EmailMe Form - Gladstone Airport Corporation

Application Number
Date of notification *
DD / MM / YYYY
ID Details and Identification *

Name

Company

This is the details of the company that is operating the crane. The crane operator is responsible for completing the form.
Contact phone number of the crane operator *
### - ### - ####
Email address for the approval *
This is the where the approval for the crane to operate will be sent.
Details of the Crane Work *

Exact address of the Works or Lat/Long

Maximum height of the Jib (in meters)

This information is used to assess if the crane may be a hazard to aircraft.
Lift Details

Yes No N/A

Will the Jib be lowered at night?

Will the work span more than a day?
Date and time for works to commence *
DD / MM / YYYY HH : MM AM/PM
Date and time for works to end *
DD / MM / YYYY HH : MM AM/PM
Upload Google Earth image of the site.
Attach a Google Earth image of the site if available

Exact address of the Works or Lat/Long
Maximum height of the Jib (in meters)

	Yes	No	N/A
Will the Jib be lowered at night?
Will the work span more than a day?

Name
Company