Fertilizers, Farm Feeds, Agricultural Remedies and Stock Remedies Act: Regulations: Pest control operators (R. No. 98 of 2011)

14 No.34020 No. R. 98 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 FERTILIZERS, FARM FEEDS, AGRICULTURAL REMEDIES AND STOCK REMEDIES ACT, 1947 (ACT NO. 36 OF 1947) PEST CONTROL OPERATOR REGULATIONS 18 February 2011 The Minister for Agriculture, Forestry and Fisheries has under Section 23 of the Fertilizers, Farm Feeds, Agricultural Remedies and Stock Remedies Act, 1947 (Act No. 36 of 1947), made the regulations in the Schedule. STAATSKOERANT, 18 FEBRUARIE 2011 INDEX PART I Definitions REGISTRATION Application for registration of pest control operators Approval of Refusal of Applications Period of registration Renewal of registration Refusal, Revocation and Suspension of Registration Return of certificate of registration Submission of appeals Address for submission of appeals PART II PEST CONTROL OPERA TORS Skills Application of Agricultural Remedies Responsibilities of pest control operators Records to be kept PART Ill GENERAL Offences and penalties Payment of fees Address for submission of documents ANNEXURE A: APPLICATION FORM ANNEXURE B: APPLICATION FOR RENEWAL FORM No. 34020 15 16 17 19 19 19 20 21 21 22 22 24 27 27 29 29 30 31 34 16 No. 34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 SCHEDULE PART I Definitions 1. Words and phrases in these regulations shall have the meaning assigned hereto in the Act, and unless the context otherwise indicates: "the Act" means the Fertilizers, Farm Feeds, Agricultural Remedies and Stock Remedies Act, 1947 (Act No 36 of 1947); "Aerial application registration" means the registration for the application of agricultural remedies from helicopters or fixed-wing aircraft to manage weeds, insects and diseases associated with agricultural or forestry production. "Agriculture and Forestry registration" means the registration for the management of pests associated with agricultural production and forestry production. "Fumigation registration" means the registration for the management of pest in stored products, marine; soil, structures, furniture or pallets. "Grace period" means the calendar month after the closing date for the renewals within which the applicants are stlll allowed to submit the renewals applications subject to the payment of the late registration fee additional to the normal renewal application fee. "Industrial Vegetation and Noxious Weeds registration" means the registration for the management of weeds on industrial land, roads, power lines, railways and pipeline right-of-ways; including the control of weeds designated as noxious on private or public land. "Landscape registration" means the registration for the management of insects, diseases and weeds of gardens, ornamental plantings and turf. "Structural pest control registration" means the registration for the management of health and nuisance pests (e.g. cockroaches, fleas, crickets, and other household pests) associated with buildings, including all public buildings or private buildings. "Supplemental and/or remedial wood treatment registration" means the registration for the secondary treatment of wood by hand application of chemicals to control wood destroying pests (insects and fungi) in wood already in service, i.e. wooden telephone and transmission poles "Wood Preservation registration" means the registration for the primary preservative treatment of wood to control wood destroying pests (e.g., insects and fungi) in wood products. "Wood Preservation" STAATSKOERANT, 18 FEBRUARIE 2011 No. 34020 17 exclude "supplemental and remedial wood treatment" (secondary treatment) of previously untreated or treated wood product already in service. "Pest control operator" means a person who is registered in terms of section 3(2) (c) of the Act; "For reward" means that a person has been hired to do pest control for monetary consideration and it excludes an employee who performs pest control for his employer in the employer's property (not for hire). Provided any employee who handles restricted-use agricultural remedies without the direct supervision of a registered pest control operator must be registered as a pest control operator. "Supervision" means that a registered pest control operator must be physically present at the time and place where agricultural remedies are applied. PART II REGISTRATION Application for registration of pest control operators 2. (1) An application in terms of Section 3 (1) of the Act for the registration of a pest control operator shall be submitted to the Registrar on a prescribed application form. (2) Such application shall: (a) be made by a person who is resident in the Republic and who complies with the requirements referred to in paragraph (c); (b) be made by a person who is at least 18 years of age. (c) made by a person who: (i) has attained appropriate educational level of a minimum level 2 South African Qualification Authority (SAQA) qualification, or has successfully passed a relevant skills course, which is accredited by Agricultural Sector Education and Training Authority (AgriSETA) or Sector Education and Training Authority (SETA) or has a minimum level 4 SAQA qualification, which is accredited by relevant SETA in one or more of the following fields; (aa) Fumigation (bb) Aerial application {cc) Agriculture and Forestry (dd) Industrial Vegetation and Noxious Weeds (ee) Landscape 18 No. 34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 (ff) Supplemental and/or remedial wood treatment (gg) Structural (hh) any other relevant specialization. (d) The application must be accompanied by the following: (i) applicable application fee as prescribed from time to time. (ii) certificate on any SAQA qualification from a relevant SETA accredited service provider on the abovementioned fields; (Iii) a diploma/degree in biological field such as Entomology, Pathology, Crop Protection, Weed Science, or any relevant qualification. (iv) proof of practical experience i.e. at least six months for the fields (bb)- (hh) and twelve months for the field (aa) practical experience. A person with the abovementioned degree or diploma may be exempted from the requirement of practical experience depending on prior experience in the relevant field. The abovementioned experience must be under the supervision of a registered pest control operator in the field concerned. Experience must be documented by the applicant on the prescribed proof of experience form. (v) any other documents relating to the skill of the applicant concerned in the administration of agricultural remedies and the handling of the appropriate apparatus. Provided that the applicants for aerial application licenses (pilot) must first meet all requirements of the South African Aviation Authority to operate the equipment described In all application. (e) In the case of Wood Preservation Registration, 2(2)(c) and (d) above shall be disregarded, provided that the applicant (treatment plant) is in possession of an approval certifiCate issued by the National Regulator for Compulsory Specifications (NRCS) for compliance to VC 9091, the compulsory specifications for the preservative treat of Timber. VC9091 specifies compliance to requirement of SANS 10005, the Preservation Treatment of Timber, which is required to be assessed and certified by Sector Education and Training Authority (SANAS) accredited certification bodies, e.g. South African Bureau of Standards (SABS) and South African Technical Auditing Services (SAT AS). STAATSKOERANT, 18 FEBRUARIE 2011 No. 34020 19 In such cases the application must be accompanied by copies of the NRCS approval certificate and copies of the product certification and copies of the product certificate/s issued by the SANAS accredited certification body which includes the information on the chemical (agricultural remedy) for certified for. Approval or Refusal of Applications 3. {1) The Registrar may after evaluation of the application for registration as a pest control operator, approve or reject such application. {2) If the Registrar approves the abovementioned application, he will issue the applicant with a registration certificate. (3) If the Registrar rejects the abovementioned application, he will provide the applicant with reasons for his decision. In this regard, the applicant may in terms of regulation 8, appeal against the decision of the Registrar. Period of registration 4. (1) Subject to the provisions of section 4 of the Act, registration for pest control operator shall be valid for a period of three years. (2) The Registrar may if it is in the public interest, approve a particular application for registration for a shorter period of validity as may be indicated on the certificate of registration concerned. Renewal of registration 5. {1) Registrations of pest control operators will be renewed every third year. (2) An application for the renewal of the registration shall be submitted to the registrar on a prescribed form for that purpose or on a clearly legible facsimile thereof. (3) Such application shall be: (a) made by a person who is a registered pest control operator. (b) accompanied by: (i) the copy of the registration certificate of applicant; (ii) the applicable application fee; (iii) proof of medical check - up by a registered occupational health practitioner; 20 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 (iv) proof of continual education training and/or information obtained with regard to usage, safety and latest development on the regulatory matters of agricultural remedies within current registration cycle; (v) copies of records prescribed in regulation 13. Such records must be for the last six months period before the renewal period. (4) The closing dates for the submission of renewal applications are the 31't March, 30th April, 31 1t May, 30tn June, 31st July or 30111 August depending on the first alphabetical letter of the applicants' surname as indicated bellow: (a) March· A; B; C; (b) April- D; E; F; G; (c) May- H; I; J; K; L; (d) June- M; N; O; (e) July- P; Q; R; S; T; (f) August- U; V; W; X; Y; Z. (5) An application made in terms of regulation 