Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 1 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
Environmental Impact Assessment (EIA)
SITE / LOCATION:
DURATION OF
PROJECT:
JOB DESCRIPTION /
SCOPE : (Define location, geography, proximity to waterways, area of vegetation and / or land to be disturbed, proximity to public use and
access areas, machinery, materials & equipment to be used and activities required to complete the work objectives. If the scope of
works change at any stage prior to or during the project, this Assessment must be reviewed to consider the relevant changes)
PROJECT MANAGER
EIA PREPARED BY:
(PCMW):
FINAL COPY APPROVED
SAP Project Number:
(signature and date):
LEGAL ASSESSMENT
Does this activity require a Permit or the requirement to notify a regulatory body? (The following list are examples of the most common applicable to Hydro
Tasmania operations)
Local Council/State:
Council Planning / Building Permits
Heritage Permits (Aboriginal / Cultural)
Threatened Flora / Fauna Species Permit to Take
Mining Lease or Licence
Forest Practices Plan
Reserve Activity Assessment (TWWHA and other
Parks reserves)
Dam works Permit
Environment Management Pollution Control Act Permit (level 2 activities or other)
Crown land Works Authority
Scientific Research Permit
Commonwealth:
Referral under Environmental Protection and Biodiversity Conservation Act 1999 for
significant impacts on matters of National Environmental Significance
See - HSER0201.4 - Register of Permit and Notification Requirements and EnviroLaw /
SafetyLaw and seek assistance with identifying applicable legal requirements and obligations
If yes, please describe actions / Permits and attach documents:
CAUTION: Printed Document is UnControlled
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 2 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
Work within the Tasmanian Wilderness World Heritage Area (TWWHA) and other reserves (Refer to ‘HSEP0911 - Operations in the TWWHA’ for more detail)
 New work in the TWWHA and other reserves may require the completion of the Parks & Wildlife Services Reserve Activity Assessment (PWS RAA)
 Maintenance work in the TWWHA will require notification to Parks and Wildlife Services in the form of a cover letter (HSEF0911.1 WHA Notification of
Works) and may also require the attachment of this completed form. Seek advice and refer to HSEP0911 - Operations in the TWWHA.
Is the land vested in Hydro Tasmania (See HT Map Viewer – HT Property)?
What is the reserve Category of the land (See HT Map Viewer – Public Land
Classification)?
What is the zoning of the land under the TWWHA Management Plan (See HT
Map Viewer - TAS – PWS WHA Zones and PWS WHA Overlays)?
What is the Wilderness Quality Rating of the land (See HT Map Viewer - TAS PWS Wilderness Quality 2005)?
What distance are the works from a public road, defined hiking trail or other
public access route (e.g. Franklin River)
What alternatives were Considered? (Include the option to do nothing, and
other economically acceptable alternative actions available)
Specific matters relating to PWS managed values that shall be included in the Assessment, where necessary or relevant, include:
•
Documentation of practical alternatives to the proposed activity;
•
The area of vegetation to be cleared and any ground disturbance;
•
Proximity to a public road, designated walking track or other access route (e.g. Franklin River);
•
The zoning of the affected land under the Management Plan;
•
The quality of wilderness values in the area of the activity and are these being impacted;
•
Whether vegetation clearance is likely to impact a listed threatened flora species or vulnerable vegetation community;
•
Whether the activity impacts on a listed geoheritage feature;
•
Whether the activity will result in the taking of a listed threatened fauna species or habitat of a threatened fauna species?; and
•
The potential for the activity to impact on water quality
CAUTION: Printed Document is UnControlled
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 3 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
STAKEHOLDER MANAGEMENT
Will this activity affect any stakeholders listed below?
Local council
State Government dept (e.g. Inland Fisheries, Parks and Wildlife)
Visual amenity
Adjacent landowners (up and downstream)
Recreational Users / Community Groups
Local Businesses
If yes, describe the proposed actions:
CAUTION: Printed Document is UnControlled
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 4 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
CAUTION: Printed Document is UnControlled
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 5 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
ASPECT (HAZARD)
LAND
Sensitive ecosystems
FLORA – land and aquatic
Storage of equipment and / or Site shed
Soil type
Flooding Risk
Excavation
N/A
Vegetation mgmt. / clearance
Threatened Species, Communities & Habitat
Weed and disease on Site
Disturbance / removal of habitat
N/A
Changes in water quality
particularly for downstream users
Disturbance of fish passages /
breeding / migration
FAUNA (both land and aquatic)
Threatened fauna
CONTROLLED
RISK LEVEL
CONTROLS
N/A
Erosion / landslip Hazards
WATER
UNCONTROLLED
RISK LEVEL
HAZARD DESCRIPTION
Unnatural, extreme or long term changes to water
levels or flows
Pest fish
issues
N/A
Injury / death of fauna (stranding,
drowning)
CAUTION: Printed Document is UnControlled
Changes to recreational uses e.g. rafting,
water sports, water skiing
Disturbance to spawning, nesting or breeding seasons
(e.g. Eagles, Eels)
Disturbance to sensitive
habitats
Flow change affecting fauna
downstream
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 6 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
ASPECT (HAZARD)
HAZARD DESCRIPTION
AIR and NOISE QUALITY
Dust
UNCONTROLLED
RISK LEVEL
CONTROLLED
RISK LEVEL
CONTROLS
N/A
Noise from blasting
Emissions from machinery / trucks
Excavation noise
Noise from works outside 7:30am – 6pm
Other
HERITAGE
Note: If Heritage Values are rated as High Significance or High Potential or above, a Heritage Impact Assessment(HIA) must be done – see HSEP0912 – Cultural Heritage
Management Procedure
N/A
Damage to HT heritage
Disturbance to artefacts
Sites on the Tasmanian Heritage Register
High Aboriginal artefact potential
Tasmanian Aboriginal Sites Index (TASI)
National heritage listing
Planning scheme lists
Forestry Tas list
WASTE MANAGEMENT includes onsite storage, transfer and transport of waste. See HSEP0914 –Waste Management Procedure
Waste oil
Contaminated waste (e.g. PCB)
Construction waste
N/A
Excavation spoil
(e.g. spoil, human waste)
Concrete slurry
HAZARDS
Asbestos / Coal Tar Enamel (CTE) waste
Hydrocarbons
Volume of Waste ……………………………………
N/A
Land contamination
Dam failure
Fire
Hazardous Goods (storage and spill Risk)
Acid sulphate soils
Seismic activity
CAUTION: Printed Document is UnControlled
Oil / fuel spill to land, air and water
Print Date: 12/02/2016
Health, Safety and Environment
HSEF0301.1 – Environmental Impact Assessment and Management Plan (EIA EMP)
Approved by: WHS & HSE Systems Manager
Revision: 1
Date: Jun 2015
Page 7 of 6
Form variations to suit user, system / software constraints, legal requirements or corporate requirements are permissible, as long as the intent of the form is not compromised.
Sign-on Sheet (Project Manager responsible for completing the work / task must complete the following pre-start Assessment)
Are there any Moderate or higher Controlled Risk Levels?
Yes ☐ No ☐
YES – Do not start work and notify your manager / supervisor immediately
Provide a brief explanation as to why the Controlled Risk Level is Moderate or High:
NO – Start Work. Remember to continually monitor and review the EIA throughout the job and amend whenever necessary
Team Member Name
Signature
CAUTION: Printed Document is UnControlled
Date
Team Member Name
Signature
Date
Print Date: 12/02/2016