Professional Documents
Culture Documents
Ref No:
Date:
Details of:
A. Environmental Incident
Please provide relevant details below:
B. Feedback/Suggestion
Issue No. 2
Section 2C
Page 1 of 2
Air Emission
Solvents/ other hazardous substances, or combustion products, please specify:
Type/Ingredient: __________________________________ Concentration: _______ Quantity: ________
Energy Management
Please advise of areas where energy savings can be made, particularly by turning off items when not in use.
Lights
Air conditioning Computers Cold rooms/freezers
Other, please specify _________________________________________________________________
Details __________________________________________________________________________________
Noise
Building site
Entertainment / concert
Sports activities
Other, please specify: _________________________________________________________________
Not contained
Waterways
Erosion
Wildlife
Habitat / nesting area disturbed
Other, please specify _________________________________________________________________
Vegetation
Damage to trees/vegetation
Noxious weeds
Please complete the following section, submit it to your Head of School/Centre/Organisational Unit for
signature, and send it to the Environmental Engineer, Property and Facilities Division.
Date incident occurred: __________________________________ Time: ________________________________
Reported by: ___________________________ Sch/Ctr ______________________________ Ph: ____________
Location of Environmental Incident:
Site: ________________________ Building: __________________________ Room No. ___________________
Immediate Corrective Action taken: ______________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Follow up Corrective Action to be taken: __________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
If unable to correct problem, please explain: ________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Signature of Head of School/Centre: _________________________________________ Date: _______________
Office Use Only
Action taken:
Date:
File:
Issue No. 2
Section 2C
Page 2 of 2