5(2) which: (a) is received by the Registrar after the closing dates as indicated in subregulation 5 (4) above, shall be considered only if the applicable application fee is also accompanied by the applicable additional late application fee or (b) is received by the Registrar after the grace period, shall not be considered and therefore the registration concerned shall lapse. The pest control operator whose registration has lapsed in terms of this paragraph must make a new application for registration to the Registrar for his consideration. However, the fact that such pest controller had previous registration does not guarantee that such application will again be acceptable for registration. Refusal, Revocation, or Suspension of Registration 6. A registered pest control operator may have his application for renewal refused, or his registration revoked, or suspended by the Registrar for any of the following: (a) failure to adequately supervise the use of a agricultural remedies; (b) failure to comply with any applicable provision of these regulations; (c) making any false or fraudulent record or report; (d) failure to apply agricultural remedies according to label registrations; STAATSKOERANT, 18 FEBRUARIE 2011 No. 34020 21 (e) using banned substances or unregistered products; (f) mixing of cocktails of any nature other than the registered and approved mixes; (g) failure to comply with the Occupational Health and Safety Act [OHSA], 1993 (Act No. 85 of 1993) and Hazardous Chemicals Substances Act; 1973 (Act No. 15 of 1973) or (h) failure to issue treatment notice prior to application of agricultural remedies and also keeping records. Retum of certificate of registration 7. A certificate of registration which is returned in terms of section 4A (3) of the Act shall reach the Registrar: (a) within 14 days from the date on which: (i) the person to whom the certificate of registration in question was issued, was notified in terms of section 5 of the Act in writing of the reasons for the cancellation of such registration; or (ii) the registration of a pest control operator concerned has lapsed in terms of section 4A (2A) or (28) of the Act, as the case may be. Submission of appeals 8. (1) An appeal in terms of section 6 of the Act shall be submitted to the Minister: Agriculture; Forestry and Fisheries within 60 days from the date on which the reasons for the decision against which is appealed, were furnished in terms of section 5 of the Act. (2) Such appeal shall: (a) be in the form of a written statement which is sworn to or attested by a commissioner of oath; (b) state the reference number and date of the document by means of which such applicant or person was notified of that decision; (c) state the grounds on which the appeal is based; (d) be accompanied by the documents relating to the subject of the appeal and; (e) be accompanied by the applicable fee. 22 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 (3) If such appeal is submitted by a person other than the person against whom the decision has been made, such appeal shall be accompanied by a statement in which the person concerned discloses his int~rest in that decision or action. (4) The amount referred to in subregulation (2) (e) shall be paid by cheque, postal order or money order made out in favour of the Director-General: Agriculture, Forestry and Fisheries: Provided that if the appeal concerned Is delivered by hand, such amount may be paid in cash. Address for submission of appeals 9. An appeal referred to in regulation 8(1} shall: Skills 10. (a) when forwarded by post, be addressed to the Director-General, Department of Agriculture, Forestry and Fisheries, Private Bag x343, Pretoria 0001; and (b) when delivered by hand, be delivered to the Director-General, Department of Agriculture, Forestry and Fisheries, Agriculture Place, 20 Beatrix Street, Pretoria. (1) PART Ill PEST CONTROL OPERATORS A pest control professional shall be skilled in the following areas: (a) Appropriate procedures for the application of agricultural remedies including but not limited to the following: (i) knowledge of various formulations of agricultural remedies and proper methods of application; (ii) the relationship of agricultural remedies application to proper use, unnecessary use, and misuse; (iii) knowledge of the calibration of sprayers. (b) Label and labelling comprehension, including but not limited to the following: (i) the general format and terminology of agricultural remedies labels and labelling; STAATSKOERANT, 18 FEBRUARIE 2011 No.34020 23 (ii) understanding instructions, classifications, warnings terms. symbols, and . other information commonly appearing on agricultural remedies labels; (iii} understanding the requirements of agricultural remedies use consistent with the label including the recommended doses given on the label. (c) Pest identification and pest management. including but not limited to the following: (i) knowledge of general insect ,disease, and weed characteristics used for identification; (ii) integrated pest management and its techniques (d) Safety factors including but not limited to the following: (i) agricultural remedies toxicity and common routes of exposure; (ii) precautions necessary to prevent injury to applicators and other Individuals, including the appropriate use of protective clothing and equipment; (iii) symptoms of agricultural remedies poisoning; (iv) first aid and means of obtaining emergency medical treatment in case of an accident. (e) The potential environmental consequences of the use and misuse of agricultural remedies as they may be influenced by such factors as environmental fate of agricultural remedies and their effect on non-target organisms. (f) Applicable bylaws and national laws and regulations. (2) The Registrar may request a pest control operator to do a test at the time and place which he may determine to ascertain the following: (a) whether such pest control operator has the skill as contemplated in subregulation (1); and (b) whether the knowledge of the applicable provisions of the Act and of the applicable codes of practice for the use of agricultural remedies, as compiled by the South African Bureau of Standards, is sufficient to be in the public interest for applicant be registered. 24 No. 34020 GOVERNMENT GAZETrE, 18 FEBRUARY 2011 Application of Agricultural Remedies 11. (1) The pest control operator must issue a treatment notice before applying any agricultural remedies. A pre - treatment notice must contain all of the following information: (a) a description of the area to be treated; (b) name of the targeted pest; (c) name of the agricultural remedies to be used, its active ingredient(s) and its registration number; (d) proposed date and start time, and proposed alternate dates and times, of the agricultural remedies use; (e) name and registration number of the pest control operator and a phone number at which the pest control operator can be reached for more information about the proposed agricultural remedies use: (f) the hazards associated with agricultural remedies intended to be used; and (g) precautions that should be taken to minimize exposure to agricultural remedies or its residues, including a statement that indicates the period following the use during which people should not enter the treated area (re-entry period); and if fruit-bearing trees or other food crops are treated, the number of days before food can be harvested safely. (2) A pest control operator must provide the abovementioned treatment notice prior to a proposed agricultural remedies use. (a) For fumigation and wood preservation, the pre- treatment notice must be given to the occupants of the living accommodations (including the owner or manager of the building) in case. (b) For Aerial application; Agriculture and Forestry, Industrial Vegetation and Noxious Weeds; and Landscape; the pre - treatment notice must be given to the occupants adjacent (within five kilometer radius) to the treated area such as schools, other public areas and residential area. (3) A treatment notice must be in the format of a sign of at least 550 cm2 in siZe (a letter size sheet of paper). The sign must (a) be constructed of water resistant material if the notice may be exposed to water, STAATSKOERANT, 18 FEBRUARIE 2011 No.34020 25 (b) be in type or letters that are clearly legible to a person approaching the treatment area: (c) contain a cautionary symbol (such as a stop sign or raised hand} that will draw the attention of a person approaching the treatment area; and (d) display. in bold block letters. the words "NOTICE OF AGRICULTURAL REMEDIES USE". (4) Treatment notices must be posted so that the notice is clearly visible and will provide notice of the agricultural remedies use to any person approaching the treatment area. (5) In the case of the notice furnished verbally, such notice must be confirmed in writing within three days after the administration. Such confirmation must be done in accordance with sub-regulation 1 above. (6) The pest control operator must ensure that agricultural remedies are used (including the use in the workplace) in accordance with approved label and with good application practice. Such agricultural remedies must be registered in terms of the Act and labelled by the manufacturer as required by the Act (7} The pest control operator must make readily available to workers the Material Safety Data Sheet {MSDS) or its written equivalent for all agricultural remedies used at the workplace. (8) The pest control operator must ensure that equipment used to mix, load or apply agricultural remedies is: (a) constructed of materials which are chemically compatible with the agricultural remedies in use if contact with the agricultural remedies is likely to occur; (b) operated only by trained persons; (c) used in accordance with instructions from the agricultural remedies supplier; (d) maintained in a safe operating condition; {e) cleaned, repaired and maintained by workers who have been adequately instructed in safe work procedures; and (f) in a safe condition before maintenance or repair work is carried out, including welding