Farm Drought Relief Application

Applicant Contact Information

Name of applicant *

Address *

Email address *

Phone number *

Will you be carting the water your self, or engaging a water carter, or both?

I will cart the water myself
I will engage a water carting company
I will cart the water myself and will also enagage a water carting company

If you will be using a water carter company, please add their name

Water type

What type of water would you like to apply for?

Untreated water
Class A recycled water
Class B recycled water (please note we are not currently accepting applications for Class B water for stock drinking or cattle farms)

If you are applying for untreated water, please estimate how much you will need over the next three months

If you are applying for Class A recycled water, please estimate how much you will need over the next three months

If you are applying for Class B recycled water, please estimate how much you will need over the next three months

Site location and description

Name and address of the water application site *

Describe the site use * Eg farmland, construction site, parkland

Describe the use of land of neighbouring properties *

Water use

What is the intended use for the water? *

Stock drinking water
Irrigation, including irrigation of pasture crops,food crops or municipal gardens and landscapes
Construction use (eg. dust suppression)
Other (eg. washdown of dairy sheds)

Stock drinking: List the types of stock. (ie. cattle, sheep, goats, chickens, horses, etc) Note: cattle less than 12 months of age and pigs (any age) must not consume recycled water.

Irrigation: Please specify type of irrigation (ie. agriculture, municipal gardens, sports fields, landscapes, etc) Eg turf, flowers, trees

Please specify irrigation method (ie. handheld hose, sprinkler, drip irrigation, subsurface irrigation)

For agricultural irrigation, please specify crop type (ie. pasture for hay, pasture for silage, pasture for grazing, maize, lucerne, lettuce, herbs, berries, fruit trees, grapevines, etc)

Construction: Please describe what the water will be used for, and describe the method of application

If you are using the water for another purpose, describe how it will be used, and how it will be applied

Sensitive receptors

If you are intending to use recycled water for irrigation or construction use, please attach a scaled site location map (e.g. Google Maps, Vic Roads map etc) with the following items clearly marked:

The property boundary
The area where recycled water will be used
Location of recycled water storage (e.g. location of storage dams or tanks)
Location of drainage lines, waterways (creeks, rivers, lakes), wetlands
Nearby land uses: location and distance to nearby residences, dams, stock drinking troughs, groundwater bores, other sensitive uses (schools, shops etc)

This information is used to assess whether your property is suitable to receive recycled water. Please provide as much detail as possible to avoid delays in your application.

Water collection and transport

What volume of water will you require for each collection?

What site will the water be collected from?

Colac Water Treatment Plant (untreated water)
Armstrong Creek (Class A recycled water)
Colac Water Reclamation Plant (Class B recycled water)

How many times will this volume be required?

How will the water be transported to the site?

Water storage on site

How long will the water be stored after collection?

How will the water be stored? What is the size of the storage?

Is the storage site secure to prevent stock access? Ie.fenced, tank

If stored for more than two days, describe the management plan for a blue-green algal bloom in your water supply

Is the storage site lined? If yes, describe the lining

Is there a connection between the water storage site and any water storage or distribution for human contact/consumption? If yes, describe.

Preventing run-off to waterways

Is there a waterway within 100 meters of the application site or a drain that leads to the waterway?

If using the water for irrigation, describe the irrigation area slopes

If using the water for irrigation, describe the soil types

If there is a risk of run-off to a waterway, how will the risks be managed? Eg. cutoff drains, re-use dam

Human contact

Will the water have the potential for human contact?

If yes, please provide detail Ie.. accidental ingestion, inhalation, spray drift

Is there potential for cross contamination for recycled and potable supplies (including connecting and crossing pipes)?If yes, please describe

Declaration

Acknowledgement

I hereby certify and warrant that:

I have read and understood the supplied information for the use of untreated and/or reycled water
The information in this application is accurate, true and complete in every detail and not misleading
I am the owner of the land; or
I herewith act, and I am authorised to act, on behalf of the landowner.

I acknowledge that Barwon Water is entitled to refuse this application if it has reasonable grounds to believe that the application site is not suitable for the use of untreated and/or reycled water or if any information or supporting documents provided are incorrect, incomplete, false or misleading.

Applicant name

Date

If your application is successful, are you happy for Barwon Water to contact you about your experience?

Privacy statement

Barwon Region Water Corporation ABN 86 348 316 514 (BW) is a Statutory Corporation created as a Water Authority under the Water Act. BW is bound by the Victorian Privacy and Data Protection Act 2014. We respect your privacy and will only collect and use personal information for legitimate purposes.

By completing this form you are providing personal information to BW for the primary purpose of BW providing you with a water and were applicable, a recycled water and/or sewer supply.

To read Barwon Water’s complete privacy statement, please visit www.barwonwater.vic.gov.au

Water and waste

Farm Drought Relief Application

Sensitive receptors

Declaration

Privacy statement

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