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Development Application part 2 OF 2 All of CD, Information in notes - MCU12/0216
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EMERGENCY AND INCIDENT
Department of Environment and Heritage Protection Further Notification Form
Not more than 14 days following the initial notification of an emergency or incident, the holder of this development permit must
provide the following written advise along with the initial notification form.
This record must be kept for a period of five (5) years.
Development Approval Number ........................................................................................................................................
Designated Contact Person ..............................................................................................................................................
Date of Release: ……/……/…… Time of Release: ……………. am/pm
Proposed Action to prevent a recurrence of the Emergency or Incident
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Outcomes of Actions taken at the time to prevent or minimise Environmental Harm and/or
Environmental Nuisance
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Results of any Environmental Monitoring performed
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Further comments
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Name: .................................................. Signature: .......................................................
GROUNDWORK p l u s
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