operations. {9) The pest control operator must ensure safe application of agricultural remedies. In this regard, the pest control operator must ensure that: G11-122818-C 26 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 (a) agricultural remedies are applied in a manner that controls the risk of adverse health effect or injury to any person; (b) before agricultural remedies are applied, all workers in the area that is to be treated and who are not required for the application of agricultural remedies are moved to a safe location; and (c) if practicable, the schedule for the agricultural remedies application in a building is at the time when the building is unoccupied. (10) Before using Extremely Hazardous (class 1a, Red Band Product), Highly Hazardous (class 1b Red Band Product) and moderately Hazardous (class 11, Yellow Band product) agricultural remedies is applied the pest control operator must ensure that: (a) warning signs are visibly posted at normal points of worker entry to the area to be treated, and (b) if agricultural remedies are applied in an enclosed space, all entrances to the space are secured to prevent unauthorized persons from entering. (1 1) A pest control operator must ensure that all reasonable precautions are taken to prevent the drift or spread of agricultural remedies from a treated area. If agricultural remedies under the control of a pest control operator has drifted or spread to a non-targeted area, the pest control operator must: (a) notify the adjacent occupants of the following: (i) identity of the agricultural remedies, (ii) nature of its harmful characteristics, and (iii) precautions required for the safety of people, environment or crops. (b) in the case of the drift, take all reasonable steps to (i) identify the agricultural remedies and advise any persons who may be exposed to it of the nature of the agricultural remedies, its harmful characteristics and the precautions required for safety, and (ii) ensure that any hazards to persons from exposure to the agricultural remedies are eliminated or controlled. (12) A person who uses agricultural remedies must store and dispose of such agricultural remedies in a manner that minimizes hazards to human health and the environment and in accordance with the requirements of the Handling, Storage and Disposal of Agricultural remedies (SANS 10260: 2007). STAATSKOERANT, 18 FEBRUARIE 2011 No. 34020 27 · Responsibilities of pest control operators 12. (1) A registered pest control operator who functions in a supervisory role shall be responsible for the actions of a pest control operator (s) under his/her instruction or management. (2) The registered pest control operator shall be physically present to supervise the application of agricultural remedies by an unregistered pest control operator(s). (3) The pest control operator must: (a) know about applicable safe use requirements specified in regulations and on the agricultural remedies labeling; (b) ensure that person working under his supervision Is 18 years of age or over; (c) inform the people working under his supervision, in a language the person understands, of the following: (i} the specific agricultural remedies being used, (ii) agricultural remedies safety hazards, (iii) the personal protective equipment and other equipment to be used, (iv) work procedures to be followed, (v) agricultural remedies safety regulations applicable to all activities they may perform; (vi) provide a safe work place for people under his supervision and require employees to follow safe work practices; and (vii) take all reasonable measures to ensure that employees handle and use agricultural remedies in accordance with the requirements of Occupational Health and Safety Act, 1993 (Act No. 85 of 1993) and agricultural remedies product label. Records to be kept 13. (1) A registered pest control operator or business which instructs a pest control operator to administer an agricultural remedy shall in respect of each separate administration of an agricuHural remedy, keep comprehensive records of: 28 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 (a) the name and address of the owner or person in charge of the place where agricultural remedies was administered; (b) The name and registration number of the pest control operator who used or supervised the use of the agricultural remedies (c) the place where such administration was performed including the physical address of such place; (d) the size, expressed in cubic metres, square metres or hectares, as the case may be, of such a place; (e) trade name of agricultural remedies used with L registration number; (f) the purpose for which such place was treated and, if applicable, the crop grown thereon or the commodity kept therein at the time of the administration concerned; (g) the approximate extent to which the place, crop or commodity was infected with the pest concerned at the time of the administration concerned; (h) the date and time on which the administration concerned was done; (i) for each agricultural remedy used, the method and rate of application and