Tickit on Demand - Department of Fire and Emergency Services

TFB & Exemption Online Notification

This form should be used to notify DFES and local governments of any of the following:

During a Total Fire Ban (TFB), activities such as hot work (welding & grinding), road work (grading & bituminising), off-road (use of internal combustion engines on vegetated land), blasting, gas flaring, and catering (cooking involving fire).

Exemptions under sections 22C or 25A of the Bush Fires Act 1954 that permit work during a total fire ban or restricted and prohibited burning times.

When acting in accordance with a Direction Notice issued by a Bush Fire Control Officer in accordance with Regulation 39C of the Bush Fires Regulations 1954.

This form is not an exemption application form, but rather a notification of your intention to work under regulations or with a valid exemption on TFB days or restricted and prohibited burning times. If you need an exemption, go to dfes.wa.gov.au.

For the regulatory conditions that must be met while carrying out the work or activity, refer to your exemption, the Bush Fires Regulations 1954, or the total fire ban page on dfes.wa.gov.au.

NOTIFICATION FOR UNDERTAKING EXCEPTED ACTIVITY

Australian Business Number (ABN):^*

Trading Name:^*

Business/Industry Type: ^*

Select from the list below what business/industry type you operate under

Details of business/industry type^*

Select one, if other was chosen, specify business/industry type below

Notifiers name^*

Enter the name of the person completing the form

Notifiers contact number^*

Enter the contact number of the person completing the form

Notifiers email address^*

Enter the email address of notifier

SITE CONTACT DETAILS

Name of on-site contact^*

Enter 'as above' if same as notifier

Phone number of on-site contact ^*

Enter 'as above' if same as notifier

Email of on-site contact ^*

Enter 'as above' if same as notifier

FIRE DANGER RATING FOR AREA OF OPERATION

What is the fire danger rating for the date and area in which the work will be carried out?

Fire Danger Ratings can be found at emergency.wa.gov.au

Fire Danger Rating (FDR)^*

Choose the fire danger rating for the work or activity site

Refer to the relevant fact sheet on dfes.wa.gov.au or your exemption for additional restrictions when the FDR is catastrophic; most work must stop

EXEMPTION DETAILS

Choose Yes and complete the details if you are working under an exemption issued by DFES under section 22C or 25A or a Direction Notice under regulation 39C.

Choose No if you are working under the regulations (i.e. hot work, road work)

Are you working under your exemption? ^*

Select yes if you have been issued an exemption by DFES, you will need to quote the exemption reference number.

Exemption correspondence number^*

Insert the DFES exemption correspondence number found on the first page of your exemption notice (e.g. 22/123456)

WORK / ACTIVITY DETAILS

Will the work or activity take place during a Total Fire Ban? ^*

Select Yes if work or activity are occurring during a total fire ban.

YesNo

Date of work or activity^*

Enter the work or activity date

Work or activity start time^*

Enter the time the work or activity is planned to begin.

Describe the work or activity^*

Provide a brief description of the work or activity being carried out

Work or activity to be undertaken ^*

Select which activities you are carrying out (can select multiple)

MANDATORY CONDITIONS - HOT WORK ACTIVITY

Strict conditions apply when carrying out activities involving HOT WORK. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIRE-REGULATIONS-FACT-SHEET-HOT-WORK.pdf

Hot Work Activity Factsheet

DFES-BUSHFIRE-REGULATIONS-FACT-SHEET-HOT-WORK.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for HOT WORK activity:^*

Please confirm that you have read, understood and agree to abide by the conditions to carry out hot work activities.

YesNo

MANDATORY CONDITIONS - BLASTING ACTIVITY

Strict conditions apply when carrying out activities involving BLASTING. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIREREGULATIONS-FACTSHEET-Blasting.pdf

Blasting Activity Factsheet

DFES-BUSHFIREREGULATIONS-FACTSHEET-Blasting.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for BLASTING activity:^*

Please confirm that you have read, understood and agree to abide by the regulations regarding blasting.

YesNo

MANDATORY CONDITIONS - GAS FLARING ACTIVITY

Strict conditions apply when carrying out activities involving GAS FLARING. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIREREGULATIONS-FACTSHEET-GasFlaring.pdf

Gas Flaring Activity Factsheet

DFES-BUSHFIREREGULATIONS-FACTSHEET-GasFlaring.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for GAS FLARING activity:^*

Please confirm that you have read, understood and agree to abide by the conditions to carry out Gas Flaring activities.

