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Feedback form

Document: National Pollutant Inventory - Form (published 01.01.04)

NPi Feedback Form

npi_feedback.pdf (174.7 kb)

Facility registration form: Online reporting system

Document: National Pollutant Inventory - Form (published 01.05.12)

Facility Registration Form

npi_form.pdf (51 kb)

Notification of sale/installation/relocation of an X-ray unit

Document: Radiation - Form (published 30.10.12)

If you are relocating X-ray apparatus, you must notify the EPA using the form below within fourteen days of the change.

radiation_sale.pdf (47 kb)

Template for a Combined Radiation Management Plan and Radiation Source Register for a business using ultraviolet cosmetic tanning units

Document: Radiation - Form (published 03.07.12)

This template has been developed to assist businesses that operate a cosmetic tanning unit in the preparation of a Radiation Management Plan and Radiation Source Register that will required under the licence to possess a radiation source.

draft_template_CTU_RMP_Version_1_July_2012.pdf (797.5 kb)

Auditor accreditation proof of identity

Document: Site contamination - Form (published 01.01.09)

Auditor accreditation proof of identity form

sc_auditor_identity.pdf (88.2 kb)

Application for mutual recognition as a site contamination auditor in South Australia

Document: Site contamination - Form (published 01.01.09)

Application form for mutual recognition as a site contamination auditor in South Australia.

sc_auditor_recognition.pdf (37.8 kb)

Site contamination auditor specialist team members

Document: Site contamination - Form (published 01.01.09)

This form is to be used by site contamination auditors accredited pursuant to the Environment Protection Act 1993 to provide details of their specialist team members, and details of any changes to their specialist team members which occur during their accreditation term, to the Environment Protection Authority (EPA).

sc_auditor_specialist.pdf (108.7 kb)

Solaria form

Document: Radiation - Form (published 01.03.08)

Consent to exposure to UVR from a tanning unit form

solaria_consent_form_v1.pdf (26.2 kb)

Surrender of environmental authorisation

Document: Licensing - Form (published 01.07.09)

Surrender of Environmental Authorisation form.

surrender.pdf (24.1 kb)

Changes to vehicle details

Document: Licensing - Form (published 01.07.09)

Changes to Vehicle Details - Application for Approval.

vehicles.pdf (36.9 kb)

Transfer of authorisation form

Document: Licensing - Form (published 03.07.12)

This form needs to be filled out if you want to apply for the Transfer of an existing EPA Environmental Authorisation (Licence or Exemption or Works Approval).

transfer_authorisation.pdf (177.3 kb)

Application for Accreditation as a Compliance Tester

Document: Radiation - Form (published 29.02.12)

form_radiation_accreditation.pdf (77.8 kb)

Compliance statement: Plain dental x-ray apparatus

Document: Radiation - Form (published 01.06.09)

Compliance statement - plain dental x-ray apparatus

form_radiation_statement.pdf (249.7 kb)

Auditor annual return

Document: Site contamination - Form (published 09.04.10)

Auditor annual return form

sc_annual return.pdf (60.2 kb)

Applicaton for renewal of accreditation as a site contamination auditor pursuant to the Environment Protection Act 1993

Document: Site contamination - Form (published 10.07.12)

This form is to be used by persons who wish to apply for renewal of their accreditation as a site contamination auditor pursuant to the Environment Protection Act 1993 (the Act).

sc_audit_renewal.pdf (132.8 kb)

Site contamination system - notification by auditor after commencement of audit

Document: Site contamination - Form (published 11.09.12)

A site contamination auditor must, within 14 days after the commencement of a site contamination audit for which the auditor is the responsible auditor, notify the Authority in writing of the person who commissioned the audit and the location of the land to which the audit is to relate.

sc_audit_comm.pdf (138.6 kb)

Site contamination audit statement

Document: Site contamination - Form (published 08.09.09)

Site contamination auditor form - Site Contamination Audit Statement

sc_audit_stmt.pdf (37 kb)

Notification by auditor after termination (before completion) of audit

Document: Site contamination - Form (published 08.09.09)

Site contamination auditor form: Notification by auditor after termination (before completion) of audit

sc_audit_term.pdf (26.1 kb)

Interim Audit Advice

Document: Site contamination - Form (published 22.10.09)

Site contamination auditor form: Interim Audit Advice

sc_audit_advice.pdf (48 kb)

Notification by Owner of Sale/Disposal of an X-ray apparatus

Document: Radiation - Form (published 01.03.11)

Regulations 54 and 55 require that anyone selling, replacing or disposing of x-ray apparatus or major components must notify the division in writing within seven days of the sale or disposal.

radiation_55.pdf (47 kb)

Radiation Incident Form

Document: Radiation - Form (published 01.05.12)

Radiation Incident Form

radiation_incident_form.doc (118.8 kb)

NPI audit checklist

Document: National Pollutant Inventory - Form (published 31.10.09)

NPI audit checklist

npi_audit checklist.pdf (28 kb)

Application form - Limited purposes for railway systems

Document: Licensing - Form (published 22.09.09)

Limited purposes for railway systems.

form_limited_railway.pdf (42.9 kb)

Annual waste management plan/application for approval to dispose of unsealed radioactive substances

Document: Radiation - Form (published 22.09.09)

Annual waste management plan/application for approval to dispose of unsealed radioactive substances.

form_wmp.doc (172 kb)

Application for Approval of Collection Depot Reverse Vending Machine (RVM)

Document: Container deposit - Form (published 02.07.12)

Application for Approval of Collection Depot Reverse Vending Machine (RVM) Environment Protection Act 1993 Section 69 Beverage Container Provisions. This form is designed to be used in conjunction with Guidelines for collection depots–RVM.

collection_depot_rvm.pdf (57.6 kb)

Application to Vary an Approval for a Collection Depot

Document: Container deposit - Form (published 02.07.12)

This form is to be used to apply for a variation to an approval to operate a collection depot. It is relevant for a change of ownership or change of proprietor/s name. An Application for Approval of a Collection Depot must be submitted if the depot is changing location, thereby requiring a new approval.

collection_depot_vary.pdf (60.6 kb)

Application for a Licence to Possess a Non-Ionising Radiation Source

Document: Radiation - Form (published 03.07.12)

As from 1 July 2012, owners (includes leasees) of commercial tanning units (CTUs) that emit non-ionising radiation, must apply for a Licence to Possess using this form.

application_possess_non_ionising.pdf (92.1 kb)

Application for a Licence to Possess an Ionising Radiation Source

Document: Radiation - Form (published 03.07.12)

As from 1 July 2012, owners (includes leasees) of radiation sources (ionising radiation apparatus, sealed radioactive sources and premises where unsealed radioactive substances are used or stored), must apply for a Licence to Possess using this form.

application_possess_ionising.pdf (59 kb)

Notification of a Research Study Involving Exposure of Humans to Ionising Radiation

Document: Radiation - Form (published 30.10.12)

Researchers to notify the Radiation Protection Branch of their intention to undertake research involving exposure of research participants to ionising radiation and to provide summary information.

rpc_human research.pdf (106.7 kb)

Setting Environmental Values for Lake Bonney SE and its catchments

Document: Water - Form (published 23.03.12)

The EPA is responsible for managing the water quality of inputs to Lake Bonney SE and is seeking to develop community agreed Environmental Values for the lake through informed community consultation process.

lake_bonney_feedback.pdf (312.6 kb)

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