. The information in this matrix isarequirement for the preparation of the DOt investment data sheer in the Philippine Energy Plan and the subsequent endorsement to the BOt.
V. PLANNED INVESTMENT FOR THE NEXT FIVE YEARS
Details Cost in Philippine Peso Nunsber of Manpower Requirement
Refinery
Import Terminal
Depot Terminal
Distribution Facilities
LPG Refilling Plant
LPG Marketer
LPG Retail Outlet
Liquid Fuel Retail Outlet
Operational Cast
TOTAL
Note: Please attached detailed fact sheet of the individual derails of itivestenetit above. The inforniation in this inairix is a requiremeni forthe preparation of the DOl investment data sheet or the Philippine Energy Plan and the subsequent endursement to the BOl.

Reminder I Instruction: Supporting Documents

t. Updated executive briefer of operation; II. Updated Fire Safety Inspecrioti Certificate for tIme Office Building, Storage arid Blending Facilities front the concerned Bureau of Fire Pcorectroti;
2. Updated site. refinery, terminal, storage and blending facility layoui plan with sufficieni descnption and supported by blueprint copy with legemsd; 12. Updated Pernmit to Operate unfired pressure vessel per tank for LPG Business from the Department of Labor and Employment:
3. Updated Business/Mayor's Permit for the applied business activity from the Civ,' or Municipalmis; 3. Updated Enviromnental Compliance Certificate of the site, office building. sinrge mid blending facility from the DENR;
4. Updated Certificate of Accreditatioti as Importer from the Bureau of Customs: 14. Updated fire prerentioti and response manual;
5. Updated peinutn from BIR; 15. Updated Oil and'or Finished Petroleum Product and Biofuel onshore (lund) spill pcevenuoti and response muttual;
6. Updated Official Receipt and Certificate of Registration per transport vehicle from the Land Transportation Office: 16. Updated Oil and.'or Finished Petroleum Product and Biofliel offshore (water) spill prevention and response manual; and
7. Updated Cotivevatice Permit per transport vehicle from the Bureau of Fire Protection; 17. Updated Company Secretary's Certificate for authorized representative and signatory
I. Updated Calibratioti Certificate per transport vehicle from the Department of Science arid Technology;
9. Updaled Registry Certificate per transport vessel from hluritune Industry Authority:
10. Updated Accreditation Certificate per transport vessel from the Phrlrppttie Ports Amitltonty:

Page 3 of 3
Department of Energy Annex AR-C
Oil Industry Management Bureau (01MB) Jul' 2021

REFINER

ANNUAL UPDATE REPORT ON REFINERY PROFILE

Company Name! Address: Contact Details (email and tel 0); Covered Year.

Prepared By Approved By: Deadline of Submission

(Position and Sianature over Pnnted Name i (Position and Signature over Printed Name) Not later than the 20th calendar day of January of the succeeding year
I. COMPANY PROFILE
Facility Name:
Address-Location: Longitude:
Date Commissioned: Latitude:
Date of Start of Operation:
Cost of Investment (PhP):
II. EXECUTIVE MANAGEMENT ORGANIZATIONAL STRUCTURE
Name Position

add ,rnv s u.s necessary


III. PROCESS UNITS AND TURNAROUND SCHEDULE
(a) Units fbi Capucity" (C) Service Factor )d( TttmarotutdShatdown S rhedulea
(MBSD1 (exct. turnaround) (dl) Date (d2) No. of Days - )d3) Reason

'add run- .c icc necessary


I\'. PRODUCT PROCESSING CAPABILITY PARTICULkRS
(a) Products.Process Unit (bi % of Feed" (c) Product Capacity (MBCD)
I. Product I (pls. specifyl
Process Unit ft )pls. specify(
Process Unit #2 (pls. specif.) -
Process Unit 03 pls. specify)
2. Product #2 (pta. specify)
Process Unit 01 (pts. specify)
Process Unit #2 (pls. specify)
Process Unit 03 (ph. speciR)
3. Product #3 (p15. specify)
Process Unit FT (pls. specify)
Proress Unit 02 )pls. specify)
Process Unit 03 (pls. spect) -
add row a as necessary (per product per process 77771:)

Page 1 o12
Department of Energy Annex AR-C
Oil Industry Manacement Bureau 01MB) July 2021

REFINER

ANNUAL IJI'DATE REPORT ON REFINERY PROFiLE

Company Name / Address: Contact Details )email and tel i)): Covered Year.

