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Reporting Pollution
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Commercial in Confidence;OFFICIAL:Sensitive|Sensitive;OFFICIAL:Sensitive
showmetadata=true&entityname=PollutionReportAnonymous
Pollution Type
*
Odour
Noise
Waste
Water
Smoke
Dust
Banned Products
First Name
*
Last Name
*
*
Contact Number
*
Address
*
Email
*
*
I wish to remain anonymous
Report Source- Who is reporting?
Both EPA and Council
Body Corp
Business/Industry
Community
Community/Environmental Group
Council
Emergency Services
Government
Internal (EPA)
Individual/Resident
Member of Parliament
Other
What type of pollution is it?
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If other, please provide more details on the type of pollution
*
If known, what type of premises is the pollution coming from?
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If known, please identify the name of the premises where you believe the pollution is coming from.
*
*
Chosen Alleged Location Payload
*
*
Where is the pollution located?
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If other, please provide more details of the pollution location
*
Chosen Location Payload
*
What is the size/amount of the pollution?
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Where are you being affected? Select all that apply.
Pollution Experience Date and Time
*
What is making the noise?
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Describe what is making the noise
*
Describe the noise
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Details that describe the noise
*
What is the colour of the Smoke?
Black
Grey
White
Other, If coloured please Specify
Other, If coloured please Specify
*
If you can smell the pollution, how would you describe it?
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Select an option that best describes the smell
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Other, please Specify
*
If the pollution is coming from a business and it's safe to do so, have you tried contacting them about it? They may not be aware that they are affecting you.
Yes
No
What is the type of smell?
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Can you please tell us what it smells like?
*
Select an option that best describes the odour
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Can you please describe the odour?
*
How is the smell affecting how you live? (tick all that apply)
Other please specify
*
Where can you smell the odour?
Outside my home/premises
Both inside the home/premises and outside
What is occurring?
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If known, what is occurring?
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Ongoing Issue?
New
Ongoing
Is the pollution still occurring?
Yes
No
Unsure
What was the date and time you observed or experienced this pollution?
*
If known, what was the Pollution end date & time?
*
Have you experienced this before?
Yes
No
If yes, Frequency?
First time
Daily
Weekly
Monthly
Occasionally
Constant / ongoing
Other
Has the physical or mental health of you or anyone in your care been impacted by the pollution?
*
Yes
No
Select how the health of you or anyone in your care has been impacted by the pollution. (Tick all that apply) Please seek medical help if you are unwell.
Please specify below
*
Provide any further details of how your health has been impacted (optional).
*
If you have photos and or videos or other evidence of the pollution please upload them here. These can provide valuable insights to help us understand the nature of the pollution incident
*
Ensure you have uploaded the correct files before clicking "Save and next". Once saved, files can only be removed
by submitting a request to EPA
. Uploading files is a two step process:
Step 1: Select your files
File properties:
Name
File size
Sensitivity:
Step 2: Upload your files
0% Complete
This type of file can't be uploaded. It must be one of these file types:
This file can't be uploaded. File name must not include following characters: "~", "#", "%", "&", "*", "{", "}", "\", ":", "<", ">", "?", "/", "+", "|", ".."
This file can't be uploaded. File name must not exceed 255 characters.
File has already been uploaded for this application
File uploaded successfully
Please let us know if you have any more information you'd like to include in your report. The more details you can provide, the more helpful it will be for our response.
*
If our officers need to contact you for further information, are you willing to assist?
Yes
No
Would you like to be notified of the outcome of your report?
Yes
No
Do you consent for your details to be passed onto other Government agencies if required?
Yes
No