Cooling Tower or Warm Water Storage System Variation

About this form

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

If you are changing location or the registered person's details, this variation form cannot be used. A transfer application form or a new registration application form must be completed and submitted to the Health Protection Service.

This application form must be completed by the registered person.

There is no fee required to complete this form.


  • If you have made any significant changes to the cooling tower or warm water storage system, an engineer's risk assessment is required to be completed and submitted with this application.
  • You will need to upload a copy of your current registration certificate, or return the certificate to the Health Protection Service.

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.