Prepared By Approved By: Deadline of Submtsston

(Position and Signature over Printed Name) (Position and Signature over Prtnted Name) Not later than the 20th calendar day of January of the succeeding year
V. REFINERY STORAGE CAPACITIES
1.CRUDE OIL (KL)
Products Working Capacity )excl. heels) Design Capacttv

JJ row s as nrcessarr
2. INTERMEDIATE STOCK (KL)
Products Working Capacity cxci. heels) Oestgn Capacity

'add row .5 as iieceewrr

3. FINISHED PRODUCT (KL)


Products Working Capacity (excl. heels) Design Capacitx

'add row S CS flCCtSSOfl°

Other Obsei-vations1lnformation:

Page 2 of 2
Annes AR-D
Department of Energy
Jul5 2021
Oil Industry Management Bureau (01MB)

IMPORTER, REFINER. BULK DISTRIBUTOR. TERMINAL OPERATOR/LESSOR, BUNKER TRADER OR OWN USER

ANNUAL UPDATE REPORT ON IMPORT TERMINAL I DEPOT PROFILE

Company Name Address: Contact Details (email and tel 5 ): Covered Year:

Prepared By Approved By: Deadline of Submission

(Position arid Signature over Printed Namet (Position and Signature over Printed Name) Not later than the 20th calendar day of January of the succeedinc year
I. COMPANY PROFILE
Facility Name:
Address Location:
Longitude: Latitude.
Facility Layout: (p/s iriiac/t as-hut/i plan)
Total Lot Area (m2 (
Type of Facility: ( (Import Termittal ( Depot I I Warehouse
Type of Operation: Ownershtp.
By its own ( I Cotupany ownedioperated
Rationalized ( ) By constant
with whom with whom:
Joint Operation valid imtil:
with whom:
Cost of investment (PhP(: Longitude.
Date Commissioned Latitude.
Date of Start of Operation
IL EXECUTIVE MANAGEMENT ORGANIZATIONAL STRUCTURE
Name: Position

0dd ruts s as ,tccrs: art


Ill. SUPPLY. RECEIVING, MARKETING AND DISTRIBUTION
SUPPLY
a. Importation.
Source Product Frequency ldaily/weeklv/tuonthly) Volume (KU

add rows as necessary


b. Local Purchase:
Company Product Frequency (dailv.'weeklwtnottthlvl Volume (KL)

°csdd row s as necessary


REPLENISHMENT
Product Mode Frequency (dailyweeklv/tnonthly) Voltuitn (UI-)

*sekj row s as necessary


AREA COVERAGE
Product Mode Frequnacy lduilyrweekly/tnonthly) Cltents / Area Coverage

*add row s as necessarr

Page 1 ofS
Annex AR-D
Department of Energy
July 2021
Oil Indusoy Mananentent Bureau (01MB)

IMPORTER, REFINER, BULK DISTRIBUTOR, TERMINAL OPERATORILESSOR, BUNKER TRADER OR OWN USER

AJIN1)M. UPDATE RIPORT ON IMPORT TERMLNAL / DEPOT PROFILE

Company Name / Address: Contact Details (email and tel hi: Covered Year

Prepared By Approved By. Deadline of Submission

(Position and Signature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of January of the succeedine year
IV. TANK LISTING
Tank /2 Tank 13 Tusk 14 Tank 15 Tank/k Tank Tank vS
Tusk vi
Tank ID No.
Product Type
Capacity (design), KL
Capacity (working), KL
Thruput (KLCD)
Date last cleaned (dd/mm/yvvv)
Date due for repainting (dd'mm!vyyv)
Type of Leak Detection System entploved
Type of Conosioti ; Cathodic Protectioti employed
Type of Over-fill Protection' Alarm employed
Tank Grounding (Y/N)
STATUS
(YIN) Operational (YIN) Operational (YIN) Operational (YIN) Operational (YIN) Operational (YIN) Operational YIN) Operational
(YIN) Operational
Y,N Back-up tanks (YIN) Back-up tanks Y.N Back-up tanks (YIN) Back-up tanks (YIN) Back-up tanks (YIN) Back-up tanks (V/k) Back-up tanks
(YIN) Back-up tanks
(V/k) For distitaittling! (YIN) For dismantling (YIN) For distnatttlingl (YIN) For dismantling (YIN) For disutatitluig (YN) For dismantling.' (YIN) For dismantling I (YIN) For distnanthng!
disposal disposal disposal disposal disposal disposal disposal
disposal
fleasonls:
Period (indicate specific dates for dismantling):
(Y/N) For repair. (YIN) For repair / (YIN) For repair. (YIN) For repair / (YIN) For repair! (YIN) For repair! (YIN) For repair 1
(YIN) For repair /
rehabilitation rehabilitation rehabilitation rehabilitation rehabilitation reltabilitation rehabilitation
rehabilitation
Reason/s:
Period (indicate specific dates for repair;rehalt):
Cost of repair. Php:
(YIN) Available for lease (YIN) Available for lease (YIN) Available for lease (YIN) Available for lease (YIN) Available for lease (V/k) Available forlease (YIN) Availableforlease
(YIN) Available for lease
Available period (indicate specific dates for lease):
Cost of leasinfi Nip:
(YIN) For other use (YIN) For other use (V/N) For other sine (YIN) For other use (Y/N) For other tine (Y/N) For other use (YIN) For other use
(V/N) For other use
Specify: 1
1f their are inure titan eitiht vh) storage tanks, please use tmotht'r sheet

