The inspecting authority on inspection of the premises, shall communicate to the licence holder and licensing authority in writing, his observations, discrepancies or the violations, if any, of the rules or contravention of conditions of the licence; and a copy of the inspection report shall be endorsed to the licensing authority for taking further necessary action.
49[Form A-1
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(See Part-1 of Schedule II, rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012) APPLICATION FOR APPROVAL OR GRANT OR AMENDMENT OF LICENCE TO MANUFACTURE AND POSSESS FOR SALE OR CONVERT MELT TO SOLID AND VICE VERSA AND POSSESS FOR SALE OF AMMONIUM NITRATE |
Please affix a recent passport size colour photograph of occupier with signature in front |
| |
|
Purpose (tick any one): Approval Grant Amendment
1. Type of applicant (tick any one):Individual Company
Partnership Firm Proprietary Firm Society
2. Applicant's detail:
(a) Name in which licence is sought (see note below) ---------------------------------------
(b) CIN No/Firm registration No (in case of company/Firm) -------------------------------
(c) Age in case of individual Aadhaar No ------------------------------------------------------
(d) Postal address ---------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- City -------------- District ----------------- State ------------------ PIN Code ------------- Phone No with STD code ------------------ Mobile No ---------- E-mail ----------------
3. Address of the proposed premises:
Survey No/Gat No/Khasra No ------------------------------- Town/Village ----------------
Manda1/Taluk/Tehsil --------------------------- Railway Station -----------------------------
Police Station ------------------------------------- District --------------------------------------
State ------------------------------------------------- PIN Code-----------------------------------
4. Qualification and experience of applicant and technical personnel employed by him.
(Give individual's details and attach separate sheet if required)
--------------------------------------------------------------------------------------------------------
5. Details of industrial licence (attach copy): ----------------------------------------------------
6. Details of Ammonium Nitrate proposed to be (1) Manufactured Converted
| Quantity proposed to be manufactured/converted per day (in MT) |
Quantity proposed to be manufactured/converted per annum (in MT) |
Approved annual capacity as per Industrial Licence (in MT) |
Proposed capacity of attached storehouse for possession and sale (in MT) |
| |
|
|
|
| |
|
|
|
7. Details of amendment proposed or additional information ------------------------------------- ---------- ---------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------
8. (a) Particulars of the other licences under Explosives Act, 1884, if any held by the applicant during the last ten years --------------------------------------------------------------------------------------------------
(b) Was any licence cancelled or not renewed? Yes No
If yes, give details -----------------------------------------------------------------------------------------
9. (a) Has the applicant been convicted under any offence or ordered to execute bond under
Chapter VIII of Code of Criminal Procedure, 1973, during the last ten yearsYes No
(b) If yes, give details --------------------------------------------------------------------------
10. Fee details --------------------------------------------------------------------------------------------------
11. List of documents attached:
I hereby certify that the above particulars given by me are correct.
| Date: -------------------------- |
Signature of applicant in the box above |
| Place: ------------------------- |
Full name ---------------------------------- |
| |
(Authorised person in case of company) |
Notes: Please see the rules for the purpose and documents to be attached.
(1) In case where application is made by a person other than individual, the name and address of the occupier as per Rule 2 and directors or partners or members, as the case may be and specimen signatures of authorised person to be attached.
(2) Six copies of the passport size signed colour photographs of the occupier to be attached.
(3) Any change in the above information should be immediately communicated to the licensing authority or authority renewing the licence.
Statutory Warning: Mishandling and misuse of Ammonium Nitrate shall constitute serious criminal offence under the applicable law.
Form A-2
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(See Part-1 of Schedule II, rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012) APPLICATION FOR APPROVAL OR GRANT OR AMENDMENT OF LICENCE TO STEVEDORE, BAG AND STORE AMMONIUM NITRATE |
Please affix a recent passport size colour photograph of occupier with signature in front |
Purpose (tick any one): Approval Grant Amendment
1. Type of applicant (tick any one):Individual Company
Partnership Firm Society Proprietary Firm
2. Applicant's details:
(a) Name in which licence is sought (see note below) -----------------------------------------
(b) CIN No/Firm registration No. (in case of company/Firm) ---------------------------------
(c) Age in case of individual ----------------------------- Aadhaar No.---------------------------
(d) Postal address -------------------------------------------------------------------------------------------- City ------------------ District ----------------- State ------------- PIN Code ----------------- Phone No with STD code -------------------- Mobile --------------- No E-mail -------------
3. Address of the proposed premises:
Survey No/Gat No/Khasra No -------------------------------------- Town/Village ---------------------
Manda1/Taluk/Tehsil ------------------------------------------ Railway Station -------------------------
Police Station --------------------------------------------- District -----------------------------------------
State ------------------------------------------------------- PIN Code ----------------------------------------
4. Details of the registration of stevedore with port authority: -----------------------------------------------
-------------------------------------------------------------------------------
5. Qualification and experience of applicant and technical personnel employed by him. (Give individual's details and attach separate sheet if required)
----------------------------------------------------------------------------------------------------------
6. Details of Ammonium Nitrate proposed to be bagged:
| Quantity proposed to be bagged per day (in MT) |
Annual installed capacity (in MT) |
Proposed bulk storage capacity for possession (in MT) |
Proposed capacity of attached storehouse(s) for storage of bagged Ammonium Nitrate (in MT) |
| |
|
|
|
| |
|
|
|
7. Details of amendment proposed or additional information -------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------
8. (a) Particulars of the other licences under Explosives Act, 1884, if any held by the applicant during the last ten years. ------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------
(b) Was any licence cancelled or not renewed?Yes No
If yes, give details ------------------------------------------------------------------------------
9. (a) Has the applicant been convicted under any offence or ordered to execute bond under
Chapter VIII of Code of Criminal Procedure, 1973, during the last ten years Yes No
(b) If yes, give details -----------------------------------------------------------------------------------
10. Fee details -----------------------------------------------------------------------------------------------
11. List of documents attached:
I hereby certify that the above particulars given by me are correct.
| Date: -------------------------- |
Signature of applicant in the box above |
| Place: ------------------------- |
Full name ---------------------------------- |
| |
(Authorised person in case of company) |
Notes: Please see the rules for the purpose and documents to be attached.
(1) In case where application is made by a person other than individual, the name and address of the occupier as per Rule 2 and directors or partners or members, as the case may be and specimen signatures of authorised person to be attached.
(2) Six copies of the passport size signed colour photographs of the occupier to be attached.
(3) Any change in the above information should be immediately communicated to the licensing authority and authority renewing the licence.
Statutory Warning: Mishandling and misuse of Ammonium Nitrate shall constitute serious criminal offence under the applicable law.
Form A-3
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(See Part-1 of Schedule II, rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012) APPLICATION FOR APPROVAL OR GRANT OR AMENDMENT OF LICENCE FOR POSSESSION AND SALE OR USE OF AMMONIUM NITRATE |
Please affix a recent passport size colour photograph of occupier with signature in front |
| Purpose (tick any one): Approval Grant Amendment |
1. Licence sought for (tick any one):
(a) Licence to possess for sale of Ammonium Nitrate from a store house or a tank not exceeding 30 MT; or
(b) Licence to possess for sale of Ammonium Nitrate from a store house or a tank exceeding 30 MT; or
(c) Licence to possess for use of Ammonium Nitrate from a store house or a tank attached to explosives/ANFO/Nitrous Oxide manufacturing unit; or
(d) Licence to possess for use of Ammonium Nitrate for agriculture purpose from a store house not exceeding 3 MT.
2. Type of applicant (tick any one): Individual Company Partnership Firm
Society Proprietary Firm
3. Applicant's detail:
(a) Name in which licence is sought (see note below) -----------------------------------------
(b) CIN No/Firm registration No (in case of Company/Firm ---------------------------------
(c) Age in case of individual -----------------------Aadhaar No --------------------------------
(d) Postal address ----------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------- City ------------------- District ----------------- State --------------- PIN Code ------------ Phone No with STD code ------------------- Mobile No --------------E-mail --------------
4. Address of the proposed premises:
Survey No/Gat No/Khasra No ------------------------------- Town/Village ------------------
Manda1/Taluk/Tehsil -------------------------------------- Railway Station --------------------
Police Station ------------------------------------ District ------------------------------------------
State ----------------------------------- PIN Code ----------------------------
5. Qualification and experience of applicant and technical personnel employed by him. (Give individual's details and attach separate sheet if required)
----------------------------------------------------------------------------------------------------------------
6. Quantity of Ammonium Nitrate proposed to be possessed at any one time:--------------- MT.
7. Quantity of Ammonium Nitrate proposed to be sold in a day: ------------------------------ MT.
8. Quantity of Ammonium Nitrate proposed to be sold in a month: --------------------------- MT.
9. Quantity of Ammonium Nitrate proposed to be used in a day: ------------------------------ MT.
10. Quantity of Ammonium Nitrate proposed to be used in a month: -------------------------- MT.
11. Are the premises attached to the factory licenced to manufacture of explosives/nitrous oxide: Yes No
12. Details of amendment proposed or additional information ------------------------------------------ ------------------------------------------------------------------------------------------------------------------ -----------------------------------------------------
13(a). Particulars of the other licences under Explosives Act, 1884, if any held by the applicant during the last ten years.
-----------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------
(b). Was any licence cancelled or not renewed? Yes No
If yes give details -------------------------------------------------------------------------
14. (a) Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973, during the last ten years? Yes No
(b) If yes, give details ----------------------------------------------------------------------
15. Fee details: ----------------------------------------------------------------------
16. List of documents attached:
I hereby certify that the above particulars given by me are correct.
| Date: -------------------------- |
Signature of the applicant in the box above |
| Place: ------------------------- |
Full name ---------------------------------- |
| |
(Authorised person in case of company) |
Notes: Please see the rules for the purpose and documents to be attached.
(1) In case where application is made by a person other than individual, the name and address of the occupier as per Rule 2 and directors or partners or members, as the case may be and specimen signatures of authorised person to be attached.
(2) Six copies of the passport size signed colour photographs of the occupier to be attached.
(3) Any change in the above information should be immediately communicated to the licensing authority and authority renewing the licence.
Statutory Warning: Mishandling and misuse of Ammonium Nitrate shall constitute serious criminal offence under the applicable law.
