Dams Safety NSW - Dam owner's contact form

Declared dam owners must provide Dams Safety NSW with a contact person for their dam.

The nominated contact person must be involved in the business of the owner, and be reasonably available to be contacted by Dams Safety NSW (Clause 24A). Note that official correspondence will be sent to this contact person.

Dams Safety NSW must be updated within 14 days of any changes of contact person.

In addition to the nominated contact person, this form requires details for the person responsible for ensuring compliance with the dam safety management system (Clause 13 1A) and any specialist, competent person the dam owner uses.

For smaller organisations, the same person may hold multiple roles.

Required fields are marked with asterisk (*)

Section 1 - Details of declared dam owner

Name of declared dam

Dam owner /Organisation

(person or public authority who, whether solely or with some other person or public authority, owns, controls, operates, manages or maintains the Dam, or proposed dam)

ABN

Numerical value only. This will be the ABN used for fees associated with the Dam Levy. If no ABN please enter 00000

If you (or your organisation) do not own the land please provide details of the landowner.

Select to enter details of landowner

Landowner name / organisation

Address of landowner

Dam owner office holder(s) (Person responsible for ensuring the safety of the dam) Eg. General Manager, Directors, Company Secretary, CEO, Secretary of Department, Individual

First name of dam owner office holder

Last name of dam owner office holder

Position of dam owner office holder

Email of dam owner office holder

Phone number of dam owner office holder

NOTE: Dam emergency plan for the dam/s and all relevant documents must be updated to reflect the change in contact person/s.

Is there a second officer holder?

select to add second office holder

Phone number of dam owner office holder 2

Email of dam owner office holder 2

Position of dam owner office holder 2

First name of dam owner office holder 2

Dam owner office holder(s) (Person responsible for ensuring the safety of the dam) Eg. General Manager, Directors, Company Secretary, CEO, Secretary of Department, Individual

Last name of dam owner office holder 2

Dam owner office holder(s) (Person responsible for ensuring the safety of the dam) Eg. General Manager, Directors, Company Secretary, CEO, Secretary of Department, Individual