Petroleum Storage Tank Contractor's Licence

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Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988. c.F-15.01, as it relates directly to and is necessary for processing an application for a Petroleum Storage Tank Contractor's Licence. If you have any questions about the collection of this personal information, please contact the Chief Boiler Inspector, Inspection Services at 31 Gordon Drive, PO Box 2000, Charlottetown, PE C1A 7N8 or by telephone at 902-368-5567.

Identification

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Employer Information

Business Name