Form A-4
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(See Part-1 of Schedule II, rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012) APPLICATION FOR GRANT OR AMENDMENT TO TRANSPORT AMMONIUM NITRATE |
Please affix a recent passport size colour photograph of occupier with signature in front |
| Purpose (tick any one): Grant Amendment |
| 1. Type of applicant (tick any one): Individual Company Partnership Firm |
| Society Proprietary Firm |
2. Applicant's details:
(a) Name in which licence is required to be granted (see note below) -----------------------------------
(b) Status (Please tick): Individual Company Partnership Firm Society Proprietorship Firm
(c) CIN No/Firm registration No (in case of company/Firm) --------------------------------------------
(d) Age (in case of individual) --------------------------- Aadhaar No ------------------------------------
(e) Postal address:---------------------------------------------------------------------------------------------- City ----------------------- District ----------------- State ----------------- PIN Code -------------------
(f) Phone no with STD code -------------------- Mobile No ---------------- E-mail ---------------------
3. Qualification and experience of applicant:----------------------------------------------------------------
4. Particulars of places from where and to Ammonium Nitrate to be transported:
(a) Manufacturing factory situated at --------------------------------------------------------- to all India.
(b) Port name ----------------------- to the premises of Stevedore situated at ----------------------------
(c) Port name ------------------------ to the storehouse situated at ------------------------------------------
(d) Stevedore's premises at -------------------------------------------------------------------to storehouses.
(e) Store house situated at -------------------------------------------------- to all India
(f) Store house situated at within/to the state/ Districts of
5. Particulars of licences held by the applicant under Explosives Act, 1884:
(a) Ammonium Nitrate manufacturing Licence no (if applicable) ---------------------------------------
(b) Srevedore's Licence no (if applicable):------------------------------------------------------------------
(c) Licence no of storehouse:
(i) Possession & sale ------------------------------- (ii) Possession & use ------------------------------
6. Mode of transport:-----------------------------------------------------------------------------------------
7. (a) Has the applicant held other licences under Explosives Act, 1884 in the last ten years? (Y/N)
(b) Has any licence held by applicant been cancelled or not renewed in the last ten years? (Y/N)
(c) Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973, during the last ten years. Yes No
If answer is yes to any of the question above, give details ------------------------------------------
8. Fee details -------------------------------------------------------------------------------------------
9. List of documents attached:
I hereby certify that the above particulars given by me are correct.
| Date: -------------------------- |
Signature of applicant in the box above |
| Place: ------------------------- |
Full name ---------------------------------- |
| |
(Authorised person in case of company) |
Notes: Please see the rules for the purpose and documents to be attached.
(1) In case where application is made by a person other than individual, the name and address of the occupier as per Rule 2 and directors or partners or members, as the case may be and specimen signatures of authorised person to be attached.
(2) Six copies of the passport size signed colour photographs of the occupier to be attached.
(3) Any change in the above information should be immediately communicated to the licensing authority and authority renewing the licence.
(4) Copy of licence held in Form P-1, P-2, P-3 or P-5 of Ammonium Nitrate Rules, 2012
Statutory Warning: Mishandling and misuse of Ammonium Nitrate shall constitute serious criminal offence under the applicable law.
| |
Form A-5 (See Part-1 of Schedule II, rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012) APPLICATION FOR GRANT OF LICENCE TO IMPORT AMMONIUM NITRATE OR EXPORT AMMONIUM NITRATE |
Please affix a recent passport size colour photograph of occupier with signature in front |
| Purpose (tick any one): IMPORT EXPORT |
| 1. Type of applicant (tick any one): Individual Company Partnership Firm |
Society Proprietary Firm
2. Applicant's details:
(a) Name in which licence is sought (see note below) -----------------------------------------
(b) CIN No/Firm registration No. (in case of Company/Firm) --------------------------------
(c) Age in case of individual Aadhaar No ----------------------------------------------------
(d) Postal address --------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------
City ------------- District -------------------- State PIN -------------- Code ------------
Phone No with STD code ------------- Mobile No --------------- E-mail --------------
3. In case of import:
a) Quantity of Ammonium Nitrate proposed to be imported: ....
b) UN No. of Ammonium Nitrate proposed to be imported: .
c) Bagging pattern of Ammonium Nitrate to be imported: . .
d) Name and address of Consignor: .
e) Name and address of the manufacturer of Ammonium Nitrate to be imported:
f) Name and address of Trading Agent, if any:
g) Country of foreign sea port or place of loading: h) Indian Port or place of import:
i) Imported consignment received directly by the importer or through the stevedoring agent:
j) If received through stevedoring agent, particulars of his name address and licence Nos:
.
k) License particulars of the importers storehouse(s), where Ammonium Nitrate will be stored after import, either directly received by the importer or through the stevedoring agent:
4. In case of export:
a) Quantity of Ammonium Nitrate to be exported: ..
b) UN No. of Ammonium Nitrate to be exported : .
c) Bagging pattern of Ammonium Nitrate to be exported: . .
d) Name and address of consignee: ..
e) Name and address of the manufacturer of Ammonium Nitrate to be exported:
f) Country to where Ammonium Nitrate is exported: ..
g) Indian Place or port from which Ammonium Nitrate will be exported:
h) Likely date of dispatch of Ammonium Nitrate export consignment:
5. (a) Particulars of the other licences under Explosives Act, 1884, if any held by the applicant during the last ten years.----------------------------------------------------------------
(b) Was any licence cancelled or not renewed? Yes No
If yes give details:---------------------------------------------------------------------------------
6. (a) Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973, during the last ten years Yes No
(b) If yes, give details ----------------------------------------------------------------------
7. Fee details ------------------------------------------------------------------------------
8. List of documents attached:
I hereby certify that the above particulars given by me are correct.
| Date: -------------------------- |
Signature of applicant in the box above |
| Place: ------------------------- |
Full name ---------------------------------- |
| |
(Authorised person in case of company) |
Notes: Please see the rules for the purpose and documents to be attached.
(1) In case where application is made by a person other than individual, the name and address of the occupier as per Rule 2 and directors or partners or members, as the case may be and specimen signatures of authorised person to be attached.
(2) Six copies of the passport size signed colour photographs of the occupier to be attached.
(3) Any change in the above information should be immediately communicated to the licensing authority and authority renewing the licence.
Statutory Warning: Mishandling and misuse of ammonium nitrate shall constitute serious criminal offence under the applicable law.]
Form A-2
(See Part-1 of Schedule II and Rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012)
Application for licence to stevedore, bag and store Ammonium Nitrate
I, . . . . . . . . . . . . . . . . . . . . . . . . . . . on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . . . .apply for approval or grant or amendment of licence for the following purpose.
Purpose: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. I require licence in the following name and postal address:
| (a) |
Name in which licence is required to be granted (see notes below) . . . . . . . . . . . . . . . |
| (b) |
Status . . . . . . . . . . . . . . . |
| (c) |
Age . . . . . . . . . . . . . . . . . |
| (d) |
Postal address: |
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .City . . . . . . . . . . .District . . . . . . . . . . . . . . . . . . . . . . . . . . . State . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . . .Police Station . . . . . . . . . . . . . .Railway Station or Steamer Ghat . . . . . . . . . Phone . . . . . . . . . . . . . . . . . . . . . . . E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
2. The proposed bagging premises is situated at the following address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Survey number . . . . . . . . . . . . . . .City . . . . . . . . . . . District . . . . . . . . . . . . . State . . . . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . . . Police Station . . . . . . . . . . . . . . . . . . . . . Railway Station . . . . . . . . . . . . Port of import . . . . . . . . . . . . . Phone . . . . . . . . . . . . . . . . . E-mail . . . . . . . . . . . . Fax . . . . . . . . . . . . . . .
3. Details of the registration of Stevedoring agent by Port Authority . . . . . . . . . . . . . . . . . . . . . . . . .
4. Qualifications and experience of applicant and the technical personnel employed by him . . . . . . . . . . . . . . . . . . . . . . .
5. Bagging capacity of Ammonium . . . . . . . . . . . . . . . . . . .
| (a) |
Annual bagging capacity . . . . . . . . . . . . . . . . . . . |
| (b) |
Quantity of Ammonium Nitrate present at any one time in each bagging go down . . . . . . . . . . . . . . And attached storehouse (if any . . . . . . . . . . . . . . . .) |
| (c) |
Total Quantity of Ammonium Nitrate proposed to be stored at any one time both in bulk and bagged condition . . . . . . . . . . . . . . . . |
| (d) |
Details of amendment proposed or additional information, if any . . . . . . . . . . . . . . . . . . . . . |
6. Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) during the last 10 years. Yes . . . . . .No . . . . .
If yes, please give details . . . . . . . . . . . . . . . . . . . . .
| 7.(a) |
Particulars of other licences under Ammonium Nitrate Rules, 2012 if any held by the applicant during the last 10 years . . . . . . .: |
| (b) |
Was any licence cancelled or not renewed? . . . . . . . . . . .Yes . . . . . . . . . No . . . . . |
| (c) |
If yes, give details . . . . . . . . . . . . . . . . . . . |
8. Particulars of amendment proposed/Additional information if any . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I hereby certify that the above particulars given by me are correct.
| Date . . . . . . . . . . . . . . . . . |
Signature of applicant . . . . . . . . . . . . . . . (Authorised person in case of a Company) Full Name . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . |
Notes:
Please see the rule for the purpose and documents to be enclosed.
| (1) |
In case where application is made by a person other than an individual, the names and addresses of the occupier as per Rule 2 and directors or partners or members, as the case may be, and specimen signatures of authorised person to be attached. |
| (2) |
Passport size photographs of the occupier to be attached. |
| (3) |
Any change in the above information should be immediately communicated to the Chief Controller of Explosives, District Authority and authority renewing the licence. |
| (4) |
Age to be given in case the applicant is an individual. |
| (5) |
(a) Ammonium Nitrate storehouse shall maintain; |
| |
(i) for storage not exceeding 30 MT, Safety Distance of 4.5 metres from store house to the compound wall and 45 metres from any protected works; |
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(ii) for storage exceeding 30 MT, Safety Distance of 9 metres from store house to the compound wall and 90 metres from any protected works; |
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law.
Form A-3
(See Part-1 of Schedule II and Rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012)
Application for grant/amendment of:
| (a) |
Licence to possess for sale or use of Ammonium Nitrate from a store house not exceeding 30 MT; or |
| (b) |
Licence to possess for sale or use of Ammonium Nitrate from a store house exceeding 30 MT; or |
| (c) |
Licence to possess for use of Ammonium Nitrate from a store house attached to explosives manufacturing/Nitrous Oxide manufacturing unit; or |
| (d) |
Licence to possess for use Ammonium Nitrate for agricultural purpose from a storehouse. |
I, . . . . . . . . . . . . . . . . . . . . . . . . . .. on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . . . .apply for approval or grant or amendment of licence for the following purpose.
