Freshwater land-based aquaculture reporting template:
Appendix 3 escape notification form
The plain text on this page is for your information only.
To submit your report, please download the Excel (.xlsx) version and return it to us.
Depending on your browser settings, you may need to right click on the document link and select a ‘save’ option.
Instructions for using this Excel template:
- Go to "step 1 - general info" worksheet.
- Select licence holder name from drop-down list
- Then select “facility reference no" from drop-down list
- Complete the remaining columns (if applicable)
- Go to "Step 2 - report details" worksheet.
- Enter data and complete the remaining columns (if applicable)
- Data can be copied and pasted into multiple subsequent rows. However, please note that data can not be copied to cells marked "do not enter".*
- This template has a limit of 1000 rows of data. Should you have data to submit in excess of 1000 rows, please contact The Department.
Colour meaning:
Red - mandatory field (data missing)
Grey - do not enter
White - enterable field
* N.B. in order to maintain data integrity, data from external sources should not be copied directly into greyed-out cells. Please input the data directly into this spreadsheet.
Step 1 - general info
| Licence holder name | Facility reference no. | Facility name | Contact name | Contact phone no. | Contact email |
|---|---|---|---|---|---|
| Pick Licence holder (start here) | Pick Licence holder before select facility here | Do not enter | Input format: first last name | Input format: 9999999999 | Input format: abc@hotmail.com |
Step 2 - report details
| Escape date | Incident time | Occurrence category | Escaped species (common name) | Estimated number escaped | Average weight (grams) | Date stocked | Stock source facility name | Drug administered |
|---|---|---|---|---|---|---|---|---|
| Suspected escape date Format: YYYY-MM-DD | Suspected time of escape Format: HH:MM (24hrs) | Pick list | Pick list | Estimated number of escaped fish - format: 1-999999 | Average weight of escaped fish (grams)- format: 1-999999 | Date stocked - format:YYYY-MM-DD | Name of facility where fish were produced | Pick list |
| Treatment start date | Treatment end date | Prescribing veterinarian name | Prescribed withdrawal period | Inventory lots treated | Incident cause | Planned mitigation measures | Comments |
|---|---|---|---|---|---|---|---|
| Date of commencement of drug treatment - format: YYYY-MM-DD | Date of completion of drug treatment - format: YYYY-MM-DD | ||||||
Guidance for reporting of escapes events
Escape date - The date on which the escape or suspected escape was discovered.
Incident time - The time that the escape or suspected escape was discovered.
Occurrence category
- New - 24 hour - For notification of new escape incidents. Reports must include as much information as possible and be submitted within 24 hours of discovery, as per Condition of Licence.
- 7 day Follow-up - A complete report must be submitted to the Department within 7 days of the Incident Date, as per Conditions of Licence.
Escaped species (common name) - The species of cultivated fish that escaped or is suspected to have escaped from the containment structure.
Estimated number escaped - The number of cultivated fish estimated to have escaped from the containment structure.
Average weight (grams) - The average weight of cultivated fish that escaped or are suspected to have escaped from the containment structure.
Date stocked - The date on which the cultivated fish that escaped or were suspected to have escaped arrived at the facility if transferred, or ponded if the hatchery is on site.
Stock source facility name - The source facility of the fish that escaped or were suspected to have escaped.
Drug administered - List each therapeutant (still within the prescribed withdrawal period) administered to these fish
Treatment start date - Date of commencement of the drug treatment, if applicable.
Treatment end date - Date of completion of the drug treatment, if applicable.
Prescribing veterinarian name - The name of the veterinarian that prescribed the drug treatment, if applicable.
Prescribed withdrawal period - The prescribed withdrawal period of drugs administered, if applicable.
Inventory lots treated - Describe the inventory lots treated with drugs administered, if applicable.
Incident cause - Describe in detail the case or suspected cause of the escape or suspected escape.
Planned mitigation measures - Describe in detail the mitigation measures that have been or will be put in place to prevent future escapes.
Comments - Any additional comments pertaining to the confirmed or suspected escape incident.
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