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<!doctype html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Permits SampleForm</title>
<link rel="stylesheet" href="application-approved.css">
</head>
<body>
<div class="header" id="header">
<img src="logo.jpg" alt="" class="logo">
<div class="header-text">
<div class="header-text-title">Permit to move goods</div>
<p>From protected zone area to Torres Strait permanent biosecurity monitoring zone, or from either of these zones to the Australian mainland Section 177 of the <em>Biosecurity Act 2015</em></p>
</div>
</div>
<div class="clearfix"></div>
<div class="main-content">
<div class="permit-number">
<div class="permit-number-content">
PERMIT NUMBER: BP-2016-000-026
</div>
</div>
<h2>Permit holder details</h2>
<table class="table table-bordered">
<tbody>
<tr>
<td colspan="2">Given name(s): Test</td>
<td>Family name: User</td>
</tr>
<tr>
<td colspan="2">Business/organisation: <strong>Test Medical Research Institute</strong></td>
<td>ABN/ ACN: N/A</td>
</tr>
<tr>
<td colspan="2">Street number and name: 300 test Rd. </td>
<td>Suburb/Town: Brisbane</td>
</tr>
<tr>
<td class="w25">State: QLD</td>
<td class="w25">Postcode: 4006.</td>
<td class="w50">Country: Australia</td>
</tr>
<tr>
<td colspan="2">Email: test.user@tester.edu.au</td>
<td>Fax: 07 3362 0111</td>
</tr>
<tr>
<td colspan="2">Mobile: 0411 222 333</td>
<td>Landline: 07 1122 3322</td>
</tr>
</tbody>
</table>
<h2>Receiver details</h2>
<table class="table table-bordered">
<tbody>
<tr>
<td colspan="2">Given name(s): Test</td>
<td>Family name: User</td>
</tr>
<tr>
<td colspan="2">Business/organisation: <strong>Test Medical Research Institute</strong></td>
<td>ABN/ ACN: N/A</td>
</tr>
<tr>
<td colspan="2">Street number and name: 300 test Rd. </td>
<td>Suburb/Town: Brisbane</td>
</tr>
<tr>
<td class="w25">State: QLD</td>
<td class="w25">Postcode: 4006.</td>
<td class="w50">Country: Australia</td>
</tr>
<tr>
<td colspan="2">Email: test.user@tester.edu.au</td>
<td>Fax: 07 3362 0111</td>
</tr>
<tr>
<td colspan="2">Mobile: 0411 222 333</td>
<td>Landline: 07 1122 3322</td>
</tr>
</tbody>
</table>
<br/>
<table class="table table-bordered">
<tbody>
<tr>
<th class="w30" align="left">Place of origin of goods</th>
<td class="w70">Suburb/Town: Thursday Island, Hammond Island and/or Masig Island</td>
</tr>
<tr>
<th align="left">Final destination of goods</th>
<td>Suburb/Town: Brisbane</td>
</tr>
</tbody>
</table>
<h2>Transport details</h2>
<table class="table table-bordered">
<tbody>
<tr>
<td class="w50">Airline/aircraft registration: N/A</td>
<td class="w50">Flight number(s): TBA</td>
</tr>
<tr>
<td>Vessel name / registration: N/A</td>
<td>IMO/Lloyd’s number: N/A</td>
</tr>
<tr>
<td>Departure date / time: TBA</td>
<td>Port of departure: Horn Island.</td>
</tr>
<tr>
<td>Arrival date / time: N/A</td>
<td>Port of arrival: Brisbane.</td>
</tr>
<tr>
<td colspan="2">Route information (e.g. transhipment information): From TI to Horne Island (Ferry), Horne-Brisbane (Air).</td>
</tr>
</tbody>
</table>
<h2>Approval is granted for the movement of the following goods</h2><p class="note">[Note for officer completing form: delete commodity table if not required]</p>
<table class="table-bordered">
<colgroup width="30%">
<colgroup width="35%">
<colgroup width="35%">
<thead>
<tr>
<th colspan="3">Live plants, plant products, soil, fungi and animal products</th>
</tr>
</thead>
<tbody>
<tr>
<th>Common/product name</th>
<td colspan="2"><strong>Asian Tiger Mosquito</strong></td>
</tr>
<tr>
<th rowspan="2">Scientific/Botanical name</th>
<td colspan="2">Genus: <strong><em>Aedes</em></strong></td>
</tr>
<tr>
<td colspan="2">Species: <strong><em>albopictus</em></strong></td>
</tr>
<tr>
<th class="w30" rowspan="3">Description</th>
<td class="w35">Brand name:<br/> N/A</td>
<td class="w35">Strain/Variety/Cultivator: Torres Strait strain</td>
</tr>
<tr>
<td colspan="2">Ingredients:<br/>N/A</td>
</tr>
<tr>
<td colspan="2">Details of processing or treatment:</td>
</tr>
<tr>
<th>Quantity/Volume</th>
<td>5000</td>
<td>Unit (e.g. Kg or Lt.): eggs</td>
</tr>
<tr>
<th colspan="3">This movement is subject to conditions as specified below</th>
</tr>
</tbody>
</table>
<br/>
<table class="table-bordered">
<thead>
<tr>
<th colspan="3">Live animals</th>
</tr>
</thead>
<tbody>
<tr>
<th>Common name </th>
<td colspan="2"></td>
</tr>
<tr>
<th>Breed</th>
<td colspan="2"></td>
</tr>
<tr>
<th>Name of animal</th>
<td colspan="2"></td>
</tr>
<tr>
<th class="w30">Age</th>
<td class="w35">Years: 1</td>
<td class="w35">Months: 2</td>
</tr>
<tr>
<th>Gender</th>
<td colspan="2"></td>
</tr>
<tr>
<th rowspan="2">Identification method</th>
<td>Microchip number:</td>
<td>Registration number:</td>
</tr>
<tr>
<td colspan="2">Other (colour, markings, etc.):</td>
</tr>
<tr>
