Bunker Permit

Bunkering without a permit, including refuelling activities in Port Limits is prohibited. This permit is for the purpose of obtaining permission prior to conducting bunkering, inclusive of fixed cabinet bowsers.

This application is to be completed by, or on behalf of the person conducting bunkering operations. *Mandatory fields.

APPLICANT DETAILS

Name of Permit Applicant
(person undertaking work onsite)

Alternative / back-up / emergency company representative contact
(if different to permit applicant)

DESCRIPTION OF LOCATION AND ACTIVITY

Is A less than B?(Required)
NB: Minimum ullage 2% tanks not pressed up

PORT INDUCTION DETAILS

(if using bowser)

DD slash MM slash YYYY

BUNKERING PERMIT DATES

Permit requested for
(to be filled out by permit applicant)

DD slash MM slash YYYY
Start Time(Required)
:
DD slash MM slash YYYY
End Time(Required)
:

SECTION 4 – PERMIT CONDITIONS

Permit Applicant to tick agree or not agree to the following

A JHA/procedure has been prepared and is available for the works.(Required)
The area where bunkering is occurring will be assessed for potential hazards. All sources of ignition are clear of the 8m isolation zone around the discharge point. Intrinsically safe electrical equipment only within this zone. (No ULP, Jet A1 bunkering at Berth 1 and 2 unless the inner Berth is blocked off).(Required)
The area will be barricaded and warning signs displayed.(Required)
The person(s) conducting the bunkering is inducted on the bowser? (if being used)(Required)
The person conducting the bunkering is competent, suitably trained (inducted) and is accompanied by valid certification and Safety Data Sheet of the bunkered product (DG Licence required for Class 3 products).(Required)
The required PPE has been identified and will be worn by all persons involved in the activity.(Required)
A spill kit and firefighting equipment is on standby at all times?(Required)
The equipment you are using is fit for purpose, meets the Australian Standards and is accompanied by valid test certificates?(Required)

APPLICANT STATEMENT OF ACKNOWLEDGEMENT

I acknowledge the requirements of the Kimberley Ports Authority to identify and control risks and work in a safe manner at all times.
I confirm the company I represent or that is undertaking the work:

  1. have safe systems of work in place;
  2. use equipment that is certified (when required) and fit for purpose;
  3. be competent in the type of work being undertaken; and
  4. hold all required permits and licences.
Signature(Required)
Clear Signature
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Bunker Permit

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