Free F700-135-000 Seasonal Agricultural Group Variance Application - Washington


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Date: July 19, 2007
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State: Washington
Category: Government
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http://www.lni.wa.gov/forms/pdf/700135af.pdf

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Department of Labor and Industries Employment Standards Program PO Box 44510 Olympia WA 98504-4510 Phone: (360) 902-5316 FAX: (360) 902-5300 Email: teensafety@Lni.wa.gov http://www.TeenWorkers.Lni.wa.gov

SEASONAL GROUP VARIANCE APPLICATION
For Exception from the Hours of Work for Minors

Instructions for completing and submitting this form are on the next page.

Variances must be approved by the Department of Labor and Industries to be valid. Your business will receive an Approved Variance Certificate if this application is approved.
WAC 296-131-140, VariancesAgricultural Employment, and WAC 296-125-0600, VariancesNon-Agricultural Employment, provides that the Department of Labor and Industries may grant an employer a variance from specific rules. The employer must show good cause as defined in the regulations in order to be granted a variance. The affected minor employees, school (if in session) and parent or legal guardian must be advised of the requested variance, and the required Parent/School Authorization form must include the proposed exceptions. Parents and schools have the ability to adjust the hours of work for their child, despite the variance approval. The department will review the following information in consideration of granting the requested variance. In order for us to process this application, it must be completed in full. 1. UBI NUMBER FOR THIS BUSINESS LOCATION: 2. Business name Mailing address 3. Location address Point of Contact 4. Number of minors affected by age-group: 14-15 year-olds: 16-17-year-olds: Email address City City Telephone number State State FAX number ZIP+4 ZIP+4

__ __ __ __ __ __ __ __ __
9-Digit Unified Business Identifier (UBI)

__ __ __
3-Digit Business ID

__ __ __ __
4-Digit Location ID

5. Section(s) of minor work rules for which variance is requested. (Indicate Yes or No for each section below)

WAC 296-131-120 WAC 296-125-027

Hours of Work for Minors in Agricultural Employment:

Yes

No Yes No

Hours of Work for Minors in Non-Agricultural Employment (16- and 17-year-olds only):

6. Proposed alternative to rule. Please describe what you want minor(s) to do, e.g., work more hours, total number of hours per day and week, etc. Please distinguish between 14- and 15- year-olds vs. 16- and 17-year-olds in the details of your request, if applicable. More space available on attached tables.

NOTE: A fully completed copy of the Parent/School Authorization form (F700-002-000) for each minor listed above must be obtained. Each minor's form must include the proposed exception. 7. Reason(s) and circumstances specified along with any information necessary to support your request, e.g., demonstration of good cause.

Date

Title

Printed Name

Signature of employer representative (electronic accepted)

F700-135-000 seasonal ag group variance 7-2007

Mail completed application to the address above.

(If additional space is needed, attach a separate sheet.)

Variance Application Instructions
Variance Application forms may be faxed to (360) 902-5300. If you would like the approved Variance Certificate faxed back to your business, please state so on your cover sheet. This form is a word document and can be completed electronically. If you have an electronic signature, you may use it on the form. You may save the form and send it as an attachment via email to the address at the top of the form, i.e., teensafety@Lni.wa.gov. If you do not have an electronic signature, complete the form, save it in your files, print it, sign it and fax or mail it to the address at the top of the form. The Department can accept only those Variance Applications that have been completed in full. Any applications not completed in full will be returned to the employer for completion. Following are some guidelines for completing the form: 1. The complete Uniform Business Identifier (UBI) number from the Master Business License for the business location where the minor will be working. 2. The complete business name and mailing address as shown on the Master Business License. 3. If the minor is working at a business location other than the mailing address, please let us know the location. We must have the UBI number on this application for the location where the minor is working. 4. Identify the anticipated number of minors involved by age-group (i.e., 14- and 15-year-olds vs. 16- and 16year-olds). Parent/School permission forms must be obtained on each minor hired. Parents have the option to adjust their child's hours of work regardless of an approved variance. 5. Indicate which section of the minor work regulations are you seeking a variance. Options include: WAC 296-131-120: Hours of work for minor working in agriculture (e.g. picking fruit, or packing produce by the farmer owner); or WAC 296-125-027: Hours of work for minors working in non-agricultural jobs, such as packing produce for multiple growers.

6. List the specific details of the variance request, for example, work more hours, work earlier or later hours, duties, etc. Please list the specific shifts, total number of hours each day, total number of hours each week, or specific prohibited duties, etc., that you wish the minor(s) to work. 7. Explain briefly the reasons (good cause) for this variance request, such as, minor is self-supporting and needs additional hours, longer hours required to meet business needs, etc. Also, please indicate if the minor is attending school and his or her school hours. 8. Attached to this form are tables created to help employers identify the specific details of their request. There is a different table for those that are covered by the non-agricultural regulations (e.g., packing produce for multiple employers; and those covered by the agricultural regulations (e.g., picking fruit or packing produce owned by the grower). See more details on the attached tables.

Note: The Department of Labor and Industries will not approve a variance that conflicts with federal child labor laws. If you have questions regarding coverage under federal law, please call the U. S. Department of Labor toll-free at (866) 487-9243.
F700-135-000 seasonal ag group variance instructions 7-2007

Variance Request for Hours of Work for Minors Agriculture (WAC 296-131-120)
Work Hours 12- and 13-year-olds
Non-School Allowable Working Hours Max Hours per Day Max Hours per Week Max Days per Week OffPeak 6 weeks Peak 2 weeks

14- and 15-year-olds
Non-School Allowable Off-Peak 6 weeks Peak 2 weeks

16- and 17-year-olds
NonSchool Allowable 5 a.m. 10 p.m. 10 Off-Peak 6 weeks Peak 2 weeks

5 a.m. 9 p.m. 8

5 a.m. 9 p.m. 8

40

40

50

6

6

6

Please fill in the gaps for what the hours of work will be during the off-peak time and indicate how many weeks the peak hours would apply. The harvest season dates are approximately: June_______ - August _______. Contact: Mary E. Miller, MN, RN at mmar235@Lni.wa.gov or 360.902.6041. If you anticipate different hours of work for youth during different times in the season during the non-school weeks, please describe what is generally anticipated for extended hours during peak and non-peak weeks. Provide more detail below if needed:

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

F700-135-000 seasonal ag group variance instructions 7-2007

Request for Hours of Work for Minors Non-Agriculture (WAC 296-125-027)
Work Hours 16- and 17-year-olds
Non-School Allowable Hours a Day 8 Hours a Week 48 Days a Week Start Times Quit Times 6 5 a.m. Off-Peak 6 weeks Peak 2-3 weeks

12 a.m.

The harvest season dates are approximately June_______ August________ Peak Dates for extended work hours are approximately: _________________ Contact: Mary E. Miller, MN, RN at mmar235@Lni.wa.gov or 360.902.6041 If you anticipate different hours of work for youth during different times in the season during the nonschool weeks, please describe what is generally anticipated for extended hours during peak and non-peak weeks.

Provide more detail below if needed:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

RESET
F700-135-000 seasonal ag group variance instructions 7-2007