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Dust Complaint Form

Your details
Full name
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Phone number
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Email address
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Address
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Details of the dust event
Date the event started
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(estimated if not witnessed)

Date the event finished
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Please provide additional information (if you think you know):
Period of the day
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If you know prevailing wind direction during this period
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Location
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Please indicate where you observed the dust fallout / deposition

Type of dust
Colour
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If other please specify below:

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How the dust looks
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Other observations
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Deposition density
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How much dust (see key below)

Key

Low Density : Dust particles covered less than 20% of the surface

Medium Density: Dust particles covered 20 to 50% of the surface area

High Density : Dust particles covered more than 50% of the surface area

The following diagrams is a general guide to assist in determining how much dust fall out has occurred

lowdensitymediumdensityhighdensity

Dust source
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If you think you know, please state where you think the dust was emitted from.

Impact on your household or family
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Did the dust disrupt your activity? If yes, what did you have to change?

Health effect
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If you experience health effects, please provide details

  • How did the odour make you feel?
  • How long did you feel this?

Additional comments
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Upload photos
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