Item registration NSW Resources Regulator Renewal of registration – diesel engine systems February 2022 About this form This form is to be used to apply for renewal of registration of item of plant of diesel engine systems used in underground coal mines, only if there are no changes to the information that was previously provided to the NSW Resources Regulator. Otherwise, if there are changes, complete the Change of information for item registration form. Clause 177 of the Work Health and Safety (Mines and Petroleum Sites) Regulation 2014 and Part 5.3 of the Work Health and Safety Regulation 2017 sets out requirements for the item registration of specific plant used in mines. In this form, words have the same meaning as that defined in the Work Health and Safety (Mines and Petroleum Sites) Act 2013 and Work Health and Safety Act 2011 and their respective Regulations. Applicant details An application can be made by a person who has control of the plant, can identify the plant and state that the plant has been inspected by a competent person and is safe to operate. Is the applicant a person with management or control of the item of plant? Yes No* *If no, please do not proceed with this form. 1
Transcript
NSW Resources Regulator
Item registration
Renewal of registration – diesel engine systemsMay 2023
About this formThis form is to be used to apply for renewal of registration of item of plant of diesel engine systems used in underground coal mines, only if there are no changes to the information that was previously provided to the NSW Resources Regulator. Otherwise, if there are changes, complete the Change of information for item registration form.
Clause 177 of the Work Health and Safety (Mines and Petroleum Sites) Regulation 2014 and Part 5.3 of the Work Health and Safety Regulation 2017 sets out requirements for the item registration of specific plant used in mines.
In this form, words have the same meaning as that defined in the Work Health and Safety (Mines and Petroleum Sites) Act 2013 and Work Health and Safety Act 2011 and their respective Regulations.
Applicant detailsAn application can be made by a person who has control of the plant, can identify the plant and state that the plant has been inspected by a competent person and is safe to operate.
Is the applicant a person with management or control of the item of plant? Yes No*
*If no, please do not proceed with this form.
Optional: What is the role of the applicant in relation to the item of plant being renewed?
Mine operator
Contractor
Hire company
Other (specify)
Body corporate (if applicable)Registered name
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NSW Resources Regulator
Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – diesel engine systems
Registered business (trading) name, if applicable. If the organisation is a trustee for a trust, include the name of the trust. Attach a certificate or other written evidence of the registration of the business name to the application.
ABN
ACN
Individual or contact person for body corporateFirst name
Other given name (if applicable)
Last name
Email address*
Daytime contact telephone
Mobile number
* The primary means of correspondence will be via email. Contact person for body corporate must provide a generic email address so that through organisational changes in your company the department can still maintain contact.
Street address (must NOT be a PO Box)Body corporate to provide their registered business address. Individuals to provide their residential address.
Unit/street/property number
Street name
Suburb
State
Postcode
Country (if other than Australia)
Postal address Same as the street address.
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NSW Resources Regulator
Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – diesel engine systems
Unit/street/property number
Street name
Suburb
State
Postcode
Country (if other than Australia)
Information previously provided for registration of diesel engine systems
Has all the information that was previously provided for registration of the diesel engine system remained the same?
Yes No
If yes, please proceed to section 3 on the next page.
If no, please do not proceed with this form. Please complete the Change of information for item registration form.
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NSW Resources Regulator
Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – diesel engine systems
Registration number(s) of the item(s) of plant
Please provide a list of the plant registration number(s). If you require more space, please attach copies of this page.
Further details (if not previously provided)If known, date the item of plant was first commissioned or was first registered, which ever occurred first
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NSW Resources Regulator
Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – diesel engine systems
Additional informationDetails of last examination of the plant (diesel engine system). If you require more space, please attach copies of this page.
Person (company) who carried out last overhaul
Name
ExDES (RSF) license No
Date
ExDES (RSF) report identification number
FeesA fee of $71.50 is payable for each item of plant application and a fee of $2 for each additional item of plant for the same owner at the same address, applied for in the same application form. The Resources Regulator uses a third-party secure payment service to receive payments.
Please visit the website below and make payment prior to submitting this application. We will receive confirmation of your payment directly from RegOnline and will then process your application once received.
1. Visit online payment website:
www.regonline.com.au/itemofplantrenewal2. Enter your email address and select ‘Start a New Registration’ and then follow the prompts on
screen to complete the payment.
Applicant’s declarationI declare that:
an equivalent registration granted by a corresponding regulator under a corresponding work health and safety law is not held; and
the information supplied in this application is true and correct to the best of my knowledge; and
I confirm that the item of plant has been inspected by a competent person and assessed by that person as being safe to operate; and
Form | WHS (MINES AND PETROLEUM SITES) LEGISLATIONRenewal of registration – diesel engine systems
none of the information supplied by me in this application or any document attached or submitted in support of this application is false or misleading; and
in making this application, I have not failed to provide material information relating to the matters addressed above; and
I confirm the conditions of the Notice of registration item of plant (diesel engine system) have been complied with; and
I confirm that the item of plant (diesel engine system) has been maintained, inspected and tested in accordance with clause 213 of the Work Health and Safety Regulation 2017; and
I consent to the department making enquiries and exchanging information with SafeWork NSW and other work health and safety regulators in other states regarding any matter relevant to this application.
Name
Signature
Date
Note: Giving false or misleading information is a serious offence under section 268 of the Work Health and Safety Act 2011, and Part 5A of the Crimes Act 1900.
Submitting the formRequests must only be sent to the addresses below.
This publication is copyright. You may download, display, print and reproduce this material in an unaltered form only (retaining this notice) for your personal use or for non-commercial use within your organisation. To copy, adapt, publish, distribute or commercialise any of this publication you will need to seek permission from the NSW Department of Planning and Environment.
Disclaimer: The information contained in this publication is based on knowledge and understanding at the time of writing (May 2023). However, because of advances in knowledge, users are reminded of the need to ensure that information upon which they rely is up to date and to check currency of the information with the appropriate officer of the NSW Department of Planning and Environment or the user’s independent advisor.
