Organization Unit:                                                                    Environment Department                                                                                    : اﻟﻮﺣﺪة اﻟﺘﻨﻈﻴﻤﻴﺔ
Work Instructions title:                                       Dangerous Goods Storage Permit Application Form                                                                                        : ﻋﻨﻮان اﻟﻮﺛﻴﻘﺔ
 Doc Ref.                                                                                       DM-ED-P8-F05                                                                                              : رﻗﻢ اﻟﻮﺛﻴﻘﺔ
Date
GENERAL INFORMATION
                                      Company Name (English)
       Company
        Details                       Company Name (Arabic)
                                                                                                                                   Makani No.                                     Plot No.
        License
        number
       Address of
        Facility                      Telephone number                                                                             Fax number                                    P.O. Box:
 Contact Person                       Designation                                                                                  Email Address                                 Mobile No.
    Facility/Building: Design                                     New                        Renewal                     Construction                   Modification
REQUIRED ATTACHMENTS                                                                             GENERAL CONDITIONS:
1. Copy of the valid license of the tha company                                                 1. The company should allow access and assist the authorized representatives of DM-Environment Department in
                                                                                                    carrying out inspections, incident investigations, taking of pictures; and in obtaining relevant information on sources of
2. Location Map with Makani Number                                                                  emission, or waste and waste discharges at the project site at any time.
3. Material Safety Data Sheet (MSDS)                                                            2. Any malfunction or breakdown leading to abnormal emissions/spill should be dealt promptly and process operations
4. Spill and gas leak emergency procedure                                                           should be adjusted until normal conditions are restored. A logbook to record all accidents shall be maintained.
5. Copy of Dubai Civil Defense approval                                                         3. The storage of dangerous goods shall not cause any adverse impacts to the environment and/or result in any
                                                                                                    complaints from the public or from the surrounding land users.
6. Copy of EJARI or Tenancy Contract
                                                                                                4. All Chemicals should be properly packed, marked and labeled. All Chemicals Storage and Handling of Chemicals in the
7. Tank third-party inspection certificate for bulk storage (if applicable)                          warehouse/storage areas shall be as per UAE laws and regulations and MSDS.
SPECIFIC CONDITIONS IN THE SEGREGATION OF DANGEROUS GOODS:
Hazard class 2.1 must be separated at least 10 meters from class 2.3, 4.2, 5.1 and 5.2 and must be separated at least 5 meters from class 3, 4.1, 4.3, 6.1 and 8.
Hazard class 2.2 must be separated at least 10 meters from class 2.3, must be separated at least 5 meters from class 4.2, and 5.2 and must be separated at least 3 meters from class 3, 4.1, 4.3, 5.1, 6.1 and 8.
Hazard class 2.3 must be separated at least 10 meters from class 2.1, 2.2, 3, 4.1, 4.2, 4.3, 5.1, 5.2, 6.1 and 8.
Hazard class 3 must be separated at least 10 meters from class 2.3, 5.1 and 5.2 and must be separated at least 5 meters from class 2.1, 4.1, 4.2, 4.3 and 6.1 and must be separated at least 3 meters from class 2.2 and 8.
Hazard class 4.1 must be separated at least 10 meters from class 2.3, 5.1 and 5.2 and must be separated at least 5 meters from class 2.1, 3, 4.2, 4.3 and 6.1 and must be separated at least 3 meters from class 2.2 and 8.
Hazard class 4.2 must be separated at least 10 meters from class 2.1, 2.3, 5.1 and 5.2 and must be separated at least 5 meters from class 2.2, 3, 4.1, 4.3 and 6.1 and must be separated at least 3 meters from class 8.
Hazard class 4.3 must be separated at least 10 meters from class 2.3, 5.1 and 5.2 and must be separated at least 5 meters from class 2.1, 3, 4.1, 4.2, 6.1 and 8 must be separated at least 3 meters from class 2.2.
Hazard class 5.1 must be separated at least 10 meters from class 2.1, 2.3, 3, 4.1, 4.2 and 4.3 and must be separated at least 5 meters from class5.2, 6.1 and 8 and must be separated at least 3 meters from class 2.2.
Hazard class 5.2 must be separated at least 10 meters from class 2.1, 2.3, 3, 4.1, 4.2, 4.3 and 6.1 and = must be separated at least 5 meters from class 2.2, 5.1 and 8.
Hazard class 6.1 must be separated at least 10 meters from class 2.3 and 5.2 and must be separated at least 5 meters from class 2.1, 3, 4.1, 4.2, 4.3 and 5.1 and must be separated at least 3 meters from class 2.2 and 8.
Hazard class 8 must be separated at least 10 meters from class 2.3 and must be separated at least 5 meters from class 2.1, 4.3, 5.1 and 5.2 and must be separated at least 3 meters from class 2.2, 3, 4.1, 4.2 and 6.1.
 Company Stamp / Full Name and Signature                                                                                                                                             Date
 03/04/2019                                                                                                                                                                                                           V 5.0
 ﻋﺎم                                                                                                                                                                                                        درﺟﺔ اﻟﺴﺮﻳﺔ