APPLICATION FOR LICENCE TO DEAL IN EXPLOSIVES

Transcription

1 SAPS (Draft) SUID-AFRIKAANSE POLISIEDIENS SOUTH AFRICAN POLICE SERVICE APPLICATION FOR LICENCE TO DEAL IN EXPLOSIVES INSTRUCTIONS FOR COMPLETING THIS FORM 1. Use only black ink and complete in clearly legible block letters. 2. Only originally completed applications, and no faxes or s, will be accepted. 3. Dealer s licences are only issued by the Chief Inspector and will be processed within ten working days after receipt of correctly completed applications. 4. If the legal person s premises is situated in a business or industrial area where explosives are to be stored in an occupied building, the fire department having jurisdiction in that area, must conduct a fire safety inspection and issue an inspection report, which must be attached to this application. 5. The local inspector, whose contact details may be obtained from the nearest SAPS Community Service Centre or the Chief Inspector, must conduct an inspection of the premises, and complete the inspection report on this form before submission to the Chief Inspector. 6. Incomplete applications will not be processed. A. PARTICULARS OF APPLICANT A1. PERSONAL DETAILS (Responsible Person OR Owner. See E3) Surname Initials Full names Identity number Passport number Business address Postal address Telephone number Home ( ) Work ( ) Cell number Fax ( ) A2. LEGAL PERSON DETAILS (Business) Legal person name Name under which business is to be conducted CIPC or SARS registration number Business address

2 B. PARTICULARS OF PREMISES WHERE EXPLOSIVES ARE TO BE STORED AT AND SOLD FROM B1. PHYSICAL ADDRESS Number Street name Name of building/farm/plot/place Suburb/extension/area Town/city Province Nearest SAPS Community Service Centre B2. TYPE OF PREMISES (Indicate with an X) Business Industrial Plot/farm B3. TYPE OF STORAGE FACILITY (Indicate with an X) Store-room Movable magazine Strong-room Lockable steel cabinet Built magazine Lockable glass counter Safe B4. DESCRIPTION OF STORAGE FACILITY (eg. internal dimensions, construction material, etc)

3 B5. ADDITIONAL PHYSICAL SECURITY MEASURES TO PREVENT THEFT OF, OR UNAUTHORISED ACCESS TO EXPLOSIVES ON PREMISES (Indicate with an X) Alarm system with sensors Burglar proofing at windows Security gates at doors Armed response Guards Electric fencing A floor plan (on A4 or A3 size paper) of the premises must be submitted in triplicate where explosives will be stored at business or industrial premises. Magazine plans must be submitted in terms of Chapter 7 of the Explosives Regulations for larger quantities than those specifically provided for in the Regulations. C. PARTICULARS OF EXPLOSIVES TYPE OF EXPLOSIVES United Nations Classification Number (Eg.UN 0323) Units Cartons/ Boxes QUANTITY Gross mass (kilograms) Net explosives quantity (kilograms) Consumer fireworks Display fireworks Stage or special effect pyrotechnics Model rocket motors Pyrotechnic signals Power device cartridges Industrial cartridges Blank cartridges Smokeless powder Black powder Blasting explosives Blasting accessories Ammonium nitrate Igniters Rock breaking cartridges (RBC)

4 D. PARTICULARS OF SUPPLIER(S) D1. Registered name of supplier D2. Registered name of supplier D3. Registered name of supplier E. DECLARATION BY APPLICANT I am aware that it is an offence in terms of section 24 of the Explosives Act, 1956 (Act No 26 of 1956) to give false information to an inspector. I am further aware of all relevant sections and/or Regulations of the Act pertaining to the explosives mentioned in this application. The following documents are attached to this application (where applicable) and if not previously submitted for registration (Indicate with an X): (1) Certified copy of the identity document of the responsible person together with 2 x colour passport photos. Foreign nationals must attach a copy of a valid passport AND relevant supporting documents eg work permit, proof of refugee status or permanent residence permit. (2) Certified copy of SAPS issued criminal record clearance or name clearance certificate of the responsible person. (3) Original letter of appointment of the responsible person on a letterhead of the legal person and signed by both the responsible person and the manager/senior official of the legal person, OR statement if owner will be the responsible person. (4) Certified copy CIPC registration certificate, if a registered company OR SARS tax registration certificate (5) Certified copy to deal in firearms and ammunition issued in terms of the Firearms Control Act, 2000 (Act No 60 of 2000). (6) Floor plan of premises indicating all entrances, exits, fire extinguishers, storage and retail areas (in triplicate). (7) Written permission and contact details of the owner of the building/premises, stating that he/she has no objection against the storage and trade of explosives. (8) Original report from the local fire department in which compliance with applicable fire safety measures is certified (occupied buildings only) No No (9) Material safety data sheet for each product to be sold. (10) Inspection report from the inspector (part of this form).

5 I certify that the information given on this form is true to the best of my knowledge. I undertake to obtain a copy of all relevant sections and/or Regulations of the Explosives Act, 1956 (Act No 26 of 1956) as soon as a licence is issued and to furnish each employee engaged in selling explosives with a copy and of the conditions of the licence to deal. Designation Signature of responsible person and name in print Date FOR OFFICIAL USE BY THE INSPECTOR of business confirmed according to own observation (written out completely) How many entrances and exits? Total floor space m 2 Suitable facilities available for the safe storage of explosives (Indicate with an X) No Description of facilities Recommendation of application (Indicate with an X) Recommended Not recommended Comment Persal number Place Signature of inspector Rank, initials and surname Date FOR OFFICIAL USE BY THE OFFICE OF THE CHIEF INSPECTOR Date received Licence number Magazine number Date finalised CTP number Date issued Disposal of original licence Posted Collected Date Rank Initials Persal number Surname Signature of inspector Official date stamp