Safety advice form

To obtain a safety advice from us, please complete the below form.

Please note that should we be required to carry out work, a quotation for this work will be completed and sent to you.

We typically require 10 working days lead time from receipt of payment to complete most requests.

Please ensure you have familiarised yourself with the Electrical Safety Code of Practice 2010 - Working near overhead and underground electric lines to understand your obligations and prospective means of meeting them.

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Required fields are marked with an asterisk (*).

Contact Details

Person responsible for the worksite

Company name

ABN

Business address

Postal address

Contact number *

Email address *

Re-enter email address *

Work Information

Work industry

Work type

Other Please complete if you selected Other in Work type

Work machinery / Equipment / People

Other Please complete if you selected Other in Work machinery / Equipment / People

Details of work being performed

Address Enter the location of work being completed

Surburb/Town

State

Postcode

Work commencement date Please select date or enter in format dd/mm/yyyy

Estimated completion date Please select date or enter in format dd/mm/yyyy

DBYD enquiry / Referral number Required for Underground Assets

Building or adding to structure near an electric line Are you proposing to build or change a building or structure or do other work on a building or structure within 5 meters of an electric line?

Please note: Under the Electrical Safety Regulation 2013 section 209 you must provide notification to us before works start on any construction or addition or other work on a building or structure that is likely to come within the clearance requirements under the Electrical Safety Regulation 2013 for an overhead or underground electric line. Any reasonable costs associated with required relocation or modification of our assets will be at the cost of the responsible person.

Attachments (add any relevant attachments)

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Terms and Conditions

Electrical Safety Code of Practice 2010: Electrical Safety Codes of Practice

Entity Requirements (PDF 725 KB)

I have obtained a copy of the Electrical Safety Code of Practice 2010 - Working near overhead and underground electric lines and the Entity Requirements document Working near overhead and underground electric lines

Exclusion zones:

I am aware that prior to receiving written Safety Advice all exclusion zones must be maintained and communicated to the Person Responsible for the work site.

Written safety advice:

I am aware that a written Safety Advice will need to be issued in person at the intended work site to the Person Responsible for the work site.

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13 10 46

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1300 135 210

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Interpreter Service

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