FUELS AND LPG OPERATIONS Last update : Apr 2, 2014
Application for Terminal Entry
Truck X Driver X Attendant Management PICTURE To: Terminal Manager Date: 18.10.2024 Port Dickson Sepangar Bay Bagan Luar X Sandakan Pasir Gudang Tawau Kuantan KVDT
Please issue security passes to our driver / truck / management to entry the terminal for purpose of loading products. We agree to abide all traffic, safety and security regulations as enforced by Terminal Management.
Full name (as per NRIC) : MOHD HAFIZ BIN ROSLAN Signature : New NRIC No : 950707-02-5375 Telephone No. : 013-4825508
Truck No : AHU 3888 Rubber stamp of Company
Employer Signature :
Employer Name : TERENCE JAMES LEE
Employer Designation : MANAGER
Employer Tel. No. : 012-4848088
For Terminal Use Only
Part 1 Terminal Induction Application approved / rejected Safety induction done on :
Conducted by : Signed by : Date : Date :
Valid from to
For Fleet Management, I&W and Suply use only
Part 3 Security Screening Yes No Part 4 A&D Test
- Applicant is not listed in Ban list Done / Not Done
- Truck is not listed in Ban list
Approver Signature Date
Approver name
For Security Use Only For Applicant Acknowledgement Only
Security Approver Signature : Applicant Signature
Security Approver Name : Applicant Name
Security Pass Issued by Signature : Date Received
Security Pass Issued by Name :
Kindly sent scan copy of complete application form with supporting document to fleet@petron.com.my
