PA Action St ERA ESR-2015-1791 Completed 02-2023

Application form

Development application Form 1 - Application details—attachment for an
application for an environmental authority

 

Note that where you are applying new ERAs, and your existing EA is an amalgamated EA, the application for
ERAs associated with the DA application will create a new EA for the new ERAs. In this case you may wish to
nominate a take effect date in the future which, post approval of this application, will provide you with enough
time to amalgamate your current and new EAs. Amalgamating your EAs prior to the take effect date of your new
EA will prevent you being required to pay the first annual fee for your new EA.

 

Do you want the EA to take effect on the decision date, nominated date, or pending development approval?*

 

XX] Decision date The take effect date will be the date of the decision.

 

 

 

LJ Nominated date Details of nominated take effect date:

 

 

12. Nomination of site contact

An alternative contact nominated by the legal person which holds, or will in future hold, a relevant authority
issued by the department. The department may direct correspondence relating to actual or potential compliance
matters to the site contact.

 

OO No

Do you want to nominate a site contact?* |
Yes, provide details below

 

 

 

 

Title* First Name* Surname*
Mr Robert Watson
Email Address* X Indicate if you want to receive

correspondence via email
[email protected] et

 

 

 

Phone

 

 

 

13. Nomination of application contact

An alternative contact nominated by the legal person which has submitted, or will in future submit, applications
to be assessed by the department. All departmental correspondence relating to the assessment of applications
will be directed to the application contact, however, if the application results in the issuing of a relevant authority,
the relevant authority will be sent to the applicant.

Name or Position*

Robert Watson VP, Quality

Primary Phone*
0401 021 198
Secondary Phone

 

 

 

 

Email Address*
[email protected]

 

 

Page 9 of 12 * ESR/2015/1791 + Version 8.00 + Last reviewed: 12 AUG 2021 Department of Environment and Science