APPLICATION FORM
Transhipment
To obtain approval to tranship a hazardous
substance through New Zealand
Send to Environmental Protection Authority preferably by email (HSApplications@epa.govt.nz) or alternatively by post
(Private Bag 63002, Wellington 6140)
Payment must accompany application; see our fees and charges schedule for details.
Name of the substance to be transhipped
Date
www.epa.govt.nz
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Application Form Approval to tranship a hazardous substance through New Zealand
Completing this application form
1. This form has been approved under section 51 of the Hazardous Substances and New
Organisms (HSNO) Act 1996. It covers the importation of hazardous substances into New
Zealand solely for transhipment, i.e. export within 20 working days to a destination outside
New Zealand. This includes goods which remain on a craft or vessel, and those which are
removed for short-term storage before export. If you intend processing the goods in any way,
including repackaging, then this is not transhipment but importation and/or manufacture.
2. This form is to be used for an application to tranship through New Zealand any hazardous
substance which does not have a relevant HSNO approval or for which the approval
conditions cannot be met. If the criteria for transhipment cannot be met, you will need to apply
for an approval to import or manufacture a hazardous substance for release or into
containment. All forms are available on our website.
3. It is recommended that you contact an Applications Advisor at the Environmental Protection
Authority (EPA) as early in the application process as possible. An Applications Advisor can
assist you with any questions you have during the preparation of your application.
4. This application form may be used to seek approvals for more than one hazardous substance,
if the substances and uses are of a similar nature.
5. Unless otherwise indicated, all sections of this form must be completed for the application to
be formally received and assessed. If a section is not relevant to your application, please
provide a comprehensive explanation why this does not apply. If you choose not to provide
the specific information, you will need to apply for a waiver under section 59(3)(a)(ii) of the
HSNO Act. This can be done by completing the section on the last page of this form.
6. Any extra material that does not fit in the application form must be clearly labelled, crossreferenced, and included with the application form when it is submitted.
7. Please add extra rows or tables where needed.
8. You must sign the form (the EPA will accept electronically signed forms) and enclose the
application fee (including GST) unless you are already an approved EPA customer. To be
recognised by the EPA as an “Approved customer”, the applicant must have submitted more
than one application per month over the preceding six months, and have no history of delay in
making payments, at the time of presenting an application.
9. Information about the application fees is available on the EPA website.
10. All application communications from the EPA will be provided electronically, unless the
applicant specifically requests otherwise.
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Application Form Approval to tranship a hazardous substance through New Zealand
Commercially sensitive information
11. The EPA strongly advises applicants to provide as much information relating to the hazard
classification and use of their substance as possible to help inform the EPA’s assessment as well
as for submitters and decision-makers. We expect this information to be publicly available in the
application unless there is a genuine argument for it to be considered as commercially sensitive.
12. Commercially sensitive information may be put in a confidential appendix to this form (also
available on our website) and be identified as confidential. If you consider any information to be
commercially sensitive, please show this in the relevant section of this form providing your detailed
reasons for considering it to be commercially sensitive and cross referencing to where that
information is located in the confidential section.
13. Any information you supply to the EPA prior to formal lodgement of your application will not be
publicly released, unless it has already been made publicly available as part of the consultation
process. Following formal lodgement of your application any information in the body of this
application form and any non-confidential appendices will become publicly available.
14. Once you have formally lodged your application with the EPA, any information you have supplied
to the EPA about your application is subject to the Official Information Act 1982 (OIA). If a request
is made for the release of information that you consider to be confidential, your view will be
considered in a manner consistent with the OIA and with section 57 of the HSNO Act. You may be
required to provide further justification for your claim of confidentiality.
Definitions
CAS Number
Chemical Abstracts Service number. This is a unique identifier for a chemical
substance
Any substance with one or more of the following intrinsic properties:
Hazardous substance

Explosiveness

Flammability

A capacity to oxidise

Corrosiveness

Toxicity (including chronic toxicity)

Ecotoxicity, with or without bioaccumulation, or
which on contact with air or water (other than air or water where the temperature
or pressure has been artificially increased or decreased) generates a substance
with any one or more of the properties specified in this definition
IMDG / IATA Code
The principal international rules for the carriage of packaged dangerous goods by
sea are published in the International Maritime Dangerous Goods Code (IMDG
Code). The International Air Transport Association (IATA) Dangerous Goods
Regulations (DGR) Manual is the industry standard for transportation of
dangerous goods by air
IUPAC

