Forms
Appeal of a decision, order or administrative penalty
All appeals will be directed to the Labour Board. Visit Labour Board Forms.
Compliance Notice – Form 401
Used to submit a Compliance Notice (in response to an order).
Form 401 (PDF: 200k)
Form 401 (MS Word)
Reprisal Complaint – Form 503
Used to make a reprisal complaint to the Occupational Health and Safety Division. This form is not to be used for a Reprisal Appeal (the form required for the appeal is found on the Labour Board website).
Deviation Application – Form 301
An application to deviate from a regulation as provided in Section 83(1) of the Occupational Health and Safety Act.
Code of Practice Application
An employer can apply to the Director for a code of practice under certain Regulations. Contact the Safety Branch for assistance at 1-800-952-2687.
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: 229k)
Form 1101 (MS Word)
Other
Fire Safety Checklist (PDF: 120k)
Hazard Assessment (PDF: 80k)
Musculoskeletal Disorder Report (PDF: 80k)
New Employee (PDF: 169k)
Sample Incident Report (PDF: 162k)
Sample Investigation Report in English (PDF: 57k)
Sample Investigation Report in French (PDF: 86k)
Sample Workplace Inspection Checklist in English (PDF: 250k)
Sample Workplace Inspection Checklist in French (PDF: 258k)
Violent Incident Report (PDF: 120k)
Workstation Evaluation Report (PDF: 142k)