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Appendix C - Cultural Heritage Impact Assessment - Peabody Energy

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Office Use Only<br />

Entered by (I.D.)<br />

Site Number<br />

Aboriginal Site Recording Form<br />

AHIMS Registrar<br />

PO Box 1967, Hurstville NSW 2220<br />

Date received Date entered into system Date catalogued<br />

Information Access<br />

Gender/male<br />

For Further Information Contact:<br />

Gender/female Location restriction General restriction No access<br />

Nominated Trustee<br />

Title Surname First Name<br />

Organisation<br />

Address<br />

Initials<br />

Office Use<br />

Only<br />

Client on<br />

system<br />

Phone number<br />

Fax<br />

Knowledge Holder<br />

Title Surname First Name<br />

Organisation<br />

Address<br />

Phone number<br />

Fax<br />

Aboriginal <strong>Heritage</strong> Unit or <strong>Cultural</strong> <strong>Heritage</strong> Division Contacts<br />

Initials<br />

Client on<br />

system<br />

Geographic Location<br />

Site Name W A M B O S I T E 3 6 0<br />

Easting 3 1 0 1 4 9 Northing 6 3 9 1 1 5 9<br />

Mapsheet D O Y L E S C R E E K 1 : 2 5 0 0 0<br />

Zone 56<br />

Location Method Differential GPS<br />

AGD/GDA<br />

GDA<br />

Other Registration<br />

Primary Recorder<br />

Title Surname First Name<br />

M s G o o d e G i l l i a n<br />

Initials<br />

Organisation<br />

Address<br />

Phone number<br />

Date recorded<br />

R P S<br />

P O B O X 4 2 8 H A M I L T O N N S W 2 3 0 3<br />

2 4 9 4 0 4 2 0 0 Fax 2 4 9 6 1 6 7 9 4<br />

07/07/2011<br />

Client on<br />

system

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