Application for Working In
Laboratory/Workshop After Hours
On completion, please return this document to Matthew Day, Michael Joseph or the School Office.
1.0
Information
Name of Applicant


Position
Post Graduate Student
Staff


Honours Student
Affiliate
University ID Card Number
Building Name and Number
Contact mobile phone number
Commencement Date: ____________________________
Period of Work
Completion Date:
____________________________
From: ________________________
Duration of Work
To:
________________________


Limited
Overstay
Categories of Work



Low Risk Tasks
Moderate Risk Tasks
High Risk Tasks
Risk Assessment Undertaken
(for Moderate-High Risks Tasks)

YES
After Hours requirements


Weekday
Weekday


Weekend/Public Holiday
Weekend/Public Holiday
Brief description of tasks, equipment used
including reason for use of the laboratory after
hours.
Issue date: July 2014
Review date: July 2015

NO
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2.0
Declaration by Applicant
I confirm that I have my supervisor’s permission to work these hours and have undertaken a risk
assessment for the tasks.

1
Name of Applicant
Signature
Date
2
Approval by supervisor
Name
Signature
Date
3
Approval by Head of School or School Safety Officer
Name
Signature
Date
3.0
Details of Student(s) Accompanying (if any)
Name of Student
ID number
1
2
3
4
5
4.0 Definitions
Normal Operating Hours
Limited After Hours
Overstay
Work
Monday to Friday, 8.00 am to 6.00 pm.
The normal operating hours may vary from workplace to workplace.
Monday to Friday 5.00 am to 8.00 am and 6.00 pm to 11.00 pm.
Saturday, Sunday and Public Holidays 9.00 am to 5.00 pm.
Monday to Friday 11.00 pm to 5.00 am.
Saturday, Sunday and Public Holidays 5.00 pm to 9.00 am.
Any activity undertaken on behalf of the University including clerical duties, study,
laboratory work, research, data collection/analysis
Reference http://sydney.edu.au/whs/guidelines/others/working_after_hours.shtml
Issue date: July 2014
Review date: July 2015
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