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Road Traffic (Carriage of Dangerous Substances in Road Tankers and Tank Containers) Regulations (Northern Ireland) 1992

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PART VFORM OF CERTIFICATE FOR DRIVER-CONTROLLED DELIVERIES

Road Traffic (Carriage of Dangerous Substances in Road Tankers and Tank Containers) Regulations (Northern Ireland) 1992 (“the Regulations”)Driver-controlled deliveries in accordance with Part III of Schedule 4 to the Regulations

PART A
First ColumnSecond ColumnThird ColumnFourth ColumnFifth ColumnSixth ColumnSeventh Column

Note: The licensee or some other competent person acting on his behalf must enter, in the first column, the address of the licensed premises concerned;; in the second column, the licensee’s name; in the third column, the relevant storage tank number, letter or number and letter; in the fourth and fifth columns, the quantity and grade respectively of petrol to be delivered; in the sixth column, his signature; and, in the seventh column, the correct date and time. This Part must be completed before delivery into the tank commences. The sixth column may only be completed after the person concerned has measured the ullage space in the tank.

Address of licensed premisesName of licenseeStorage tank number, letter or number and letterQuantity of petrol to be deliveredGrade of petrol to be deliveredSignature of licensee or competent person (to certify that in accordance with 3 paragraph 21(a) of Schedule 4 to the Regulations he has visually checked the ullage space in the storage tank)Date and time of completion of this Part of the Certificate
PART B
First ColumnSecond ColumnThird Column

Note: in this Part, the driver must enter, in the first column, the relevant storage tank number, letter or number and letter; in the second column, the number of each compartment of any carrying tank from which the petrol is to be delivered; and, in the third column, his signature. This Part must be completed after Part A has been completed by the licensee or by a competent person acting on his behalf, but before delivery into the tank commences.

Storage tank number, letter or number and letterRoad tanker carrying tank compartment numbersSignature of driver

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