This form is to be completed by persons carrying out works on, over or under Safe Transport Victoria managed waters or unmanaged Victorian State waters and who wish to apply to control navigation, prohibit navigation and movement of vessels and/or regulate anchoring of vessels.

Safe Transport Victoria can only issue a works direction or notice in relation to the operation of vessels on waters under their control or unmanaged waters.

Works include:

    • construction, maintenance or decommissioning of a facility or infrastructure;
    • dredging a channel and related activities;
    • construction, maintenance or decoration of a building or other structure;
    • demolition or removal of a building or other structure;
    • erection, maintenance and removal of signs or hoardings;
    • removing, destroying or lopping vegetation

As part of this application you will need to attach or fill out an assessment of safety risks associated with the works and the proposed risk controls to be implemented to eliminate or reduce those safety risks. Your application cannot be considered without a risk assessment

If you are seeking an exclusion zone or vessel anchorage regulation, you must attach a map marking the exclusion and/or regulation areas. The map cannot be hand drawn. Maps must show relevant infrastructure and reference Lat/Long coordinates to to WGS84.

There is no fee to lodge this form.

Works application form

Applicant Details

Business address(Required)
Postal Address

Work details

Specify the waters affected by the works.
Specify the waters affected by the works)
Duration of works: Start date(Required)
Duration of works: Finish time(Required)
:
Duration of works: Finish date(Required)
Duration of works: Finish date(Required)
:

Restriction and/or prohibition information

What regulation or prohibition are you seeking to restrict the navigation or movement of vessels? Choose all that apply and provide details.
MSA 211 (1)(a) Directions to vessel masters to regulate navigation or movement of vessels within the works vicinity.
MSA 211 (1)(b)(i) Exclusion zone - prohibit all vessels and/or persons in the works vicinity.
MSA 211 (1)(b)(ii) Regulate the position and manner in which any vessel may anchor or be secured in the works vicinity.

Zone management and infrastructure

(eg. type quantity & location of signs/bouys/markers)
(e.g signs/notices at location, notifying local clubs and user groups, engagement with other authorities)
Are you installing any infrastructure or intending to use heavy machinery/equipment within the works area?(Required)
(eg. Scaffolding, lighting, generators, heavy lift equipment)

Vessel Usage

Vessels used for commercial purposes must comply with the Marine Safety Domestic Commercial Vessels National Law Act. For details on National Law please contact the Vessel Safety Unit on 1800 223 022.
Will vessels be used in conjunction with the works?(Required)

Risk assessment

As part of this application, you must include an assessment of risks associated with the works including risks specific to vessels and persons in the works vicinity.
Have you already completed a risk assessment to identify the risks/hazards associated with the works on, over or under waters and listed control measures to mitigate or reduce the risks/hazards?(Required)

Risk Assessment

  1. Identify and consider each of the hazards/risks associated with the works. What can happen, how it can happen given a number of different circumstances, or in conjunction with another hazard?
  2. Identify the Likelihood of each hazard/risk occurring. Is it Almost Certain, Likely, Moderate, Unlikely or Rare? Identify what the Consequence would be. Would it be Insignificant, Minor, Moderate, Major or Catastrophic?
  3. Match the Likelihood score and the Consequence score to determine the Risk Rating. Is it High, Significant, Moderate or Low? Any identified Risk Rating in the Moderate, Significant or High categories require some form of control measure to reduce the risk.
  4. Identify and record the control measures that are already in place to reduce the level of risk associated with the hazard and determine if any additional controls are required to reduce the risk to an acceptable level. Include both preventative controls (to prevent a hazard from occurring) and mitigating controls (to reduce the degree of harm in the event of a hazard or incident occurring). Ensure that the number and effectiveness of controls reflect the level of risk.
  5. Re-assess the risk rating for each identified hazard/risk taking into account the specified control measures.

Likelihood (L)

Likelihood Description Score
Almost Certain Event expected to occur (5) High (15 - 25)
Likely Event may occur (4) Significant (10 - 14)
Moderate Event may occur once in 3 events (3) Moderate (5 - 9)
Unlikely Event may occur once in 10 events (2) Low (1 - 4)
Rare Event occurs only in exceptional circumstance (1) Low (1 - 4)

Consequence (C)

Consequence Description Score
Insignificant First aid (1) Low (1 - 4)
Minor Medical treatment (2) Low (1 - 4)
Moderate Hospitalisation (3) Moderate (5 - 9)
Major Single death/ multiple injuries (4) Moderate (5 - 9)
Catastrophic Multiple deaths (5) High (15 - 25)

Risk assessment (If not attached)

Hazard/Risk
Identify, record and assess the hazards and risks with this activity/event
Initial likelihood (score 1 - 5)
Initial consequence (score 1 - 5)
Initial risk rating (likelihood score x consequence score)
 
Preventative controls
List control measures in place to prevent a hazard from occurring
Revised likelihood (score 1 - 5)
Revised consequence (score 1 - 5)
Revised risk rating (likelihood score x consequence score)
 
Mitigating controls
List control measures to reduce the degree of harm in the event of an incident occurring
 

Attachments

Attach your risk assessment, maps marking the exclusion and/or regulation areas and any other supporting documentation.
Max. file size: 100 MB.

Declaration and signature

Declaration(Required)
Date(Required)

Safe Transport Victoria collects and holds the personal information provided in this notice to assist the Director, Safe Transport Victoria to administer the Marine Safety Act 2010 (Vic) and Marine Safety Regulations 2012 (Vic).

Safe Transport Victoria is committed to protecting personal information in accordance with its obligations under the Marine Safety Act 2010 (Vic) and the Privacy and Data Protection Act 2014 (Vic). The personal information provided in this notice may be disclosed to other government agencies in accordance with section 306 of the Marine Safety Act 2010 (Vic) and section 177 of the Transport Integration Act 2010 (Vic).

It is an offence under the Marine Safety Act 2010 (Vic) to give information that is false or misleading in relation to a request to make a waterway rule. The individuals whose personal information is collected on this notice have a right to seek access to this personal information and to seek correction of any error in the personal information held. All individuals whose personal information is included with this notice should be informed of this fact.