Engineering Authority Application
Refer RailCorp Engineering Procedure EPA 241 – Engineering Authority for Design.
Note: This form is to be a part of an overall application for Engineering Authority. This
form is only for engineering authority for design roles named in EPA 241.
The form has two Parts. Part A is submitted once per discipline for each group of
applicants and Part B may be copied for multiple applicants for the same discipline and
submitted together.
Checklist and instructions are provided on the last pages.
PART A: Organisation and Project Information
1
External reference identifier
2
Project name and
RailCorp project number if known
3
Design discipline
Choose only ONE discipline for each
group of applicants in Part B.
Refer RailCorp Engineering Procedure
EPA 241 Engineering Authority for
Design – Appendix
Double click the relevant box and
select “checked”
4
Civil / Structural
Stations and buildings
Electrical
Survey
Geotechnical
Telecommunications
Rolling stock
Track
Signals and control systems
Other (specify):
Brief scope of design services to
be provided and boundaries/
locations
For complex projects attach the scope
5
Design team structure
If Applicant will be part of a design team, attach a Design team structure.
6
Name and design roles of all designers included in this application
Designer name
7
Discipline – Role – Design task competence area(s)
Evidence of organisation’s quality accredited design procedures relevant to RailCorp
projects
e.g. assessment body and reference number or date, or link to certificate register or attach copy
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EPA 241 FM 01 ver 3.1
(Insert External reference ID)
8
(Insert Project Name)
Organisation representative(s)
Name
Position title
Signature
_______________________________
_______________________________
Date
Organisation representative use — Checklist
PART A
Attached – Design team structure if part of a design team
Attached – Quality assurance accreditation evidence if available
Attached – All relevant completed Part B
© RailCorp
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EPA 241 FM 01 ver 3.1
(Insert External reference ID)
(Insert Project Name)
PART B: Applicant Information – Role, Skills and Experience
Part B may be copied for each applicant if there are a group of applicants for the same discipline.
Ensure External reference ID is shown at header of each page
9
Name of applicant
10
Design discipline
Civil / Structural
Stations and buildings
This should match with Item 3.
Double click the relevant box and
select “checked”
Electrical
Survey
Geotechnical
Telecommunications
Rolling stock
Track
Signals and control systems
Other (specify)
Concept
Detail design
11
Design stage
Investigation e.g. Survey, Geotechnical, Environmental or
other report type
Other (specify)
12
Design role(s) and Scope of role(s)
The design role(s) and scope that the applicant is to perform and which the organisation considers the
applicant to have competence. For descriptions of roles, see the instructions.
Double click the relevant box(es) and select “checked”
Proposed design role
Scope of role
e.g. ‘Salt Pan Creek Bridge’ or ‘Belmore Road Overbridge – superstructure
modifications’
Designer
Design checker or
reviewer
Independent design
checker
Design verifier
Design validator
Other (specify):
13
Design competence — Self assessment
Attach competence self assessment with details or cross references that relate the qualifications,
skills and experience to the relevant competence manual or matrix
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EPA 241 FM 01 ver 3.1
(Insert External reference ID)
14
(Insert Project Name)
Experience –show only RELEVANT previous experience
Provide sufficient information on to support the requested competence levels and relevant to the project work.
If there are more than two relevant projects, repeat the following table in an attachment.
Project 1
Project 2
Employer
Client
Project name
Project scope
How was this project
similar to the one you are
applying for?
Your role
The engineering services
you provided (nature and
amount of your
participation)
Your start and finish
dates
Referee name and
number
If you are applying for a
project with complex or
large scale aspects, add
any other relevant factors
which support your
suitability to perform the
work
15a Discipline-specific information
Civil applicants only
Bridges, culverts and/or subways
Right of way
Buffer stops
Services under track
Guard rails
Track slabs
Level crossing (civil aspects)
Transmission line structures
Miscellaneous structures
Tunnels
Platform structures
Stormwater drainage systems
Retaining walls
Walkways and access tracks
15b Discipline-specific information
Signals and control
systems applicants
only
© RailCorp
Issued September 2012
Control tables
Design integrity checks
Microlok Circuits
SSI Circuits
Microlok Data
SSI Data
Relay based interlockings
Other
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(Insert External reference ID)
(Insert Project Name)
Certify
16
Applicant
‘I certify that the information provided in this form and my attachments are correct.’