total amount quantity used; 0) measures taken to prevent exposures to non - target areas; (k) the type of apparatus used for the administration concerned; (I) advice given to the owner or manager of the treatment area, including safe re-entry time, the number of days before a crop can be harvested safely (where applicable), and any additional precautions that should be taken to minimize exposure to the agricultural remedies; (m) the particulars of which the owner or person referred to in paragraph (a) was notified in terms of section 10 (1) of the Act: Provided that a copy of the written notice referred to in section 10 (2) of the Act may be attached to the particulars to be recorded in terms of this subregulation; and (n) if applicable: (i) any spillage of the agricultural remedies concerned which occurred during the administration concerned; STAATSKOERANT, 18 FEBRUARIE 2011 No.34020 29 (ii) any case of poisoning of a person or animal resulting from the administration concerned; and (iii) any complaint received in connection with the administration concerned. (2) The documents in which the particulars referred to in subregulation (1) are recorded, shall be preserved at the address of the registered pest control operator or business referred to in subregulation (1), or at such other place as may on application be approved by the Registrar, for at least two years after the day on which the administration concerned was made for general pest control and 5 years or the period of guarantee expressed on a guarantee certificate for termite proofing: Provided that if a complaint was received in connection with such administration, the records in respect thereof shall not be destroyed within two years after the date of such complaint. PART IV GENERAL Offences and penalties 14. Any person who refuses or fails to comply with the provisions of these regulations shall be guilty of an offence and liable on conviction to a fine or imprisonment or to both such fine and imprisonment as per section 18 of the Act. Payment offees 15. (1) The postage on and delivery costs of any application or document submitted in terms of these regulations, as well as on or of anything else pertaining thereto, shall be paid by the applicant. {2) Any fee payable in terms of these regulations shall be paid by means of a cheque, made out in favour of the Director-General: Agriculture, Forestry and Fisheries or electronic transfer: Provided that if such fee is delivered by hand, it may be paid in cash. For electronic payments, the applicant must use one of the following reference numbers together with the applicant's full names and registration number where applicable: {a) 16 PC 1 for new applications; (b) 16 PC 2 for renewal applications; and (c) 16 PC 3 for duplicate certificates {3) Monies paid in terms of these regulations, except in terms of Section 6 of the Act. are not refundable. 30 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 Address for submission of documents 16. Any application or document or anything else pertaining thereto, which is required in terms of these regulations t9 be submitted to the Registrar shall: (a) when forwarded by post, be addressed to; The Registrar: Act No. 36 of 1947, Private Bag X343, Pretoria, 0001. (b) when delivered by hand; be delivered to: The Registrar: Act No 36 of 1947, 20 Beatrix Street, Agricultural Place. Room LA GF • 08 STAATSKOERANT, 18 FEBRUARIE 2011 ANNEXURE A agriculture, forestry & fisheries Oepattmont Agrlcult~We, Forestry and Fisheries REPUBLIC OF SOUTH AFRICA Republic of South Africa Registrar: Act 36/1947 Private Bag X343 0001 Pretoria No. 34020 31 FERTIUZERS, FARM FEEDS, AGRICULTURAL REMEDIES AND STOCK REMEDIES ACT, 1947 (ACT No. 36 OF 1947), AS AMENDED APPLICATION FOR REGISTRATION AS A PEST CONTROL OPERA TOR INFORMATION FOR APPLICANTS 1. The application fonn must be duly completed in all respects. 2. Submit only a single application togethe.r with the prescribed registration fee 3. The application must be accompied by educational qualification and practical experience obtained 4. A medical report on the accompanying form is also required 5. The application must be submlttad to the Registrar: Act No. 36 of 1947, Private Bag X343, Pretoria, 0001. 6. For further lnfonnatlon visit our website at www.daff.qov.za Full names and surname: Postal address: ---------------------- Postal code: Physical/Residential address: City: ------------- Province: Postal code: Tel: L j Cell phone L j. E-mail: Date of birth: I 1.0. No.: MM DO yy Are you registered in another field? c::::J Yes C] No If Yes, which Field (s)? Name of Employer I Own Business: Physicai/Residenrtail address. City: ------------- Province: ---------Postal code: 32 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 [Tel: L ) Fax: L ) E-mail I I FIELD(S) OF PEST CONTROL IN WHICH REGISTRATION IS REQUIRED (Please tick) (i) Aerial application (ii) Agriculture and Forestry (iii) Industrial Vegetation and Noxious Weeds (iv) Landscape (v) Structural (vi) Fumigation (vii) Supplemental and/or remedial wood treatment (viii) Any other relevant