1. Purpose: . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
2. I require licence in the following name and postal address:
| (a) |
Name in which licence is required to be granted (see notes below) . . . . . . . . . . . . . . . |
| (b) |
Status . . . . . . . . . . . . . . . |
| (c) |
Age . . . . . . . . . . . . . . . |
| (d) |
Postal address: |
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .City . . . . . . . . . . .District . . . . . . . . . . . . . . . . . . . . . . . . . . .. State . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . . ..Police Station . . . . . . . . . . . . . ..Railway Station or Steamer Ghat . . . . . . . . . Phone . . . . . . . . . . . . . . . . . . . . . . . E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
3. The proposed premises are situated at the following address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Survey number . . . . . . . . . . . . . . . . . . City . . . . . . . . . . . . .District . . . . . . . . . . .. State . . . . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . .. Police Station . . . . . . . . . . . . . . . . . .Railway or Steamer Ghat . . . . . . . . . . . . .. Phone . . . . . . . . . . . . . . . . . E-mail . . . . . . . . . . . .. Fax . . . . . . . . . . . . . . .
4. Qualifications and experience of applicant and the technical personnel employed by him . . . . . . . . . . . . . . . ..
5. Ammonium Nitrate proposed to be possessed and sold:*
| (i) |
Quantity of Ammonium Nitrate proposed to be possessed at any one time . . . . . . . . . . . . . . . . . . . |
| (ii) |
Quantity of Ammonium Nitrate proposed to be sold in one month . . . . . . . . . . . . . .. |
6. (a) Ammonium Nitrate proposed to be possessed and used*
| (i) |
State the purpose of Ammonium Nitrate usage . . . . . . . . . . . . . . . . |
| (ii) |
Quantity of Ammonium Nitrate proposed to be used per day . . . . . . . . . . . . . . . |
| (iii) |
Quantity of Ammonium Nitrate proposed to be used in one month . . . . . . . . . . . . . . . |
| (iv) |
Quantity of Ammonium Nitrate proposed to be possessed for use at any one time . . . . . . . . . . . . . . . |
| (b) Details of site and distance of site where the AN will be used from the storage premises mentioned in Item 3 . . . . . . . . . . . . . . . .. |
7. Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) during the last 10 years. Yes . . . . . . No . . . . ..
If yes, please give details . . . . . . . . . . . . . . . .
| 8.(a) |
Particulars of other licences under Ammonium Nitrate Rules, 2012 if any held by the applicant during the last 10 years. . . . . . . . . . . . . . . . . . . . .. |
| (b) |
Particulars of licence/s under Explosives Rules, 2008, if any held by the applicant during the last 10 years . . . . . . . . . . . . . . . . . . . |
| (c) |
Was any licence cancelled or not renewed? Yes . . . . . . . . .. No . . . . . |
| (d) |
If yes, give details . . . . . . . . . . . . . . . . . . . |
9. Particulars of amendment proposed/Additional information if any . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I hereby certify that the above particulars given by me are correct.
| Date . . . . . . . . . . . . . . . . .. |
Signature of applicant . . . . . . . . . . . . . . .. (Authorised person in case of a Company) Full Name . . . . . . . . . . . . . . . . .. Address . . . . . . . . . . . . . . . . . . .. |
*strikeout inapplicable portion
Notes:
Please see the rule for the purpose and documents to be enclosed
| (1) |
In case where application is made by a person other than an individual, the names and addresses of the occupier as per Rule 2 and directors or partners or members, as the case may be, and specimen signatures of authorised person to be attached. |
| (2) |
Passport size photographs of the occupier to be attached. |
| (3) |
Any change in the above information should be immediately communicated to the Licence Issuing authority and authority renewing the licence. |
| (4) |
Age to be given in case the applicant is an individual. |
| (5) |
(a) Ammonium Nitrate storehouse shall maintain; |
| |
(i) for storage not exceeding 30 MT, Safety Distance of 4.5 metres from store house to the compound wall and 45 metres from any protected works; |
| |
(ii) for storage exceeding 30 MT, Safety Distance of 9 metres from store house to the compound wall and 90 metres from any protected works; |
| |
(b) the storehouse may be adjacent to the explosives/nitrous oxide manufacturing plants, but shall observe the provisions of Clause 4(a)(i) and (ii) of Rule 12. |
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law.
Form A-4
(See Part-1 of Schedule II and Rules 33, 35 and 37 of Ammonium Nitrate Rules, 2012)
Application for grant/amendment of licence to transport Ammonium Nitrate
I, . . . . . . . . . . . . . . . . . . . . . . . . . .. on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . ..apply for grant of a licence/amendment of licence No . . . . . .to transport Ammonium Nitrate. The particulars are given below and other documents are enclosed as required.
Replies to be given in this column
| (1) |
Name of the applicant (see notes below) |
. . . . . . . . . . . . . . . . . |
| (2) |
Applicant's postal address |
. . . . . . . . . . . . . . . . . |
| |
Pin Code No. |
. . . . . . . . . . . . . . . . . |
| |
Telephone No. |
. . . . . . . . . . . . . . . . . |
| |
Telex |
. . . . . . . . . . . . . . . . . |
| (3) |
Particulars of licence granted under Ammonium Nitrate Rules, 2012 held by the applicant from where the Ammonium Nitrate will be transported licence no |
. . . . . . . . . . . . . . . . . |
| |
Situation of premises |
. . . . . . . . . . . . . . . . . |
| |
Licensed capacity |
. . . . . . . . . . . . . . . . . |
| |
Date up to which the licence is valid |
. . . . . . . . . . . . . . . . . |
| 4. |
Particulars of place/s to which the Ammonium Nitrate will be transported |
. . . . . . . . . . . . . . . . . |
| 5. |
Mode of transport: |
. . . . . . . . . . . . . . . . . |
| 6. |
(a) Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) during the last 10 years. |
Yes . . . . . . No . . . . .. |
| |
(b) If yes, please give details |
. . . . . . . . . . . . . . . . . |
| 7. |
(a) Particulars of other licences under Explosives Act, 1884 if any held by the applicant during last 10 years. |
. . . . . . . . . . . . . . . . . |
| |
(b) Was any licence cancelled/not renewed? |
. . . . . . . . . . . . . . . . . |
| |
(c) If yes, give details |
. . . . . . . . . . . . . . . . . |
| 8. |
Particulars of amendment proposed/Additional information if any |
. . . . . . . . . . . . . . . . . |
I hereby certify that the above particulars given by me are correct.
| Date . . . . . . . . . . . . . .. |
Signature of applicant . . . . . . . . . . . . . . .. |
| |
(Authorised person in case of a Company) |
| |
Full Name . . . . . . . . . . . . . . . . .. |
| |
Address . . . . . . . . . . . . . . . . . . .. |
Notes:
Please see the rule for the purpose and documents to be enclosed
| (1) |
In case where application is made by a person other than an individual, the names and addresses of the occupier as per Rule 2 and directors or partners or members, as the case may be, and specimen signatures of authorised person to be attached. |
| (2) |
Passport size photographs of the occupier to be attached. |
| (3) |
Any change in the above information should be immediately communicated to the licensing authority and authority renewing the licence. |
| (4) |
Age to be given in case the applicant is an individual. |
| (5) |
Copy of license form P-1, P-2, P3 or P-5 |
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law.
Form A-5
(See Part-1 of Schedule II and Rules 33 and 35 of Ammonium Nitrate Rules, 2012)
Application for grant of licence to
| (a) |
Import Ammonium Nitrate; or |
| (b) |
Export Ammonium Nitrate |
I, . . . . . . . . . . . . . . . . . . . . . . . . . .. on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . ..apply for grant of licence for the following purpose.
1. Purpose: Import or Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Name: I require licence in the following name and postal address:
| (a) |
Name in which licence is required to be granted (see notes below) . . . . . . . . . . . . . . . |
| (b) |
Status . . . . . . . . . . . . . . . |
| (c) |
Age . . . . . . . . . . . . . . . |
| (d) |
Postal address: |
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .City . . . . . . . . . . .District . . . . . . . . . . . . . . . . . . . . . . . . . . .. State . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . . ..Police Station . . . . . . . . . . . . . ..Railway Station or Steamer Ghat . . . . . . ..Phone . . . . . . . . ..E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
3.(a) (For Import)
| (i) |
Quantity of Ammonium Nitrate proposed to be imported at a time . . . . . . . . . . . . . . . |
| (ii) |
Name and address of the manufacturer and or country of importer of Ammonium Nitrate to be imported . . . . . . . . . . . . . . . . . |
| (iii) |
Particulars of the storehouse where Ammonium Nitrate will be stored after import: |
| (iv) |
Port or place of import . . . . . . . . . . . . . . . . . . . . . . . |
| (v) |
Whether import of Ammonium Nitrate is in bulk or bagged form . . . . . . . . . . . . . . . . . . |
| (vi) |
Particular of Stevedoring agent giving his name addressed and licence No . . . . . . . . . . . . . . .. |
| (b) (for Export) |
| (i) |
Quantity of Ammonium Nitrate to be exported . . . . . . . . . . . . . . . . .. |
| (ii) |
Name and address of consignee or country of Export . . . . . . . . . . . . . . . .. |
| (iii) |
Place or port from which Ammonium Nitrate will be exported . . . . . . . . . . . . . . . . . . . |
4. Has the applicant been convicted under any offence or ordered to execute bond under Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) during the last 10 years. Yes . . . . . . No . . . . ..
If yes, please give details . . . . . . . . . . . . . . . .
| 5.(a) |
Particulars of licences/under Explosives Act, 1884, if any held by . . . . . . . . . . . . . . . . .the applicant during the last 10 years. |
| (b) |
Was any licence cancelled or not renewed? Yes . . . . . . . . .. No . . . . . |
| (c) |
If yes, give details . . . . . . . . . . . . . . . . . . . |
| 6.(a) |
Has applicant imported or exported Ammonium Nitrate in the past Yes . . . . . . No . . . . . . . . |
| (b) |
If yes details thereof for last three years . . . . . . . . . . . . . . . . . . . |
7. Particulars of amendment proposed/Additional information if any . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I hereby certify that the above particulars given by me are correct.
| Date . . . . . . . . . . . . . . . . .. |
Signature of applicant . . . . . . . . . . . . . . .. (Authorised person in case of a Company) Full Name . . . . . . . . . . . . . . . . .. Address . . . . . . . . . . . . . . . . . . .. |
Notes:
Please see the rule for the purpose and documents to be enclosed
| (1) |
In case where application is made by a person other than an individual, the names and addresses of the occupier as per Rule 2 and directors or partners or members, as the case may be, and specimen signatures of authorised person to be attached. |
| (2) |
Passport size photographs of the occupier to be attached. |
| (3) |
Any change in the above information should be immediately communicated to the Licence Issuing authority and authority renewing the licence. |
| (4) |
Age to be given in case the applicant is an individual. |
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law.
CERTIFICATES
Form C-1
(See Rule 18(5) of Ammonium Nitrate Rules, 2012)
Declaration to be made by the master of a ship carrying Ammonium Nitrate before entering a port or by the ship's agent
| 1. |
Name of ship . . . . . . . . . . . . . . . . . |
| 2. |
Date of Arrival at . . . . . . . . . . . . . Port . . . . . . . . . . . . . . . . . . .. |
| Description of Ammonium Nitrate |
Date of manufacture, batch number and other distinguishing marks on Bags |
Total quantity carried Kilogramme or Bags |
Quantity to be landed at port Kilogramme or Bags |
Remarks |
| |
|
|
|
|
Place: . . . . . . . . . . . ..
Date: . . . . . . . . . . . ..
Signature of Master or Agent of Ship
50[Form C-2
Format of No Objection Certificate
(See Rule 34 of the Ammonium Nitrate Rules, 2012)
No Objection Certificate under the Ammonium Nitrate Rules, 2012
With reference to the application no dated . submitted by .. and in pursuance of Rule 34 of the Ammonium Nitrate Rules, 2012, there is no objection for granting licence under the Ammonium Nitrate Rules, 2012 to . of address . for the following purpose, kind and quantity of Ammonium Nitrate in the premises at Survey no. or Gat no or Khasra no , village . tehsil or taluka .., district ., state . as shown in the site plan duly endorsed and enclosed herewith.
1. Purpose:
(please mention any one of possession for sale or possession for use)
2. Quantity of Ammonium Nitrate:
(a) at any one time .
(b) in a month
(Signature of the no objection certificate issuing authority with his official seal) (District Magistrate or Director General of Mines Safety or Deputy Director General of Mines Safety or Director of Mines Safety).]
Licence Form P-1
Photograph of the licence holder or occupier with signature
(See Sl. No. 1 of Schedule I and Rule 35 of Ammonium Nitrate Rules, 2012)
| Licence to manufacture and possess for sale Ammonium Nitrate or convert melt to solid and vice versa and possess for sale of Ammonium Nitrate |
.png) |
| Licence No . . . . . . . . . . . . . . . . . . |
| Annual Fees Rs . . . . . . . . . . . . . .. |
1. Licence is hereby granted to:
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . Pin Code . . . . . . . . . . . 51[* * *]
52[1(a). Name of the Occupier ]
2. Status of licence holder: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Licence is valid for the following purpose: . . . . . . . . . . . . . . . . . . . . . . . . . . ..
4. Licence is valid for the following quantity of Ammonium Nitrate:
| (i) |
Quantity of Ammonium Nitrate at any one time . . . . . . . . . . . . . . . . . . . |
| (ii) |
Quantity of Ammonium Nitrate per year . . . . . . . . . . . . . .. |
5. The licensed premises shall conform to the following drawing(s):
Drawing No. . . . . . . . . . . . . . . . . . . . . ..dated . . . . . . . . . . . . . . . . . .
6. The Licensed premises are situated at following address: . . . . . . . . . . . . . . .. Survey No. . . . . . . . . . . . . . . City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . Police Station . . . . . . . . . . . . . .. Railway Station or Steamer Ghat . . . . . . . . . . .. Phone . . . . . . . . . . . . . . . . . . . . .. E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
7. The premises consist of following facilities:
| (i) |
Manufacture/Conversion facilities |
| (ii) |
No. of storehouses . . . . . . . . . . . . . .. |
| (iii) |
No. of melt storage tanks |
*Strike out whichever is not applicable
8. The licence is granted subject to the provision of Explosives Act, 1884 as amended from time to time and the Ammonium Nitrate Rules, 2012 framed thereunder and the conditions, additional conditions and annexure.
| (1) |
Drawings (showing site, constructional and other details) as stated in Serial No. 5 above. |
| (2) |
Conditions and Additional Conditions of this licence signed by the Chief Controller of Explosives. |
9. This licence shall remain valid till 31st day of March . . . . . . . ..
This licence is liable to be suspended or revoked for any violation of the Explosives Act, 1884 or Ammonium Nitrate Rules, 2012 framed thereunder or the conditions of this licence, if the authorized premises are not found conforming to the description shown in the plans and annexure attached hereto.
| Dated the . . . . . . . . . . . . . . .20 . . . .. |
Signature, |
| |
Designation and seal |
| |
[Chief Controller or Controller of Explosives] |
Space for Endorsement of Renewals
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law . . . . . . . . . . . . . . . . . . . . . . . .
Conditions
| 1. |
The manufacture or conversion of Ammonium Nitrate shall be done from the plant shown in approved plan attached with licence. |
| 2. |
The possession or storage of Ammonium Nitrate shall be done in the licensed storehouse or melt storage tank shown in the approved plan attached with the licence. |
| 3. |
The quantity of Ammonium Nitrate in the premises or any part thereof shall not exceed at any one time the quantity for which licence has been issued. |
| 4. |
Spilled or sweepings of Ammonium Nitrate the waste Ammonium Nitrate collected from sweeping or spilled shall be destroyed by the licence holder and account thereof shall be maintained indicating the quantity of the Ammonium Nitrate destroyed. |
| 5. |
The licence holder and every person employed in or about the manufacture, conversion premises shall take all due precautions for the prevention of accidents by fire or explosion in the manufacture, conversion premises and for preventing unauthorised person from having access to the manufacture, conversion premises or to the Ammonium Nitrate therein and shall abstain from any act whatsoever which tends to cause fire or explosion and is not reasonably necessary for the purposes of work in the manufacturing, conversion premises. |
| 6. |
No additions and alterations shall be carried out in the licensed premises without a previous sanction in writing of the Licence Issuing authority. |
| 7. |
The licence holder shall appoint a competent person to supervise the manufacturing, conversion process and the operations shall be conducted under the supervision of the competent person. |
| 8. |
Free access to the licensed premises shall be given at all reasonable times to any inspecting officer and all facilities shall be offered to the officer for ascertaining that the provisions of the Act and rules and the safety conditions are duly observed. |
| 9. |
If the Licence Issuing authority or the inspecting officer informs in writing, the holder of the licence to execute any repairs or to make any additions or alterations to the licensed premises or carry out recommendations, which are in the opinion of such authority may pose unacceptable risk and therefore the same is necessary for the safety or security of the premises or persons, the holder of the licence shall execute the recommendations and report compliance within the period specified by such authority. |
| 10. |
Accidents by fire or explosion and losses, shortage or theft of Ammonium Nitrate shall be immediately reported to the nearest police station, the District Authority and Chief Controller or Controller. |
| 11. |
Ammonium Nitrate shall be stored in 53[Ammonium Nitrate melt in tank or] attached storehouse(s) duly bagged and marked as per Rules 8 and 9 of Ammonium Nitrate Rules, 2012. |
| 12. |
The quantity of Ammonium Nitrate manufactured or converted or possessed shall not exceed the limit prescribed in the licence. |
| 13. |
Licence holder engaged in manufacture or conversion and possession for sale of Ammonium Nitrate shall maintain records in the prescribed forms specified in Schedule II Part 3 and shall produce such records on demand to authority specified in 54[Rule 50]. |
| 55[14. |
The licence holder shall maintain account of Ammonium Nitrate manufactured or converted in Form R-2 and submit monthly returns of Ammonium Nitrate manufactured or converted, received, used, sold, destroyed and stolen in the prescribed Form R-9 of Part 3 of Schedule II so as to reach Licensing Authority and District Authority on or before the tenth day of every succeeding month.] |
| Dated the . . . . . . . . . . . . . . . ..20 . . . . . . . . .. |
Signature |
| |
Designation and seal |
| |
[Chief Controller or Controller of Explosives] |
Licence Form P-2
(See Sl. No. 2 of Schedule I and Rule 35 of Ammonium Nitrate Rules, 2012)
| Licence to stevedore, bag and store Ammonium Nitrate |
.png) |
| Licence No . . . . . . . . . . . . . . . . . . |
| Annual Fees Rs . . . . . . . . . . . . . .. |
1. Licence is hereby granted to:
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . 56[* * *]
57[1(a) Name of the Occupier ..]
2. Status of licence holder: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Licence is valid for the following purpose: Stevedoring, bagging involving unloading Ammonium Nitrate from ship, transport to his licensed storehouse for storing and bagging.
4. Licence is valid for the stevedoring, bagging of following quantity of Ammonium Nitrate:
| (a) |
Quantity of Ammonium Nitrate at any one time . . . . . . . . . . . . . . . . . . . |
| (b) |
Quantity of Ammonium Nitrate per month . . . . . . . . . . . . . .. |
5. The authorised premises shall conform to the following drawing(s):
Drawing No. . . . . . . . . . . . . . . . . . . .dated . . . . . . . . . . . . . . . . . .
6. The licensed premises are situated at following address: . . . . . . . . . . . . . . .. Survey No. . . . . . . . . . . . . . . City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . Police Station . . . . . . . . . . . . . .. Railway Station . . . . . . . . . . . . . . . . . . . . . . .. Port of Import . . . . . . . . . . . . .. Phone . . . . . . . . . . . . . . . . . . . . .. E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
7. The premises consist of following facilities:
| (i) |
Bagging facilities |
| (ii) |
Storehouse |
8. The licence is granted subject to the provision of Explosives Act, 1884 as amended from time to time and the Ammonium Nitrate Rules, 2012 framed thereunder and the conditions, additional conditions and annexure.
| (a) |
Drawings (showing site, constructional and other details) as stated in Serial No. 5 above. |
| (b) |
Conditions and Additional Conditions of this licence signed by the District Authority. |
9. This licence shall remain valid till 31st day of March . . . . . . . ..
This licence is liable to be suspended or revoked for any violation of the Explosives Act, 1884 or Ammonium Nitrate Rules, 2012 framed thereunder or the conditions of this licence, if the authorized premises are not found conforming to the description shown in the plans and annexure attached hereto.
| The . . . . . . . . . . . . . . .20 . . . .. |
Signature, |
| |
Designation and seal |
| |
58[Chief Controller] |
Space for Endorsement of Renewals
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law . . . . . . . . . . . . . . . .
