Australian Antarctic Division ANTARCTIC TREATY (ENVIRONMENT PROTECTION) ACT 1980 ANTARCTIC MARINE LIVING RESOURCES CONSERVATION ACT 1981 REPORT OF ACTIVITIES Season …………………….... Authorisation/Permit Holder.…………………………. Project Number (if relevant)…….……..……………… File [Records] ref: 06/344-3 Container: Rec No: Responsible Officer: TET Environmental Policy Officer Authorising Officer: TET Manager Authorisation Date: 17 July 2014 Review Date: April 2015 Location of Hard Copies/Points of Use: TET Report of Activities EXPLANATORY NOTE Use this template to report on your activities authorised under the Antarctic Treaty (Environment Protection) Act 1980 (ATEP Act), or the Antarctic Marine Living Resources Conservation Act 1981 (AMLR Act). Subsection 21(1) of the ATEP Act requires permit holders to submit a report on the activities relating to their permit, including measures taken to ensure compliance with the permit conditions. It is also a standard condition of environmental authorisations issued under Section 12F of the ATEP Act, and permits issued under Section 9 of the AMLR Act, that a report is submitted describing the activities carried out under the authorisation or permit, including measures taken to ensure compliance with the permit or authorisation conditions. This report is required on or before the date stipulated as a condition of your authorisation or permit. INSTRUCTIONS Did you have an authorisation for your activities? (This is issued as a ‘Notice of Determination and Authorisation’) Yes No If yes, complete Part A. Did you have an ATEP and/or AMLR permit? Yes No If yes, complete Part B. Did you enter or undertake an activity in an ASPA? Yes No If yes, also complete Part C. Please send the SIGNED completed report (including all relevant parts) to: Manager Territories Environment and Treaties Section Australian Antarctic Division 203 Channel Highway KINGSTON TASMANIA 7050 Or by email: permits@aad.gov.au For further information, email: permits@aad.gov.au _________________________________________________________________ Contact Information Name of authorisation or permit holder (to whom the authorisation or permit was granted): …………………………………………………………………………………………………. Organisation/business/expedition: ……………………………………………………………. Email address: …………………………………………………. Phone number: …………………………………………………. ________________________________________________________________ Page 2 of 10 Report of Activities Part A – Environmental Authorisation Report 1. Authorisation Complete this part if you have an authorisation for your activities? (This is issued as a ‘Notice of Determination and Authorisation’) 1.2 What is the authorisation expiry date?………………………… 1.3 List the conditions of your authorisation and comment on your compliance with each listed condition. Please ensure that each condition has been addressed. Photographs of your activities associated with your authorisation conditions are encouraged. Authorisation Condition No. and details Comment For example: For example: 1. The Activity must only be undertaken in the Antarctic between the periods of [date] and [date] All activities were undertaken within the specified timeframe. 1.4 Did your activities differ substantially from that detailed in your Environmental Approvals Application Form? (A substantial difference would alter the anticipated environmental impacts and could include, for example, travel to a different location, using a different method of transport, undertaking a different objective, or use of different equipment) Yes No If yes, please describe the different activities and explain circumstances: Page 3 of 10 Report of Activities 1.5 Did your activities result in any unforeseen environmental impacts, or require different or additional mitigation measures to those detailed in your Environmental Approvals Application Form? Yes No If yes, please describe: 1.6 Please provide descriptions and locations (including within any ASPAs) of markers, instrumentation or equipment installed and/or removed, or any material released into the environment (noting how long these are intended to remain in the area). Please include information about any unlabelled materials you observed that may have been left by other parties. Signature of Authorisation Holder: ………………………………….. Date: ………………………………. ___________________________________________________________________ Page 4 of 10 Report of Activities Part B – Permit Report 1. Permit Type (i.e. ATEP or AMLR) and Number: ………….