Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
Applicants should refer to the most recent version of EPA Publication 865, Environmental auditor guidelines for appointment and conduct, for
an understanding of the initial appointment process and the assessment criteria to which this form relates. This form must be completed in
conjunction with Form 1 - General Criteria (or Form 1R – Mutual Recognition, for application through mutual recognition process).
Please ensure that all sections of the form are completed, and that all requested information and attachments are provided and labelled as
indicated.
CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
EPA Publication 865, Ref 3.2 (xiii), 3.2 (xiv), 3.2 (xv) and Schedule A
Please provide in the following tables summary details in the form of dot points.
Has a separate statement been provided in support to Contaminated Land Specific Assessment Criteria?
 Yes - must be labelled as Attachment 5A
 No
Attachment 5A
Statement in support to
Contaminated Land Specific
Assessment Criteria Optional
Clear Cross-Reference must be made to any statement and/or to the sample report provided in support to your application (eg. paragraph
number in the statement, section and page of the sample report, etc)
1. CORE COMPETENCIES
Applicant must demonstrate extensive experience and a high level of expertise in all the following core competencies.
SPECIFIC ASSESSMENT
CRITERIA
865
A.1.1 (i)
CRITERIA
Assessment of
Contaminant Exposure
Pathways
Version 3 – June 14
687307454
SUMMARY DETAILS DEMONSTRATING
EXPERIENCE AND EXPERTISE
CROSS-REFERENCE
SECTION
(Statement/Sample Report)
EPA USE
ONLY

1A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
1. CORE COMPETENCIES
Applicant must demonstrate extensive experience and a high level of expertise in all the following core competencies.
SPECIFIC ASSESSMENT
CRITERIA
865
SUMMARY DETAILS DEMONSTRATING
EXPERIENCE AND EXPERTISE
CRITERIA
A.1.1 (ii)
Contaminated Site
Assessment and
Remediation including
Management

A.1.1 (iii)
Evaluation and
interpretation of
Chemical and Analytical
Data

A.1.1 (iv)
Soil Sampling Design
and Methodology

A.1.1 (v)
Soil Gas Sampling
Design and
Methodology

Version 3 – June 14
687307454
CROSS-REFERENCE
SECTION
(Statement/Sample Report)
EPA USE
ONLY
2A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
1. CORE COMPETENCIES
Applicant must demonstrate extensive experience and a high level of expertise in all the following core competencies.
SPECIFIC ASSESSMENT
CRITERIA
865
SUMMARY DETAILS DEMONSTRATING
EXPERIENCE AND EXPERTISE
CRITERIA
A.1.1 (vi)
Groundwater Sampling
Design and
Methodology

A.1.1
(vii)
Identification of
Potential Human Health
and Environmental
Risks

A.1.1
(viii)
Quality
Control/Assurance
Procedures

A.1.1 (ix)
Risk Communication

CROSS-REFERENCE
SECTION
(Statement/Sample Report)
EPA USE
ONLY
EPA USE ONLY
Version 3 – June 14
687307454
3A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
2. EXPERTISE, PROFICIENCY AND EXPERT SUPPORT TEAM
Applicant must demonstrate expertise in, or access to relevant expertise in the following areas.
You must provide a current, detailed curriculum vitae for each nominated expert support team member
HIGH
SPECIFIC ASSESSMENT
LEVEL
OF
SUMMARY DETAILS DEMONSTRATING
CRITERIA
EXPERTISE
EXPERIENCE AND EXPERTISE
865 REF
CRITERIA
A1.2 (i)
Air Quality
A1.2 (ii)
Assessment of Impacts
on Groundwater from
Contaminated Sites
A1.2 (iii)
Contaminant Fate and
Transport
A1.2 (iv)
Environmental
Chemistry
A1.2 (v)
Environmental Risk
Assessment
Version 3 – June 14
687307454
YES
NO
CROSSREFERENCE
SECTION
(Statement/
Sample Report)
EPA USE
ONLY
4A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
A1.2 (vi)
Environmental
Toxicology
A1.2 (vii)
Geology
A1.2
(viii)
Human Health and
Ecological Risk
Assessment relating to
Contamination
A1.2 (ix)
Human Toxicology
A1.2 (x)
Hydrogeology
A1.2 (xi)
Identification of
Contaminants of
concern from past
Industrial land uses
A1.2 (xii)
Remedial Technologies
and Geo-technology
Version 3 – June 14
687307454
5A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
A1.2
(xiii)
Soil Science
A1.2
(xiv)
Sampling and
Interpretation of
Analytical Data for a
Variety of Media
A1.2 (xv)
Statutory and
Environmental Planning
EPA USE ONLY
*
Must be attached for nominated experts not employed by the same company as the applicant
Version 3 – June 14
687307454
6A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
3. UNDERSTANDING OF GUIDELINES
Applicant must demonstrate an understanding of all of the following:
SPECIFIC ASSESSMENT
CRITERIA
865 REF
SUMMARY DETAILS DEMONSTRATING
UNDERSTANDING
CRITERIA
CROSS-REFERENCE
SECTION
(Statement/ Sample Report)
EPA USE
ONLY

A.1.3
Australian and New
Zealand Guidelines for
the Assessment and
Management of
Contaminated Sites
(ANZEEC/NHMRC) 1992

National Environment
Protection
(Assessment of Site
Contamination)
Measure 1999
EPA USE ONLY
Version 3 – June 14
687307454
7A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
4. APPLICANT’S EXPERIENCE IN CONTAMINATED SITES
Applicant must demonstrate experience in contaminated sites work, in terms of the following:
SPECIFIC ASSESSMENT
CRITERIA
SUMMARY DETAILS DEMONSTRATING
EXPERIENCE
865 REF
CRITERIA
A.1.4
Broad scale of works
undertaken

Broad range of
contaminants
encountered

Variation in scope of
works undertaken

CROSS-REFERENCE
SECTION
(Statement/ Sample Report)
EPA USE
ONLY
EPA USE ONLY
Version 3 – June 14
687307454
8A
Application for appointment as Environmental Auditor
under section 53S of the Environment Protection Act 1970
FORM 2 – SCHEDULE A – CONTAMINATED LAND SPECIFIC ASSESSMENT CRITERIA
5. APPLICANT’S OTHER EXPERIENCE:
Experience in the following will be regarded highly:
SPECIFIC ASSESSMENT
CRITERIA
A.1.5
SUMMARY DETAILS DEMONSTRATING
EXPERIENCE
Assessment and
management of
major environmental
issues involving
complex sampling
design

Chemical or
hydrogeological data
collection and
interpretation

CROSS-REFERENCE
SECTION
(Statement/ Sample Report)
EPA USE
ONLY
EPA USE ONLY
Version 3 – June 14
687307454
9A