Form Gas-1262 - Motor Fuels Application - North Carolina Department Of Revenue - 2008 Page 16

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List Federal 637 Number (If applicable):
Alternative Fuel Provider License
Yes
No
119. Do you own trucks that use alternative fuel from the cargo tank of the truck to propel the truck?
120. How many trucks do you own that use alternative fuel from the cargo tank to propel the truck?
Yes
No
121. Do you maintain bulk storage facilities for alternative fuel in North Carolina?
122. Where is your bulk storage located?
123. Fuel Storage Capacity:
Above Ground
Below Ground
124. If no bulk storage facility is owned, explain storage arrangements.
Yes
No
125. Do you plan to import alternative fuel into North Carolina?
126. Indicate the type of petroleum products imported into North Carolina.
Compressed Natural Gas
Propane
Other - Describe
127. Indicate the means of transport for this imported product.
Seagoing Vessel/Barge
Transport Truck
Tank Wagon
Railroad Tank Car
Pipeline
Other - Describe
128. List the states from which you import alternative fuel and your license number in those states. (Attach additional sheets if necessary.)
129. Estimate the number of taxable gallons that will be sold or used in North Carolina during an average month. (Biodiesel is not
an alternative fuel and should not be included in this estimate.)
Compressed
Propane
Other
Natural Gas
Yes
No
130. Do you plan to export alternative fuel out of North Carolina?
131. Indicate the type of petroleum products exported from North Carolina. (Biodiesel is not an alternative fuel and should
not be listed below.)
Other - Describe
Compressed Natural Gas
Propane
132. Indicate the means of transport for this exported product.
Transport Truck
Seagoing Vessel/Barge
Tank Wagon
Pipeline
Railroad Tank Car
Other - Describe
133. List the destination states for exported alternative fuel and your license number in those states. (Attach additional sheets if necessary.)
Yes
No
134. Are you a shipper of record on one of the commercial pipelines serving North Carolina?
135. 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
Retailer of Alternative Fuel License
List Federal 637 Number (If applicable):
Yes
No
136. Do you store both highway and nonhighway alternative fuel in the same storage tank?
137. Fuel Storage Capacity:
Above Ground
Below Ground
138. Estimate the number of taxable gallons that will be sold in this state during an average month.
Compressed
Propane
Other
Natural Gas
139. List the states from which alternative fuel is imported.
Page 15

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