YesNo

MANDATORY CONDITIONS - ROAD WORK ACTIVITY

Strict conditions apply when carrying out activities involving ROAD WORK. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIRE-REGULATIONS-FACT-SHEET-ROAD-WORK.pdf

Road Work Activity Facthseet

DFES-BUSHFIRE-REGULATIONS-FACT-SHEET-ROAD-WORK.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for ROAD WORK activity:^*

Please confirm that you have read, understood and agree to abide by the conditions to carry out road work activities.

YesNo

MANDATORY CONDITIONS - CATERING ACTIVITY

Strict conditions apply when carrying out activities involving CATERING. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIREREGULATIONS-FACTSHEET-Catering.pdf

Catering Activity Factsheet

DFES-BUSHFIREREGULATIONS-FACTSHEET-Catering.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for CATERING:^*

Please confirm that you have read, understood and agree to abide by the conditions to carry out off road activities.

YesNo

MANDATORY CONDITIONS - OFF-ROAD ACTIVITY

Strict conditions apply when carrying out activities involving OFF ROAD ACTIVITY. Please download the attached document and acknowledge that you have read, understood and agree to abide by all the conditions for the activity.

DFES-BUSHFIREREGULATIONS-FACTSHEET-Off-Road.pdf

Off-Road Activity Factsheet

DFES-BUSHFIREREGULATIONS-FACTSHEET-Off-Road.pdf

Download:

I agree, on behalf of the company, to the mandatory conditions for OFF-ROAD activity:^*

Please confirm that you have read, understood and agree to abide by the conditions to carry out off-road activities, including checking if the local government has issued a Harvest Vehicle Movement Ban (r.24C).

YesNo

MANDATORY CONDITIONS FOR EXEMPTION HELD

Conditions listed within exemption notice issued apply when carrying out any work/activity listed within the exemption notice. These conditions must be complied with when operating under the exemption.

I agree, on behalf of the company, to the conditions listed within the exemption notice for the activity being carried out^*

Please confirm that you have read, understood and agree to abide by the conditions listed within the exemption notice.

DFES Region of work or activity

Select the DFES region and Town/Shire/City where the work or activity is taking place

Please consult the attached map if you are unfamiliar with the DFES region

DFES-Regions.pdf

Download:

Select Lower South West LG Areas^*

Please select the relevant LG Areas

Select Pilbara LG Areas^*

Please select the relevant LG Areas

Select Kimberly LG Areas^*

Please select the relevant LG Areas

Broome, Shire ofDerby-West Kimberley, Shire ofHalls Creek, Shire ofWyndham-East Kimberley, Shire of

Location where the works are to be undertaken ^*

Latitude/longitude coordinates can be used in the absence of a street address. If working at multiple addresses please list them here or attach supporting documentation.

Also enter the nearest landmark, such as mine site name, for remote locations.

Avoid SLK references

PARKS & WILDLIFE SERVICE NOTIFICATION

You must notify the relevant DBCA Regional Office 24 hours to 30 minutes before starting an activity within 3km of DBCA Parks and Wildlife Service land.

Please see the map for DBCA Regional Office contact information.

DBCADistrictDutyOfficerContacts.pdf

Download:

DECLARATION BY NOTIFYING OFFICER

Please complete the below

To support your notification, you can attach fire and emergency response plans, permits, maps, and work locations (press the submit button at the bottom of the page to see an attachments option)

Refer to your exemption, Bush Fires Regulations 1954 or dfes.wa.gov.au for conditions

On behalf of the above-mentioned company, I agree that the information provided is correct^*

Conditions have been read and understood^*

The person completing this form has read and understood the work or activity conditions

Aware of penalties and infringements that may be applied for non-compliance^*

Breaching the regulatory requirements during a total fire ban is an offence and may result in a $1,000 infringement or a maximum penalty of $25,000 and/or 12 months imprisonment.

Breaching the regulatory requirements during the local government's restricted and prohibited burning times is an offence and may result in a $250 infringement or a $10,000 fine.

Declaration completed by (full name):^*

Date^*