application form skin penetration beauty and hairdresser premises 1
This document is the official application form used by the Shire of Esperance for businesses seeking approval to operate skin‑penetration, beauty‑therapy, or hairdressing premises. It collects detailed business and proprietor information, specifies the primary services offered, and requires classification of each service as non‑critical, semi‑critical, or critical with accompanying cleaning, disinfection or sterilisation procedures. The form outlines mandatory premises infrastructure – hand‑wash basins, sinks, warm water, laundry facilities, sharps containers, and personal protective equipment – and asks applicants to confirm compliance. It also lists required supporting documents (ASIC registration, scaled floor plan, staff qualifications), includes a declaration of truthfulness and regulatory understanding, provides submission options (email, mail, in‑person), and states the applicable application fee of $91 for the 2022‑2023 financial year.
Topics
Business and Proprietor Information Requirements
Fields capturing the trading name, address, contact details, proprietor name, ABN/ACN, and the person in charge, as well as the type of premises (commercial, mobile, home occupation).
Service Classification and Procedure Risk Levels
Applicants must identify the primary uses (e.g., acupuncture, laser, beauty therapy, hairdressing) and classify each as non‑critical, semi‑critical, or critical, providing corresponding cleaning, disinfection, or sterilisation protocols and product safety data sheets.
Premises Facility and Equipment Standards
Requirements for sinks, hand‑wash basins (hands‑free, soap and paper‑towel dispensers), warm water, laundry facilities, sharps containers compliant with AS4031, and personal protective equipment (gloves, eye protection, aprons, masks). Also includes questions about refreshments provision and workstation counts for hairdressing.
Required Supporting Documentation and Compliance Attachments
Checklist of mandatory attachments: ASIC record of business name registration, a scaled (1:50) floor plan showing treatment rooms, sinks, ventilation, and refreshment area, and copies of each staff member’s qualifications.
Declaration, Submission Process, and Fees
A legal declaration confirming truthfulness and understanding of relevant regulations, signature fields, submission channels (email, mail, in‑person), and the $91 application and assessment fee for the 2022‑2023 financial year.