Sch 2Forms

Schedule 2—Forms Form 1—Provisional improvement notice To: [the responsible person within the meaning of clause 37(2) of Schedule 7 of the Act] I, [name of the health and safety representative issuing the notice], selected as the health and safety representative under clause 24 or 25 of Schedule 7 of the Act for [description of the designated work group], after consultation in accordance with clause 37(1) of Schedule 7 of the Act, believe that the following provision, or provisions, of the Act or regulations is, or are, being contravened or is, or are, likely to continue to be contravened: The contravention is [a brief description]: The contravention is occurring at [location]: The reasons for my opinion are as follows: In accordance with clause 37(5)(b) of Schedule 7 of the Act, action necessary to prevent the contravention, or the likely contravention, of the provision or provisions referred to above must be taken before (the date of a day that is— (a) not less than 7 days after the day when the notice is issued; and (b) reasonable in the opinion of the health and safety representative). In accordance with clause 37(6) of Schedule 7 of the Act, I specify the following action to be taken: Signed: [signature of health and safety representative] 1. Under clause 38(1) of Schedule 7 of the Act, a person to whom a provisional improvement notice is given may, within 7 days, request the Safety Authority or an OHS inspector to conduct an investigation into the subject matter of the notice. 2. Clause 38(5) of Schedule 7 of the Act requires a responsible person to whom a provisional improvement notice is given— • to notify each group member affected by the notice of the fact that the notice has been issued; and • to display a copy of the notice at or near each workplace at which work that is the subject of the notice is being performed. 3. Under clause 38(6) of Schedule 7 of the Act, a provisional improvement notice ceases to have effect when— • it is cancelled by the health and safety representative or an OHS inspector; and • the responsible person takes the action specified in the notice, or if no action is specified, takes the action that is necessary to prevent the contravention, or likely contravention, with which the notice is concerned. 4. Clause 38(7) of Schedule 7 of the Act requires the responsible person— • to ensure, as far as possible, that a provisional improvement notice is complied with; and • to inform the health and safety representative who issued the notice of the action taken to comply with the notice. 5. Under clause 65 of Schedule 7 of the Act, if an OHS inspector has confirmed or varied a provisional improvement notice— • the operator of the facility or an employer affected by the decision; or • the health and safety representative for a designated work group that includes a group member affected by the decision; or • the owner of any plant substances or thing to which that decision relates; or • the person to whom the notice was issued; or • a workforce representative in relation to the designated work group that includes a group member affected by the decision; or • if there is no designated work group—a workforce representative in relation to a member of the workforce affected by the decision, may request the Australian Industrial Relations Commission in writing to review the OHS inspector's decision. Form 2—Notice of removal of plant or sample To: [name of operator, employer or owner of the plant, substance or thing (if applicable)] and [name of health and safety representative for designated workgroup] I, [name of OHS inspector], an OHS inspector within the meaning of the Act, in the course of conducting an inspection under clause 48 of Schedule 7 of the Act, have taken possession of: [description of item removed] from the workplace at: [address] The reason for this action is: [explanation of why removal of item was necessary] 1. This notice must be displayed in a prominent place at the workplace from which the item was removed. 2. Under clause 63 of Schedule 7 of the Act, this notice must not be tampered with or removed until the item has been returned to the workplace. 3. Under clause 63 of Schedule 7 of the Act, a person who tampers with, or removes, a notice, before the item has been returned to the workplace, may be liable to a penalty of not more than $11 000 in the case of a natural person or $55 000 in the case of a body corporate. 4. Under clause 65 of Schedule 7 of the Act, any of the following persons may request the Australian Industrial Relations Commission in writing to review the OHS inspector's decision— • the health and safety representative for a designated work group that includes a group member affected by the decision; • a workforce representative in relation to the designated work group that includes a group member affected by the decision; • if there is no designated work group—a workforce representative in relation to a member of the workforce affected by the decision; Form 3—Do not disturb notice To: [name of operator's representative at the facility] I, [name of OHS inspector] an OHS inspector within the meaning of the Act, direct that: [description of the affected workplace or part of workplace, plant, substance or thing] is not to be disturbed during the period from [insert specified time] am/pm to [insert specified time] am/pm on [insert date]. The reasons for issuing this notice are: 1. Under clause 58 of Schedule 7 of the Act, an operator of a facility who does not ensure that a notice is complied with may be liable to a penalty of not more than $27 500 in the case of a natural person and $137 500 in the case of a body corporate. 