DNRM Alleged non-Compliance report form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Status of alleged non-compliance

• Please mark the appropriate statement

  the alleged non-compliance has already occurred

  the alleged non-compliance is currently occurring

  the alleged non-compliance has yet to occur

Client details

• Title and name

• Organisation

• Mobile number

• Email

• Home phone number

• Office phone number

• Postal address

• Any other relevant information: Is an interpreter required, are gates locked,

• Confidentiality: does the client want their identity protected from alleged offender

  Yes

  No

  N/A

Identity of the alleged offender

• Company name

• Persons name

• Approx time and date of alleged offence

• Alleged offenders address

• Number of people involved

• Vehicle registration and description

• Equipment used

Alleged non-compliance location

• Co-ordinates

• Nearest intersection, road, river, town

• Any other identification marks for example signs etc

Alleged rules contravened.

• Check what resource operation plan

• Check if have any entitlements or permits

• Check if exempted under guidelines

• Check google earth drainage maps

• What rules have been contravened

Details of the alleged non-compliance. Points of proof

• Who did it?

• What did they do

• When did they do it When was it observed

• Where was it done

• Why was it done

• How did they do it

Photos maps and drawings

• Map

  Drawing

• Photo

  Media

Officers details

• Officers involved

• Date n time

  Date

• Signature

  Sign