Structural Engineering / Structural Engineers in New Zealand

Apply for a Compliance Certificate

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Full Name of PCBU/Owner

Legal Entity Name

Business Trading / Trading As name

NZBN / Company Number

Landline

Mobile

Email Address

Address Info

Site/Location Address

Street Address

City

Postcode

Postal/Accounts Address (if different to site address)

Contact Info

Site Contact Name (if different)

Site Contact Phone (if different)

Site Contact Email (if different)

Accounts email address

Substance Info

Is this a new Hazardous Substance Location?

Yes

Site must be notified 5 days prior to commissioning for LPG and 30 days prior to commissioning for everything else.

Click here for the WorkSafe Notification Form

Has a “Notification of Commissioning of Hazardous Substance Location or Transit Depot” been filed with WorkSafe?

Yes

Please upload below or send a copy of the Notification Document or the email receipt from WorkSafe. If currently certified a copy of the Compliance Certificate or a copy of the Hazardous Substance Location Notification document.

HSL Notification or Current Certificate

Drag ‘n Drop files here

Max file size: 9.54 MB. | Allowed file types: pdf,jpg,doc,docx

Select Files

Stationary Container System

Existing tank

New tank

Class

Quantity

Secondary Containment Details

Other Substances onsite (Class, Name and Quantity)

Name of Authorised Person

Date ×

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