14Capo D’Orlando Drive

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14 Capo D’Orlando Drive SOUTH FREMANTLE WA 6162 A summons will then be issued to you. *[Back of Form 3]* I elect to have this matter heard by a Court. *(Please use block letters)* Surname ________________________________________________ Given Names ________________________________________________ Address ________________________________________________ ______________________________Postcode __________ Signature ________________________________________________ Date _____/ _______/ _______ [Form 3 amended: Gazette 10 Nov 2006 p. 4710‑11; 4 Oct 2019 p. 3608.] **Form 4** [reg. 161] (Section 231(1)) **WITHDRAWAL OF INFRINGEMENT NOTICE** To: AN INFRINGEMENT NOTICE SERVED ON YOU HAS BEEN WITHDRAWN AND NO FURTHER ACTION WILL BE TAKEN*/ A SUMMONS WILL BE ISSUED* Details of the withdrawn notice: | Date of service: Alleged offence: Notice No.: | | | Issued at: by: Signature: | | * Delete where not applicable. **Form 5** [reg. 165] (Section 249(3)(a)) **NOTICE TO ATTEND OR PRODUCE DOCUMENTS** To: An inquiry is being conducted by an appointed person under section 249(3)(a) of the Act. | The inquiry is about: | | What you must do: | You must: Attend before the appointed person:  Produce the following documents before the appointed person:  | | Information about the inquiry: | Where you must go: When: | Time Date Month Year and then from day to day until the end of the inquiry or until excused by the appointed person. | | Issued at: by: Signature: Telephone contact: | Date: (appointed person) | If you do not attend or produce the documents: It is an offence not to comply with this summons unless you have a reasonable excuse. The maximum penalty to which you may be liable is $5 000. **Form 6** [reg. 173] (Section 255(1)) **NOTICE PROHIBITING ACTIVITIES THAT POLLUTE WATERS** No. of Notice: To: You are prohibited from engaging in the following activity which is polluting, or likely to pollute, the aquatic environment: Information about the prohibition: | Period of prohibition: Circumstances and times: | | | Issued at: by: Signature: Telephone contact: | The Minister for Fisheries | If you contravene this notice: It is an offence to contravene this notice. The maximum penalty to which you may be liable is: For an individual: $25 000. For a body corporate: $50 000. **Form 7** [reg. 174] (Section 255(2)(c)) **NOTICE TO VARY OR REVOKE A NOTICE PROHIBITING** **ACTIVITIES THAT POLLUTE WATERS** To: The notice served on you prohibiting you from an activity that was polluting, or likely to pollute, the aquatic environment is varied*/revoked* — Which notice is varied/revoked? | No. of notice: Served: By: Time: | Date: | **This is the variation of the notice. | Issued at: by: Signature: Telephone contact: | The Minister for Fisheries | If you contravene this notice: It is an offence to contravene this notice. The maximum penalty to which you may be liable is: For an individual: $25 000. For a body corporate: $50 000. * Delete where not applicable. ** Score through this section if not applicable. **Form 8** [r. 144E(5)(b)(ii)] **DECLARATION REGARDING MORTALITY AND DISEASE OF PEARL OYSTERS** Name: __________________________________________________________ Address: ________________________________________________________ ________________________________________________________ Phone no: _______________________________________________________ I declare that: 1. The sample of pearl oysters with which this declaration is submitted was taken on _____________________ from pearl oysters being held at (*location of hatchery, quarantine site etc.*) ___________________________________________________________ ___________________________________________________________ 2. No unexplained mortalities have occurred, and no signs of clinical disease have been seen, in the last 12 months among pearl oysters being held at that place. Signature: _____________________ Date: _________________________ [Form 8 inserted: Gazette 24 Sep 2013 p. 4450-1.] **Form 9** [r. 144F(4)] **CERTIFICATE OF HEALTH — PEARL OYSTERS** Name: __________________________________________________________ Address: ________________________________________________________ ________________________________________________________ Phone no: _______________________________________________________ I am an approved fish pathologist and certify that: 1. This certificate has been issued in respect of a sample of pearl oysters marked ______________________ which was taken from pearl oysters being held at (*location of hatchery, quarantine site etc*.) _____________ _____________________ The sample was delivered to me for disease testing on _____________ by _________________________________ 2. I have no reason to doubt the information given as to the origins of the pearl oysters or the levels of mortality or clinical disease in the hatchery, quarantine site or other place where the pearl oysters are being held. 3. The following tests were carried out for clinical disease or significant pathogens. | **Test** | **Number tested** | **Date** | **Result** | | --- | --- | --- | --- | 4. No clinical disease or significant pathogen was detected in the sample. 5.* The following genetic tests were carried out ______________________ __________________________________________________________ with the following results _____________________________________ __________________________________________________________ and no genetic components not of Western Australian origin were detected. * Delete if inapplicable. Signature: ____________________________ Approved fish pathologist Date: ________________________________ | OFFICE USE ONLY 1. AHL No: ________________________________________________ 2. Name of licensee or permit holder: ____________________________ | [Form 9 inserted: Gazette 24 Sep 2013 p. 4451-2.] Schedule 15 — Tour management zones [r. 128J] [Heading inserted: Gazette 29 Jun 2001 p. 3180; amended: Gazette 30 May 2014 p. 1737.] 1. Zone 1: Pilbara/Kimberley Pilbara and Kimberley Region [Clause 1 inserted: Gazette 1 Oct 2003 p. 4346.] 2. Zone 2: Gascoyne Gascoyne Region [Clause 2 inserted: Gazette 1 Oct 2003 p. 4346; amended: Gazette 23 May 2006 p. 1861.] 3. Zone 3: West Coast West Coast Region [Clause 3 inserted: Gazette 23 Jan 2015 p. 407.] 4. Zone 4: South Coast South Coast Region [Clause 4 inserted: Gazette 23 Jan 2015 p. 407.] Schedule 16 — Abalone zones [r. 3(1)] [Heading inserted: Gazette 10 Nov 2006 p. 4711; amended: Gazette 27 Aug 2013 p. 4057; 4 Oct 2019 p. 3609.] 1. Abalone Zone 1: Busselton Jetty to Greenough River mouth (b) all land in the State, that are on the seaward side of the high water mark and are — (c) in the area that is — (i) south of 28° 51.9′ south latitude; and (ii) north of 33° 29′ south latitude; and (iii) west of the high water mark along the west coast between those 2 parallels; or (d) in the area that is bounded by a line commencing at the intersection of 115° 20.675′ east longitude and the high water mark in Geographe Bay (Busselton Jetty) and extending — (i) north along that meridian to its intersection with 33° 29′ south latitude; and (ii) east along that parallel to its intersection with the high water mark; and (iii) then generally south westerly along the high water mark to the intersection with 115° 20.675′ east longitude. [Clause 1 inserted: Gazette 10 Nov 2006 p. 4711‑12.] 2. Abalone Zone 2: Greenough River mouth to Northern Territory border (b) land in the State, that are on the seaward side of the high water mark and north of 28° 51.9′ south latitude. [Clause 2 inserted: Gazette 10 Nov 2006 p. 4712.] 3. Abalone Zone 3: Busselton Jetty to South Australian border (b) land in the State, that are on the seaward side of the high water mark and south of 28° 51.9′ south latitude excluding Abalone Zone 1. [Clause 3 inserted: Gazette 10 Nov 2006 p. 4712.]