Conditions
| (1) |
The storage and bagging of Ammonium Nitrate shall be done in Licensed permises shown in approved plan attached with the licence. |
| (2) |
The quantity of Ammonium Nitrate in the premises or any part thereof shall not exceed at any one time the quantity for which licence has been issued. |
| (3) |
Spilled or sweepings of Ammonium Nitrate the waste Ammonium Nitrate collected from sweeping or spilled shall be destroyed by the licence holder and account thereof shall be maintained indicating the quantity of the Ammonium Nitrate destroyed. |
| 59[(4) |
The licence holder and every person employed in or about the stevedore, bag and store premises shall take all due precautions for the prevention of accidents by fire or explosion in the stevedore, bag and store premises and for preventing unauthorised person from having access to such premises or to the Ammonium Nitrate therein and shall abstain from any act whatsoever which tends to cause fire or explosion and is not reasonably necessary for the purposes of work in the stevedore, bag and store premises.] |
| (5) |
No additions and alterations shall be carried out in the licensed premises without a previous sanction in writing of the Licence Authority. Such additions and alterations so sanctioned shall be shown in the amended plan attached to the licence. |
| (6) |
The licence holder shall appoint a competent person to supervise the 60[stevedore, bag and store] process and the operations shall be conducted under the supervision of the competent person. |
| (7) |
Free access to the licensed premises shall be given at all reasonable times to any inspecting or sampling officer and all facilities shall be offered to the officer for ascertaining that the provisions of the Act and rules and the safety conditions are duly observed. |
| (8) |
If the Licence Issuing authority or the inspecting officer informs in writing, the holder of the licence to execute any repairs or to make any additions or alterations to the licensed premises or carry out recommendations, which are in the opinion of such authority may pose unacceptable risk and therefore the same is necessary for the safety or security of the premises or persons, the holder of the licence shall execute the recommendations and report compliance within the period specified by such authority. |
| (9) |
Ammonium Nitrate shall not be sold by the licensee. The bagged Ammonium Nitrate shall be despatched to the importer under whose licence the Ammonium Nitrate is imported 61[restricted to the store house capacity of the importer]. |
| (10) |
Accidents by fire or explosion and losses, shortage or theft of Ammonium Nitrate shall be immediately reported to the nearest 62[police station, the District Authority and the Chief Controller]. |
| (11) |
Ammonium Nitrate brought to the licensed storehouse(s) shall be bagged in suitable bags as expeditiously as possible and stored, duly marked as per Rules 8 and 9. |
| (12) |
No vehicle should move over heap of Ammonium Nitrate. |
| (13) |
Weigh bridge shall be provided near stevedore's storehouse. |
| 63[(14) |
Licence holder shall maintain records in the prescribed forms specified in Part 3 of Schedule II and shall produce such records on demand to authority specified in Rule 50.] |
| (15) |
The licence holder shall submit monthly returns of Ammonium Nitrate in the Form R-9 of Part 3 of Schedule II so as to reach Licensing Authority and District Authority within 10th day of every succeeding month. |
| (16) |
The licensee or his authorized agent shall take all due precautions to prevent spillage, contamination and loss on transit of Ammonium Nitrate while unloading from the ship, transiting to the licensed storehouse, bagging and dispatching . |
Signature Designation and seal of 64[Chief Controller]
Licence Form P-3
(See Sl. No. 3 of Schedule I and Rules 35 of Ammonium Nitrate Rules, 65[2012])
| Licence No . . . . . . . . . . . . . . . . . . |
.png) |
| Annual Fees Rs . . . . . . . . . . . . . .. |
| (a) |
Licence to Possess for sale 66[* * *] of Ammonium Nitrate from a store house not exceeding 30MT; or |
| 67[(b) |
Licence to possess for sale of Ammonium Nitrate from a store house exceeding 30 MT or Ammonium Nitrate melt in tank; or;] |
| 68[(c) |
Licence to possess for use of Ammonium Nitrate from a store house or Ammonium Nitrate melt in tank attached to explosives manufacturing or Nitrous Oxide manufacturing unit or industrial applications; or] |
| 69[(d) |
Licence to possess for use of Ammonium Nitrate for agriculture purpose from a store house not exceeding 3 MT.] |
1. Licence is hereby granted to:
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . 70[* * *]
71[1(a) Name of the Occupier ..]
2. Status of licence holder: Individual or company
3. Licence is valid for the following purpose: . . . . . . . . . . . . . . . . . . . . . . . . ..
| 4.(a) |
Licence is valid for . . . . . . . . . . . . . . . .. quantity of Ammonium Nitrate at any one time |
| 72[(b) |
Quantity of Ammonium Nitrate to be purchased in a month ..; |
| (c) |
Quantity of Ammonium Nitrate to be purchased in a financial year ..] |
5. The licensed premises shall conform to the following drawing(s):
Drawing No. . . . . . . . . . . . . . . . . ..dated . . . . . . . . . . . . . . . . . .
6. The licensed premises are situated at following address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . . . Police Station . . . . . . . . . . . . . .. Railway Station or Steamer Ghat . . . . . . . . . . .. Phone . . . . . . . . . . . . . . . . . . . . .. E-mail . . . . . . . . . . . . . . . .Fax . . . . . . . . . . . . . . . . .
7. The licensed premises consist of following facilities: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. The licence is granted subject to the provision of Explosives Act, 1884 as amended from time to time and the Ammonium Nitrate Rules, 2012 framed there under and the conditions, additional conditions and the following annexure
| (1) |
Drawings (showing site, constructional and other details) as stated in Serial No. 5 above. |
| (2) |
Conditions and additional conditions of this licence signed by the Licence Issuing Authority. |
9. This licence shall remain valid till 31st day of March . . . . . . . ..
This licence is liable to be suspended or revoked for any violation of the Explosives Act, 1884 or Ammonium Nitrate Rules, 2012 framed there under or the conditions of this licence, if the authorized premises are not found conforming to the description shown in the plans and annexure attached hereto.
| Dated . . . . . . . . . . . . . . .20 . . . .. |
Signature, |
| |
Designation and seal |
| |
[Licensing Authority] |
Space for Endorsement of Renewals
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law
Conditions
| (1) |
The Ammonium Nitrate shall be possessed only in the licenced storehouse or melt storage tank shown in the approved plan attached with the licence. |
| 73[(2) |
The quantity of Ammonium Nitrate received or stored, or sold in the premises shall not exceed at any one time the quantity for which licence is issued.] |
| (3) |
Spilled or sweepings of Ammonium Nitrate the waste Ammonium Nitrate collected from sweeping or spilled shall be destroyed by the licence holder and account thereof shall be maintained indicating the quantity of the Ammonium Nitrate destroyed. |
| (4) |
The licence holder and every person employed shall take all due precautions for prevention of accidents by fire or explosion in the licensed premises and for preventing unauthorised person from having access to licensed premises and shall abstain from any act from whatsoever which tends to cause or explosion and is not reasonably necessary for the purposes of works related thereto. |
| (5) |
No additions and alterations shall be carried out in the licensed premises without a previous sanction in writing of the Licence Authority. Such additions and alterations so sanctioned shall be shown in the amended plan attached to the licence. |
| 74[(6) |
The licence holder shall appoint a competent person to supervise the operations in the premises.] |
| (7) |
Free access to the licensed premises shall be given at all reasonable times to any inspecting or sampling officer and all facilities shall be offered to the officer for ascertaining that the provisions of the Act and these rules and the safety conditions are duly observed. |
| (8) |
If the Licence Issuing authority or the inspecting officer informs in writing, the holder of the licence to execute any repairs or to make any additions or alterations to the licensed premises or carry out recommendations, which are in the opinion of such authority may pose unacceptable risk and therefore the same is necessary for the safety or security of the premises or persons, the holder of the licence shall execute the recommendations and report compliance within the period specified by such authority. |
| (9) |
Accidents by fire or explosion and losses, shortage or theft of Ammonium Nitrate shall be immediately reported to the nearest 75[police station, District Authority and the Chief Controller]. |
| 76[(10) |
Licence holder shall maintain records in the prescribed forms specified in Part 3 of Schedule II and shall produce such records on demand to authority specified in Rule 50.] |
| (11) |
The licence holder shall submit monthly returns of 77[Ammonium Nitrate received, sold, used, stolen] and destroyed in the form prescribed in Form R-9 of Part 3 of Schedule II so as to reach Licensing Authority and District Authority within 10th day of every succeeding month. |
Signature Designation and seal of Licensing Authority
Licence Form P-4
(See Sl. No. 4 of Schedule I and Rules 35 of Ammonium Nitrate Rules, 2012)
| Licence to transport Ammonium Nitrate |
.png) |
| Licence No. |
Fees Rs . . . . . . . . . . . . . ..(Per year)
| (1) |
Licence is hereby granted to . . . . . . . . . . . . . ..to transport Ammonium Nitrate |
| 78[(1-a) |
Name of the Occupier ] |
| (2) |
From the premises licensed in form . . . . . . . . . . . . .bearing licence No . . . . . . . . . . .. Situated at . . . . . . . . . . . . .to places specified below. Places of destination |
| |
Sl. No. . . . . . . Place . . . . . . . . . . . . . . District . . . . . . . . . . . . . . . . State . . . . . . . . . . . . . . |
| |
Subject to the provisions of the Explosives Act, 1884 and the Ammonium Nitrate Rules, 2012 framed there under and to the conditions of this licence. |
| (3) |
Postal address of licensee . . . . . . . . . . . . . . . . . . |
| (4) |
This licence shall remain valid till 31st day of March, 20 . . . . . . |
This licence is liable to be suspended or revoked for any violation of the Explosives Act, 1884 or Ammonium Nitrate Rules, 2012 framed there under or the conditions of this licence.
