FOR OFFICE USE ONLY
L.P. Gas Plant Licence
Application
Inv. No.
Amount
Plant Licence No.
Service NL
File No.
Part 1 (Please print clearly)
Company Name
Mailing Address
City/Town
Telephone Number
Postal Code
(
)
Plant Location (Civic Number and Street)
Part 2
Application is made to the Government Service Centre for Plant Licensing under Section 66 of the Boiler, Pressure
Vessel and Compressed Gas Regulations, 1996, as follows (indicate by marking one box only).
Class A
Class B
Class C
Plant’s propane storage capacity (in litres)
Part 3
It is understood as per Section 69 of the Boiler, Pressure Vessel and Compressed Gas Regulations, 1996, Plant
Certification is subject to approval of a program* for the purpose of training employees.
I hereby certify that this training program is fully implemented.
Signed:
Date:
Name (Please Print):
NOTE: *
Position:
FOR CLASS “A” AND “B”
Details of this training program are submitted to this department for review and approval
prior to a licence being issued.
FOR CLASS “C”
Must submit a signed training agreement which includes name of training provider,
certification obtained (i.e. PTI 100-01) and provisions for re-certification.
Return completed form to:
Engineering and Inspection Services Division
Government Service Centre
Department of Government Services
P. O. Box 8700
St. John’s, NL A1B 4J6
09 75_04-2014
(Senior Plant Official)