…………………… (include variations, if applicable) 2. Permit Details 2.1 Was the activity undertaken within the specified permit period? Yes No Add further information if you carried out any part of the activity outside the permit period: 2.2 List people who undertook activities associated with this permit: 2.3 Did anyone not listed in the permit undertake this activity (or part thereof)? Yes No If yes, please explain circumstances. If you had an ATEP permit, comment on whether a ‘principal’ accompanied the non-listed participant: Page 5 of 10 Report of Activities 2.4 Were there any locations you undertook your activity that were not listed in your permit? (Refer to the section titled ‘Location’ or ‘Approved Location/s’) Yes No If yes, please explain circumstances: 3. Approved activities Refer to the next section of your permit which outlines permit conditions specific to your project. This section will be titled ‘Approved Activities’, ‘Approved Wildlife Disturbance’, ‘Approved Species and Limit’, ‘Approved Specimens and Quantities’, or similar. 3.1 Comment on your activities under this section in relation to each listed condition. However, if the permit condition is specific to an ASPA, then this information should be provided in Part C of this form. Please ensure that each permit condition under this section of your permit has been addressed. Photographs of your activities associated with your permit conditions are encouraged. Permit Condition No. and details Comment (Permit condition number refers to the number used for each permit condition in your permit) For example: For example: The specified activities must only be undertaken in the Antarctic between the periods of [date] and [date]. All activities were undertaken within the specified timeframe. Page 6 of 10 Report of Activities 3.2 If your activities involved collecting samples, please also fill in the table below. However, if all sampling was conducted inside an ASPA, this information should be provided in Part C. (If you sampled both inside and outside an ASPA, use the table below to detail only the sampling that was conducted outside an ASPA) Type of sample Number and/or quantity of samples collected Location where the samples were collected Other comments Signature of Permit Holder: ………………………………….. Date: ………………………………. ___________________________________________________________________ Page 7 of 10 Report of Activities Part C – Antarctic Specially Protected Area (ASPA) Visit Report (If more than one ASPA is associated with this permit, please use a separate ASPA Visit Report for each ASPA). Report on only those parts of your activities that were undertaken in an ASPA. 1. ASPA name and number: 2. List of dates of entry, duration of visit, and all persons who entered the area under the current permit: Date and duration of visit(s) Names 3. Objectives of the visit to the area under the current permit: 4. Describe mode of transport to/from and within the Area: Page 8 of 10 Report of Activities 5. Describe activities conducted in the Area, including impacts on the habitats and remedial action taken, where applicable (e.g. collect water, soil, or ice, etc, or operational/management activities): 6. Sampling activities conducted within the Area: Ensure you provide sufficient detail describing the following: i. Gathering, collecting, injuring or otherwise interfering with any native plants. ii. Killing, taking, injuring, disturbing or otherwise interfering with, any native birds or seals (including any dead specimens, bones or eggs). iii. Taking, or impacting the habitat of any native invertebrates. iv. Gathering and collecting rocks and meteorites. Type of sample Number and/or quantity of samples collected Location (within the ASPA) where the samples were collected Other comments 7. Describe any measures taken during this visit to ensure compliance with the ASPA Management Plan that were difficult or impractical. Were there any activities that did not comply with the ASPA Management Plan? Page 9 of 10 Report of Activities OPTIONAL SECTION Information provided in this section could assist with the future protection and management of the ASPA. 8. Any other comments or information, such as: i. Report on any observations of human effects on the area, distinguishing between those resulting from your visit and those due to previous visitors. ii. Comment on whether the values for which the Area was designated are being adequately protected and provide any recommendations on further management measures needed to protect the values. iii. Note any features of special significance that have not been previously recorded for the Area. iv. Please attach a copy of the map of the Area showing the location of activities performed under this permit (as applicable) - camp site location(s) land/sea/air movements or routes, sampling sites, installations, deliberate or accidental release of materials, any other impacts, and features of special significance not previously recorded. Signature of Permit Holder ………………………………….. Date: ………………………………. ___________________________________________________________________ Page 10 of 10