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International Union of Pure and Applied Chemistry. The world authority on
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Application Form Approval to tranship a hazardous substance through New Zealand
chemical nomenclature
Relabelling
Action of changing the label of a formulated substance intended to be imported in
New Zealand in order to meet the EPA criteria for information content. This
action can also occur when the formulated substance is repacked into packaging
of different sizes
Repackaging
Movement or transfer of a substance from one container to another without a
change in composition of the formulation or the labelling content, for sale or
distribution
Any of the following:

Any element, defined mixture of elements, compounds or defined mixture of
compounds, either naturally occurring or produced synthetically, or any
mixtures thereof;

Any isotope, allotrope, isomer, congener, radical or ion of an element or
compound which has been declared by the Authority, by notice in the
Gazette, to be a different substance from that element or compound;

Any mixtures or combinations of any of the above;

Any manufactured article containing, incorporating or including any
hazardous substance with explosive properties.
Substance
(section 2(1) HSNO Act)
Transhipment
The importation of hazardous substances or new organism(s) into New Zealand
solely for the purpose of exporting them within 20 working days to a destination
outside New Zealand. This includes goods which remain on a craft or vessel, and
those which are removed for short-term storage prior to re-export.
If the goods are processed in any way, including repackaging, then this is not
transhipment but importation or manufacture
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Application Form Approval to tranship a hazardous substance through New Zealand
1. Applicant details
1.1.
Applicant
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
Phone (office and / or mobile):
Fax:
Email:
1.2.
Applicant’s location address in New Zealand (if applicable and different from above)
Address:
1.3.
Formal correspondence contact
All formal correspondence will be sent to the contact person for the application identified here
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
Phone (office and / or mobile):
Fax:
Email:
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Application Form Approval to tranship a hazardous substance through New Zealand
1.4.
Invoice contact
Only if different from 1.3. Formal correspondence contact - invoice will be sent to the contact person identified
here
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
Phone (office and / or mobile):
Fax:
Email:
1.5.
Shipping Organisation
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
Phone (office and / or mobile):
Fax:
Email:
1.6.
Supplier Organisation
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
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Application Form Approval to tranship a hazardous substance through New Zealand
Phone (office and / or mobile):
Fax:
Email:
1.7.
Port Agent
Company Name:
Contact Name:
Job Title:
Postal Address (provide only if not the same as the physical):
Physical Address:
Phone (office and / or mobile):
Fax:
Email:
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Application Form Approval to tranship a hazardous substance through New Zealand
2. Identity of the substance
Any commercially sensitive information may be provided in the confidential appendix of this form
This section should include sufficient information to identify the substance(s) unequivocally.
For example:
Substance information
Details
Other Classes
Class 1
Substance name (as listed in the IMDG / IATA Code)
UN ID number
Trade Names
Chemical Name (Chemical Abstracts Preferred Index
name or IUPAC name)
Molecular Formula
CAS Registry Number
Impurities
For mixtures, the composition of the substance should also be provided, i.e. list the chemical name
and CAS number (if provided), function (e.g. active ingredient, emulsifier, surfactant, filler) and
percentages of ALL components (including non-hazardous components and impurities). This
information may be best expressed in tabular form. Note: This may be provided in a confidential
appendix.
3. Hazardous properties of the substance
Information should be provided on the hazardous properties of the substance(s) known to the
applicant. You must consider each of the six hazardous properties below and provide information on
those properties that trigger any threshold level.
Hazard Class
Explosiveness
Flammability
Oxidising properties
Corrosiveness
Toxicity
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Hazard Classification
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Application Form Approval to tranship a hazardous substance through New Zealand
Hazard Class
Hazard Classification
Ecotoxicity
If your substance is a mixture and you cannot provide direct information on its hazardous properties,
you can apply mixture rules to the hazardous components of the mixture. If you do this, then you will
need to provide information on the hazardous properties of each hazardous component of the mixture,
and show your workings.
The above information can be provided in terms of the HSNO classification, if known and the UN
hazard class and any subsidiary risks (where the UN hazard classification reflects all hazardous
properties).
4. Management of the substance
4.1.
Cargo details
Provide information on the hazardous substance(s) to be transhipped.
Cargo information
Packaging (UN packaging code,
if applicable)
Labelling
Quantity of the substance(s)
Total gross weight
Total net weight
Total Net Explosive Quantity
(NEQ, NEM, NEC)
Stowage arrangements on board
the vessel / craft
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Details
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Application Form Approval to tranship a hazardous substance through New Zealand
4.2.
How the substance(s) will be managed while in transit
Provide information on how and where the substance(s) will be stored both on and off the vessel or
craft. Include details on transportation to and from the storage facility and the security of the storage
facility.
Cargo information
Details
Stowage arrangements on board the
vessel / craft
Security arrangements if stored on board
the vessel while in port
Unloading and loading arrangements if
storage is required off the vessel while port
activities take place
Storage location
Location Test Certificate (if available)
Security arrangements if storage is
required off the vessel while port activities
take place
4.3.
Emergency plans for the substance(s) while in transit
Provide information on any management contingency plans to be implemented in case of an
emergency. Describe actions to be taken to:
Scenario
Warn people at the location, and in
surrounding areas that may be adversely
affected by any emergency
Tell people at the location, and in surrounding
areas what actions they should take to protect
themselves
Tell people at the location, and in surrounding
areas how to contact an emergency service
provider
Tell people at the location, and in surrounding
areas how to obtain information about the
hazardous properties
Highlight the purpose and location of
equipment or material to be used to manage
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Action
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Application Form Approval to tranship a hazardous substance through New Zealand
Scenario
Action
an emergency and how to use them
Aid or treat any person injured in an
emergency
Manage an emergency so that:

its adverse effects are first restricted to the
area initially affected

it is reduced in severity as soon as
practicable

it is eliminated, if reasonably possible

re-establish controls on the substance if
any is remaining after an emergency
Identify the persons with responsibility for
undertaking the above actions with:

how to contact the person

any special skills the person is required to
have

any actions that person is expected
undertake
4.4.
Information on import/export arrangement
Information needs to be provided on the:

primary origin of shipment

last port prior to import into New Zealand

mode of transport into and out of New Zealand (e.g. ship or aircraft)

flight number / ship name into and out of New Zealand

date / time of arrival into and departure out of New Zealand

port of entry into New Zealand / port of exit from New Zealand

next port after departure from New Zealand
When approval is sought for the repeated transhipment of a substance over a lengthy period, the
information supplied should describe the import / export arrangements as specifically as possible
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Application Form Approval to tranship a hazardous substance through New Zealand
5. Miscellaneous
Provide any other information you consider relevant to this application that is not already included.
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Application Form Approval to tranship a hazardous substance through New Zealand
6. Checklist
This checklist is to be completed by the applicant
Application
Comments/justifications
All sections of the application form
completed or you have requested an
information waiver under section 59 of the
HSNO Act
☐ Yes ☐ No
Confidential data separate to the main form.
Please note the EPA strongly encourages
applicants to provide as much information as
possible in the main body of the application
form unless there is a genuine argument that
it is commercially sensitive.
☐ Yes ☐ No
Appendices enclosed
☐ Yes ☐ No
(If No, please discuss with an
advisor to enable your application
to be further processed)
Administration
Are you an approved EPA customer?
☐ Yes ☐ No
If yes are you an:
Applicant: ☐
Agent:
☐
If you are not an approved customer,
payment of fee will be by:

Direct credit made to the EPA bank
account (preferred method of payment)
Date of direct credit:
☐ Yes ☐ No
☐ Payment to follow

Cheque for application fee enclosed
☐ Yes ☐ No
☐ Payment to follow
Electronic signed copy of application emailed to the EPA
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☐ Yes
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Application Form Approval to tranship a hazardous substance through New Zealand
Signature of applicant or person authorised to sign on behalf of applicant
☐
I am making this application, or am authorised to sign on behalf of the applicant or applicant
organisation.
☐
I have completed this application to the best of my ability and, as far as I am aware, the
information I have provided in this application form is correct.
Signature
Date
Request for information waiver under section 59 of the HSNO Act
☐
I request for the Authority to waive any legislative information requirements (i.e. concerning the
information that has been supplied in my application) that my application does not meet (tick if
applicable).
Please list below which section(s) of this form are relevant to the information waiver request:
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