Notification of Public Swimming Pool or Spa Pool

Notification of Public Swimming Pool or Spa Pool

Section 35(2) Public Health Act 2010, Section 30 Public Health Regulation 2022
Yass Valley Council must be notified within 7 days of any change of particulars.

Pool Premises Details
Name*

First NameLast Name
Company
ABN or ACN
Address of Pool Premises:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Email*
example@example.com
Business Phone Number*

Area CodePhone Number
Mobile Number

Occupiers Residential Details
Occupiers Residential Address*

Street Address

Street Address Line 2

CityState

PostcodeCountry
Residential Phone Number

Area CodePhone Number
Mobile Number
Occupiers Email*
example@example.com

Details of Pool(s) or Spa(s)
Number of Pools
Type of Treatment
eg chlorine, bromide, ozone or other
Number of Spas
Type of Treatment
eg chlorine, bromide, ozone or other
Additional Information

Privacy and Personal Information Protection Notice

Purpose of Collection:	For collection of information in relation to Section 35(2) Public Health Act 2010 and section 30 Public Health Regulation 2022
Intended recipients:	Council staff and approved contractors of Council.
Supply:	Required under Section 35(2) Public Health Act 2010 section 30 Public Health Regulation 2022.
Access / Correction:	Contact Council Customer Service Team on (02)6226 1477 to access or correct this information.
Storage:	Yass Valley Council, 209 Comur Street Yass, NSW 2582

Privacy and Personal Information Protection Act 1998

Compliance with Section 10

This information is required to ensure that Council can communicate with you in relation to this notification. All information is private and confidential and Council must not disclose the information to any person or body if it is not directly related to the purpose for which the information was collected.

If you have a complaint about the use of your personal information, contact the Yass Valley Council Public Officer. The information contained or referred to in this form may be corrected and updated by you, by contacting the Council.

Privacy Statement

You will need to provide personal information to Yass Valley Council in respect of this application. Council is required under the Privacy & Personal Information Protection Act 1998 (PPIPA) to collect, maintain & use your personal Information in accordance with the Privacy Principles & other relevant Requirements of the PPIPA. For further clarification please contact the Privacy Contact Officer at Yass Valley Council

Public Swimming Pool Notification*

Public Swimming Pool Notification$105.00AUD

Please enter a short description.

Quantity

Total $0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: