Information
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Name of Builder
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Address of Property
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Weather Conditions
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Conducted on
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Prepared by
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Location
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Is there a sediment control in plan *For the start of each day *For the end of each day - site cleanup and check
- yes
- no
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General comments
Point system: If the total combined score exceeds 20points AND/OR the answer to number 12 is YES then a PIN is to be issued. If the total score is 10 points or less it is considered a minor technical breach, and a warning of technical breach or compliance should be issued
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15. Compliance action required?
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16. OUTCOME Total Points
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17. Site compliant (no PIN to be issued
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18. Non-compliant - warning issued Minor technical breach only - compliance directions to be given)
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19. Non-compliant (PIN to be issued)
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20. Photos Take photos of site which should show site conditions and all offences identified Photos must show overall site context as well as individual issues on site.
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21. Penalty Infringement Notice issued:
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22. Date PIN issued
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23. Number of PIN:
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24. Officer details: Name: Date: Signature: