Application for Access to Bungendore Recycled Water Truck Fill Station

This form must be filled out to access recycled water in Bungendore.

Applicant Details

Company Name *

ABN *

Business address *

Street address *

City *

State *

Contact Name *

Contact number *

Contact email *

Account name (if different to contact)

Account email (if different to contact)

Intended use for Recycled Water *

Please note that:

Council will provide recycled water that is compliant with the Bungendore Recycled Water Management System.
Council will endeavour to provide an ongoing supply of recycled water at the fill station, however, no guarantee is provided that recycled water will be available in the required quantities at the required time.
Council will only provide access to the fill station to registered companies.
The fill station has been constructed to suit the dimensions and turning capabilities of a single-unit heavy rigid vehicle. Larger vehicles, or combination vehicles, are not able to use the fill station.

Applicant acknowledgements

I am authorised to complete this application on behalf of the named company *

I, and my agents or employees, will:

Only use recycled water for the stated purpose

Not attempt to enter the fill station with a vehicle larger than a 12.5m heavy rigid vehicle, or with any vehicle and trailer combination

Only use vehicles fitted with appropriate backflow protection devices (such as an air-gap) and prominently displaying “Not suitable for drinking” signage

Pay for all water drawn using my customer access number

Only provide the customer access number to person(s) approved to draw water on my behalf

Follow any reasonable direction or request from site staff about the use of the fill station

Provide updated contact details as necessary

Act in a lawful and safe manner while accessing and using the fill station

Ensure that any agent or employee is aware of these requirements

Suspension or Termination of Agreement

Council may suspend or terminate this agreement if it considers the Applicant or its agents actions as not complying with the Acknowledgements provided above.

Either party may end this agreement by providing written notice of their intention and the date at which it will terminate (which shall not be less than 48 hours from the time that notice was provided).

The Applicant shall pay any monies outstanding following suspension or termination of this Agreement.Council may elect to deactivate the customer access number for accounts that have not drawn recycled water in the previous six (6) months.