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IDAS Form 24-Contaminated Land

Attached to the e-mail Development Application MCU - 226 David Low Way Peregian Beach-Report & Form 24(Email 1).

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 IDAS form 24—Contaminated land
 (Sustainable Planning Act 2009 version 3.0 effective 1 July 2013)

 This form must be used for development applications for:
 •     a material change of use that is assessable development relating to contaminated land matters under the
       Sustainable Planning Regulation 2009, schedule 3, part 1, table 2, items 6 to 7
 •     reconfiguring a lot relating to contaminated land or residual unexploded ordnance (UXO) risks that requires
       referral under the Sustainable Planning Regulation 2009, schedule 7, table 2, item 22
 •     a material change of use that is assessable development relating to residual UXO risks under the Sustainable
       Planning Regulation 2009, schedule 7, table 3, item 11.

 You MUST complete ALL questions that are stated to be a mandatory requirement unless otherwise identified on this
 form.

 For all development applications you must:
 •     complete IDAS form 1—Application details
 •     complete any other forms relevant to your application
 •    provide any mandatory supporting information identified on the forms as being required to accompany your
      application.
 Attach extra pages if there is insufficient space on this form.

 All terms used on this form have the meaning given in the Sustainable Planning Act 2009 (SPA) or the Sustainable
 Planning Regulation 2009.

 This form can also be completed online using MyDAS at www.dsdip.qld.gov.au/MyDAS

 Mandatory requirements

 1.     What is the nature of the application? (Tick all applicable boxes.)

  ✔    Material change of use                      Reconfiguring a lot

 2.     What is the nature of the contamination or potential contamination? (Tick all applicable boxes.)

All or part of the premises:

       (i)      is on the Environmental Management Register (EMR)
       (ii)     is on the Contaminated Land Register (CLR)
       (iii)    has a notifiable activity which is currently taking place or has previously taken place
       (iv)     is currently used for, or has previously been used for, an industrial activity and the proposed use is for a
                potentially sensitive material change of use
       (v)      in an area where an area management advice (AMA) has been given for natural mineralisation or
                industrial activity and the proposed use is for a potentially sensitive material change of use
  ✔    (vi)     is in an area for which an AMA has been given for unexploded ordnance (UXO).
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    3.     Confirm the following mandatory requirements accompany this application
    Mandatory requirements                                                         Confirmation of       Method of
                                                                                   lodgement             lodgement

    In regard to 2(i) to 2(v)
    If the application involves a material change of use from an industrial use to a potentially sensitive material change of
    use
    A detailed site history outlining previous potentially contaminating uses          Confirmed
    on the premises                                                                ✔   Not applicable
    In regard to 2(vi)
    Where applicable, any existing report on prior investigation or                ✔   Confirmed
    remediation of the premises by a UXO contractor or consultant                      Not applicable
    accredited by the Department of Defence

    Mandatory supporting information

    4.     Confirm that the following mandatory supporting information accompanies this application
    Mandatory supporting information                                               Confirmation of       Method of
                                                                                   lodgement             lodgement

    For all applications

    A statement addressing the relevant part(s) of the State Development           ✔   Confirmed
    Assessment Provisions (SDAP).                                                      Not applicable

    In regard to 2(i) to 2(v)

    Plans showing where any notifiable activities, hazardous contaminant or            Confirmed
    potentially contaminating activity has occurred on the premises
    In regard to 2(vi)
    Plans showing where excavation, earthworks or other disturbance of             ✔   Confirmed
    land associated with this development will occur relative to any part of           Not applicable
    the premises categorised by the Department of Defence as having a
    ‘substantial’ UXO potential

   Privacy—Please refer to your assessment manager, referral agency and/or building certifier for further details on the
   use of information recorded in this form.


   OFFICE USE ONLY

    Date received                                              Reference numbers

   The Sustainable Planning Act 2009 is administered by the Department of State Development, Infrastructure and
   Planning. This form and all other required application materials should be sent to your assessment manager and any
   referral agency.




Department of State Development, Infrastructure and Planning
PO Box 15009 City East Qld 4002
tel 13 QGOV (13 74 68)
[email protected]                                                                           IDAS form 24—Contaminated land
                                                                                                         Version 3.0—1 July 2013
www.dsdip.qld.gov.au

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