Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • This provisional improvement notice (PIN) is issued under section 90 of the Work Health and Safety Act 2011 (the Act). This PIN requires the duty holder to whom it is issued to remedy a contravention, prevent a likely ontravention from occurring or remedy the things or operations causing the contravention or likely contravention of the Act or Regulations. Depending on the particular contravention, the duty holder may be an individual natural person or an organisation such as a company or public authority. Section 97 of the Act requires that the person to whom a PIN is issued must, as soon as practicable, display a copy of the PIN in a prominent place at or near the workplace, or part of the workplace at which work is being carried out that is affected by the PIN. There are a number of things that must be done or taken into account before a PIN is issued by a HSR – see reverse side of this form for relevant information.

1. Health and safety representative (HSR)

  • First Name:

  • Surname:

  • Contact number:

  • Work group represented:

2. PIN issued to:

  • Name of duty holder: (i.e. individual natural person or an organisation such as a company or public authority as relevant)

  • Address:

  • State / territory:

  • Postcode:

3. PIN given to (if the PIN is given to someone on behalf of the duty holder):

  • First Name:

  • Surname:

  • Position:

  • Contact number:

4. I have consulted with the duty holder prior to issuing this PIN (section 90(3)) of the Work Health and Safety Act 2011:

  • Yes

  • No

5. Details of contravention:

  • Photos

  • Add location
  • I (name):

  • reasonably believe on:

  • Date:

  • Time:

  • that you are contravening a provision

  • or have contravened a provision in circumstances that make it likely that the contravention will continue or be repeated; of the:

  • Work Health and Safety Regulation 2011, regulation 315A

  • Brief description of how the provision is being or has been contravened:

  • Note: The HSR may, but is not required to, specify measures, in accordance with section 93 (1) of the Work Health and Safety Act 2011,that they believe should be taken to remedy or prevent the contravention or likely contravention or matters or activities causing the contravention or likely contravention:

6. Compliance:

  • Date PIN issued:

  • Date compliance with PIN required (Minimum of 8 calendar days after date PIN issued):

  • Signature of HSR:

General information about provisional improvement notices (PINs)

  • 1. A health and safety representative (HSR) may issue a PIN if they reasonably believe that a provision of the Work Health and Safety Act 2011 (WHS Act) or any regulation is being contravened or has been contravened in circumstances that make it likely that the contravention will continue or be repeated.

  • 2. A PIN is issued to the relevant duty holder to remedy a contravention or likely contravention of the Act or Regulation. The duty holder may be an individual natural person or an organisation such as a company or public authority. The duty holder does not necessarily have to be in the workplace where the HSR works – for example, they could be a designer of plant, buildings and structures; or a manufacturer or supplier of plant or substances. However, the contravention must relate to the work group the HSR represents.

  • 3. A HSR can issue a PIN to the relevant duty holder by one of the methods listed in section 209 of the WHS Act. For example:
    • delivering it personally to the duty holder, or
    • leaving it for the duty holder at the workplace to which the PIN relates with a person who is in management or control of that workplace (for example, leaving it with the area manager).
    If the above methods of delivery are not possible, the HSR can send it by post, fax or electronic transmission to the home or business address of the duty holder or leave it for the duty holder at their home or business with a person over 16 years who lives or works there.

  • 4. The HSR must consult with the duty holder about remedying the contravention prior to issuing the PIN (see section 90(3)) of the WHS Act).

  • 5. A HSR cannot issue a PIN unless the HSR has completed an approved initial HSR training course or completed that training when acting as a HSR for another workgroup or completed training equivalent to HSR training under the WHS Act.

  • 6. A HSR cannot issue a PIN in relation to a matter if an inspector has already issued (or decided not to issue) an improvement notice or prohibition notice in relation to the same matter (see section 90(5) of the WHS Act).

  • 7. The duty holder to whom the PIN is issued is responsible for fixing the identified contravention by the date written in ‘Date compliance with this PIN is required’. It is an offence under section 99 of the WHS Act for the person not to comply with the PIN by the ‘Date compliance with the PIN is required’ – penalties apply.

  • 8. If the PIN recipient wishes to dispute the PIN, they can contact the regulator and request an inspector to review the PIN – this must be done within seven days of the ‘Date of issue’ of the PIN. The inspector will review and inquire into the circumstances that are the subject of the PIN up to and after the compliance date for the PIN has expired. An inspector can confirm, confirm with changes or cancel the PIN. A copy of a decision by an inspector must be given to the applicant for the PIN review and the HSR who issued the PIN. If the PIN is confirmed (with or without changes), the PIN is taken to be an improvement notice issued by the inspector.

  • 9. For urgent issues that are an immediate threat to the health and safety of any person, a PIN may not be an appropriate means to address the situation. Refer to section 85 of the WHS Act regarding the right of a HSR to direct that unsafe work cease.

  • 10. If there is more than one contravention, a separate PIN should be written for each contravention.

  • 11. If the PIN contains formal irregularities, defects or fails to use the correct name of the person to whom the PIN is issued, the PIN may still be valid. The PIN will not be valid, however, if the formal irregularity or defect causes or is likely to cause substantial injustice to the PIN recipient or if the PIN fails to sufficiently identify the PIN recipient (see section 98 of the WHS Act.)

  • 12. A reasonable time should be allowed between the ‘Date PIN issued’ and the ‘Date compliance with PIN required’, to enable compliance to be achieved. However, the date for compliance must be at least eight days after the date of issue.

  • 13. The HSR should retain a copy of the completed PIN for their records.

  • 14. If the issue has not been remedied by the ‘Date compliance with PIN required’ and an inspector has not already attended the workplace, the regulator should be contacted.

  • 15. The PIN recipient must as soon as practicable, display a copy of the PIN in a prominent place at or near the workplace, or part of the workplace that is affected by the PIN.

  • 16. A person must not intentionally remove, destroy, damage or deface a PIN that is displayed during the period the PIN is in force.

  • 17. Failure to do any of the things referred to in points 15 and 16 is a contravention of the WHS Act and penalties apply.

  • 18. If the person to whom the PIN is issued disagrees with the PIN or believes they will have difficulty complying with it, they should discuss this with the HSR who issued the PIN. They may also request an inspector to attend (see point 8 above).

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.