Information
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Liquid Trade Waste Reference Number
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Site/Client
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Location
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Lot Section & DP
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Parcel number
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Assessment number
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Conducted on
Contact Details
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Contact Person
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Contact phone number/s
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Contact email address
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Owners name
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Owners mailing address
Premises & Inspection Details
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Approval number
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Business Type
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Classification
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Category
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Water Meter #
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Meter size
- 20mm
- 25 mm
- 32 mm
- 40 mm
- 50 mm
- 80 mm
- 100 mm
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Liquid Trade Waste Discharge Factor
- 0
- 10
- 20
- 30
- 50
- 60
- 80
- 90
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Sewer Discharge Factor
- 0
- 10
- 50
- 70
- 75
- 80
- 85
- 90
- 95
- 100
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Sewerage Treatment Plant catchment
- Bermagui
- Bega
- Candelo
- Cobargo
- Eden
- Kalaru
- Merimbula
- Tathra
- Wolumla
- Tura Beach
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Sewerage Pump Station catchment
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Drawing of system (if required)
Reason for Inspection
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Reason
- New Discharger
- Initial Inspection
- Routine Annual Inspection
- Re-Inspection
- Investigation
- Sample taken
PRETREATMENT
Equipment Type
Oily Water Separator
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Required
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In Place
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Maintained
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Condition OK
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Compliant
Waste Arrestors -FW
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Required
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In Place
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Maintained
-
Condition OK
-
Compliant
Collection Pits / Pumps
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Required
-
In Place
-
Maintained
-
Condition OK
-
Compliant
Pit Screens
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Required
-
In Place
-
Maintained
-
Condition OK
-
Compliant
Sink Screens
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Required
-
In Place
-
Maintained
-
Condition OK
-
Compliant
Other (please describe)
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Required
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In Place
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Maintained
-
Condition OK
-
Compliant
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Additional notes
Containment Methods
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STORMWATER
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Isolated from sewer
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Roofing
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Bunding
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CHEMICAL / OIL STORAGE
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Isolated from sewer
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Roofing
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Bunding
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Additional notes
Housekeeping/other
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Spill Procedure Satisfactory
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Separator Site Accessible
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Separator Maintenance Documents
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Oil disposal by DECCW approved contractor
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Coolant disposal by DECCW approved contractor
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Spent Filters disposal to DECCW approved site
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Oily Rags & Absorbent material disposal to DECCW approved site
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Activities within classification /approval
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Current Material Safety Data Sheets (MSDSs) available
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Correct Back flow prevention device in place
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Back flow Prevention Device certification to Council current
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Additional notes
FOLLOW UP REQUIREMENTS
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- Immediate
- 1 week
- 2 weeks
- 1 month
- 6 months
- 12 months
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- Immediate
- 1 week
- 2 weeks
- 1 month
- 6 months
- 12 months
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- Immediate
- 1 week
- 2 weeks
- 1 month
- 6 months
- 12 months
General Comments
Information to be provided to Council
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- Liquid Trade Waste Application
- Back flow Prevention Device Certification
Further Action
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Further action required
- Nil
- Reinspection
- Warning letter
- Improvement Notice
- Prohibition Order
- Penalty Notice
- Other
- Pending
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Comments
Fees to be Charged
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Inspection fee
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Administration fee
I have read this report and understand the contents.
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Owner / Employee signature
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Officers Name
- Tony Jolley
- Anthony Dowd
- Ken McLeod
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Officers signature
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NB: Assessment report contains findings from date/time of inspection only