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.
Select from the list below what business/industry type you operate under
Select one, if other was chosen, specify business/industry type below
Enter the name of the person completing the form
Enter the contact number of the person completing the form
Enter the email address of notifier
Enter 'as above' if same as notifier
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
Select yes if you have been issued an exemption by DFES, you will need to quote the exemption reference number.
Insert the DFES exemption correspondence number found on the first page of your exemption notice (e.g. 22/123456)
Select the activity being carried out as specified in your DFES exemption notice.
Select Yes if work or activity are occurring during a total fire ban.
Enter the work or activity date
Enter the time the work or activity is planned to begin.
Provide a brief description of the work or activity being carried out
Select which activities you are carrying out (can select multiple)
Please confirm that you have read, understood and agree to abide by the conditions to carry out hot work activities.
Please confirm that you have read, understood and agree to abide by the regulations regarding blasting.
Please confirm that you have read, understood and agree to abide by the conditions to carry out Gas Flaring activities.
Please confirm that you have read, understood and agree to abide by the conditions to carry out road work activities.
Please confirm that you have read, understood and agree to abide by the conditions to carry out off road activities.
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).
Please confirm that you have read, understood and agree to abide by the conditions listed within the exemption notice.
Please select the relevant LG Areas
Please select the relevant LG Areas.
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
The person completing this form has read and understood the work or activity conditions
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.
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