| The . . . . . . . . . . . . . . .20 . . . .. |
Signature, |
| |
Designation and seal of Licensing Authority |
Space for Endorsement of Renewals
Statutory Warning: Misuse of Ammonium Nitrate shall constitute serious criminal offence under the law
79[Conditions]
| (1) |
This licence becomes void on the expiration of the terms mentioned therein or if a consignment breaks before reaching the place of destination or if the Ammonium Nitrate is taken from or to any place other than the places mentioned in the licence. |
| (2) |
The licensee shall transport only Ammonium Nitrate as he is authorised to possess under the Act and the Ammonium Nitrate Rules, 2012 framed there under. |
| (3) |
The quantity of Ammonium Nitrate despatched to any consignee shall not exceed the quantity which such consignee is entitled to possess under a licence granted under these rules. |
| (4) |
Each consignment of Ammonium Nitrate shall be covered by a pass in Form 80[R-11(b)] and that (when the Ammonium Nitrate is transported by rail) such pass shall be attached to the way bill or the invoices as the case may be. |
| (5) |
A copy of each pass issued for each consignment shall be sent to |
| |
(i) Licensing authority; |
| |
(ii) Controller of Explosives in whose jurisdiction the premises from which the consignment is sent, is situated; and |
| |
(iii) The Controller of Explosives in whose jurisdiction the premises to which the Ammonium Nitrate are sent is situated. |
| (6) |
Any loss, shortage or theft of Ammonium Nitrate in transit shall be reported without delay to the licensing authority and to the police station and to the Controller of Explosives in whose jurisdiction the loss, shortage or theft is discovered. |
| (7) |
The Ammonium Nitrate shall be packed and marked in accordance with Rules 8 and 9 of the Ammonium Nitrate Rules, 2012. |
Additional Conditions
| (1) |
This licence is not transferable. |
| (2) |
This licence or its authenticated copy shall at all times be kept in the transporting vehicle and produced on demand by an inspecting officer. |
| (3) |
Ammonium Nitrate shall not be transported with any other explosives, inflammable substances, oil, carbonaceous matter etc. |
| (4) |
The driver or operator of vehicle carrying or containing an Ammonium Nitrate shall not stop unnecessarily or for a longer period than is reasonably required, and shall avoid stops or places where public safety is in danger: |
| |
Provided that where vehicle transporting or containing Ammonium Nitrate is parked over night due to breakdown of vehicle or melt tanker or any reasons beyond the control of the driver, the premises in which the vehicle is parked |
| |
(a) shall not be used for any purpose that might give rise to the presence therein of an open flame, matches or any substance or article likely to cause explosion or fire; |
| |
(b) shall be away from any habitation of any go down containing articles of a flammable nature or other hazardous goods: |
| |
Provided further that the nearest police station shall be informed about the location and temporary parking of the vehicle |
| (5) |
Vehicle while transporting Ammonium Nitrate shall be adequately secured at the expense of the licence holder. If the consignment of Ammonium Nitrate is likely to pass through sensitive areas notified by the Ministry of Home Affairs, it should be escorted by armed police escort or guard, provided by the District Police Administration. |
| (6) |
Ammonium Nitrate melt shall be transported in specially designed tankers with manhole and discharge faucets duly sealed by the melt supplying firm. The melt tanker shall carry a quality control certificate issued by the AN melt supplying company. The receiver shall verify that the seal on manhole and discharge faucet is intact and verify concentration factor of Ammonium Nitrate. |
| (7) |
Transport of Ammonium Nitrate in sensitive area notified by Ministry of Home Affairs shall not be allowed during the period of Sunset to Sunrise. |
| (8) |
No smoking and no fire or artificial light or any article capable of causing fire shall be allowed on the vehicle carrying Ammonium Nitrate or Ammonium Nitrate melt. |
| (9) |
The vehicle shall not be used for carrying passenger. |
| (10) |
The vehicle, while Ammonium Nitrate are being loaded or unloaded or transported shall always be under the charge of competent person who shall be experienced in handling of Ammonium Nitrate and fully conversant there under. Where the vehicle not driven by the licence holder, a document signed by the licence holder naming persons authorised to drive and accompany the vehicle shall be carried in the vehicle and produced on demand to an inspecting officer. |
| (11) |
The Ammonium Nitrate shall be loaded into the vehicle only at the licensed premises of consignor and unloaded from vehicle at the licensed premises of the consignee. |
| (12) |
The licence holder shall maintain account of Ammonium Nitrate transported in Form R-6 and present the same on demand by an inspecting officer. |
| (13) |
Free access shall be given at all reasonable times to any inspecting or sampling officer and every facility shall be afforded to the officer for ascertaining that the provisions of the Act or these rules and these conditions are duly observed. |
| (14) |
Accidents by fire or explosion and losses, shortage or theft of Ammonium Nitrate shall be immediately reported to the nearest police station and the District Authority. |
Signature, Designation and seal of Licensing Authority
. . . . . . . . . . . . . . . . . . . . ..
Licence Form P-5
(See Sl. No. 5 of Schedule I and Rule 35 of Ammonium Nitrate Rules, 2012)
| (a) Licence to Import Ammonium Nitrate; or |
.png) |
| (b) Licence to Export Ammonium Nitrate; |
Licence No . . . . . . . . . . . . . . . . . .
Fees Rs . . . . . . . . . . . . . ..
1. Licence is hereby granted to:
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..City . . . . . . . . . . .District . . . . . . . . . . . . . . State . . . . . . . . . . . . Pin Code . . . . . . . . . . . . . . 81[* * *]
82[1(a) Name of the Occupier]
2. Status of licence holder: . . . . . . . . . . .
3. Licence is valid for the following kinds and quantity of Ammonium Nitrate:
(a) Ammonium Nitrate to be Imported
| Weight in Metric Tonnes of Ammonium Nitrate imported |
83[* * *] |
Consignor's name and address |
Licence number of the store house or houses of the consignee |
Port of import |
Mode of import |
84[Particulars of stevedore licence issued under Ammonium Nitrate Rules, 2012] |
(b) Ammonium Nitrate to be Exported
| Weight in Metric Tonnes of Ammonium Nitrate to be exported |
No. of the bags |
Consignee's name and address or Country's details |
Licence number of the store house of the consignor |
Port of export |
Mode of export |
4. The licence is granted subject to the provision of Explosives Act, 1884 as amended from time to time and the Ammonium Nitrate Rules, 2012 framed there under and the conditions annexed.
5. This licence shall remain valid till . . . . . . . . . ..(maximum one year from the date of issue).
This licence is liable to be suspended or revoked for any violation of the Explosives Act, 1884 or Ammonium Nitrate Rules, 2012 framed there under or the conditions of this licence.
| The . . . . . . . . . . . . . . .20 . . . .. |
Signature, |
| |
Designation and seal of Chief Controller of Explosives |
Conditions
| (1) |
The Ammonium Nitrate imported shall be removed to the licensed stevedore's storehouse and bagged in water proof bags. |
| (2) |
The marking on each Ammonium Nitrate bag shall be in accordance with Rules 8 and 9 of Ammonium Nitrate Rules, 2012. |
| (3) |
The import licence holder shall take delivery of the bagged AN from the stevedore's licensed storehouse and shall deliver at the licensed storehouse of the seller or user. |
| (4) |
Only Ammonium Nitrate licenced under this licence shall be imported. |
| (5) |
The quantity of Ammonium Nitrate imported or exported shall not exceed that authorised by this licence. |
| (6) |
No ship or boat containing Ammonium Nitrate imported or exported on the strength of this licence shall bring to and no such Ammonium Nitrate shall be unloaded or transhipped from any ship or boat except at the port authorised by this licence. |
| (7) |
The licence holder shall comply with all the rules and regulations in force at the port of import mentioned in this licence. |
| (8) |
The owner and master of the ship or boat in which Ammonium Nitrate are imported/exported on the strength of this licence, shall, if and when required by an inspecting authority or the custom's authority having jurisdiction over the place of importation, allow such inspector or officer to take for examination samples of any Ammonium Nitrate so imported. |
| (9) |
Free access shall be given at all reasonable times to any inspecting or sampling officer and every facility shall be afforded to the officer for ascertaining that the provisions of the Act or these rules and these conditions are duly observed. |
| (10) |
Accidents by fire or explosion and losses, shortage or theft of Ammonium Nitrate shall be immediately reported to the nearest police station and the District Authority and Chief Controller of Explosives or Licence Issuing Authority. |
| (11) |
The quantity of Ammonium Nitrate exported or imported or possessed shall not exceed the limit specified in the licence. |
| (12) |
Licence holder shall maintain records and submit returns in the prescribed forms specified in Part 3 of Schedule II and shall produce such records demand to authority specified in 85[Rule 50]. |
| 86[(13) |
Licence holder for export of Ammonium Nitrate shall submit declaration in Form R-12 soon after the consignment of ammonium Nitrate is dispatched from Indian sea port.] |
Signature Designation and seal of Chief Controller of Explosives
SCHEDULE II
(Part 3)
Returns
Form R-1
(See Rules 36 of Ammonium Nitrate Rules, 2012)
Application for Renewal of Licence
(See note below before filling up the form)
From . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . ..
To
_____________________
_____________________
Dear Sir,
| 1. |
I, . . . . . . . . . . . . . . . . . . . . . . . . . .. on behalf of . . . . . . . . . . . . . . . . . . . . . . . . . . . .apply for renewal of licence number . . . . . . . . . . . .in form . . . . . . . . . . . ..for the period from . . . . . . . . .to . . . . . . . . . .. and furnish the following information: |
| During the last five years |
| |
(i) I was or we were |
| |
(a) not convicted or convicted (Strike off which ever not applicable) and sentenced for . . . . . . for following offences . . . . . . . . . . . . . . . |
| |
(b) not ordered or ordered to execute under Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) a bond for keeping peace or for good behaviour. |
| |
(c) not issued any direction from the Court in connection with the above said licence or certificate. (Give details if answer in affirmative) |
| |
(ii) Licence or Certificate No. . . . . . . . . . . . . . . . . .in Form . . . . . . . . . . .granted under the Act and these rules to me or us were cancelled or not renewed by the Licence Issuing authority. |
| 2. |
I or We also enclose the following documents: |
| |
(i) Licence or certificate No . . . . . . . . . .. in Form . . . . . . . . . . . . . ..together with approved plans and schedules. |
| |
(ii) Renewal fee of Rs . . . . . . . . . . . .by bank draft of . . . . . . . . . . . ..(name of issuing bank) bearing number . . . . . . . . .. date . . . . . . . . . payable in favour of . . . . . . . . . . . . . . . . . . |
| 3. |
I or We confirm that I or we shall inform you about the court's order or direction, interim or otherwise, if any issued in connection to the licence for which renewal is being applied, failing which I or we shall commit a punishable offence. |
| 4. |
I or We hereby certify that |
| |
(i) the above particulars given by me or us are correct. |
| |
(ii) I am or we are aware that if Ammonium Nitrate is illegally transferred by me or us to any unauthorised person (s), I or we shall commit a punishable offence. |
| |
(iii) I am or we are aware that if I or we conceal any material information relevant to this application, I or we shall commit a punishable offence and in addition, any administrative action can be taken against me or us. |
Signature of Licence holder . . . . . . . . . . . . .
(Authorised person in case of company)
Place . . . . . . . . . . .
Date of application . . . . . . . . . . . ..
Notes.
| 87[(1) |
The renewal application should reach to the renewal authority before the date of expiry of the licence to avoid payment of late fee.] |
| (2) |
Strike out the inapplicable portion. |
Form R-2
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Form of account to be maintained by a licence holder Accounts of Ammonium Nitrate manufactured or converted
Note. This record should be kept up to date.
