Resources Regulator publication€¦  · Web viewItem registration. Item registration. Item registration. Form | WHS (MINES AND PETROLEUM SITES) LEGISLATION. Renewal of registration

NSW Resources Regulator

Item registration

Renewal of registration – booster fansMay 2023

About this formThis form is to be used to apply for renewal of registration of item of plant of booster fans used in underground coal mines, only if there are no changes to the information that was previously provided to the NSW Resources Regulator. Otherwise, if there are changes, complete the Change of information for item registration form.

Clause 177 of the Work Health and Safety (Mines and Petroleum Sites) Regulation 2014 and Part 5.3 of the Work Health and Safety Regulation 2017 sets out requirements for the item registration of specific plant used in mines.

In this form, words have the same meaning as that defined in the Work Health and Safety (Mines and Petroleum Sites) Act 2013 and Work Health and Safety Act 2011 and their respective Regulations.

Applicant detailsAn application can be made by a person who has control of the plant, can identify the plant and state that the plant has been inspected by a competent person and is safe to operate.

Is the applicant a person with management or control of the item of plant? Yes No*

*If no, please do not proceed with this form.

Optional: What is the role of the applicant in relation to the item of plant being renewed?

Mine operator

Contractor

Hire company

Other (specify)      

Body corporate (if applicable)Registered name

1

NSW Resources Regulator

Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – booster fans

Registered business (trading) name, if applicable. If the organisation is a trustee for a trust, include the name of the trust. Attach a certificate or other written evidence of the registration of the business name to the application.

ABN                      

ACN                  

Individual or contact person for body corporateFirst name      

Other given name (if applicable)      

Last name      

Email address*      

Daytime contact telephone      

Mobile number      

* The primary means of correspondence will be via email. Contact person for body corporate must provide a generic email address so that through organisational changes in your company the department can still maintain contact.

Information previously provided for registration of item of plant

Has all the information that was previously provided for registration of the booster fan remained the same?

Yes No

If yes, please proceed to section 3 on the next page.

If no, please do not proceed with this form. Please complete the Change of information for item registration form.

2

NSW Resources Regulator

Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – booster fans

Registration number of the item of plantPlant registration number      

Further details (if not previously provided)If known, date the item of plant was first commissioned or was first registered, whichever occurred first

FeesA fee of $71.50 is payable for each item of plant application and a fee of $2 for each additional item of plant for the same owner at the same address, applied for on the same application form. The Resources Regulator uses a third-party secure payment service to receive payments.

Please visit the website below and make payment prior to submitting this application. We will receive confirmation of your payment directly from RegOnline and will then process your application once received.

1. Visit online payment website:www.regonline.com.au/itemofplantrenewal

2. Enter your email address and select ‘Start a New Registration’ and then follow the prompts on screen to complete the payment.

Applicant’s declarationI declare that:

an equivalent registration granted by a corresponding regulator under a corresponding work health and safety law is not held; and

the information supplied in this application is true and correct to the best of my knowledge; and

I confirm that the item of plant has been inspected by a competent person and assessed by that person as being safe to operate; and

none of the information supplied by me in this application or any document attached or submitted in support of this application is false or misleading; and

in making this application, I have not failed to provide material information relating to the matters addressed above; and

I confirm the conditions of the Notice of registration item of plant (booster fan) have been and will continue to be complied with; and

I confirm that the item of plant (booster fan) has been maintained, inspected and tested in accordance with clause 213 of the Work Health and Safety Regulation 2017; and

3

NSW Resources Regulator

Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – booster fans

I consent to the department making enquiries and exchanging information with SafeWork NSW and other work health and safety regulators in other states regarding any matter relevant to this application.

Name      

Signature

Date      

Note: Giving false or misleading information is a serious offence under section 268 of the Work Health and Safety Act 2011, and Part 5A of the Crimes Act 1900.

Submitting the formRequests must only be sent to the addresses below.

Email: [email protected]

Mail: Central Assessment Unit,

NSW Resources Regulator,

PO Box 344, HRMC NSW 2310

If you have any queries or need assistance submitting your application, please contact the Central Assessment Unit on 1300 814 609.

© State of New South Wales through the NSW Department of Planning and Environment 2018.

This publication is copyright. You may download, display, print and reproduce this material in an unaltered form only (retaining this notice) for your personal use or for non-commercial use within your organisation. To copy, adapt, publish, distribute or commercialise any of this publication you will need to seek permission from the NSW Department of Planning and Environment.

Disclaimer: The information contained in this publication is based on knowledge and understanding at the time of writing (May 2023). However, because of advances in knowledge, users are reminded of the need to ensure that information upon which they rely is up to date and to check currency of the information with the appropriate officer of the NSW Department of Planning and Environment or the user’s independent advisor.

PUB18/166

4