Page 2 of 3
Department of Energy Annex AR-D
Oil Industry Management Bureau 101MB) July 2021

IMPORTER, REFINER, BULK DISTRIBUTOR. TERMINAL OPERATOR/LESSOR. BUNKER TRADER OR OWN riSER

ANNUAL UPDATE REPORT ON IMPORT TERMINAL / DEPOT PROFILE

Compact Name / Address: Contact Details (entail and tel l: Covered Year:

Prepared By Approved By: Deadline of Submisston

(Position and Signature over Printed Name) (Position and Signature over Printed Name) Not later than the 20th calendar day of January of the succeeding tear
V. FACILITIES
Fmdin"s
Particulars Remarks
Yes No
Blending 1 ) EIO I B2 I I Both
Manual
in-Line
Provision of port or receiving line
Tank truck loading rack (JTLR) or Gantr
Tank truck grounding
Oil Water Separator
Generator Set
for Back-up Power
for Fire pump
Fire Protection / prevention
Water Tank Capacity:
Extinguisher
Safety Shower and Eve Wash Station (3in-15m from the hazard)
Emergency Shutdown System
Emergency Evacuation Area
Oil Spill Containment Appacatus
0,iiv at'pikahle to depots located its coastal areas
Other Observations/Information:

Page 3 of 3
Department of Energy Annex AR-E
Oil Industry Management Bureau (01MB) July 2021

IMPORTER. REFINER. BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER

ANNUAL UPDATE REPORT ON PROJECTED ANNUAL SUPPLY AND DEMAND BALANCE FOR THE NEXT FIVE (5) YEARS

Company Name Address: Contact Details (email and tel 0): Covered Year:

Prepared By Approved B: Deadline of Submission

(Position and Sienasure over Printed Narnet (Position and Signature over Printed Name) Not later than the 20th calendar day of January of the succeedine year
I. DEMAND (C) Finished Petroletun Product I (in EL) (d) Finished Petroleum Product 2 (in 1(L) (e) Ethanol (EL) (ft CME) in 1(L)
(b) Crude (1(L)
(a)
DEMAND DETAILS tat Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year

Ia. Crude Ron., Product Sales


lb. Export
Ic. Total Demand ) la)+( lbt - -
II. SUPPLY
(hi Crude (ci Product Type I (d( Product Type 2 e) Ethanol If) CIvIE
2. SUPPLY DETAILS 1st Year 2nd Year 3rd Year 4th Year 5th Year, 1st Year ,2nd Year 3rd Year 4th Year 5th Year tot Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year

2a. Production
2b. Import
Zr. Local Purchase
2d. Total Supply = (2a)-(2b)4-t2c) -
Ill. INV. BUILD-UP/(DRAWDOWN)
(hi Crude (ci Product Type I (d) Product Type 2 e) Ethanol (f CME
3 INVENTORY Details 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year I 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year 1st Year 2nd Year 3rd Year 4th Year 5th Year
3a. Opening
3b. Ending = (3a) (2d) - (Ic) - j -

Page 1 of I
Annex SR-A
Department of Enerey
July 2021
Oil Industry Mananement Bureau (01MB)

IMPORTER, REFINER. BULK DISTRIBUTOR, TERMINAL OPERATOR/LESSOR, BUNKER TRADER OR OWN USER

MAINTENANCE SHUTDOWN NOTIFICATION REPORT

Company Name I Address: Contact Details (email aM tel u ) Reporting Date:

Approved By: Deadline of Submission:


Prepared By:
Not later than 5th calendar day front the scheduled maintenance start date or tsrtlsm 24 hours
(Position and Signature over Printed Namet (Position and Signature over Printed Natnc( front oceutrence of an emergency shutdown.
Weekly Inventory Status for Operational Storage Capacity
LOCATION
Non- Individual On Hand! to- Country Repleraishnient
Contingency Measures
Operationai Description the Planned Tateet Finished Product
Affected Affected Part of Being Implemented To
Storage Capacity Maintenance Maintenance Completion / No. of Days Ave. Daily Number of Number of
Name City Secure Continous V ol Vol (KU)
Region Province Product the Facility )
Days Supply Days Supply ETA
Municipality of the Facility Requirement Start Date Start-Up Date Demand
Supply of Fuel (B) (C)
Vol (KU) (A) (B/A) (CIA)

L LIST OF REFLNERY

add row n as nacessarr


IL LIST OF IMPORT TERMINAL

idd roll n paecexvafl


III. LIST OF STORAGE DEPOT

adJ roil a as necr,5.sarl

Page 1 of I
Department of Enetuy Atmen SR-Al
Oil lndusov Manaetnent Bureau (01MB) July 2021

IMPORTER. REFINER, BULK DISTRIBUTOR, TERMINAL OPERATOR/LESSOR, BUNKER TRADER OR OWN USER

MAINTENANCE SHUTDOWN MONTHLY PROGRESS REPORT

Company Name I Address: Contact Details (email and tel il): Repothng Date:

Prepared By: Approved By: Deadline of Submissiois:

(Position and Signature over Printed Name) (Posttton and Sienature over Printed Namet Not later than the end of every month
LOCATION Weekly Inventory Status for Operanonal Storage Capacity
Individual
Non- Operational Description of Progress On Hand/In- Country Replenishment
Rate of Actual Finished Product
Affected Storage Capacity Affected Part the Report on the Completsotii
Name City Completion Maintenance No. of Days Ave. Daily Number of Number of
Region Province Product of the Facility of the Facility Maintenance Maintenance Start-Up Date Vol (KL) Vol (KL(
Municipality (%) Start Date Demand Days Supply Days Supply ETA
Vol (KL( Requtrement Requtrernent (B) (C)
(A) (B/k) (C/A)

1. LIST OF REFINERY

eaj jj ron s as flrcrsSary


IL LIST OF IMPORT TERMINAL

adJ ron s as ,lecrssars


111. LIST OF STORACE DEPOT

J
add von .c U.s ),crr.s:srjry

Page 1 of I
Department of Energy Annex SR-B
Oil Industry Management Bureau 101MB) July 2021

IMPORTER. REFINER. BULK DISTRIBUTOR. TERMINAL OPERATOR/LESSOR. BUNKER TRADER OR OWN USER

CALAMITY OR EMERGENCY DAMAGE ASSESSMENT AND DAILY PROGRESS REPORT

Company Name I Address: Contact Details (email and tel a: Reporting Date:

Prepared By: Approved By: Deadline of Submission:

(Position arid Signature over Printed Namei (Position and Signature over Pnnted Name) Every day. not later than 5:00 in the afternoon.
Description of Calamitvl Emergency:

LOCATION Repair Plan of the Facilits Actual Repair Inspiementation Insentory Status for Operational Storage capacity
Contingency Individual On handl In- country Replenishment
Non- Measures Being Finished
Operational Implemented to Product Ave. Number of Number of
Target Vol
Affected Part of Storage Contain the Description of Planned - Progress Report Rate of Actual Daily Demand Days Supply Days Supply
Nanre City: Completioiu No of Completion No. of (ii KU Vol
Region Province the Facility Capacity of Damage and Repair Repair Start on the Repair Conspletion Repair (Based on (Volunse Ave. (\olunse Ave.
Msuucipaiit'v Operational Days Date Days (B) ETA
the Facility (in Secure Requirements Date Requirement (%) Start Date previous mouth Daily Daily
Date (C)
KL) Csntinous and in KLday( Demand) Dentand)
Supply of Fuel (A) (B/C) (C/B)

I. LIST OF OPERATIONAL FACILITY


A. List of Refinery
I I I I I I I I I I
B. List sf Import Terminal
I I I I I I I
C. List of Storage Depot
I I I I I I I I I I
D. List of LPGRefillinig Plant
I I I- I I 1 I 1
E. Litt of Liquid Fuel Retail Outlets
I 1 I I I I I I I I
F. List of LPG Dealer
I I I I I I I 1 I I I I
II. LIST OF NON-OPERATIONAL/ DAMAGED FACILITY
A. List of Refinery
1 1 I I I I I I I 1 I 1 1 I I 1
B. List uf Import Tenninal
I I I I I I I I I I I
C. List of Storage Depot
I I I I I I I I 1 I I I I I I I I I
D. List of LPG Refilling Plant
I I 1 I I I I I T I I I I I I I I
E. List of Liquid Fuel Retail Outlets
I I I I I I I I I I I I I
F List of LPG Dealer
I I I I I I I I I I
iosr a a.i necessary