specialization EDUCATIONAL QUALIFICATIONS OBTAINED (PLEASE ATT ACHEA CERTIFIED COPY) Qualifications Subjects obtained Training centre Date obtained PROOF OF PRACTICAL EXPERIENCE OBTAINED (PLEASE ATTACHE AN AFFIDAVIT FROM THE APPLICANT AND CONFIRMATION DOCUMENT FROM THE SUPERVISOR/EMPLOYER). Name of business/Supervisor Field of pest control Period in training I [ I I l STAATSKOERANT, 18 FEBRU ARIE 201 1 No. 34020 33 I hereby certify that the information furnished in this application and data provided in support is to the best of my knowledge true, correct, complete and complies with the requirements of Act No. 36 of 1947; acknowledge my responsibilities in terms of the Act; and grant permission to the Registrar of Act No. 36 of 1947 to cancel this registration in terms of Section 4 of the Act should it be established that the information supplied in this application and with this application is not true and does not comply with the requirements of the Act. . ........................................ . Name in full (printed) Signature Date Official Title {Note. Any person who m any application makes any statement whiCh 1s false m any matenal respect, knowing it to be false. or fails to disclose any information with intent to deceive, shall be guilty of an offence). DECLARATION TO BE MADE IN THE PRESENCE OF A JUSTICE OF PEACE/COMMISSIONER OF OATHS I certify that the deponent has acknowledged that he/she knows and understands the contents of this declaration which was sworn to/affirmed before me and the deponents signature/thumb print/mark was placed thereon in my pJesence . ....................... . . . .............. u ............... . ...................... .......... ........ INITIALS AND SURNAME OF THE APPLICANT I ................................................................ . ............................................. I ..................................... H ............... SIGNATURE OF APPUCANT DATE i TEL.NO. ............................................... ............................................... . JUSTICE OF THE PEACE/ COMMISSIONER OF OATHS FOR OFFICIAL USE Official Stamp of Applicant! Company (where applicable) Registration is: Recommended 0 Not Recommended 0 34 No.34020 GOVERNMENT GAZETTE, 18 FEBRUARY 2011 ANNEXUREB agriculture, forestry & fisheries Department: Agnculture, Foresoy and Fiaheri<>e REPUBLIC OF SOUTli AFRICA Republic of South Africa Registrar. Act 36/1947 Private Bag X343 0001 Pretoria FERTILIZERS, .FARM FEEDS, AGRICULTURAL REMEDIES AND STOCK REMEDIES ACT, 1947 (ACT No. 36 OF 1947), AS AMENDED APPLICATION FOR RENEWAL OF REGISTRATION AS A PEST CONTROL OPERATOR INFORMATION FOR APPLICANTS 1. The application form must be duly completed in all respects. 2. Submit only a single application together with the prescribed registratiOn fee 3. The appllcantlon must be accompled by proof of continual education training and/or information obtained within current registration cycle 4. A medical report on the accompanying form is also required 5. The application must be submlttad to ttte Registrar: Act No. 36 of 1947, Private Bag X343, Pretoria, 0001. 6. For further Information visit our website at www dattgoy.za Full names and surname: Postal address: ------------ --- -------Postal code: PhysicaVResidential address City: - ------------ Province: - --------Postal code: Tel: ( ) Cell phone( )~ E-maU: Date of birth: t !. I.D. No.: MM DO YY P. registration number ----------- - Name of Employer I Own Business:. Physical/Residential address--------- ----------- City: --- ---------- Province: Postal code: Tel: Fax: E-mail STAATSKOERANT, 18 FEBRUARIE 2011 No. 34020 35 I hereby certify that the infonnation furnished tn this application and data provided in support is to the best of my knowledge true, oorrect, oomplete and complies with the requirements of Act No. 36 of 1947; acknowledge my responsibilities in terms of the Act; and grant permission to the Registrar of Act No. 36 of 1947 to cancel this registration in tenns of Section 4 of 1he Act should it be established that the information supplied in this application and with this application is not true and does not comply with the requirements of the Act. Signature Date Any person any makes any any knowing it to be false, or fails to disclose any information with Intent to deceive, shall be guilty of an offence). DECLARATION TO BE MADE IN THE PRESENCE OF A JUSTICE OF PEACEJCOMMISSIONER OF OATHS I certify that the deponent has ad<nowledged that he/she knows and understands the contents of this declaration which was sworn to/affirmed before me and the deponents signature/thumb print/mart< was . placed thereon In my presence. I ....... iNrri"Ls.AN.o'S"uR:NAile·o;;·:r.:ie··..:;;·;;t:icANr· .. ··· j ' .................................................................. ! ............................................ . .......................................................... SIGNATURE OF APPLICANT DATE TEL. NO. ................................................................................................. JUSTICE OF THE PEACE/ COMMISSIONER OF OATHS