Mine Safety forms

The documents on this list are provided in Adobe Portable Document (PDF) format. Acrobat PDF files require the free Acrobat Reader plug-in, which is available from Adobe.

Application forms

MS Provisional improvement notice (SHR) - Pro forma (181773 bytes)
MS Registration of classified plant (all types) - Pro forma (211347 bytes)
MS Application for copy of a certificate (156484 bytes)
MS Application for authorised mine surveyors certificate (69506 bytes)
MS Application for first class mine managers certificate (226571 bytes)
MS Application for mutual recognition WA (218934 bytes)
MS Application for quarry managers certificate (229162 bytes)
MS Application restricted quarry managers certificate (expl) (227278 bytes)
MS Application for underground supervisors certificate (227150 bytes)
MS Application for approval as a noise officer (105339 bytes)
MS Application restricted quarry managers certificate (non-expl) (227626 bytes)

Notification forms

MS CONTAM system registered sampler form (147737 bytes)
MS Exploration operation notification (106975 bytes)
MS Health assessment form (confidential) (506305 bytes)
MS Notification of election of safety and health representatives (147054 bytes)
MS Notification of occupational disease (98397 bytes)
MS Minehealth approved person form (148597 bytes)
MS Biological monitoring results form (158618 bytes)
MS Referral of improvement notice for review (75796 bytes)
MS Referral of prohibition notice for review (74193 bytes)
MS CONTAM System sample record sheet (163220 bytes)
MS Notification of a noise report (121637 bytes)
MS Personal noise exposure recordings (134922 bytes)
MS CONTAM System work survey (189276 bytes)

Schedule of fees and charges

Schedule of fees and charges (from 1 July 2008) (96620 bytes)