Reminderflnscructioii:

I. Please provide NA for fields not applicable

Page t of I
Department of Energy Annex SR-C'
Oil IndustTy Management Bureau (01MB) JulY 2021

IMPORTER, REFINER, BULK DISTRIBUTOR, TERMINAL OPERATORJLESSOR, BUNKER TRADER, HAULER OR OWN USER

OiL SPILL NOTIFICATION REPORT

Company Name I Address: Contact Details (email and tel li): Reporting Date:

Prepared By Approved By: Deadline of Submission

(Posmon and Signature over Printed Name) (Position and Signature over Printed Name Within twelve hours (12) from occurrence or discoven- of the spill.
PARTICULARS OF THE AFFECTED FACILITY (accomplish one report per affected facilitt)
Facility Name:
Address'Location: Longitude:
Name of health & safety officer: Latitude:
Contact Details of health & safety officer: Dale and Time of spill:
Location of the incident (Describe Details Below):

Initial assessment of possible source and cause of the Spill (Describe DetaiLs Below)

Type of fuel spilled and estonated quantity (Describe Details Below):

Initial assessment affected facilities, areas, damages, and human injuries (Describe Details Below):

Initial mitigating and containment measures implemented IDescribe Details Below):

Initial evacuation measures implemented IDescribe Details Below):

Spill Containment Response Contxactor and other Assisting Parties front both private and Government (Describe Details Below):

Page 1 of I
Department of Energy Annex SR-Cl
Oil Industry Management Bureau (01MB) July 2021

IMPORTER, REFINER, BULK DISTRIBUTOR. TERMINAL OPERATOR/LESSOR. BUNKER TRADER, HAULER OR OWN USER

WEEKLY OIL SPILL PROGRESS REPORT

Company Name / Address: Contact Details (email and tel #): Reporting Date:

Prepared By Approved By Deadline of Submission:

(Position and Signature over Printed Name) (Position and Signature over Printed Name) On or before the end of every Friday
L REBABILITATION/ REPAIR OF NON-OPERAI1ONAL/ DAMAGED FACILITY
LOCATION Repair Plan of the Facility Actual Rçsslr Implementation Weekly Inventory Status for Operational Storage capacity
Contingency
Finished On hand/In-country Replenishment
Non- Measures Being
CityI Municipality

Product Ave.
Operational Implemented to
Affected Part Description Target Progress Daily Demand Number of Number of
Storage Contain the Description of Planned Rat of Actual
Region

Name of the of Calamity! Completion! No. of Report on Completion No. of (Based on Days Supply' Days Supply
Capacity of Damage and Repair Repair Completion (1(J) Vol
Facility Emergency Operational Days the Repair Date Days previous (Volume! (Volume!
the Facility Secure Requirements Start Date (%) Date ETA Vessel
Date Rent month and in Ave. Daily Ave. Daily
(1(L) Continous
KlJday) renianii fl.mand)
Supply of Fuel
(A) (B/C) (C/B)
A. List of Refln7
- - -
B. List of Import Terminal
I I _I_ I I _I I I I I I I I I I _l I I
C. List of Storage Depot
I I I I I I I I _I_ I I I I.
D. List of LPG Refilling Plant
I I I I I I I I I I I I
E. List of Liquid Fuel Retail Outlets
I I I I I I I I I I _I I I
F. List of Vessel
I I I I I I I I _I I I I I I I I I I
G. List of Transport Vehicle
I I I I I I .1 1 I I I _I_ I_ I I
•adci mw/s as necessary
II. REHABILiTATION! REPAIR OF DAMAGE TO PROPERTY OR ENVIRONMENT

Contingency Measures Description of Target Progress


timm Cost Estimated Cost of Rate of Actual
Affected Property) City / Owner of Description Being Implemented To Rehabilitation! Repair Planned Rehabilitation! Completion Report on . Actual Rehabilitation! No. of
of Damage No. of Days Rehabilitation! Repair Completion Completion
Environment F Municipality Property of Damage Contain the Spill and Requirements for each Repair Start Date /Operasional the Repair Repair Start Date Days
0 a ) (%) Date
De Co cyMen Date Reqt

add mw/s as necessary

Page 1 of I

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