EPA FORM Request to host ‘Invitation for public comment’ for the purpose of the assessment bilateral agreement PURPOSE OF THIS FORM Under the assessment bilateral agreement between the Commonwealth of Australia and the State of Western Australia, proponents are required to release draft assessment documentation1 for public comment where the proposal will be assessed at the level of Assessment on Proponent Information - Category A. Public comment is to be sought on the likely significant impacts of proposals on matters of national environmental significance. The EPA is facilitating this public participation by hosting proponent invitations for public comment on its Consultation Hub. The Consultation hub will link to the proponent’s website2 where the draft Environmental Review documentation is located. The EPA will also receive and transmit submissions to proponents. The purpose of this form is to ensure that both the proponent’s invitation for public comment and the draft assessment documentation meet the requirements of the bilateral agreement. It also provides a mechanism for the proponent to request the EPA to prepare an invitation for the Consultation Hub. INFORMATION REQUIREMENTS 1. Proponent Name Joint Venture parties (if applicable) Proponent contact for the proposal: Name, physical address, phone, email Consultant for the proposal (if applicable): name, address, phone, email 2. Location Name of the Local Government Authority in which the proposal is located. Location: street address; lot number; suburb or locality; If remote: nearest town; distance and direction from that town to the proposal site. 1 Draft assessment documentation is the relevant extract of the draft API Environmental Review document that addresses impacts on matters protected by Part 3 of the EPBC Act. 2 Proponents that do not have a website are required under the bilateral agreement to arrange their own advertising through newspapers circulating generally in each State and self-governing Territory. 3. Proposal Name of proposal Brief description of the proposal (100 word limit) 4. Matters Protected by Part 3 of the EPBC Act Tick the matters that may be or are likely to be significantly impacted by the proposal world heritage properties ☐ national heritage places ☐ ☐ wetlands of international importance (listed under the Ramsar Convention) listed threatened species and ecological communities migratory species protected under international agreements ☐ ☐ a water resource, in relation to coal seam gas development and large coal mining development the environment in the case of nuclear actions (including uranium mines) Commonwealth marine areas* Commonwealth land* ☐ ☐ ☐ ☐ 5. Public access to draft assessment documentation Web address where the proposal draft assessment documentation will be available for download 6. Public comment period The bilateral agreement requires that proponents of proposals that are assessed under the agreement at the level of API-A release their assessment documentation for public comment for at least 14 calendar days Start date of public comment period e.g. Wednesday, 5th November 2014 End date and time of public comment period e.g. Thursday 20th November 2014 7. Proponent contact for transmittal of submissions The EPA will transmit all submissions received during the public comment period directly to the contact provided below. Name of person receiving submissions Email / dropbox/ other electronic address to receive submissions Contact details of person receiving submissions: phone, email (if different to above) *The bilateral agreement does not cover proposals located within the Commonwealth marine area or on Commonwealth land; however, projects not located in those areas that may impact the environment in those areas can be assessed through the bilateral agreement. CHECKLIST FOR CONTENT OF DRAFT ASSESSMENT DOCUMENTATION The information in the checklist below must be included in the documentation provided during the public comment period in order to meet the requirements of the bilateral agreement. Does the draft assessment documentation that will be released on your website describe: (i) Yes ☐ the proposed action; and (ii) the likely significant impacts on matters protected by Part 3 of the EPBC Act; and Yes ☐ (iii) to the extent practicable, any feasible alternatives to the proposed action; and Yes ☐ (iv) possible mitigation measures? Yes ☐ DECLARATION For completion by Proponent: I, ………………………………………………., (full name) declare that I am authorised on behalf of…………………………………………. (being the person responsible for the proposal) to submit this form and further declare that the information contained in this form is true and not misleading. Signature Name (print) Position Company Address Street No. Suburb Street Name State Postcode Date Please return completed form to [email protected] For any enquiries please contact your Assessment Officer, Branch Manager or the Environmental Officer (EIA Improvement) on 08 6145 0842.