D
S
C
NOTICE OF COMPLETION OF CONSTRUCTION OF A NEW / MODIFIED DAM
New Sout h Wales
Da ms Safety Committee
D4(6/91)
(Attach copy of Construction Report, Work as Executed Plans and Construction Certificate)
(For Items 2-19, notify only changes to Information previously submitted)
1.
NAME OF DAM: ________________________________________________________________________________________________
2.
LOCATION OF DAM: _______________________________
(Place name & map co-ordinates)
4.
DAM OWNER:
5.
DAM OWNER’S ADDRESS: _______________________________________________________________________________________
6.
NAME AND AFFILIATION OF OWNER’S LIAISON OFFICER/PROJECT MANAGER:
3.
RIVER/
STREAM: _____________________________________________
_________________________________________________________________________________________________
______________________________________________________________________________________________________________
2
8.
PURPOSE OF DAM: ______________________________________
10.
LENGTH OF CREST: ___________________________________ m
7.
CATCHMENT AREA: _______________________ km
9.
HEIGHT OF DAM:
11.
TYPE OF DAM: _________________________________________________________________________________________________
12.
VOLUME OF STRUCTURE __________________ m
14.
NAMES OF AND DISTANCES TO DOWNSTREAM RESERVOIRS:
15.
BASIS OF FLOOD DESIGN ASSESSMENT: __________________________________________________________________________
16.
NAME OF OWNER’S REPRESENTATIVE WHO DIRECTED INVESTIGATIONS: _____________________________________________
_______________________ m
3
13.
VOLUME OF STORAGE: _______________________________ ML
_______________________________________________________
______________________________________________________________________________________________________________
17.
NAME OF FIRMS/ORGANISATIONS ENGAGED ON INVESTIGATIONS & THEIR REPRESENTATIVES WHO DIRECTED
INVESTIGATIONS:
______________________________________________________________________________________________________________
18.
NAME OF OWNER’S REPRESENTATIVE WHO DIRECTED DESIGNS: _____________________________________________________
______________________________________________________________________________________________________________
19.
NAMES & ADDRESSES OF FIRMS/ORGANIATIONS ENGAGED ON DESIGNS & THEIR REPRESENTATIVES WHO DIRECTED
DESIGNS:
______________________________________________________________________________________________________________
20.
NAME OF OWNER’S REPRESENTATIVE WHO DIRECTED CONSTRUCTION: ______________________________________________
______________________________________________________________________________________________________________
21.
NAME OF CONSTRUCTION FIRM/ORGANISATION: ___________________________________________________________________
22.
HAS A CONSTRUCTION REPORT BEEN SUBMITTED? YES/NO
If NO, when will such be available?)
________________________________________________________
23.
HAVE ‘AS CONSTRUCTED’ DRAWINGS BEEN SUBMITTED? YES/NO
If NO, when will such be available?)
___________________________________________________
24.
HAS A CONSTRUCTION CERTIFICATE BEEN SUBMITTED? YES/NO
If NO, when will such be available?)
___________________________________________________
25.
GIVE DETAILS OF PERFORMANCE MONITORING TO DATE: ___________________________________________________________
26.
HAS PERFORMANCE BEEN IN ACCORDANCE WITH PREDICTIONS? YES/NO
If NO, give explanation and advise what action is proposed)
____________________________________________
______________________________________________________________________________________________________________
27.
GIVE DETAILS OF FUTURE SURVEILLANCE: ________________________________________________________________________
______________________________________________________________________________________________________________
28.
NAME OF PERSON TO BE CONTACTED IN MATTERS RELATING TO SURVEILLANCE:
______________________________________________________________________________________________________________
29.
WHEN WILL FIRST SURVEILLANCE REPORT BE AVAILABLE? (date)
30.
WHEN WILL COPY OF EMERGENCY PROCEDURES BE AVAILABLE? (date)
_________________________________
Name
___________________________________________________
_____________________________________________
__________________________________
Signature
This document: http://www.damsafety.nsw.gov.au/ftp/publications/word/d4.doc
Page 1 of 1
_______________________
Date
June 1991