<th colspan="3">This movement is subject to conditions as specified below</th>
</tr>
</tbody>
</table>
<h2>Conditions</h2>
<table class="table-bordered">
<tbody>
<tr>
<td width="33%">This permit is valid </td>
<td width="33%">From: 30/08/2016</td>
<td width="33%">To: 30/02/2017 </td>
</tr>
</tbody>
</table>
<div class="bordered-box">
<h4>Post-arrival biosecurity containment conditions.</h4>
<span style="text-decoration: underline;">This permit updates permit <strong>2016-03-17140425</strong> by incorporating the following post-arrival containment conditions:</span>
<ol>
<li>The QAP must have work practices and adequate security to prevent the escape of live animals, or any part or product of an animal from which another animal could be produced.<br/>This includes the use of insect cages or other suitable equipment for the containment of all mosquito life stages within the nominated QAP. All insect cages and equipment used within the nominated QAP must be checked regularly for maintenance and repair.</li>
<li>The importer is responsible for ensuring that all insects are monitored for signs of abnormalities including the presence of pests, pathogens or other signs of exotic disease. If any abnormalities are present, or if following rearing of the mosquito eggs the species is not that identified on the import permit, it is the importer’s responsibility to notify the Department of Agriculture and Water Resources immediately. </li>
<li>The imported material (including direct and indirect derivatives), must remain in the nominated QAP and must not be removed from these premises without the prior written approval of the Department of Agriculture and Water Resources.</li>
<li>
The following material is approved for removal from the nominated QAP(s):
<ul style="list-style: lower-alpha;">
<li>
invertebrate material (including that infected with non-imported viruses or parasites) that has been preserved/fixed in one of the following solutions;
<ul style="list-style: disc;">
<li>60-100% alcohol</li>
<li>10% formalin</li>
<li>4% formaldehyde</li>
<li>2% glutaraldehyde</li>
<li>RNAlater</li>
</ul>
</li>
<li>invertebrate material that has been lysed in buffer containing 1% SDS or similar detergent;</li>
<li>purified genetic material, proteins, carbohydrates and lipids derived from mosquitoes (including those infected with non-imported viruses or parasites);</li>
<li>slide specimens preserved, stained and mounted;</li>
<li>cell cultures of imported mosquitoes including those infected with non-imported viruses or parasites;</li>
<li>non imported parasites or viruses in cell culture medium, or purified genetic material, proteins, carbohydrates and lipids of these that have been extracted/obtained from infected mosquitoes.</li>
</ul>
</li>
<li>The quarantine material (including direct and indirect derivatives) is for in vitro laboratory studies (or in vivo use in laboratory organisms only), unless approved by the Department of Agriculture and Water Resources for specific in vivo use in non-laboratory organisms.</li>
<li>Laboratory organisms include those defined in the following list and must be contained under laboratory or animal house conditions (or equivalent): guinea pigs, hamsters, mice, rabbits, rats, rodents or micro-organisms. Work in all other animals is not permitted.</li>
<li>The biosecurity material (including direct and indirect derivatives) is not to be exposed, either directly or indirectly, to non-laboratory animals (excluding humans).</li>
<li>Any in contact animals (excluding humans) and other biological materials must remain in the nominated QAP, or a co-located QAP approved for the containment of the in contact animal or biological material, and become subject to the quarantine, treatment and disposal conditions stipulated in this direction.</li>
<li>Any and all research activity involving the imported material (including direct and indirect derivatives) must take place within the nominated QAPs. This excludes material identified in Point 4 above.</li>
<li>It is the importer’s responsibility to ensure personnel safety and compliance with any other conditions that may be applicable under any State/Territory or other Federal Government regulatory organisations or other advisory bodies. This may include obtaining permission from the Department of Health.</li>
<li>The importer is responsible for ensuring compliance with any conditions that may be applicable to the use of viruses and/or parasites that have been imported into Australia (under a separate import permit). This may include obtaining written permission from the Department of Agriculture Biological Imports Program in Canberra.</li>
