Provide the following information. Each numbered item below should be copied and appear at the top of a page with your information below.
| 1. | Existing licence number and date of commencement of licence; |
| 2. | Application for revocation of the licence in terms of section 24 of the Act and rule 13 of these rules; |
| 3. | If the facility is not licensed, a technical description of the loading facility to be converted, including: |
| (b) | the number of loading points; |
| (c) | type of each loading point (e.g. loading arms or flexible hose); |
| (d) | details of the auxiliary pipeline/s including: |
| (iii) | storage facility connected to the pipeline; and |
| (iv) | receipts and delivery points. |
| 4. | Maps and diagrams where appropriate. |
| 5. | Details of capacities at the various stages of development, planned and potential receipt and delivery points. |
| 6. | The rate at which petroleum can be conveyed through the loading facility and the time necessary for ships to be brought into position for loading, and the dimensions and capacities of any auxiliary pipelines connected thereto. Please submit a copy of the agreement or authorisation from the National Ports Authority. |
| 7. | A full description of the intended conversion and the reasons therefor; and |
| 8. | The impact of the conversion on users of the loading facility and measures taken to ensure continued provision of service. |
