Dam Information Form

Dams Safety NSW - Incident reporting form

The purpose of this form is to enable dam owners to provide a written report of an incident to Dams Safety NSW as per Clause 19 of the Dams Safety Regulation 2019.

The incident types which are listed in the form below under (a) through (f) also require an oral report as soon as possible after the incident. If this applies to your incident and you have not made an oral report in relation to the incident, please call 0403 681 645.

Please also ensure that you have activated your dam's emergency plan as required.

If there is any other information you wish to include as part of the reporting process which does not fit into this form, please e-mail the additional information to: incident@damsafety.nsw.gov.au

Dams Safety NSW may request additional information if needed.

By submitting this form to Dams Safety NSW, you acknowledge that you have entered all required information truthfully and accurately to the best of your knowledge
Details of the dam



Details of the incident
What was the type of incident that occurred?




If this is not known, please provide best estimate

If this is not known, please provide best estimate
Contact person for incident




Person completing form




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