A Cyanide Management Plan (CMP)must be completed and maintained by the applicant. It is recommended that the plan is reviewed at least every five years or after any significant incidents or changes (e.g. organisational restructure).

This form can be used as a guide in developing your CMP. If you complete this template, it will provide with you with a cyanide management plan. Any existing plan developed to manage hazardous substances in your workplace may also meet the requirements of a CMP providing that it addresses the criteria outlined below.

This document enables how an applicant for a cyanide permit will:

  • mitigate the risks posed to public health relating to the storage, use and disposal of cyanide, given the toxic nature of the substance; and
  • ensure compliance with the requirements prescribed under section 240 of the Health (Drugs and Poisons) Regulation 1996 relating to cyanide permit holders.

Complete all relevant sections of this template.

The answers to the questions below should include as much detail as possible.

Sections 11-13refer to mobile electroplaters only.

The CMP must be authorised by the permit holder. If you have any queries, please contact the local Public Health Unit. Contact details are available at

  1. Permit holder name and address where cyanide is to be used and stored.

  1. Describe the roles and responsibilities of persons within the organisation or business who will be involved in obtaining, possessing, storage, use and disposal of cyanide under this permit.

  1. Describe training to be undertaken by employees who will be handling cyanide.

4. Describe how the cyanide (including waste) is to be stored and kept secure (e.g. lockable cabinet fixed within a storage room) at the premises described in the permit.
5. Describe who will have possession of the key/room access – either the permit holder or a responsible adult authorised to hold the key by the permit holder (Note: you can also nominate employment positions).
6. Describe how you will ensure that the cyanide will not be left (when in use or otherwise) in a place to which other (unauthorised) persons have access.
7. Describe the measures you have in place to ensure the cyanide is only used for its intended purpose (as authorised in the permit).
8. Describe the procedure in place following an adverse event such as a spillage.
9. What mechanisms will you have in place to ensure that you will apply for a new permit (if required) before the expiry of any current cyanide permit? e.g. administrative procedure for reminder notice
10. What arrangements will you have in place to ensure that any cyanide waste products or unused cyanide are disposed of in a safe manner e.g. a licensed waste contractor; or alternatively that unused cyanide is returned to the wholesaler where agreed upon.
Only complete sections 11-13 if you are a mobile electroplater.
11. Describe how cyanide will be stored on the vehicle so that it is separated from the passenger compartment during its transport.
12. Describe how you will contain an accidental spillage of cyanide on vehicle.
13. Describe how cyanide will be stored securely to prevent unauthorised access.
14. Authorisation by the permit holder
Name / Date
Position in Business

1