Title Page
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Add location
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Select date
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Identify type of infringement?
- Building Habitable
- Building Other
- Structure
- Landscaping
- Ponds or Ditches
- Other (use comments)
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Infringement notes:
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Is the infringement over the pipeline?
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If no, distance to nearest point on the pipeline?
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Additional comments regarding proximity?
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Pipeline information? (Must contain name, diameter and pressure range)
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Site contact details?
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Actions taken?
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Advice given?
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Photographs:
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Site sketch (if applicable):
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Name & Signature:
