PETROLEUM PRODUCTS RETAIL LICENCE EVALUATION AND INSPECTION

CHECKLIST

INSPECTION OBJECTIVE: ____________________________________________________________

DATE: __________________

PART A: LICENCEE/APPLICANT’S INFORMATION

S/N Description Observation
1 Company/Trading Name

2 Name of the Contact Person.

3 Telephone No and E-mail address

4 Location (Street/Ward/Village)

5 Name of the District & Region

6 The Land Use of adjacent plots and

Landscape (e.g. schools, residential,
hospital, playground, wetlands,
cultural heritage, sensitive land
etc.)
Easting Northing
7 GPS Coordinates
8 Size of the Petrol Station Plot Size Requirements as per Urban Planning &
Size of the Petrol Station Plot Vs the
Space Standards Regulations
size requirement as per Urban
Planning and Space Standards
Regulations GN 395

PART B: LICENCE APPLICATION SUPPORTING DOCUMENTS

(Note: All copies should be certified as true copies of original)
S/N Description Observation Remarks
1 Company/Business Name
Registration Certificate
2 Business Licence

3 Taxpayer Identification Number (TIN)

Certificate
4 Land Title Deed/Certificate of
Occupancy or any other authorization
from relevant Authority approving
the land use for petrol station
purposes

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5 Layout Plan of the petrol station duly
signed by registered engineer
6 Building Permit
7 Construction Approval from EWURA
(applicable for Petrol Station
Constructed after April 2009)
8 Environmental Impact Assessment
(EIA) Certificate
9 Fire Safety Certificate from Fire &
Rescue Department
10 EWURA Receipt for Application Fee

PART C: TECHNICAL ASSESSMENT OF THE FACILITY (Site Inspection)

S/N Description Observation Remarks
1 Storage Tanks
a) Storage Tank No. / Label

b) Product Type (MSP/AGO/IK)

c) Capacity (Kilo Litres)

d) Does the tank fitted with the

vent pipe (3.6m high)?
e) Does the tank’s/off-loading
manhole labelled and color
coded? (Red for Petrol, Yellow
for Diesel and Blue for
Kerosene)
f) Does the tank manhole
chamber properly constructed
so that it is watertight?
g) Are the fill pipes properly
fixed with couplings?
h) Is earthing and bonding
provided for the offloading
area?
i) Does the tank calibrated by
WMA? (verify chart/dip rod)
j) Date of the last cleaning of
the tank (verify the records)
2 Dispensers
a) Dispenser/Pump No. /Label

b) No. of Nozzles

c) Petroleum Product (AGO, MSP,

IK, AGO&MSP?)
d) Tank No./Label from which the
dispenser/pump is drawing
(show if the pump is drawing
from more than one tank)

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S/N Description Observation Remarks
e) Are the dispensing pumps in
good working condition?
f) Are the pumps calibrated by
WMA? When was the last
calibration?
g) Does the dispenser/pump
labelled?
3 Safety, Health & Environment
Safety
a) Does the petrol station has
clear and visible safety
warning signs (Switch off
Engine, Switch off mobile
phone, No smoking)
b) Does the pump island
protected with crush barriers
with height of 1m above the
ground?
c) Are the dispensers covered
with a canopy at least 3m
from the centre of the pump
island and 5m height
d) Is the petrol station equipped
with adequate and serviced
fire extinguishing equipment
including:
- Sand bucket for each pump
island?
- At least 2 x 9kg ABE
(powder type)
extinguishers located near
the dispensers or at least 1
extinguisher per pump
island?
e) Does petrol station allows
ease maneuverability,
accessibility (entrance/exit)
and no any hindrances such
parked vehicles etc?
f) Is an EMERGENCY SWITCH
properly installed, visible and
labelled?
g) Does petrol station conform
with minimum safety
distances requirements?
Health
h) Are the personnel provided
with protective clothing?
i) Are there clean and enough
toilet facilities for men and
women?
Environment

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S/N Description Observation Remarks
j) Is the petrol station’s
forecourt paved with
impervious materials such as
concrete at least 4m around
the pump island?
k) Is the offloading area paved
with concrete at least 4m
around the area?
l) Is there a well-constructed
drainage system from the
paved areas to the oil/water
separator?
m) Is the oil-water separator
properly constructed with
three chambers? Each
chamber should have at least
minimum length of 1m, width
of 2m and depth of 1m.
n) Is the oil-water separator
having light removable cover
and gate valve installed at the
effluent pipe?
o) Does the petrol station have
good housekeeping? No
accumulation of combustible
materials such as wooden
pallets, tyres, cardboard,
papers, grass, overhanging
trees and above ground tanks
in the vicinity of the petrol
station.
p) Does the petrol station have
waste bins and good waste
handling management for
solid and liquid wastes

PART D: COMPLIANCE TO CAP-PRICE

S/N Description Observation Remarks
a) Does the Petrol Station has
price board with prices
conspicuously displayed
(preferably illuminating price
board)
b) Prices at the time of Pump Price Cap Price
inspection:
MSP
AGO
IK

PART D: LICENSING STATUS AND OTHER KEY LICENCE CONDITIONS

a) Does the petrol station
have a valid EWURA

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 Licence?
b) Is the copy of the Licence
displayed?
c) Does petrol station
procure Petroleum
Products from only
licensed Wholesaler and
keep records of those
procurements?
d) Does petrol station have a
valid insurance cover to all
liabilities that may arise
from the conduct of the
Licensed Activity?
e) Does the petrol station has
customer service
standards to address its
clients concerns or
problem.

Other general remarks:

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EWURA Representative(s)

Name
Signature

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Petrol Station Representative(s)

Name
Signature

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NB:

The operator has to be aware of the following:

1. If the petrol station does not meet all the requirements above, it will be
penalized as per the provisions of the Petroleum Retail Rules. Penalties
include closure of the facility and fine payment where applicable. Also the
petrol station will not be licensed; and
2. once renovation/rectification is completed, EWURA should be informed in
writing for re-inspection.

NB: Fuel dispensing and offloading areas should be at least 8m from any source of
ignition and 10m from high tension lines.