Cooling Tower or Warm Water Storage System New Registration

About this form

The form is to be used to apply for a cooling tower or warm water storage system registration under the Public Health Act 1997.

The registration is issued to the person(s) who will have the overall responsibility for the maintenance and day to day running of the system and who would be the first point of contact in the event of a disease outbreak or emergency. The registered person(s) will also be responsible for any contraventions of the Act.

Attachments

  • One form of current photographic identification of each signatory must be provided, sighted and certified by an authorised witness. For details please see Identification requirements.
  • For Company applications a copy of the company‚Äôs current extract (issued within the previous 30 days) from the Australian Securities and Investment Commission (ASIC). This can be obtained on the ASIC website.
  • An engineer's risk assessment is required to be completed and submitted with this application.

Payment options

Visa and MasterCard logos

Payments up to $10,000 can be made with either Visa or MasterCard.

Your personal information

Access Canberra uses this form to collect information which is necessary to allow the ACT Government to provide services to you. Personal Information may be used or disclosed in accordance with the Information Privacy Act 2014.

For details on the collection of personal information in this form please refer to the Access Canberra Information Collection Notice. If you have questions about how your information will be handled please see the Access Canberra Privacy Policy and the ACT Health Privacy Notice or contact us.