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Forms: Health and Safety

  • Content last reviewed: November 2020

Several of these forms are available through ServiceOntario.

Note: You have the option of saving a draft of your form by creating a ServiceOntario account or logging into your existing account for you to access/edit/submit this form at a later time.

Construction


Notice of Project [Form 0175]

According to Section 6 of the Regulation for Construction Projects (O. Reg. 213/91) constructors are required to notify the Ministry of Labour before construction begins of any project meeting any of the requirements applicable to this section (for example, having a total expected cost of more than $50,000, or $250,000 if the project is confined to a factory that manufactures or assembles automobiles).

The paper version of this form (catalogue number 027007) is available to order online from ServiceOntario Publications. You can also order by calling 1-800-668-9938 Monday to Friday from 8:30 a.m. to 5:00 p.m. A completed form can submitted by fax but the original signed paper form must still be sent to the local office.

A signed copy of the completed form, whether done online or on the paper form, must be posted in a conspicuous place at the project or be available at the project for review by an inspector.

Registration of Constructors and Employers Engaged in Construction

e-Form | PDF [Form 016-1000E]

According to Section 5 of the Regulation for Construction Projects (O. Reg. 213/91), before beginning work at a project every constructor and employer engaged in construction has to complete an approved registration form.

This form does not have to be submitted to the Ministry of Labour, but it must be at the project while the employer is working there.

This form is available on ServiceOntario.

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Notice of Diving Operation [Form 016-0069E]

This form is used by employers to notify the Ministry of Labour prior to the start of a diving operation in Ontario. This form is available on ServiceOntario.

Notice of Trench Work [Form 016-0070E]

This form is used by constructors to notify the Ministry of Labour, before work is begun at a construction project, if the project includes work on a trench more than 1.2 metres deep into which a worker may enter. This form is available on ServiceOntario.

Notice of Window Cleaning Work [Form 016-0071E]

This form is used by employers, contractors or sub-contractors to notify the Ministry of Labour prior to carrying out window cleaning work at a building in Ontario if a suspended scaffold, boatswain’s chair or similar single-point equipment is to be used. This form is available on ServiceOntario.

Notice of Asbestos Removal Work [Form 016-0072E]

This form is used by constructors or employers to notify the Ministry of Labour before beginning a Type 3 asbestos removal operation and certain Type 2 asbestos removal operations in Ontario. This form is available on ServiceOntario.

Asbestos Work Report [Form 016-0079E]

This form is used by employers of workers in Type 2 or Type 3 asbestos operations. The form must be completed for each such worker at least once in each 12-month period and immediately on the termination of the employment of the worker. The form is submitted to the Provincial Physician at the Ministry of Labour. A copy of the completed form is given to the worker, and a copy is retained by the employer. This form is available on ServiceOntario.

Notice for Tunnels, Shafts, Caissons and Cofferdams [Form 016-0077E]

This form is used by employers to notify the Ministry of Labour before beginning construction work on a tunnel, shaft, caisson or cofferdam. This form is available on ServiceOntario.

Notice of Use of a Suspended Work Platform System [Form 016-0080]

If you’re the Constructor on a construction project, you must notify the Ministry of Labour at least 48 hours before a suspended work platform system is used for the first time. A copy of the completed notice must be kept clearly visible at the worksite for inspection. This form is available on ServiceOntario.

The paper version of this form is available from ServiceOntario Publications.

Request for Designation of Separate Projects

A property owner can apply to the Ministry of Labour to have a single project split into two or more different projects. If approved, each project must be clearly separated by time or location and will have its own constructor who is responsible for onsite workers’ health and safety. The project owner (or the owner’s agent) must make this request. This form is available on ServiceOntario.

Mining


Notice of Mining Activities [Form 016-0073E]

This form is used by employers to notify a Ministry of Labour inspector of: the installation of portable crushing, screening or associated washing equipment or to notify of exploring, dewatering or resuming work at a mine where mining operations have been suspended for more than three months. This form is available on ServiceOntario.

Notice of the Operation of a Test Drill [Form 016-0074E]

This form is used by employers in the mining sector to notify a Ministry of Labour inspector before a test drill is operated at the surface to prove mineral bearing substances, rock, earth, clay, sand or gravel. This form is available on ServiceOntario.

Notice of Magazine or Use of Explosives [Form 016-0075E]

This form is used by the operator of a surface magazine or a mine using explosives to notify the Ministry of Labour and the joint health and safety committee or health and safety representative, if any, before first use of a surface magazine or explosives and annually after first use. This form is available on ServiceOntario.

Notice of a Reportable Incident [Form 016-0076E]

This form is used by mining companies to notify the Ministry of Labour of reportable incidents as identified in section 53 of the Occupational Health and Safety Act and section 21(5) of the Regulation for Mines and Mining Plants. It includes notification of groundfall or rockburst and vehicle incident or fire. This form is available on ServiceOntario.

Notice of Diesel-Powered Equipment [Form 016-0078E]

This form is completed by employers, as required by section 182 (1) of the Regulation for Mines and Mining Plants, before diesel equipment is first used in an underground mine. The completed form must be kept readily available at the mine site. This form is available on ServiceOntario.

Hoist Operator's Medical Certificate [Form 0275E]  PDF

This form may be completed by physicians to certify that mine hoist operators are physically fit to perform their duties. Section 238 of Regulation 854 for Mines and Mining Plants requires that operators of mine hoists undergo a yearly medical examination.

Crane Operator's Medical Certificate [Form 0279E]  PDF

This form may be completed by physicians to certify that crane operators in mines and mining plants are physically fit to perform their duties. Section 195 of Regulation 854 for Mines and Mining Plants requires that operators of cranes undergo a yearly medical examination.

Radiation Protection Service


Application for Registration with the Radiation Protection Service [Form 00057E]

Learn how to register a workplace X-ray source

Before installing or using an X-ray source in the workplace, employers must register with the Radiation Protection Service (RPS). To register, you must submit:

  • an application form
  • floor plan drawings indicating where the X-ray source will be located

Radiation Protection Service will review the submission and, once you have received confirmation of approval, you can install and use the X-ray source in the workplace.

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