Petrol Station Operators - required information

To assist a smooth implementation of the new requirement for petrol stations to hold an EPA licence from January 2020, the EPA requests you complete the following information by no later than 30 June 2019.

(The information collected on this form will only be used by the EPA for the purpose of future communication with regard to the licensing of petrol stations)

Thank you for taking the time to complete this questionnaire.

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* 1. Please enter the full name of the applicant to hold the licence.

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* 2. Please provide the name and email address of a preferred contact person for future correspondence

Name

Email address

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* 3. Please enter your ABN/ACN number

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* 4. Please enter your Certificate of Title number(s)

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* 5. Please enter your street address

Unit / Street No:

Street Name:

Suburb/Town:

State:

Postcode:

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* 6. Is this your postal address? If not, please provide your postal address below?

As above

Postal Address

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* 7. Is your estimated amount of fuel turnover per annum LESS than 1ML (1 Megalitre)?

Yes (less than 1ML pa)

No (more than 1ML pa)

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* 8. Do you have any comments on the draft licence conditions provided?

Thank you for your feedback. The information you provide will help inform the design and implementation of the licensing process.