Notification Form for the use of Group 2, 3 or 4 Biological Agent

Notification Form for the use of Group 2, 3 or 4 Biological Agents

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Data Protection Note: This data may include personal information which is collected and processed by the Occupational Health and Safety Authority (OHSA collects and processes such information to fulfil its investigative, enforcement and regulatory role in accordance with the Health and Safety at Work Act – (Act XXXIII of 2024 Chapter 646) of the Laws of Malta and applicable subsidiary legislation. All data collected is processed in compliance with the General Data Protection Regulation (GDPR Data collected and processed by OHSA is held confidentially and not shared with any third parties except when necessary and with a justifiable legal basis. To learn more about how OHSA collects, keeps, and processes your private information in compliance with the GDPR, please view OHSA's Data Protection Policy which can be accessed through the following link: https://www.ohsa.mt/data-protection

Complete form must be submitted to OHSA, Chemical Section 30 days prior to the commencement of work involving the use for the first time of a group 2, 3, or 4 Biological Agent (Biological Agents are defined in Regl. 2 of LN 228 of 2003) or for the first time of each subsequent group 4 biological agent and any subsequent new group 3 biological agent where the employer himself classifies that biological agent as per Regl. 13 of LN 228 of 2003 [S.L.646.17]

Name of Company/Establishment*

MFSA Company Registration Number

Full Address of Company/Establishment*

Contact Telephone/Mobile*

Address of premises where the biological agent will be stored or used (if different to that stated above)*

Date of notification

Date

Type of Notification

First time use of Biological agent(s) groups 2, 3 or 4Each subsequent use of a new self-classified group 3 biological agentEach subsequent use of a new group 4 biological agentRe-notification following substantial changes to processes/proceduresOther

If ‘Other’ please state why or if re-notification state reasons why

Type of Biological Agents being notified*

Species of Biological Agent*

Classification Group*

Name(s) of people responsible for Safety & Health at work*

Qualifications of people responsible for Safety & Health at work*

Relevant experience of people responsible for Safety & Health at work*

Has a suitable, sufficient and systematic Risk Assessment (RA) been carried out as required by Regl. 3 of LN 228 of 2003?*

Name of person carrying out RA

Salient control measures highlighted in RA*

Name of Notifier*

0/40

Position in Company/Establishment*

Contact Telephone/Mobile*

Prior to the commencement of any work related to the use for the first time of a group 2, 3, or 4 biological agent or for the first time of each subsequent group 4 biological agent and any subsequent new group 3 biological agent where the employer himself classifies that biological agent as per Regl. 13 of LN 228 of 2003 [S.L.424.25], the completed form has to be at OHSA, Chemical Section

example@example.com

Section A

Section B

Section C