This template form can serve as a record of authorised emergency plumbing work in remote aboriginal communities as required under Part 4A of the Plumbers Licensing and Plumbing Standards Regulations 2000.

Alternate formats are acceptable, but at a minimum, any record must include the following:

• service provider;
• community;
• date work completed;
• category of work;
• address of work; and
• authorised worker.