Licence number . . . . . . . . . . . . . . . .. In Form . . . . . . . . . . . . . . . . . . . of Ammonium Nitrate Rules, 2012
| Date |
Batch numbers |
No. of bags |
Melt produced in case of manufacturer, Melt used in case of converter |
| 1 |
2 |
3 |
4 |
| |
|
|
|
| |
|
|
|
| Total quantity of Ammonium Nitrate manufactured, converted |
Remarks |
Signature of person in-charge or licence holder |
Name and address of melt supplier |
Whether full yield achieved |
| 5 |
6 |
7 |
8 |
9 |
| |
|
|
|
|
| |
|
|
|
|
| |
Signature of Licence
Holder or person In-charge
Place . . . . . . . . . . . . .
Date . . . . . . . . . . . . ..
Form R-3
(See Rule 18 of the Ammonium Nitrate Rules, 2012)
Declaration to be submitted to the Chief Controller by an importer on despatch of Ammonium Nitrate from the place or port of loading
| Import licence No. and Date |
Validity |
Quantity permitted for import |
Name and address of the manufacturer of Ammonium Nitrate |
| |
|
|
|
| |
|
|
|
Quantities of Ammonium Nitrate on the ship.
| Name and address of consignor |
Place or port of despatch |
Name of ship and date of sailing. |
Place or port of import |
Likely date of arrival |
| |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Date of manufacture |
Batch number |
Quantity |
Number of bags |
| |
|
|
|
| |
|
|
|
| Place . . . . . . . . . . . . . |
Signature of Importer |
| Date . . . . . . . . . . . . .. |
(Authorised person in case of a Company) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name in full . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
Form R-4
(See Rule 18 of the Ammonium Nitrate Rules, 2012)
Importer's despatch Schedule
Declaration to be forwarded in triplicate to the Chief Controller as soon as any consignment of Ammonium Nitrate is cleared from the place of or port of import.
| Name and address of importer |
Import licence number granted by Chief Controller under Ammonium Nitrate Rules and date of expiry of licence |
Name and address of the manufacturer of Ammonium Nitrate |
| |
|
|
Particulars of despatch from place or port of import.
| Name and address of licencee to whom Ammonium Nitrate were despatched |
Licence number and Form |
Quantity of Ammonium Nitrate despatched |
| |
|
Quantity |
Number of bags |
| |
|
|
|
| |
| Name and address of consignor |
Quantity of Ammonium Nitrate imported |
Place or port from which Ammonium Nitrate were forwarded |
Name of ship |
Date of arrival and place or port of import |
| |
|
|
|
|
| Batch number and date |
Dated of despatch |
Mode of despatch |
| |
| Place . . . . . . . . . . . . . |
|
| Date . . . . . . . . . . . . .. |
Signature of Importer (Authorised person in case of a Company) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name in full . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
Form R-5
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Form of account to be maintained by a Stevedore Account of Ammonium Nitrate stevedored, bagged, stored and dispatched
Note. This record should be kept up to date.
Licence number . . . . . . . . . . ..in Form . . . . . . . . . . . . . . ..of Ammonium Nitrate Rules, 2012
| Date |
Name of the Ship from where bulk Ammonium Nitrate unloaded on behalf of importer |
Name and address of the importer giving his import licence No. |
| 1 |
2 |
3 |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| Quantity of Ammonium Nitrate unloaded from the ship either in bulk or large size bags or container |
No. of the bags in which Ammonium Nitrate has been repacked |
Total quantity of Ammonium Nitrate repacked in bags |
No. of bags or quantity of Ammonium Nitrate dispatched to the importer |
Date of dispatch of packed Ammonium Nitrate to importer |
| 4 |
5 |
6 |
7 |
8 |
| |
|
|
|
|
| |
|
|
|
|
| Name and address of the Transporter and his Licence No. |
Registration No. of the vehicle through which Ammonium Nitrate dispatched |
Quantity of Ammonium Nitrate Spilled, collected and sent for reprocessing to converter |
Pass No. |
Signature of License holder/person in-charge |
| 9 |
10 |
11 |
12 |
13 |
| |
|
|
|
|
| |
|
|
|
|
Signature of Licence Holder or person In-charge
Place . . . . . . . . . . . . ..
Date . . . . . . . . . . . . ..
Form R-6
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Form of records to be maintained by a Transport Licence Holder Records of Ammonium Nitrate or Melt transported by vehicle
Note. This record should be kept up to date.
Licence number . . . . . . . . . . ..in Form . . . . . . . . . . . . . . ..of Ammonium Nitrate Rules, 2012
| Date |
Name, address and Licence number of the consignor |
Place of loading |
Quantity transported |
Vehicle Registration No. |
Name Address and Licence No. of the Driver |
| |
Ammonium Nitrate in bags |
Ammonium Nitrate Melt |
|
| 1 |
2 |
3 |
4 |
5 |
6 |
| |
|
|
|
|
|
| |
|
|
|
|
|
| Pass No. |
Name, address and licence number of the consignee |
Place of unloading |
Date of unloading of Ammonium Nitrate or Melt |
Remarks |
Signature of License holder/person in-charge |
| 7 |
8 |
9 |
10 |
11 |
12 |
| |
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Signature of Licence Holder or person In-charge
Place . . . . . . . . . . . . . ..
Date . . . . . . . . . . . . . .
Form R-7
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Form of account to be maintained by a licence holder Accounts of sale of Ammonium Nitrate
Note. This record should be kept up to date. Entries should be made daily and as and when Ammonium Nitrate is sold.
Licence number . . . . . . . . . . ..in Form . . . . . . . . . . . . . . ..of Ammonium Nitrate Rules, 2012
| Date |
Opening Balance (in kgs) |
Quantity of Ammonium Nitrate received (in Kgs) |
Batch Number |
Name, address and Licence number from whom Ammonium Nitrate is received |
Mode of Transport, vehicle No. and Transporters Licence No. |
Pass number |
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
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|
| Quantity of Ammonium Nitrate Sold (in kgs) |
Batch number |
Name, address and Licence Number to whom Ammonium Nitrate is sold |
Mode of Transport, vehicle No. and Transporters Licence No. |
Pass number |
Closing Balance (in kgs) |
Remarks |
| 8 |
9 |
10 |
11 |
12 |
13 |
14 |
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Signature of Licence Holder or person In-charge
Place . . . . . . . . . . . . . ..
Date . . . . . . . . . . . . . .
Form R-8
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Form of account to be maintained by a licence holder Accounts of use of Ammonium Nitrate
Note. This record should be kept up to date. The entries should be made daily and as soon as Ammonium Nitrate are issued for use or unused Ammonium Nitrate are returned.
Licence number . . . . . . . . . . ..in Form . . . . . . . . . . . . . . ..of Ammonium Nitrate Rules, 2012
| Date |
Opening Balance (in Kgs) |
Quantity of Ammonium Nitrate received (in Kgs) |
Batch No. and Date |
Name, Address and Licence No. from whom, Ammonium Nitrate is received |
| 1 |
2 |
3 |
4 |
5 |
| |
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| |
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|
|
| Pass No. |
Quantity used (in Kgs) |
Place of use |
| 6 |
7 |
8 |
| |
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Signature of Licence Holder or person In-charge
Place . . . . . . . . . . . . ..
Date . . . . . . . . . . . . . .
Form R-9
(See Rule 14 of Ammonium Nitrate Rules, 2012)
Monthly Returns of Ammonium Nitrate
Statement of Ammonium Nitrate received, used, sold, destroyed and stolen during the month of . . . . . . . . .. in respect of store house of . . . . . . . . . . . . . . . . . .situated at . . . . . . . . . . . . . . ..District . . . . . . . . . . . . . . . .. State . . . . . . . . . . . . . . .
Licence number . . . . . . . . . . . . . . .in Form . . . . . . . . . . . . . ..of Ammonium Nitrate Rules, 2012.
1. Opening balance on the 1st day of the month:
2. Account of Ammonium Nitrate:
Particulars of Ammonium Nitrate received
| Date |
Quantity (in Kgs) |
Name, Address and licence number of suppliers from whom Ammonium Nitrate was received |
Pass No. |
| 1 |
2 |
3 |
4 |
| 1. |
| 2. |
3. Total quantity of Ammonium Nitrate used or sold during the month
| Date |
Quantity Sold (in kgs) |
Name, Address and licence number to whom, Ammonium Nitrate was sold |
Pass No. |
Quantity used (in kgs) |
| 1 |
2 |
3 |
4 |
5 |
| 1. |
| 2. |
4. Particulars of Ammonium Nitrate destroyed during the month
| Date |
Quantity (in kgs) |
Reasons for destruction |
| 1 |
2 |
3 |
| 1. |
| 2. |
5. Particulars of Ammonium Nitrate stolen or short received.
| Date |
Quantity (in kgs) |
| 1 |
2 |
| 1. |
| 2. |
| 3. |
| 4. |
| Quantity (in kgs) |
Whether theft or loss reported to police and District Authority if so, give reference |
Remarks |
| 3 |
4 |
5 |
| 1. |
| 2. |
| 3. |
| 4. |
Signature of Licence Holder or Person In-charge
Place . . . . . . . . . . . . . ..
Date . . . . . . . . . . . . . .
Form R-10
(See Rule 88[27(2)(a)] of Ammonium Nitrate Rules, 2012)
Form of indent for Ammonium Nitrate
To
. . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . .
Dear Sir,
Kindly supply the following quantities of Ammonium Nitrate to me or us
Quantity (in kgs):
I or We hold a licence number. . . . . . . . . . . . . . . .. in Form . . . . . . . . . . . . . . . .. of Ammonium Nitrate Rules, 2012 for possession for sale or use of following quantities of Ammonium Nitrate
Quantity (in kgs)
The above mentioned licence is valid till . . . . . . . . . . . . . . . . .
I or We solemnly declare that
(a) the receipt of Ammonium Nitrate indented will not result in the licensed quantity being exceeded; and
(b) no identical indent has been placed with any other supplier
*The Ammonium Nitrate may please be handed over to my or our-authorized representative whose signatures are attested below:
Attested
Signature of Licence holder.
Signature of Licence holder 89[or authorised person] (Consignee)
Place: . . . . . . . . . . . ..
Date:. . . . . . . . . . . . ..
(*Strike out whichever is not applicable.)
