000A88A4.004.tif · 132003.221037

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Complete if this application involves assessment for an

Environmentally Relevant
Activity (ERA)

The comsietion of all questions on
1 Part G of this form is mandatary
| for all development app fe
i a material change.of use of premises
( foran ERA.

 

Nature of the ERA
To‘assist in.completing this sectian;
refer to: the Environmental: Protection:
Agency's (EPAs) Guideline: No.4
(PA/EPA:available.on--the:EPAs
website:at' http’ Aviww.env-did. gov au:
under Business and:Industry /
Environmental: Guidelines:/ ‘Intagrated.
Planning Act; or: contact. the lacal.
government.

To identify who the administering
authority. is for. each ERA, referto:
Schedule-1' of the Enviromental:
‘Protection Regulation 1996. or: contact
the EPA or local: government,

If the proposed: ERA-is:a Level-+
activity, ‘ani application fer:an
environmental aut hority-under:the
Environmental Protection Act 1994 is
also required before the use starts. A
fee'saving's: available ifthe
applications are lodged together.:

: Identify-each existing (if any) & proposed ERA(s) (eg.:ERA 15) & its description (Attach list if necessary)

(ERA [ES Oo) Sewace Teeacmense
Existing Level (If applicable} Proposed Level (Tick applicable-bex)
a tevelt ~~ Livevel2

Utevel1 Cl evet2
Existing Threshold (if applicable) Proposed: Threshold

| |

Q)ERA |

 

 

 

 

Proposed Level (Tick applicable box}
Level # CT Level2 CI bevel 4 Ci tevel 2

Existing Threshold (if applicable) Proposed Threshold

[ |

Existing Level: (if applicable)

 

 

Referral triggers

if this application is for a material:
change:of use for.an-ERA’and'clearing:
vegetation on freehold tand:only, it
say: trigger referra! to-an IDAS referral.
‘agency.

. Does the application trigger referral to:an:|DAS referral agency? (Tick applicable box} (Use the Referrals

Checklist to.determine-any possible a this application}:
CI No YES. ifyes, attach Referrals Checklist

 

Detalis of the land

For further: details regarding ‘preparing
‘a Proposal: Report refer te Guide 7:

: Plans'and written information:are required ta accompany. applications:for- ERAs. These plans &

information! are required to’ address the following matters regarding thé land (Tick # accompanying this
application) — Bee wevacuce Leger.
Acdescription of the existing environment (fe! maps of the land and surrounding area; zoning of the
land and stirrounding.areas)

LI. Details of the distance to any watercourse, dam, bore eic.on or adjoining the land.

(_1:..Details of any of the following typés of materials currently stored on’ the’land’((e. fammabie &
combustible materials, chémicais, other hazardous substances)

(1: Details'of the:location of any acid sulphate soils within or adjoining the land

 

Details of the activity

Arvapplication Toran environmental
televant activity must be:supported-by
enough. information:to:enable the:
administering authority to:decide'the:
application, inckiding, for.examplé,
relevant information about the-tikely:
Fisks to: the environment; details of:
waste to bé:aénerated: arid any. waste:
minimisation. sirategy:

, :Plans.and written information are.required to-accompany: applications for ERAs: These plans '&

information are required to address the following matters regarding the:proposal (Tick ff accompanying
this application) —" See —~eracnec Ceaser
A description of the activity (Le. progased operation and activities; dischargé points, process details)
Details of stormwater. generation & disposal (i.e. stormwater management'plans)
Details of waste produced, including solid and liquid waste (i.¢.. waste management, waste
minimisation plan, trade waste permit) i
Details of contaminant releases and their impacts an the receiving environment (ie. discharge to
waters, afr, land; generation 'of noise, discharge of other-contaminants)
Details of any: of the-following types of materials nroposed to be stored on the land @e:
flammable & combustible materials, chemicals; other hazardous substances
Details of proposed hours. of operation

Details of business tradiig name.

 

Fee payable

.. Provide details of the fee payable for each scheduled ERA(s) listed in Question:1 (Attach additional

details if necessary}

[Si7oO (CEPA ADNcE)

 

 

 

 

Plans and décuments

 

... Is the application. accompanied by: (Tick wen box/es}

Plans

Proposal report
1 'Other (Specify)

 

 

This appitcation cannot be accepted by the assessment manager unless accompanied by Part A of the Develonment Application

 

EO

  

faapicebie to essées:

 

manegarand alternative: ass. onl managers

 

  

  

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