Name
Signature
17
Date
________________________________________
Organisation representative
‘I certify that the above applicant is competent to undertake the role.’
Name
Date
Position title
Signature
18
________________________________________
External party review (if one exists)
‘I certify that the company has an appropriate competency assessment process in place and that
the above applicant is considered to be competent to undertake the role.’
Name
Date
Position title
Signature
________________________________________
Applicant or organisation representative use — Checklist
PART B Attachments
Design competence self assessment
Detailed CV i.e. relevant qualifications, skills and related experience.
For qualifications gained outside Australia, attach Skills Assessment Authority report, if available
Career log book or portfolio or similar
Civil only – optional: preliminary plans, sketches or draft General Arrangement
Surveying only – If monitoring the track location (e.g. underbore projects) attach a copy of the
Track Monitoring Plan.
Additional Applicant information
RSW Card Application and 100 Point ID Form (required only once per person) to
RCT_competencycards@railcorp.nsw.gov.au
RailCorp Use
Engineering authority allocated
Yes
No
EA reference #:
Comment
Assessor name
Position title
Date
END OF PART B
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EPA 241 FM 01 ver 3.1
Instructions for filling in form EPA 241 FM01
General
 Background to this form is in Engineering Procedure EPA 241 – Engineering Authority for Design.
 Use an appendix for information that does not fit in the space, e.g. landscape tables or charts.
 The instructions or examples are not intended to restrict the format or amount of information
submitted. They are intended to clarify the intent of the form.
 Remember to provide statements that relate relevant qualifications, skills and experience to the
project type and the design role.
Sections
Header, page 2: Insert External reference identifier (from 1) and Project name (from 2)
1. External reference identifier is assigned by the applying organisation.
3. Design discipline: To determine which discipline head assesses the application, refer to EPA 241,
Appendix for “Infrastructure, rolling stock, plant and systems allocation to discipline heads”. The
“RailCorp item” is an asset allocated to the discipline head. (For competencies, refer to the relevant
discipline competency manual or matrix.)
5. Design team structure: Attach a Design team structure so the assessor can see reporting lines
and spread of work (see last page for example)
6 and 12. Design role: Check the relevant boxes for design roles. Functions of the design roles are:
designer — produces a design or carries out surveying activities or engineering investigations
relating to a design
design checker — makes systematic review of design assumptions, calculations, methodology,
use of standards and compliance with mandatory requirements (the person shall not be directly
responsible for producing the design)
design reviewer * — provides a full check of a design ( * applicable to signal design)
Independent design checker — performs work similar in scope and purpose to design checker
(the person shall have had no involvement in developing the design)
design verifier — ensures that the design output for each design stage is consistent with the
design input for that stage
design validator — ensures that the final product conforms to user (customer) specifications and
requirements
12. Scope of role: Describe for example:
 the items or aspects of the project to be handled by the applicant
 area of involvement, e.g. design calculations, surveying, geotechnical investigation etc.
13. Design competence self assessment: Self assessment is carried out against discipline
competence manuals or matrixes located at RailCorp’s engineering website,
http://engineering.railcorp.nsw.gov.au or enquire with the discipline. In the self assessment of
competence, make cross references to the CV to justify the assessment (EPA 241).
14. Experience: Use a table for each relevant project. If there ire more than two relevant projects, use
copies of the table in an attachment.
Experience gained under supervision should be validated that proficiency has been attained (attach a
log book or other documentation).
Declaration form: The Declaration form is to ensure our compliance with the Rail Safety Act 2008.
More information is available at RailCorp’s Engineering web site http://engineering.railcorp.nsw.gov.au
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EPA 241 FM 01 ver 3.1
Design team structure

RailCorp assessors need to see the work each person will do and how the team will be structured.

Only show people with or applying for Engineering Authority for the given project team

You are not limited to providing the information as set out below. You may use your own format so long as it captures the same type of information for
the whole team
Example for multi-disciplinary and/or single discipline structures:
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EPA 241 FM 01 ver 3.1