Graffiti Incident Form Last updated: 06 Aug 2018 Graffiti Incident Form Request Details Reference number - date and contract number. Example: 241116R155AB * Responsible owner of asset Council asset Energex asset Main roads asset Private property * Responsible branch for organising the removal of the graffiti and closing the T1P request Building and Facilities Services Civil Works Services Parks and Gardens Waste Resource Management Community Development. Public Art ONLY * T1 request number * Purchase order number * Work order number allocated to the removal of this graffiti * Graffiti Details Date Service Request was reported. Date Service Request was reported * Enter tag description. You must enter FULL details * Method used in applying graffiti, for example spray paint, permanent marker * Further information if applicable Graffiti Location Details. Please enter the type of facility the graffiti has been applied to, for example, bin, bridge, skate facility etc. Facility type (e.g. public amenities, playground equipment, picnic table etc.) * Property or asset (Name: e.g. Charles Clarke Park) Property or asset address: * Property or asset suburb: * Cost and Coverage Total cost - excluding GST to remove graffiti * Coverage area. Approximate number of square metres of graffiti * Graffiti Removal Details Graffiti removed by External supplier Internal SCC staff member * If staff member selected enter name Staff member contact number If external supplier selected enter supplier name Supplier invoice number Supplier invoice date Photographic Evidence: Upload your photographs. Single files cannot exceed 5MB. Combined files cannot exceed 10MB. Photograph Photograph What day is it today?
