Compliance inspection

• DC Number?

• Conducted on

  Date

• Officers attending inspection

• Location
  Address

1. Penrith City Council unauthorised landfill inspection

• I have reason to believe that that unauthorised land filling has occurred on this property. I am going to ask you some questions about this incident but must in form you that you have the right to remain silent, however anything you say or do will be recorded and may be used as evidence. Do you understand?

• Date and Time of interview required

  Date

• Name of person being interviewed

• Identification Details (DOB, Res address, Licence No.)

• Address of property being filled

• Press locate button when standing beside or on subject unauthorised fill material. Record location with the coordinates button.
  Address

2. Observations of fill material

• Photograph fill material

  Media

• Where on the property is the fill material.

• Record the details of trucks and machines being used for land filling.

• Describe fill material (colour, waste present, sand, clay)

• Comment on depth, area and volume of fill material

• Square meters of unauthorised fill on property

3. Questions

• **Council officer: Have you confirmed with the person you intend to question, the location of the subject unauthorised fill material as defined in section 1 and 2 of this form?<br><br><br>

  Yes

  No

  N/A

• What is the name of the business that has employed you to carry out this land filling?<br><br><br>

  n/a

• Are you authorised to answer questions on behalf of the business that has employed you to carry out this land filling?<br><br><br>

  n/a

• Where has the fill material, deposited on this property, come from?<br><br><br>

  n/a

• How much fill material has been imported onto the property?<br><br><br>

  n/a

• Who authorised this property to be filled?<br>And how was authority given?<br><br><br>

  n/a

• How much did you pay for the land fill material that has been imported to this property?<br>And who did you pay?

  n/a

• Who owns the source site of the fill material?<br><br><br>

  n/a

• Why was the fill material imported onto the property?<br><br><br>

  n/a

• Who transported the fill material to the property?<br><br><br>

  n/a

• Who asked you to deliver fill material to the property?<br><br><br>

  n/a

Names and Signatures

• Inspectors Signature

  Sign

• Interviewee Signature

  Sign

• Witness Signature

  Sign

• Penrith Civic Centre PO Box 60 Penrith NSW 2750, Phone 0247 32 7777 - Email council@penrithcity.nsw.gov.au. -Web www.penrithcity.nsw.go.au