Application For A Licence To Use A Scheduled Carcinogen
Application for a Licence to use a Scheduled Carcinogen (PDF 281kb)
Document Type: Form
Category: Hazardous Substances, Licensing and Registrations,
Publication Date: 02 November 2011
Date First Published: 11 October 2006
Summary: This form should be used to apply for a licence to use carcinogenic substances in a Laboratory or Industrial environment.
About this form
Carcinogenic substances are hazardous substances that can cause cancer. You must have a licence if you intend to use schedule 1 or 2 carcinogenic substances.
Schedule 1 carcinogenic substances
Schedule 2 carcinogenic substances
- Class 1 (Schedule 1 carcinogen in a laboratory only)
- Class 2 (Schedule 2 carcinogen in a workplace other than laboratory)
- $67.50 per hour processing fee (up to a maximum of $761). You will be notified of this fee after your application has been processed and an inspection has been conducted in the intended workplace where the scheduled carcinogen will be used.
- Class 3 (Schedule 2 carcinogen in a laboratory only)
- $76.50 flat fee
Licence is valid for up to 5 years.
Where to send the form
WorkSafe Occupational Hygiene unit
GPO Box 4306
Complete a separate application form for each scheduled carcinogen and provide:
- details of the carcinogen you intend to use and a detailed description of the control measures used to prevent exposure to the scheduled carcinogen
Identification form – natural person to be completed by the individual who is applying for, or nominating someone to, access the HCDG. You must also provide:
- 100 points of identification at least one with a photograph and signature,
- identification showing your date of birth,
- 2 verified passport sized photographs
- Identification form – non-individual only complete this form if applicant is a body corporate or company. (If you have previously completed these identification forms, you do not need to complete them again, unless your details have changed.)
If you are renewing your licence you are not required to complete the identification forms again unless your details have changed. In addition to providing the information above, please provide your existing licence number.
- Contact WorkSafe’s Advisory Service on 1800 136 089 or email firstname.lastname@example.org
- More information about scheduled carcinogens.