Application For A Dangerous Goods Site Licence - Government Of Western Australia Page 17
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Application section – return to Resources Safety
7. Emergency plans and site operation reports
Review and tick if ‘yes’, or leave blank if ‘not applicable’
Does the quantity of dangerous goods being stored at the site exceed 10 times the manifest levels detailed in
Schedule 1 of the Dangerous Goods Safety (Storage and Handling of Non-explosives) Regulations 2007?
Has a copy of the emergency plan addressing those parts of the emergency plan as required under the
Dangerous Goods Sites - Emergency Planning Code been sent electronically to Resources Safety?
Has a copy of the written report (including a risk assessment)demonstrating that the site can be operated
in accordance with the regulations and in any event with minimal risk to people, property and the
environment, been attached to this application?
8. Shire or local authority in which the site is located
9. Accredited dangerous goods consultants
(only required for N and A type applications)
Name of responsible officer or consultant
/
/
Accreditation number
Date of assessment
10. Who can we contact with any queries regarding the application?
Name
Name
Phone
Phone
Email
Email
11. Applicant’s declaration
(must be signed by intended licensee)
I certify that the details contained in this application are true and correct and I have enclosed the necessary
documentation and fees.
Name
Position
Signature of applicant
Date
/
/
DGS REV 2
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