2. This notice must be displayed in a prominent place at the workplace and must not be tampered with or removed before the notice has ceased to have effect 3. Under clause 65 of Schedule 7 of the Act, any of the following persons may request the Australian Industrial Relations Commission in writing to review the OHS inspector's decision— • the health and safety representative for a designated work group that includes a group member affected by the decision; • a workforce representative in relation to the designated work group that includes a group member affected by the decision; • if there is no designated work group—a workforce representative in relation to a member of the workforce affected by the decision; Form 4—Prohibition notice To: [name of operator's representative at the facility] I, [name of OHS inspector], an OHS inspector within the meaning of the Act, am satisfied that it is necessary to issue a prohibition notice to the operator of [name of the facility] in order to remove an immediate threat to the health or safety of a person. I THEREFORE PROHIBIT the following activity or activities— (a) at this workplace or part of workplace: [specify workplace, or part, as the case may be] (b) using this plant or substance: [specify plant or substance, if applicable] (c) following this procedure: [specify procedure, if applicable] Omit if inapplicable] 1. Under clause 60 of Schedule 7 of the Act, an operator who fails to ensure that this notice is complied with, to the extent that it relates to a matter over which the operator has control, may be liable to a penalty of not more than $27 500 in the case of a natural person and $137 500 in the case of a body corporate. 2. This notice must be displayed in a prominent place at the workplace and must not be tampered with or removed before the notice has ceased to have effect. 3. Under clause 65 of Schedule 7 of the Act, any of the following persons may request the Australian Industrial Relations Commission, in writing, to review the OHS inspector's decision— • the operator of the facility or an employer who is affected by the decision; • a person to whom a prohibition notice has been issued; • the health and safety representative for a designated work group that has a group member affected by the decision; • a workforce representative in relation to the designated work group that includes a group member affected by the decision; • if there is no designated work group—a workforce representative in relation to a member of the workforce affected by the decision; Form 5—Improvement notice To: [name of responsible person] I, [name of OHS inspector], an OHS inspector within the meaning of the Act, am satisfied that the person named above as the responsible person is contravening, or has contravened, and is likely to contravene: (a) clause [insert clause number] of Schedule 7 of the Act; or (b) regulation [insert regulation number]; at [location of workplace]. The reasons for my opinion are: [brief description of contravention] You are required to take action within [insert number] days of the date of this notice to prevent any further contravention or likely contravention of the clause or regulation. Omit if inapplicable] When the required improvement has been completed, return this part of the notice to the following person at the address below: Name: Position: Address: Telephone number: Improvement Notice No. [insert Improvement Notice No.] has been complied with. Signed: This notice was delivered to: [insert name] in the office or position of [insert office or position] at: [insert time, am or pm] on [insert date]. 1. Under clause 62 of Schedule 7 of the Act, a person who fails to ensure that this notice is complied with, to the extent that it relates to a matter over which the person has control, may be liable to a penalty of not more than $11 000 in the case of a natural person and $55 000 in the case of a body corporate. 2. This notice must be displayed in a prominent place at the workplace and, under clause 63 of Schedule 7 of the Act, must not be tampered with or removed before the notice has ceased to have effect. 3. This notice ceases to have effect when the OHS inspector notifies the responsible person that he or she is satisfied that the responsible person has taken adequate action to remove the threat to health and safety that caused the notice to be issued. If the OHS inspector has specified action that the responsible person should take to remove the threat, the responsible person should advise the OHS inspector as soon as the action has been taken. 4. Under clause 61(7) of Schedule 7 of the Act, an operator, or an employer of a member of the workforce to whom this notice is given must— (a) give a copy of the notice to each health and safety representative for a designated workgroup having group members performing work that is affected by the notice; and (b) display a copy of the notice in a prominent place at or near each workplace at which the work is being performed. 5. Under clause 65 of Schedule 7 of the Act, any of the following persons may request the Australian Industrial Relations Commission to review the OHS inspector's decision— • any person to whom an improvement notice has been issued; • the health and safety representative for a designated work group that includes a group member affected by the decision; • a workforce representative in relation to a designated work group that includes a group member affected by the decision; • if there is no designated work group—a workforce representative in relation to a member of the workforce affected by the decision;