- Devonport City Council -
https://www.devonport.tas.gov.au
-
Water Carrier Registration Form
Posted By
Scott Newman
On
April 8, 2020 @ 1:04 pm
In Business Forms |
Comments Disabled
1
Applicant
2
Water Tanker Location
3
Tanker Details
4
Water Source
5
Carrier Activity
6
Declaration
Applicant Details:
Hidden
Type
New Application
Renewal
Applicant type
*
Company
Individual
Name of Company
*
ACN
*
Name of Individual
*
First
Last
ABN
Address of applicant
*
Street Address
City
Post Code
Is your postal address different to the applicants address?
*
Yes
No
Postal Address
*
Street Address
City
State
Post Code
Best Contact Number
*
Email
*
Details of premises where tanker is located
Address of Premises
*
Street Address
City
Post Code
Best Contact Number
*
Email
*
Contact Person
Best Contact
*
First
Last
Best Contact Number
*
After Hours Contact
*
First
Last
Best Contact Number
*
Number of Tankers to register:
*
Please enter a number less than or equal to
8
.
Tanker Details 1
Registration Number
*
Tank Construction Material
*
Stainless Steel
Fibreglass
Aluminium
Mild Steel
Type of Internal Coating on Specified Tanks
*
Type of Water Hose(s)
*
Type/means of backflow prevention devices
*
Standards that Equipment Complies With:
*
Upload Log Book
Max. file size: 50 MB.
A copy of the all log book entries for the previous 12 months MUST accompany the application
Tanker Details 2
Registration Number
*
Tank Construction Material
*
Stainless Steel
Fibreglass
Aluminium
Mild Steel
Type of Internal Coating on Specified Tanks
*
Type of Water Hose(s)
*
Type/means of backflow prevention devices
*
Standards that Equipment Complies With:
*
Upload Log Book
Max. file size: 50 MB.
A copy of the all log book entries for the previous 12 months MUST accompany the application
Tanker Details 3
Registration Number
*
Tank Construction Material
*
Stainless Steel
Fibreglass
Aluminium
Mild Steel
Type of Internal Coating on Specified Tanks
*
Type of Water Hose(s)
*
Type/means of backflow prevention
*
Standards that Equipment Complies With:
*
Upload Log Book
Max. file size: 50 MB.
A copy of the all log book entries for the previous 12 months MUST accompany the application
Tanker Details 4
Registration Number
*
Tank Construction Material
*
Stainless Steel
Fibreglass
Aluminium
Mild Steel
Type of Internal Coating on Specified Tanks
*
Type of Water Hose(s)
*
Type/means of backflow prevention
*
Standards that Equipment Complies With:
*
Upload Log Book
Max. file size: 50 MB.
A copy of the all log book entries for the previous 12 months MUST accompany the application
Tanker Details 5
Registration Number
*
Tank Construction Material
*
Stainless Steel
Fibreglass
Aluminium
Mild Steel
Type of Internal Coating on Specified Tanks
*
Type of Water Hose(s)
*
Type/means of backflow prevention devices
*
Standards that Equipment Complies With:
*
Upload Log Book
Max. file size: 50 MB.
A copy of the all log book entries for the previous 12 months MUST accompany the application
Water Source Details:
Owner of Fill Source
*
TasWater Fill Source
Privately Owned Fill Source
Primary Fill Source
*
Street Address
City
Post Code
Manager or Owner of Fill Source
*
First
Last
Is this Fill Source Classified as Drinking Water by the Owner/Manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Do you have any other water sources?
*
Yes
No
How many other water sources do you have?
*
Please enter a number less than or equal to
5
.
(maximum of 5 can be registered)
Other Fill Source
Owner of Fill Source
*
TasWater Fill Source
Privately Owned Fill Source
Manager or Owner of Fill Source
*
First
Last
Address of Fill Source
*
Street Address
City
Post Code
Is this Fill Source classified as drinking water by the owner/manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Other Fill Source 2
Owner of Fill Source
TasWater Fill Source
Privately Owned Fill Source
Manager or Owner of Fill Source
*
First
Last
Address of Fill Source
*
Street Address
City
State
Post Code
Is this fuel source classified as drinking water by the owner/Manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Fill Source 3
Owner of Fill Source
*
TasWater Fill Source
Privately Owned Fill Source
Manager or Owner of Fill Source
*
First
Last
Address of Fill Source
*
Street Address
City
Post Code
Is this fuel source classified as drinking water by the owner/Manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Other Fill Source 4
Owner of Fill Source
*
TasWater Fill Source
Privately Owned Fill Source
Manager or Owner of Fill Source
*
First
Last
Address of Fill Source
*
Street Address
City
Post Code
Is this fuel source classified as drinking water by the owner/Manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Other Fill Source 5
Owner of Fill Source
*
TasWater Fill Source
Privately Owned Fill Source
Manager or Owner of Fill Source
*
First
Last
Address of Fill Source
*
Street Address
City
Post Code
Is this fuel source classified as drinking water by the owner/Manager?
*
Yes
No
Do you have written approval to extract from this fill source?
*
Yes
No
Upload copy of written approval
Max. file size: 50 MB.
Water Carrier Activities
Please select the council areas that you will be operating in
*
Break O'day
Brighton
Burnie
Central Coast
Central Highlands
Circular Head
Clarence
Derwent Valley
Devonport
Dorset
Flinders
George Town
Glamorgan-Spring Bay
Glenorchy
Hobart
Huon Valley
Kentish
Kingborough
King Island
Latrobe
Launceston
Meander Valley
Northern Midlands
Sorell
Tasman
Waratah-Wynyard
West Coast
West Tamar
Section 136E of the Public Health Act 1997 requires only one registration from the Council where the majority of vehicles are stored for carrying out the undertaking of a commercial water carrier.
Please tick the relevant box(es) for the activities that you will be undertaking as a water carrier.
*
Cartage of Compliant Drinking Water to Individual or Businesses
Cartage of Non-Compliant Drinking Water to Individual or Businesses
Dust Suppression Activities (e.g Road Works)
Cartage of Water for Other Purposes to Individual or Businesses
Details on activities
Renewal Fee Payment
Product Name
Price:
How would you like to pay?
*
Credit Card
Invoice Me
Person to be invoiced
*
Email to send invoice
*
Credit Card
*
Hidden
Payment Type
Hidden
Narration
Application ID
Declaration
I understand that to supply drinking water to customers as a Water Carrier, I will need to:
Comply with the requirements for Water Carriers as detailed in the Public Health Act 1997;
Comply with the requirements for Water Carriers as detailed in the Tasmanian Drinking Eater Quality Guidelines 2015;
Comply with all the conditions of approval against my registration, which will be subject to regular inspections by a Council Officer to determine compliance; and
Apply for renewal of registration every 12 months.
Declaration Agreement
*
I understand and agree to the following declaration.
Privacy Agreement
I agree to the privacy policy of the Devonport City Council
Click Here to view our Privacy Policy (Opens in a new tab)
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Date
*
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