Close Approach Request

Full Name*
Company*
Postal Address*

Street Name and Number

Street Address Line 2

SuburbTown

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Start Date

MonthDayYear
Date
Work Type
Notes & Comments
Upload Supporting Documents

Cancelof
Please Confirm:*

I declare that I understand and agree to comply with the following codes of practice, and New Zealand Electrical Codes/Regulations
NZECP 34: 2001 (ISSN 0114-0663)
Guide for Safety with Underground Services (issued by OHS/Worksafe Oct 2001)
Good Practice Guidelines Excavation Safety (issued by Worksafe July 2016)
ACOP Management of Noise in the Workplace (revised OHS/Worksafe October 2002)
Code of practice for temporary traffic management (COPTTM)
Should be Empty: