Online Form - Certificate of Structural Adequacy

Thank you - your form has been submitted.

Your Name

Site Details

Venue Name*

Venue Address*

Particulars of structure / installation (attach drawings of all structural details if required)*

Details of any structures at the above venue for which you are not responsible*

Signature of Applicant*

Installation For

Hirer's Name*

Hirer's Address*

Hirer's Contact Number

Your Business Details

Business Name*

Business Address*

Business Contact Number*

Declaration

I / We hereby certify that the structures / installations (as described above) at the site specified above have been inspected by me*

YesNo

I / We certify the structures / installations to be safe, that it / they are structurally adequate for their intended use and that it / they comply with the manufacturer’s installation and erection specifications*

YesNo

Name of Applicant*

Contact Number*

Signature of Applicant*

Date*