Forms

Applications

Appeal of A Decision or Order - Form 101
-For Appealing an Officer's order(s) or decision(s) to the Executive Director of the Occupational Health and Safety Division.
Form 101 pdf (PDF: 140k)
Form 101 MS Word

Appeal of an Administrative Penalty/Fine
-For Appealing an Administrative Penalty amount only - the substance or nature of the order that led to the penalty cannot be appealed at this stage. The appeal form is found at the Labour Board website.

Compliance Notice - Form 401
-Used to submit a Compliance Notice (in response to an order).
Form 401 pdf (PDF: 112k)
Form 401 MS Word

Complaint of Discriminatory Action - Form 503
-Used to make a discriminatory action complaint to the Occupational Health and Safety Division.
-Note, this form is not to be used for a Discriminatory Action Appeal (the form required for the appeal is found on the Labour Board website under OHS Appeals).
Form 503 pdf (PDF: 146k)
Form 503 MS Word

Deviation Application - Form 301
-An application to deviate from a regulation as provided in Section 83(1) of the Occupational Health and Safety Act.
Form 301 pdf (PDF: 113k)
Form 301 MS Word

Specialized Blast and Special Case Blast Written Work Procedure Template - Form 1101
-This is a template application for specialized blasting or a special case blast.
Form 1101 pdf (PDF: 118k)
Form 1101 MS Word