Templates and checklists

See Dangerous goods safety – guidance for more information.

Templates - operational

Dangerous goods transport hazard overview - template - 306 Kb

This overview highlights the potential issues associated with the transport of dangerous goods in a variety of packaging modes. Primarily, the template is a prompting mechanism for operators to use in evaluating their control of transport hazards.

Emergency exercise evaluation tool - template - 57 Kb

Assists in analysing emergency response exercises to enable improvements in emergency planning and preparedness

Explosives road transport - template - 52 Kb

Template for explosives road transport

Dangerous goods manifest - template - 28 Kb

This template records the manifest of dangerous goods for transport and storage.

Security risk assessment and security plan template - SSAN fertiliser use - 148 Kb

Use of this template is not mandatory; however, the security plan should sufficiently address the national Ammonium Nitrate Guidance Note No.3, Agricultural Use.

Documenting a Transport Emergency Response Plan - template - 63 Kb

Under Regulation 180 of the Dangerous Goods Safety (Road and Rail Transport of Non-explosives) Regulations 2007, a prime contractor is required to have emergency plans in place.

Verification of dangerous goods driving procedures - driver interview - template - 34 Kb

This interview template prompts you to evaluate the background experience of your drivers and addresses six main areas of dangerous goods transport activity.

Handling of ERGs at a special berth - template - 101 Kb

This template should be modified to reflect requirements under the berth operator’s safety management system.

FES emergency response guide - template - 484 Kb

This template can be used to assist in reporting a FES Emergency Response.

Security risk assessment and security plan template - SSAN transport - 198 Kb

Use of this template is not mandatory; however, the security plan should sufficiently address the national Ammonium Nitrate Guidance Note No.1, Transport.

Blast plan - general purpose - template - 46 Kb

This template is designed to be used in conjunction with Resources Safety’s Blast plan preparation, including mining operations - guide.

Mining blast plan - secondary blasting operations - template - 46 Kb

This template is designed to be used in conjunction with Resources Safety’s Blast plan preparation, including mining operations - guide.

Explosives management plan - template - 43 Kb

This template records details of the individual nominated responsible for the safety and security of explosives for the licence to which this EMP relates.

Written report for the registration of dangerous goods pipeline - template - 161 Kb

Template for written report to accompany registration application for a dangerous goods pipeline.

Mining blast plan - open pit operations - template - 47 Kb

This template is designed to be used in conjunction with Resources Safety’s Blast plan preparation, including mining operations - guide.

Security risk assessment and security plan template - SSAN storage - 205 Kb

Use of this template is not mandatory; however, the security plan should sufficiently address the national Ammonium Nitrate Guidance Note No. 2, Storage.

Dangerous goods transport document for theatrical fireworks - template - 32 Kb

This template records details of the individual nominated responsible for the safety and security of theatrical fireworks.

Dangerous goods risk assessment - template - 52 Kb

This template records information about the intrinsic hazards of the dangerous goods arising from specific physical, chemical and toxicity properties.

Mining blast plan - underground stoping operations - template - 47 Kb

This template is designed to be used in conjunction with Resources Safety’s Blast plan preparation, including mining operations - guide.

Mining blast plan - underground development operations - template - 46 Kb

This template is designed to be used in conjunction with Resources Safety’s Blast plan preparation, including mining operations - guide.

Authorisation to secure nominees for unsupervised access to explosives or security sensitive ammonium nitrate - template - 38 Kb

This template records details of the authorisation to secure nominees for unsupervised access to explosives or security sensitive ammonium nitrate.

Authorisation for supervised access to explosives or security sensitive ammonium nitrate - template - 37 Kb

This template records details of the authorisation for supervised access to explosives or security sensitive ammonium nitrate

Dangerous goods transport document - template - 39 Kb

This template is a consignment note for the transportation of dangerous goods.

Templates - compliance check

AS NZS 1677.2 Refrigerating systems Part 2: Safety requirements for fixed applications - sample compliance check template - 101 Kb

AS NZS 1677.2 Refrigerating systems Part 2: Safety requirements for fixed applications - sample compliance check template

AS 4326 The storage and handling of oxidising agents - sample compliance check template - 159 Kb

Details of Proposed/Existing Storage of Oxidizing Agents

AS 3780 The storage and handling of corrosive substances - sample compliance check template - 113 Kb

AS 3780 The storage and handling of corrosive substances - sample compliance check template

AS 2507 The storage and handling of agricultural and veterinary chemicals - sample compliance check template - 109 Kb

Application for a dangerous goods vehicle licence

AS 1940 The storage and handling of flammable and combustible liquids - sample compliance check template - 184 Kb

Details of Proposed/Existing Flammable Liquid or C1 Combustible Liquid Store

AS 4452 The storage and handling of toxic substances - sample compliance check template - 117 Kb

Details of Proposed/Existing Storage of Toxic Substances

AS 2714 The storage and handling of organic peroxides - sample compliance check template - 127 Kb

Details of Proposed/Existing Organic Peroxide Liquid Store

AS 5026 The storage and handling of Class 4 dangerous goods - sample compliance check template - 168 Kb

Details of Proposed/Existing Storage and Handling of Class 4 dangerous goods

AS 2022 The storage and handling of anhydrous ammonia - sample compliance check template - 151 Kb

Details of Proposed/Existing Anhydrous Ammonia - Storage and Handling

Solid Ammonium Nitrate Code of practice 3rd edition - sample compliance check template - 69 Kb

Details of Proposed/Existing Storage of Solid Ammonium Nitrate

AS 3833 The storage and handling of mixed classes of dangerous goods, in packages and intermediate bulk containers - sample compliance check template - 129 Kb

Details of Proposed/Existing Storage of mixed classes of dangerous goods

AS 2927 The storage and handling of liquefied chlorine gas - sample compliance check template - 105 Kb

Details of Proposed/Existing Chorine Installation

AS 4897 The design, installation and operation of underground petroleum storage systems - sample compliance check template - 87 Kb

Details of Proposed/Existing Underground Tank Installation

AS 1596 The storage and handling of LP Gas - sample compliance check template - 165 Kb

Details of Proposed/Existing LP Gas Tank or Cylinder Installation

AEISG Ammonium nitrate emulsions, suspensions or gels - ANEs (UN3375) code of practice - sample compliance check template - 111 Kb

Details of Proposed/Existing Storage of Ammonium Nitrate Emulsions, Suspension or Gels

AS 4332 The storage and handling of gases in cylinders - sample compliance check template - 108 Kb

Details of Proposed/Existing gas cylinder store

AS 4681 The storage and handling of Class 9 (miscellaneous) dangerous goods and articles - sample compliance check template - 135 Kb

Details of Proposed/Existing Class 9 (miscellaneous) Dangerous Goods and Articles Storage

AS 4081 The storage and handling of liquid and liquefied polyfunctional isocyanites - sample compliance check template - 125 Kb

Details of Proposed/Existing liquid and liquefied polyfunctional isocyanates