Information

  • Liquid Trade Waste Reference Number

  • Site / Client

  • Location
  • Lot Section DP

  • Parcel number

  • Assessment number

  • Conducted on

Contact Details

  • Contact Person

  • Contact phone number/s

  • Contact email address

  • Owners name

  • Owners mailing address

Premises & Inspection Details

  • Business Type

  • Classification

  • Category

  • Water Meter #

  • Meter size

  • Liquid Trade Waste Discharge Factor

  • Sewer Discharge Factor

  • Sewerage Treatment Plant catchment

  • Sewerage Pump Station catchment

  • Drawing of system (if required)

Reason for Inspection

  • Reason

PRETREATMENT

Equipment Type

Grease Arrestor

  • Required

  • In Place

  • Maintained

  • Condition OK

  • Compliant

Floor Waste Baskets

  • Required

  • In Place

  • Maintained

  • Condition OK

  • Compliant

Sink Screens

  • Required

  • In Place

  • Maintained

  • Condition OK

  • Compliant

Other (please describe)

  • Required

  • In Place

  • Maintained

  • Condition OK

  • Compliant

  • Additional notes

Containment Methods

  • STORMWATER

  • Isolated from sewer

  • Roofing

  • Bunding

  • CHEMICAL / OIL STORAGE

  • Isolated from sewer

  • Roofing

  • Bunding

  • Additional notes

Housekeeping/other

  • Odours present

  • Housekeeping practices within approval

  • Site accessible

  • Waste disposal by NSW EPA approved contractor

  • Pits & screens clean

  • Activities within classification /approval

  • Current Material Safety Data Sheets (MSDSs) available

  • Correct Back flow prevention device in place

  • Back flow Prevention Device certification to Council current

  • Additional notes

FOLLOW UP REQUIREMENTS

General Comments

Information to be provided to Council

Further Action

  • Further action required

  • Comments

Fees to be Charged

  • Apply Inspection fee

I have read this report and understand the contents.

  • Owner / Employee signature

  • Officers Name

  • Officers signature

  • NB: Assessment report contains findings from date/time of inspection only

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