What it contains
General Information and Instructions to complete the application
- WorkSafe cannot process applications from a person whose identity has not been verified. If you have not previously done so, you must complete and submit an Identification Form – Natural Person or an Identification Form – Non-Individual with this application.
- This form is for persons applying for a Licence to use Schedule 10 Carcinogen in a laboratory, or a Schedule 11 Carcinogen in a workplace other than a laboratory, or a Schedule 11 Carcinogen in a laboratory.
The use of a Schedule 1 Carcinogen in a workplace other than a laboratory is prohibited.
- Schedule 10 and 11 Carcinogen refers to the Schedules of the OHS Regulations.
- A separate application form must be completed for each scheduled carcinogen to be used.
- You must complete all parts of the form.
Use this checklist to ensure that your Application is complete:
- Completed, signed and dated application form;
- Details of Risk Control Scheduled Carcinogen Licence Measures as required in Part 5; and
- Completed and signed Identification Form for either Non-Individual or Natural Person
Note: Unsigned or incomplete applications or applications not accompanied by the required documentation may not be processed.