Fly capture

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

LOCATION

• Find location
  Address

• Specify local - road or outside. Property No

• Select date

  Date

• 1. Select land type

  Select public highway council owned land private land housing association footpath / bridle way commercial land/ supermarket bring site water course rail land other land type

  • public highway
  • council owned land
  • private land
  • housing association
  • footpath / bridle way
  • commercial land/ supermarket bring site
  • water course
  • rail land
  • other land type

• 1.b Has the land owner been contacted

  Yes

  No

• 2. Occurred at this site before

  yes

  no

• 1.a Is this a known hot spot

  yes

  no

• Provide any further information

NATURE OF FLY TIP

• 3. Is there any animal waste /

  yes

  no

• 3.a Select type of waste

  carcas

  bones

  dead animals

  other

• Specify

• 4. Is there green waste

  yes

  no

• 4.a Indicate size

  single tree

  hippo bag

  other

• 4.b give information

• 5.Are there any vehicle parts

  yes

  no

• 5.a select type

  bumper

  batteries

  other

• 5.b Specify car parts

• 6. Is there construction demolition waste

  Yes

  No

• 6.a specify size

  black builders sack

  hippo bag

  other

• 6.b Specify details

• 7.Are there black sacks

  yes

  no

• 7.a specify number

  Select 1 2 3 4 5 5-10 more than 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 5-10
  • more than 10

• 8. Are there white goods

  yes

  no

• 8.a Select type

  fridge

  freezer

  chest freezer

  cooker

  other

• 8.b Give details

• 9. Are there other electricals

  yes

  no

• 9.a Specify

• Yes

  No

  N/A

• 10. Are there any tyres

  yes

  no

• 10.a specify quantity

  Select 1 2 3 4 5 5-10 more than 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 5-10
  • more than 10

• 10.a Has the tyre protocol been sent to WSSC for the removal

  yes

  no

  n/a

• 11. Is there asbestos / plasterboard or gypsum

  Yes

  No

  N/A

• 11.a please specify type

  single roofing sheet

  drain pipe /guttering

  plasterboard

  multiple roof sheets

• 12. Are there any black sacks

  yes

  no

  n/a

• 12.a Indicate amount

  Select 1 2 3 4 5 5-10 more than 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 5-10
  • more than 10

LAND TYPE

• Please select the nearest land type

  Select public highway council owned land private land housing association footpath / bridle way commercial land/ supermarket bring site water course rail land other land type

  • public highway
  • council owned land
  • private land
  • housing association
  • footpath / bridle way
  • commercial land/ supermarket bring site
  • water course
  • rail land
  • other land type

• Are the items on the highway

  yes

  no

  n/a

• Is it causing an obstruction or blocking the carriage way

  yes

  no

  n/a

• Does it require traffic management

  yes

  no

• Have arrangements been made for traffic management

  yes

  no

• Is it in a public footpath or bridle way

  yes

  no

• Have items originated from an adjoining property

  yes

  no

• Can you identify which one

  yes

  no

• Is it on council owned land

  yes

  no

• Select land type

  park

  recreation ground

  car park

• Please indicate location

• Find mapping location
  Address

• Landscapes notified

  yes

  no

• Is it in a watercourse

  yes

  no

  n/a

• Will it cause flooding

  yes

  no

• Environment agency notified

  yes

  no

SIZE OF FLY TIP

• Load size

  Select single item car boot size small van transit van tipper lorry multiple significant loads

  • single item
  • car boot size
  • small van
  • transit van
  • tipper lorry
  • multiple significant loads

• Tyre protocol information sent to WSSC

  yes

  no

  n/a

• Notes for county council collector

OFFICE INFORMATION

• Land type checked

  yes

  no

  n/a

• Sent to county for tyre collection

  yes

  no

  n/a

• was any evidence recovered

  yes

  no

  n/a

• List items found

• Signature of Officer completing the form William arnett

  Sign