REFERENCE DOCUMENTS - RAL25/0004 (As Published)

                                                                                                                                        Notice
                                                                                        Duty to notify of environmental harm

              POSTAL ADDRESS

              PO Box 141 Tewantin Qld 4565
              EMAIL                                                                             FACSIMILE

              [email protected]


            2. Who is giving notice about the matter
            2.1. In what capacity are you giving notice?
                   Tick relevant box
                   •    I am the owner of the land                                                               ☒
                   •    I am an occupier (e.g. lessor or tenant) of the land                                     ☐
                   •    I am a representative of a local government                                              ☒
                   •    I am an auditor performing an auditor’s function under EP Act                            ☐
                   •    I am an employer                                                                         ☐
                   •    I am an employer of someone carrying out an activity                                     ☐
                   •    I am an employee carrying out an activity and                                            ☐
                        have not been able to contact my employer
                   •    Environmental Authority (EA) holder                                                      ☐
                   •    Other (specify) Click or tap here to enter text.                                         ☐

            2.2. Please provide details of your involvement
                   For example, If you are a representative of a local government, describe the nature of the matter and how the local
                   government became aware of the matter.

              We commissioned a contaminated land investigation that identified contamination above criteria that is
              considered to be a hazardous contaminant. We are also in the process of notifying DES of historical
              Notifiable Activities identified by the contamination investigation.


            3. Details of the affected land
            3.1. Please provide details of the lot and plan description (and full street address if available).

              NAME BY WHICH THE PROPERTY IS KNOWN
              CLICK OR TAP HERE TO ENTER TEXT.

              FULL STREET ADDRESS OF THE SITE
              62 LAKE MACDONALD DRIVE, COOROY, QLD, 4563


              ANY OTHER INFORMATION THAT WILL ASSIST IN QUICKLY LOCATING THE LOCATION ASSOCIATED WITH THE RELEVANT MATTER
              CLICK OR TAP HERE TO ENTER TEXT.

              LOT(S) LOT 105                                                           PLAN(S) SP118458


              GRID REFERENCES NORTHING -26.409455O EASTING 152.915879O


              LOCAL GOVERNMENT AUTHORITY NOOSA SHIRE COUNCIL



            3.2.       Is a map or locality plan attached to this notification?

                   ☐ No          ☒ Yes

                   A map or locality plan that shows the affected land may greatly assist the processing of this notification.




            Page 2 of 9 • ESR/2016/2230 • Version 4.00 • Last Reviewed : 12 April 2023                      Department of Environment and Science
Document Set ID: 23717062
Version: 0, Version Date: 01/01/1900