Safety advice form

To obtain a safety advice from us, please complete the below form.

Please note: If we need to carry out work s a result of the Safety Advice (e.g. install tiger tails, aerial markers etc), a quote for this work will be sent to you. We typically require 10 working days lead time from receipt of payment to complete most requests.

Please ensure you have familiarised yourself with the Electrical Safety Code of Practice 2020 - Working near overhead and underground electric lines to understand your obligations and prospective means of meeting them.

Please view our privacy statement regarding the collection of data.

Required fields are marked with an asterisk (*).

Contact Details

Person responsible for the work site * Please enter first name and last name

Business name *

ABN

Street address

Suburb/town

State *

Postcode

Postal address If different to the above address

Phone number * Please enter your best business hours contact number as 10 digits with no spaces

Email address *

Work Information

Work industry *

Work type *

Work machinery / equipment / people * Select the activity that has the potential to breach the exclusion zone

Details of work being performed *

Street address of work site * Enter the location of the work site

Suburb/town *

State *

Postcode *

Work commencement date * Please select date or enter in format dd/mm/yyyy

Estimated completion date * Please select date or enter in format dd/mm/yyyy

Before You Dig enquiry / referral number Required for underground assets

Building or adding to a structure near an electric line Are you proposing to build or change a building or structure or do other work on a building or structure within 5 meters of an electric line?

Please note: Under the Electrical Safety Regulation 2013 section 209 you must provide notification to us before works start on any construction or addition or other work on a building or structure that is likely to come within the clearance requirements under the Electrical Safety Regulation 2013 for an overhead or underground electric line. Any reasonable costs associated with required relocation or modification of our assets will be at the cost of the responsible person.

Authorised Persons

Will there be an Energex approved “Authorised Person” on site to receive safety advice? An Energex Authorised Person has fulfilled certain requirements, training and has received an approval letter from us. It is NOT mandatory to receive Safety Advice, if you are unsure please select No.

Is the Authorised Person Electrical or Non-Electrical?

Authorised Person’s name

Authorised Person’s business of employment

Authorised Person’s electrical licence number

Attachments (add any relevant attachments)

Add attachment 1 Please keep file size under 5MB

Add attachment 2 Please keep file size under 5MB

Add attachment 3 Please keep file size under 5MB

Add attachment 4 Please keep file size under 5MB

Terms and Conditions

Electrical Safety Code of Practice 2020: *

I have obtained a copy and am familiar with the Electrical Safety Code of Practice 2020 - Working near overhead and underground electric lines and the Electricity Entity Requirements - Working near overhead and underground electric lines (PDF).

Exclusion zones: *

I am aware that prior to receiving written Safety Advice all exclusion zones must be maintained and communicated to the Person Responsible for the work site.

Written safety advice: *

I am aware that a written Safety Advice will need to be issued in person at the intended work site to the Person Responsible for the work site.

Safety advice form

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