<li>The QAP is responsible for maintaining records on the approximate number of insects within the facility; type of research conducted; health condition of the insects; and any transfers or disposals of imported material (including direct and indirect derivatives) These records may be subject to audit.</li>
<li>It is the end user’s responsibility to ensure that all laboratory products are used in accordance with the current AS/NZS 2243 Safety in Laboratory standards and Office of the Gene Technology Regulator (OGTR) requirements.</li>
</ol>
<p style="font-style: italic; text-decoration: underline;">Post-arrival treatment and disposal conditions</p>
<ol>
<li>
The packaging material and any solid waste material generated during quarantine must be disposed of by one of the following methods:
<ul style="list-style: lower-alpha;">
<li>high temperature incineration;</li>
<li>
autoclaving at one of the following;
<ul style="list-style: disc;">
<li>121°C core temperature for 15 minutes at 105kPa (15 psi)</li>
<li>121°C for 30 minutes at 105kPa (15 psi)</li>
<li>134°C core temperature for 4 minutes at 205kPa (30 psi)</li>
</ul>
</li>
<li>gamma irradiation at 50 kGrays;</li>
<li>export</li>
</ul>
</li>
<li>
Liquid waste generated from the rearing of mosquitoes in the QAP must be autoclaved (as outlined above) or filtered using a method capable of removing all viable mosquito life stages (i.e. maximum 100 micron aperture/pore size).<br/><br/>Any solids from the filter must be disposed of as per the methods above.<br/><br/>The filtered water must then be treated by one of the following methods prior to disposal via the sewerage system.
<ul style="list-style: lower-alpha;">
<li>freezing at -20°C for a minimum of 48 hours;</li>
<li>chlorination, to achieve a solution concentration of 1% available chlorine, held for 24 hours;</li>
<li>filtered a second time using an appropriate filter (i.e. maximum 100 micron aperture/pore size).</li>
</ul>
Where screening at the sink drainage outlet is used as the second filtration method the screening must be:
<ul>
<li>100 micron stainless steel mesh.</li>
<li>a basket arrestor type to allow easy removal for cleaning and decontamination.</li>
<li>fitted correctly to ensure screening to 100 micron standard.</li>
<li>if the in-sink filter blocks the remaining liquid in the sink must be chlorinated, to achieve a solution concentration of 1% available chlorine, prior to removing the filter basket for clearing.</li>
</ul>
</li>
<li>Non-disposable equipment must be appropriately cleaned and disinfected, or destroyed, using a method approved by the Department of Agriculture and Water Resources.</li>
<li>Other methods of disposal must be approved in writing by the Department of Agriculture and Water Resources prior to implementation.</li>
<li>The Department of Agriculture and Water Resources state office must be notified immediately of any breaches in quarantine containment or failure to meet treatment/disposal conditions outlined above.</li>
</ol>
</div>
<h2>Director of Biosecurity or delegate/sub-delegate</h2>
<table class="table-bordered">
<colgroup width="70%">
<colgroup width="30%">
<tbody>
<tr>
<td colspan="2">Signature:</td>
</tr>
<tr>
<td width="70%">Printed name: Darren Peck</td>
<td width="30%">Date: (30/08/2016)</td>
</tr>
</tbody>
</table>
<h2>Privacy Information</h2>
<div class="bordered-box">
<p>‘Personal information’ means any information or an opinion about an identified individual, or an individual who is reasonably identifiable. ’Personal information’ that is collected under or in accordance with the <em>Biosecurity Act 2015</em> is also ‘protected information’ under the Biosecurity Act.</p>
<p>The collection of ‘protected information’, including personal information by the Department of Agriculture and Water Resources (the department) in relation to this form is authorised under the <em>Biosecurity Act 2015</em> for the purposes of determining whether or not to grant a permit to move the goods and related purposes. If the relevant personal information requested in this form is not provided by you, the department may be unable to grant the permit. Information collected by the department will only be used or disclosed as authorised under the <em>Biosecurity Act 2015</em>.</p>
<p>The personal information requested on this form may be disclosed to other Australian agencies, including the Department of Immigration and Border Protection and Australian Border Force. It will not usually be disclosed overseas. In every case, it will only be disclosed if authorised by the <em>Biosecurity Act 2015</em>.</p>
<p>See our Privacy Policy webpage (<a href="http://www.agriculture.gov.au/about/privacy" target="_blank">http://www.agriculture.gov.au/about/privacy</a>) to learn more about accessing or correcting personal information or making a complaint. Alternatively, telephone the department on +61 2 6272 3933.</p>
</div>
</div>
</body>
</html>