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Health and Safety

Executive

Explosives Regulations 2014

Application for a Storage Licence under the Explosives Regulations 2014

Please read the guidance notes (?) before completing this form.

You should use this form for an application for a licence to store explosives where any of the explosives you plan to store are listed in guidance [?].

You should only use this form if you want to store no more than 2000 kg of explosives.

If there is insufficient room to provide the information requested, please continue on a separate sheet(s) (see guidance [?]).

Please note that it is an offence under Section 33 of the Health and Safety at Work etc Act 1974 to provide false information. Incomplete or inaccurate information could result in a delay in the processing of your application.

The information contained in this form may be stored electronically. The information may, where appropriate, be shared with other relevant bodies such as other local licensing authorities or the Health and Safety Executive. You have the right to request a copy of any personal information and to have any inaccuracies corrected.

 

Data will be held in accordance with HSE's privacy policy which is available on the HSE website. A printed copy is available upon

request.

*Is this an application for a new storage licence or a renewal?

*If this is a renewal application, please state the date of expiry and any reference number

Nature of business - ( choose the category or categories that apply to this application)

*Are you applying for a licence where storage will be subject to Separation distances? (see ?)

Details of the applicant (if you applying on behalf of a company or limited liability partnership (or, in Scotland only, a partnership) please give it's name)

*Are you a company or an individual?

Where applicant is an individual

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum. If the applicant is a company, please give the registered address

(eg building name)

(eg street)

(eg district)

ER2


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Health and Safety

Executive

Application for a Storage Licence under the Explosives Regulations 2014

Address where the explosives will be stored

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum

(eg building name)

(eg street)

(eg district)

Out of hours contact (please give the name and telephone number, including mobile number if appropriate, of the person to be contacted in an emergency)

Name

Details of an explosive store at a different address

*Do you have an explosives store at an address different to that above?

If yes, please provide the full address including postcode, of this store

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum

(eg building name)

(eg street)

(eg district)

*Are you the owner / manager of the business?


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Health and Safety

Executive

Application for a Storage Licence under the Explosives Regulations 2014

If the applicant is not the owner/manager of the business, please give the details of the person with management responsibilities for the explosives being stored under the licence

Name

Note: for addresses you must provide Address Line 1 or 2, Town and postcode at minimum

(eg building name)

(eg street)

(eg district)


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Health and Safety

Executive

Application for a Storage Licence under the Explosives Regulations 2014

About the explosives to be stored

Explosives to be stored and quantities (enter type and amount and Add to add to the list)

*Are you (the applicant) intending to store more than 75kg (net) of ammunition or pyrotechnic articles in a building that adjoins domestic premises?

*Have you (the applicant) had a previous licence or registration refused or revoked?

*Have you (the applicant) been convicted of an offence under legislation on health and safety?

*Have you (the applicant) been convicted of any other offences relating to the storage, sale,

supply, importation or possession of fireworks and/or any other explosives?

*Have you (the applicant) been convicted of any offence under any other legislation including

offences against the person, dishonesty offences and offences relating to the supply of controlled drugs?

Further details about your application


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Health and Safety

Executive

Application for a Storage Licence under the Explosives Regulations 2014

Declaration

Name

Please indicate the following are enclosed with your application

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