Bunker Permit

Permit to be authorised by the Operations Department.

Bunkering - all refueling activities in Port Limits is prohibited. This permit is for the purpose of obtaining permission prior to conducting bunkering, inclusive of the use of fixed cabinet bowsers.

Section 1: Applicant Details
Name of Permit Applicant
( person undertaking work onsite )
Company representative/contact filling out permit
( if different to permit applicant )

Section 2: Description of Location,Activityand person in charge of bunker delivery

Direct all cabinet bowser enquires to Broome Bunkering Services - mobile 0499 789 998

Section 3: Bunkering Permit Dates

Section 4: Permit Conditions
Permit Applicant to tick agree or not agree to the following

Section 5: Applicant Statement of Acknowledgement

I acknowledge the requirements of the Kimberley Ports Authority to identify and control risks and work in a safe manner at all times. I confirm the company I represent/undertaking the work has satisfactory documented safe systems of work in place and that all permits and licences required are current. Once the permit is authorised ensure that step 8 is completed prior to commencement of activity.

Use your mouse or finger to draw your signature above.

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