90[Form R-11(a)
(See Rule 20(3) of Ammonium Nitrate Rules, 2012)
Form of intimation to be given by the consignor or stevedore to the District Superintendent of Police before dispatch of consignment of Ammonium Nitrate
1. Quantity of Ammonium Nitrate or Ammonium Nitrate melt proposed to be dispatched .
2. Number of bags (in case of solid Ammonium Nitrate)
3. Ammonium Nitrate proposed to be transported by vehicle registration number ..
4. Name and address of consignee .
5. Number and validity of consignee's licence to store Ammonium Nitrate ..
6. Consignee's indent number and date ..
7. Name and address of authorised person who will receive the consignment .. ..
8. Date of despatch of consignment ..
9. Probable date on which consignment reaching consignee's place
| Place: |
Signature of consignor or authorised person |
| Date: |
Full Name |
| Licence Number .] |
91[Form R-11(b)
(See Rule 21(6) of Ammonium Nitrate Rules, 2012)
Pass issued by the consignor or stevedore for transport of consignment of Ammonium Nitrate
1. Pass No .. Date .
2. This pass covers . bags while in transit from village/town . District State . to village/town District State containing following quantity of Ammonium Nitrate;
(A) Ammonium Nitrate (Solid)
| Sr No. |
Explosives Name |
Quantity |
Unit (kg) |
No of bags |
Batch No |
Batch date |
| 1 |
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| 2 |
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| 3 |
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| 4 |
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(B) Ammonium Nitrate (Melt)
| Sr No |
Explosives name |
Quantity (kg) |
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3. (a) Mode of transport .
(b) Vehicle registration no.
(c) Details of P-4 licence under Ammonium Nitrate Rules, 2012 on the strength of which Ammonium Nitrate is being transported .
4. Name and address of consignee
5. Consignee's Licence number .
6. Consignee's order number with date and quantity of Ammonium Nitrate ordered ..
7. Consignee's letter number and date intimating readiness to receive Ammonium Nitrate
8. Date of despatch of consignment
9. Approximate date on which consignment should reach the destination
10. Route for transport of consignment
Place:
Signature of consignor or authorised person
Date:
Full Name
Licence Number .]
92[FORM R-12
(See Rule 19(4) of the Ammonium Nitrate Rules, 2012)
Declaration to be forwarded to the Chief Controller of Explosives as soon as any consignment of Ammonium Nitrate is dispatched by the exporter from the sea port or dispatched by road for export by land
| Sr No. |
Item |
Details |
| 1 |
Export Consignment |
|
| 2 |
Export Licence No |
|
| 3 |
Name & Address of Exporter |
|
| 4 |
Type of Ammonium Nitrate |
|
| 5 |
Quantity Permitted to Export |
|
| 6 |
Name and address of the Consignee |
|
| 7 |
Name of the Ammonium Nitrate Manufacturer |
|
| 8 |
Name Indian sea port or border |
|
| 9 |
Destination Country |
|
| 10 |
Name of the Ship |
|
| 11 |
Date of Dispatch from Indian Sea Port or by road for export by land |
|
| 12 |
Remarks of Exporter (if any) |
|
Details of dispatch of a ammonium nitratefrom the Exporter's premises:
| Sr. No |
Dispatch Date |
R-11(b) No. |
Export Indent R-10 No. |
No. of bags |
Quantitiy in each bag (Kg) |
Quantity Exported (Kg) |
Batch No. |
Batch Date |
Transport Licence No. |
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| Date: |
Signature of the exporter |
| Place: |
Authorised person in case of Company |
FORM R-13
(See rules 27(2)(d) of the Ammonium Nitrate Rules, 2012)
Pass issued by the licensee for use of Ammonium Nitrate
| |
Part-A |
| 1. 2. 3. 4. 5. |
Pass No. |
Date: |
| This pass covers following quantity of Ammonium Nitrate While transit from use store house covered under Licence No.: in Form:P-3, situated at ..to place of use at: .: |
| Sr.No |
Type of Ammonium Nitrate |
Quantity Issued for Use |
Unit |
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| The Ammonium Nitrate is being transported under the Transport Licence number |
|
| Name of agent of mine owner or authorised person of site of use |
|
| Full address of site of use |
|
| |
Purpose of use |
|
| |
Approximate Distance between Store house and Site of Use |
|
| |
Signature Name of the Agent of Mine/Owner/Authorised Person of Place of Use |
Signature (Authorised Signatory) (Licensee) Licence Number: Licence Form: P3 |
| |
Important Notes: The quantity of Ammonium Nitrate issued should be the quantity likely to be used during the day. The Place of use may be at such a distance from store house so that if any Ammonium Nitrate is left un-used, the same can be transported back and deposited in the store house referred in Sr. No. 2 of above on the same day before the sunset. |
| Part-B To be filled in case Ammonium Nitrate are left unused and to be returned in the Storehouse: |
| |
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| Sr.No |
Type of Ammonium Nitrate |
Quantity Returned |
Quantity Actually Used |
Unit |
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Signature Name of the agent of mine owner or authorised person of place of use |
Signature of licensee (Authorised Signatory) Licence Number: Licence Form: P3.] |
SCHEDULE I
Licences and Licensing Authority
(See Rule 28)
| Serial Number |
Purpose for which granted |
Form of Licence |
Licensing Authority |
| 1 |
Licence to manufacture and possess for sale Ammonium Nitrate or convert melt to solid and vice versa and posses for sale of Ammonium Nitrate |
P-1 |
Chief Controller or Controller authorised by Chief Controller |
| 2 |
Licence to stevedore, bag and store Ammonium Nitrate |
P-2 |
Chief Controller |
| 3 |
(a) Licence to possess for sale 93[* * *] of Ammonium Nitrate form a store house not exceeding 30MT; or |
P-3 |
District Authority |
| |
94[(b) Licence to possess for sale of Ammonium Nitrate from a store house exceeding 30 MT or Ammonium Nitrate melt in tank; or] |
P-3 |
Chief Controller or Controller authorised by Chief Controller |
| |
95[(c) Licence to possess for use of Ammonium Nitrate from a store house or Ammonium Nitrate melt in tank attached to explosives manufacturing or Nitrous Oxide manufacturing unit or industrial applications; or] |
P-3 |
Chief Controller or Controller authorised by Chief Controller |
| |
(d) Licence to possess for use Ammonium Nitrate for agricultural purpose from a storehouse 96[not exceeding 3 MT]. |
P-3 |
District Authority or Officer authorised by District Authority |
| 4 |
(a) Licence to transport Ammonium Nitrate for licences granted by District Authority for possession for sale or possession for use; or |
P-4 |
District Authority or Officer authorised by District Authority |
| |
(b) Licence to transport Ammonium Nitrate for Licences granted by the Chief Controller or Controller for possession for sale or possession for use. |
|
Chief Controller or Controller |
| 5 |
(a) Licence to Import Ammonium Nitrate; or |
P-5 |
Chief Controller |
| |
(b) Licence to Export Ammonium Nitrate. |
|
|
SCHEDULE II
Part 1
Application Forms
(See Rule 33 of Ammonium Nitrate Rules, 2012)
| Form No. |
Purpose |
| A-1 |
Application for licence to manufacture and possess for sale Ammonium Nitrate or convert melt to solid and vice versa and possess for sale of Ammonium Nitrate |
| A-2 |
Application for licence to stevedore, bag and store Ammonium Nitrate |
| A-3 |
Application for |
| |
(a) Licence to possess for sale 97[* * *] of Ammonium Nitrate from a store house not exceeding 30 MT; or |
| |
98[(b) Licence to possess for sale of Ammonium Nitrate from a store house exceeding 30 MT or Ammonium Nitrate melt in tank; or] |
| |
99[(c) Licence to possess for use of Ammonium Nitrate from a store house or Ammonium Nitrate melt in tank attached to explosives manufacturing or Nitrous Oxide manufacturing unit or industrial applications; or] |
| |
(d) Licence to possess for use Ammonium Nitrate for agricultural purpose from a storehouse 100[not exceeding 3 MT]. |
| A-4 |
Application for licence to transport Ammonium Nitrate |
| A-5 |
Application for licence to |
| |
(a) Import Ammonium Nitrate; or |
| |
(b) Export Ammonium Nitrate |
Part 2
Licence Forms
(See Rule 35 of Ammonium Nitrate Rules, 2012)
| Form No. |
Purpose |
| P-1 |
Licence to manufacture and possess for sale Ammonium Nitrate or convert melt to solid and vice versa and possess for sale of Ammonium Nitrate |
| P-2 |
Licence to stevedore, bag and store Ammonium Nitrate |
| P-3 |
(a) Licence to possess for sale 101[* * *] of Ammonium Nitrate from a store house not exceeding 30MT; or |
| |
102[(b) Licence to possess for sale of Ammonium Nitrate from a store house exceeding 30 MT or Ammonium Nitrate melt in tank; or] |
| |
103[(c) Licence to possess for use of Ammonium Nitrate from a store house or Ammonium Nitrate melt in tank attached to explosives manufacturing or Nitrous Oxide manufacturing unit or industrial applications; or] |
| |
(d) Licence to possess for use Ammonium Nitrate for agricultural purpose from a storehouse 104[not exceeding 3 MT]. |
| P-4 |
Licence to transport Ammonium Nitrate |
| P-5 |
(a) Licence to Import Ammonium Nitrate; or |
| |
(b) Licence to Export Ammonium Nitrate. |
Part 3
Return Forms
(See Rules 14, 18, 20, 21, 27 and 36 of Ammonium Nitrate Rules, 2012)
| Form No. |
Purpose |
| R-1 |
Application for renewal of licence |
| R-2 |
Form of Account to be maintained by licence holder Account of Ammonium Nitrate manufactured, converted. |
| R-3 |
Declaration to be submitted to the Chief Controller by an importer on despatch of Ammonium Nitrate from the place or port of loading |
| R-4 |
Importers despatch schedule |
| R-5 |
Form of account to be maintained by Stevedore Account of Ammonium Nitrate stevedored, bagged and dispatched. |
| R-6 |
Form of records to be maintained by a Transport Licence Holder Records of Ammonium Nitrate or Melt transported by vehicle. |
| R-7 |
Form of Account to be maintained by Licence Holder Account of sale of Ammonium Nitrate. |
| R-8 |
Form of Account to be maintained by Licence Holder Account of use of Ammonium Nitrate. |
| R-9 |
Monthly Returns of Ammonium Nitrate |
| R-10 |
Form of Indent for Ammonium Nitrate |
| R-11(a) |
Form of intimation to be given by the Consignor to the District Superintendent of Police before dispatch of consignment |
| R-11(b) |
Pass issued by the Consignor for transport of Consignment of Ammonium Nitrate |
| 105[R-12 |
Declaration to be forwarded to the Chief Controller of Explosives as soon as any consignment of Ammonium Nitrate is dispatched by the exporter from the sea port or dispatched by road for export by land |
| R-13 |
Pass issued by the licensee for Use of Ammonium Nitrate.] |
Part 4
Certificates
(See Rules 18 and 34 of Ammonium Nitrate Rules, 2012)
| Form No. |
Purpose |
| C-1 |
Declaration to be made by the master of a ship carrying Ammonium Nitrate before entering a port or by the ship's agent |
| C-2 |
Format of No Objection Certificate |