Forms

Environment petroleum forms

Notification of Operator Form - 534 Kb

Instrument holders should use this form to notify DMIRS of the operator of the petroleum, geothermal or pipeline activity. This form should be submitted at the time of, or prior to, submitting the first Environment Plan.

Clearing Permit Application Checklist - 61 Kb

Use this checklist to ensure your application contains all the required information.

Chemical Disclosure Report - 50 Kb

Use this template to report chemical disclosure.

Emissions and Discharges Reports Form (Quarterly) - 54 Kb

These are required to be submitted every 3 months from the date of the Environment Plan for the activity being approved. Please submit to petroleum.environment@dmirs.wa.gov.au.

Environmental & Reportable Incident/Non-compliance Reporting Form - 64 Kb

Operators are required to submit this report after the reportable incident notification.

Recordable Environmental Incident Report Form (Monthly) - 49 Kb

Use this form to report all recordable incidents occurring within a calendar month no later than 15 days after the end of that calendar month.

Environment minerals forms

Sterilisation report submission form for In-pit waste/tailings disposal proposals - 327 Kb

Sterilisation report submission form for In-pit waste/tailings disposal proposals

Mining Proposal Scoping Document - 144 Kb

Mining Proposal Scoping Document

2006 Mining Proposal Checklist - 24 Kb

Checklist to be used with the 2006 Guideline for Preparing Mining Proposals

Mine Closure Plan Checklist - 40 Kb

Checklist in word format to assist when submitting your Mine Closure Plan.

Clearing Permit Application Checklist - 61 Kb

Use this checklist to ensure your application contains all the required information.

2016 Mining Proposal Checklist - 152 Kb

Checklist to be used with the 2016 Guidelines for Preparing Mining Proposals

Proforma for notification of Minor Changes to a Mining Proposal - 142 Kb

Proforma for notifcation of minor changes to a mining proposal.

Environment Group Site details and Activity Details form - 162 Kb

Environmental Group Site details and Activity Details form

Programme of Work - Prospecting (PoW-P) Application Form - 604 Kb

PoW-P application

Programme of Work - Exploration (POW-E) Rehabilitation report - 62 Kb

On completion of a Programme of Work for exploration, a ‘Exploration Rehabilitation Report’ must be completed and submitted.

Environmental & Reportable Incident/Non-compliance Reporting Form - 64 Kb

Operators are required to submit this report after the reportable incident notification.

Programme of Work - Prospecting (POW-P) Rehabilitation Report - 101 Kb

On completion of a Programme of Work for prospecting, a ‘Rehabilitation Report for Prospecting Activities’ must be completed and submitted.

Excess Tonnage Request - 79 Kb

Template letter to request approval for excess tonnage.

Need more info, access the ‘How Do I' pages which provide detailed information on all applications, notifications and reports.