Submitted by: [Company Name] on behalf of: [Company Name] (Holder of PWA) Field Name: PWA ref & date of issue: [XX/W/XX, dd/mmm/yy] (or date PWA authorised if pre-PWA numbering) Pipelines within PWA: [PLXXXX – PLXXXX, PLXXXX] PA Ref: [PA/XXXX]
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