APPROVED HANDLER
FORM
URBAN PEST MANAGEMENT
Form 1: Assessment form for knowledge
of the HSNO Act and controls
Send by post to or fax to your test certifier. A list of Test Certifiers is available at:
http://www.epa.govt.nz/search-databases/Pages/testcertifiers-search.aspx
This form demonstrates to a test certifier an applicant’s understanding of the obligations and liabilities,
the hazard classifications, the regulations and controls imposed under the Hazardous Substance and New
Organisms (HSNO) Act 1996 for urban pest management. This form covers the requirements of
regulations 5(1)(a), 5(1)(c), 5(1)(d), 5(1)(e) and 5(1)(f) of the Hazardous Substance and New
Organisms (Personnel Qualifications) Regulations 2001. It should be completed by a training provider.
Applicant name
Contact address (work)
Contact address (home)
Contact Number
Date of Birth
Applicant Declaration
I declare the information I have supplied for this assessment is true, complete, and correct, and that I
have been assessed for the competencies listed in this form by the work supervisor or training provider
named below. I understand that it is an offence to make a false declaration, including supplying false or
misleading information.
Signature
Date
www.worksafe.govt.nz
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Approved Handler Form Urban pest management
Work Supervisor/Training Provider Details
(This section must be completed by the work supervisor or training provider)
Name:
Company Name:
Position:
Business Type:
Contact Address:
Contact Number(s):
Briefly explain the
knowledge and experience
you have with the HSNO
Act which enables you to
make this assessment.
Work Supervisor / Training Provider Declaration
I declare that the information I have supplied for this assessment is true, complete, and correct, and
I have assessed the applicant for the competencies detailed in this form and consider the applicant
has an understanding of the required competencies. I understand that it is an offence to make a
false declaration, including supplying false or misleading information.
Work Supervisor/Training Provider Signature Date Signed
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Approved Handler Form Urban pest management
Competency Assessment
(This section must be completed by the Training Provider or Work Supervisor)
Obligations and Liabilities of an Approved Handler
1. Knowledge of obligations of an Approved Handler
Competency Requirements
The applicant must be able to demonstrate an understanding of the obligations of an Approved
Handler to:

ensure hazardous substances are handled safely;

ensure hazardous substances do not harm people;

ensure hazardous substances do not harm the environment; and

provide guidance to other people handling hazardous substances and be available to assist
Yes
No
Yes
No
them.
Has the applicant demonstrated an understanding of the obligations of an Approved
Handler?
2. Knowledge of obligations of a Person in Charge (who may or may not be
the approved handler)
Competency Requirements
The applicant must be able to demonstrate an understanding of the obligations of the person in
charge to:

ensure necessary test certificates are obtained;

inform local agencies before a hazardous substance location is established;

ensure site plans are available for hazardous substance locations;

ensure protective clothing and equipment are supplied where specified;

ensure handling equipment is adequate, and that substances are contained;

ensure information about the correct disposal of substances is readily available;

ensure emergency management requirements are met;

ensure employees have access to information specific to each hazardous substance (i.e.
labels & data sheets);

ensure signage is provided where necessary;

ensure records are kept of the lifecycle and fate of tracked substances; and

ensure incidents involving hazardous substances are reported to appropriate local
enforcement agencies.
Has the applicant demonstrated an understanding of the obligations of the person in
charge?
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How were these assessments made?
Initials:
Observation
Written Assessment
Other (specify):
Purposes and Principles of the HSNO Act
3. Knowledge of the purpose of the HSNO Act
Competency Requirements
The applicant must be able to demonstrate an understanding that the purpose of the HSNO Act
is to protect the environment and the health and safety of people and communities, by
preventing or managing the adverse effects of hazardous substances and new organisms.
Has the applicant demonstrated an understanding of the purpose of the HSNO Act?
Yes
No
Yes
No
4. Knowledge of the principles of the HSNO Act
Competency Requirements
The applicant must be able to demonstrate an understanding that the principles of the HSNO
Act are to:

safeguard the life supporting capacity of air, water, soil and ecosystems; and

maintain and enhance the capacity of people and communities to provide for their own
economic, social, and cultural wellbeing and for the reasonably foreseeable needs of future
generations.
Has the applicant demonstrated an understanding of the principles of the HSNO Act?
How were these assessments made?
Initials:
Observation
Written Assessment
Other (specify):
Offence, Penalties, Defence Provisions and Compliance
Orders of the HSNO Act
5. Knowledge of the offence provisions of the HSNO Act
Competency Requirements
The applicant must be able to demonstrate an understanding that the offences under the
HSNO Act are:

the importation, manufacture, storage or use of a Persistent Organic Pollutant in
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Approved Handler Form Urban pest management
contravention of the HSNO Act;

knowingly, recklessly or negligently possessing, manufacturing, importing or using of
hazardous substances which contravene the HSNO Act;

failure to comply with controls and regulations made under the HSNO Act;

impersonation of an enforcement officer;

wilful obstruction of an enforcement officer; and

knowingly mislabelling a container containing a hazardous substance.
Yes
No
Yes
No
Yes
No
Has the applicant demonstrated an understanding of the offences under the HSNO
Act?
6. Knowledge of the defence provisions of the HSNO Act
Competency Requirements
The applicant must be able to demonstrate an understanding of the defences under the HSNO
Act. The defences are that the:

action was reasonable and was necessary to protect human life, property or the
environment, and reasonable steps were taken to mitigate or remedy the effects of the
action;

event/action was beyond the control of the defendant, was not reasonably foreseeable, and
the defendant took reasonable steps to mitigate the effects of the event afterwards;

event/action was in the control of the defendant, and the defendant took reasonable steps
to the event, and the defendant took reasonable steps to mitigate the effects of the event
afterwards;

defendant complied with an approved code of practice as a method of achieving
compliance; and

defendant held a current test certificate certifying that those controls had been met.
Has the applicant demonstrated an understanding of the principles of the HSNO Act?
7. Knowledge of the penalties and liabilities imposed by the HSNO Act
Competency Requirements
The applicant must be able to demonstrate an understanding that the penalties and liabilities
for someone who breaches the HSNO Act are:

imprisonment for up to 3 months (upon summary conviction);

fines of up to $500,000;

further fines of up to $50,000 per day for continuing offences;

revocation of permits held by that person; and/or

an order to remedy or mitigate adverse effects.
Has the applicant demonstrated an understanding of the penalties and liabilities that
may apply
to someone who breaches the HSNO Act?
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8. Knowledge of the effects of a compliance order
Competency Requirements
The applicant must be able to demonstrate an understanding that a compliance order has the
following effects:

it may require a person to cease or not commence an activity that contravenes the HSNO
Act, or regulations/controls imposed under the HSNO Act;

it may require a person to cease or not commence an activity relating to a hazardous
substance or new organism that is dangerous, or likely to be dangerous;

it may require a person do something that is necessary to ensure compliance with the
HSNO Act or regulations imposed under the HSNO Act; or anything necessary to avoid,
remedy or mitigate any adverse effects on people or the environment resulting from a
breach of regulations made under the HSNO Act which are:

caused by or on behalf of that person; or

relating to any land that person owns or occupies.
Has the applicant demonstrated an understanding of the effects of a compliance
Yes
No
Yes
No
order?
9. Knowledge of where to find other specific information
Competency Requirements
The applicant must be able to demonstrate that more specific information about the applicant's
obligations and liabilities as an Approved Handler can be found in the HSNO Act.
Has the applicant demonstrated an understanding that more specific information
about the applicant's obligations and liabilities as an Approved Handler can be found
in the HSNO Act?
How were these assessments made?
Observation
Written Assessment
Other (specify):
Hazard Classifications
10.
Knowledge of the hazard classifications for urban pest management
generally
Competency Requirements
The applicant must be able to demonstrate an understanding that:

class 6 substances are toxic to humans and class 9 substances are toxic to organisms in the
environment;
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Initials:
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
subclass numbers (decimal numbers) designate different types of sub-hazards;

category letters (A-D) designate different degrees of hazard in a descending order (i.e. that
subclass 'A' is the most hazardous; 'B' is less hazardous, etc); and

more specific information about the classification of specific substances can be found on the
product label, Safety Data Sheets, urban pest management manuals, and/or the
Environmental Protection Authority (EPA) website.
Yes
No
Has the applicant demonstrated an understanding of the properties of class 6 and 9
substances, including their subclasses, and where more specific information can be
found?
How were these assessments made?
Initials:
Observation
Written Assessment
Other (specify):
Regulations and Controls Imposed Under the HSNO Act
11.
Knowledge of the regulations likely to apply to urban pest
management substances
Competency Requirements
The applicant must be able to demonstrate an understanding that pesticides need to be stored
in appropriate containers, identified correctly and supplied with appropriate information, and
where the Packaging Regulations and Identification Regulations are likely to apply.
The applicant must be able to demonstrate an understanding that pesticides are likely to be
toxic or ecotoxic, so the following regulations are likely to apply:

regulations controlling toxic (class 6), or ecotoxic (class 9) substances (the Classes 6, 8,
and 9 Controls Regulations);

regulations requiring correct disposal (the Disposal Regulations); and

regulations requiring emergency management procedures, signage, containment and/or
emergency equipment (the Emergency Management Regulations).
The applicant must be able to demonstrate an understanding that some urban pest
management are toxic or ecotoxic so they may be subject to regulations:

requiring record keeping (the Tracking Regulations);

that require the user to be qualified to use that substance (the Personnel Qualifications
Regulations).
The applicant must be able to demonstrate an understanding that the specific regulations
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which apply to each transferred or approved substance may have been varied by EPA and the
specific regulations which apply to a substance can be found on the EPA website.
Yes
No
Yes
No
Has the applicant demonstrated an understanding of the regulations likely to apply to
urban pest management, and where more specific information can be found?
12.
Knowledge of the conditions of an Approved Handler’s Test Certificate
Competency Requirements
The applicant must be able to demonstrate an understanding that their Approved Handlers
Test Certificate will limit:

the substance or group of substances they can handle and may also indicate which
substance or group of substances they are not qualified to handle;

which parts of the lifecycle of a substance or group of substances they are qualified for and
may indicate which parts of the lifecycle they are not qualified to manage.
Has the applicant demonstrated an understanding of the regulations likely to apply to
urban pest management, and where more specific information can be found?
How were these assessments made?
Initials:
Observation
Written Assessment
Other (specify):
Notes
Record any other information or experience the Test Certifier may need to know in order to assess
the applicant’s ability to obtain an Approved Handler Test Certificate.
September 2014