New South Wales Consolidated Regulations

WATER (PART 5--DRILLERS' LICENCES) REGULATION 1995 - SCHEDULE 1

SCHEDULE 1 – Forms

Form 1

(Clause 5)

APPLICATION FOR DRILLER’S LICENCE

(Section 118A, Water Act 1912 )

To: The Water Administration Ministerial Corporation
I,of.

1. I *ama licensed driller.
*am not

2. Date of birth:

3. Class of licence applied for:

*(a)	Class 1.	Licence that allows construction of water level and water quality monitoring bores.
*(b)	Class 2.	Licence that allows construction of sub-artesian stock and domestic supply bores up to 152 mm nominal bore casing.
*(c)	Class 3.	Licence that allows the activities of a class 2 licence and also allows the construction of sub-artesian, screened and developed bores (with open hole, slotted casing or screen completion methods, including the use of a formation stabiliser, but not including gravel filter envelope completion techniques).
*(d)	Class 4.	Licence that allows the activities of a class 3 licence and also allows the use of gravel filter envelope completion techniques.
*(e)	Class 5.	Licence that allows the activities of a class 2 licence and also allows the construction of flowing and non-flowing bores that penetrate the sandstone aquifers of the Great Artesian Basin and the construction of flowing bores elsewhere in New South Wales.
*(f)	Class 6.	Licence that allows the activities of both a class 4 licence and a class 5 licence.

4. Types of drilling methods to be used:

*(a) auger;

*(b) jetting;

*(c) cable tool;

*(d) rotary air;

*(e) rotary hydraulic;

*(f) other (specify)

5. Length of experience:

*(a) as a licensed driller:years.

*(b) as an employee of a licensed driller:years.

6. Number of sub-artesian stock bores:

*(a) constructed by me as a licensed driller:

*(b) on which I have worked as an employee of a licensed driller:

7. Number of screened and developed irrigation industrial supply or town-water supply bores:

*(a) constructed by me as a licensed driller:

*(b) on which I have worked as an employee of a licensed driller:

8. Number of artesian bores:

*(a) constructed by me as a licensed driller:

*(b) on which I have worked as an employee of a licensed driller:

9. Number of bores:

*(a) pressure-cemented by me as a licensed driller:

*(b) pressure-cemented by me as an employee of a licensed driller:

10. The depth and location of:

*(a) deepest bore sunk by me as a licensed driller:

*(b) deepest bore on which I have worked as an employee of a licensed driller:

11. The make, type and capacity of plant now being operated by me are:

12. Description of drilling plants previously operated by me:

13. Names and addresses of drillers and/or drilling contractors for whom I have worked as a driller:

Note: Copies of testimonials or references from employers should be attached.)

14. Other information relevant to this application:

* Strike out if inapplicable.

Form 2

(Clause 6)

DRILLER’S LICENCE No.

(Section 118A, Water Act 1912 )

of.

Classlicence.

This licence is limited to the following drilling methods:

Dated:

Signed
(For and on behalf of the Water
Administration Ministerial Corporation)