Approved Form Environmental Protection Act 1994
Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application
The purpose of this form is to keep records for agricultural environmentally relevant activities (ERAs) in relation to agricultural chemicals, fertilisers and soil conditioners applied on agricultural properties in the Great Barrier Reef catchments: Wet Tropics, Burdekin Dry Tropics and Mackay Whitsundays catchments, under the Environmental Protection Act 1994 (the EP Act).
This approved form should be used to record the information below within 10 business days after undertaking the activity/event. References to the Environmental Protection Regulation 2008 (the EP Reg) are also made within this approved form. It is a requirement of the EP Act that this record be kept for at least five years, and be produced to an officer of the Department of Environment and Heritage Protection if requested.
Note: if records are kept in another manner that meets all the requirements of this approved form, you do not need to complete this approved form, and those records will be deemed to be an agricultural ERA record. However, all other record keeping requirements must be met, including the requirements to make the record within 10 business days after the activity/event has occurred, and to keep the record for at least five years.
Part 1: Property and contact details
Person responsible for the
Company name (if applicable)
Property address
Postal address
Farm identification number (if
Name of person making record
Date of record
Part 2: Records for agricultural chemicals, fertilisers and soil conditioners application (Section 83(2)(a) of the EP Act)
Product trade name Method of application (Section 22F(b) of the EP Reg) Date of application
Page 1 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 ABN 46 640 294 485 Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
Page 2 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
Page 3 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
surface – broadcast
surface – banded
sub – surface
surface – broadcast and incorporated
surface – banded and incorporated
aerial
Page 4 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application over canopy
under canopy/directed spray
shielded/hooded sprayer
spot spray application
band spraying
Part 3: Calculation of optimum amounts (Section 83(2)(c) of the EP Act)
Calculated optimum rate of
Calculated optimum rate of
Part 4: Soil test reports (Section 83(2)(b) of the EP Act)
Name of person conducting
Characteristics of the soil
Part 5: Property boundaries (Section 22F of the EP Reg)
Please describe the boundaries of the following as maps or diagrams of the relevant agricultural property: (Note: maps or diagrams may be included in the space below, or attached to this approved form) 1. Crops or paddocks from which soil has been taken for testing; and
2. The areas to which fertilisers or soil conditioners have been applied.
Page 5 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application
Page 6 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection Approved Form Agricultural Environmentally Relevant Activities – agricultural chemicals, fertilisers and soil conditioners application
Page 7 of 7 • ESR/2016/2525 • Version 2.00 • Effective: 21 07 2016 Department of Environment and Heritage Protection