Form Gas-1262 - Motor Fuels Application - North Carolina Department Of Revenue - 2008 Page 15

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Biodiesel Provider License
List Federal 637 Number (If applicable):
101. Do you produce biodiesel in North Carolina?
Yes
No
102. How many gallons of biodiesel are produced in North Caroline each month?
Yes
No
103. Do you maintain bulk storage facilities in North Carolina?
104. Where is your bulk storage located?
105. Fuel Storage Capacity:
Above Ground
Below Ground
106. If no bulk storage facility is owned, explain storage arrangements.
Yes
No
107. Do you plan to import petroleum products into North Carolina?
108. Indicate the type of petroleum products imported into North Carolina.
Undyed Biodiesel
Undyed Diesel
Dyed Diesel
Dyed Biodiesel
109. Indicate the means of transport for this imported product.
Seagoing Vessel/Barge
Transport Truck
Tank Wagon
Railroad Tank Car
Pipeline
Other - Describe
110. List the states from which you import petroleum products and your license number in those states. (Attach additional sheets if necessary.)
111. Estimate the number of taxable gallons that will be sold or used in North Carolina during an average month.
Undyed
Undyed
Diesel
Biodiesel
Dyed
Dyed
Diesel
Biodiesel
Yes
No
112. Do you plan to export petroleum products out of North Carolina?
113. Indicate the type of petroleum products exported from North Carolina.
Undyed Diesel
Undyed Biodiesel
Dyed Diesel
Dyed Biodiesel
114. Indicate the means of transport for this exported product.
Transport Truck
Seagoing Vessel/Barge
Tank Wagon
Pipeline
Railroad Tank Car
Other - Describe
115. List the destination states for exported petroleum products and your license number in those states. (Attach additional sheets if necessary.)
116. Are you a shipper of record on one of the commercial pipelines serving North Carolina?
Yes
No
117. What other types of operations will you be engaged in?
Exchanges
Direct shipments
Other - Describe
Sales on consignment
Sell petroleum products
Operate service stations
Trade petroleum products
118. Provide the following information about suppliers from whom you purchase motor fuel and exchange partners from whom you
receive motor fuel. (Attach additional sheets if necessary.)
Shipping/Delivery Point
Product
Name
Page 14

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