a
Trading Standards Service
Application for a Petroleum Storage Certificate
(in accordance with the Petroleum (Consolidation) Regulations 2014)
QD153
We shall use this information to process your application for a Petroleum Storage Licence. The data collected is in accordance with current data
protection legislation, and will be used only for the purpose outlined in this form. For further information on how this data will be processed
please see the Fair Processing Notice on our website at www.leicestershire.gov.uk/about-the-council/data-protection
QD153-Petroleum Storage Certificate Application Form.docx Page 1 of 2 V1-30/01/19
Please note: To maintain the integrity of the data, we request returned electronic versions of this form to be
submitted as a PDF document
Please provide the following information.
1. The application is for:
[tick the box that applies]
New Storage Certificate Renewal Storage Certificate
2. Enter Site Address
[including Postcode]
3. Enter Date you want the certificate to come into force
4. Tank Information [N.B. Please provide all details of all fuel storage tanks].
Tanks in which the Petroleum Enforcing Authority is required to permit petroleum to be stored:
Tank
Compartment
(Split compartment tanks)
Maximum Working
Capacity
Fuel Currently Stored
QD153-Petroleum Storage Certificate Application Form.docx Page 2 of 2 V1-30/01/19
5. Fees: please specify the initial period for which you intend to pay the fee (annual periods only)
Please note: Paying for more than one year now will reduce the administrative burden on your business
and enable you to purchase at the current year's fee rate. The Regulations are subject to review, however,
and the inclusion of fees could be changed.
Please indicate the number of years for which you would like to pay the fee in the table below: [tick years required]
1 Year 2 Years 3 Years 4 Years 5 Years
6 Years 7 Years 8 Years 9 Years 10 Years
6. Keeper of Petroleum details
Name of Keeper
Registered Address
[if limited company]
Main Contact Name
Telephone Mobile No
Email Address
7. Acknowledgement
Please advise if the PEA may correspond with you electronically [tick one box] Yes No
8. Please provide any additional information you consider relevant below:-
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