Privacy Notice: Tablelands Regional Council is collecting this information in support of our disaster management activities, and will assist in providing support to you and/or surrounding properties in the event of a disaster. We may also use the information to update and improve the currency of other Council data sets used in normal operations. Tablelands Regional Council is bound by, and committed to, the provisions of the Information Privacy Act 2009, and any personal information you supply to us on this form will be treated accordingly. This information will be held and accessed by employees of Tablelands Regional Council, although we may provide relevant information to other response agencies (e.g Police, State Emergency Services, Ergon Electricity) to assist in the overall management of local disaster events. Information provided on this form will not be used for any other purpose unless you have given us permission or we are required to do so by law.

For further information contact Sarah Dean on 4043 4000 or by email to sarahd@trc.qld.gov.au

HOUSEKEEPING INFORMATION

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Name of Property / Station

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Address

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Postal Address

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Telephone Contacts

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Email Contacts

GENERAL INFORMATION

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Head of Household:

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Number of Persons who normally reside on the property:

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Number of Houses:

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Size of Property (e.g. acres, hectares):

DETAILS OF COMMUNICATIONS

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Satellite Phone Number:

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Mobile Phone Number:

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Landline Phone Number:

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Radio:

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Do you have a satellite internet connection?

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Alternate contacts whenever absent from property:

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Name/s of nearest neighbouring properties / stations:

AERODROME

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Availability:

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Length (in metres):

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Capacity:

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If OTHER please list here:

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How far is the Aerodrome from the Homestead?

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Can a Helicopter land close to the Homestead?

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Access to fixed wing aircraft?

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If YES please specify:

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Access to Helicopter?

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If YES please specify:

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Are you willing to use these resources to support the response?
E.g. check on stations that cannot be contacted, assist with resupply etc

GPS COORDINATES

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Homestead:

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Airstrip:

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Outstations:

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Other (if any):

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Other (if any)

ACCESS TO MACHINERY & EQUIPMENT

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Type of Machinery / Equipment:

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Is your homestead on mains power?

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Do you have sufficient generator power?

HEALTH

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Do you have any special needs that we should know about?

OTHER

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Any other potentially useful information you would like add:

Thank you for taking the time to complete this form. The information you have provided will be very useful.

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