Gonneville Project Water Use Survey (2025) "*" indicates required fields Step 1 of 5 20% Landowner Contact InformationProperty Address Lot Landowner (Company/Trust Name) Primary Landowner ContactFirst name* Last name* Email MobilePreferred method of contact Mobile Email Text Prefer not to say Prefer not to say Second landowner contact (if applicable)First name Last name Email MobilePreferred method of contact Mobile Email Text Prefer not to say Prefer not to say 1. Which best describes primary use/purpose of the property?* Private residential Agricultural (wheat, sheep, cattle?): Secondary residence/ weekend retreat Industrial/ Commercial Tourism business/ Air BnB Other (please specify) Agricultural (wheat, sheep, cattle)?* Other (please specify)* 2. How is water supplied to the property?* Town water (i.e. mains) Bore water Rainwater Surface water (i.e. river, creeks or dams) Other (please specify) Other (please specify)* 3. Is there an operational bore on the property?* Yes No Unsure (any other known details) Unsure (any other known details)* To help us understand the aquifers, it’s useful for Chalice to know where bores are located on your property. If possible, please attach a map showing their approximate locations — a simple marked-up screenshot from Google Maps is perfectly fine. If you would like, Chalice can email a high resolution image of your property for you to mark up and return Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB. This information will not be shared without your permission and will only be used to contact you regarding the Gonneville project and related infrastructure.Please use the contact details provided to arrange for a high-resolution map of my property Please use the contact details provided to arrange for a high-resolution map of my property 3.1. If yes, do you still use the bore and how often?* Daily Weekly Monthly Annually No longer in use Never used Date /year of last known use* 3.2. What is the bore used for on the property? (please tick all that apply and identify the primary use)* Domestic Human consumption/ Drinking water Stock (i.e. troughs or dams) Horticulture (i.e. crops, orchards, market gardens) Other (i.e. bushfire readiness or specify?) Other (i.e. bushfire readiness or specify)?* 3.2.1. if yes, do you still use the bore and approximately how often?* Drinking Cooking / kitchen Showering Washing machine/clothes Flushing toilets Garden watering Other uses not listed (swimming, pets, please specify) Other uses not listed (swimming, pets, please specify)* 4. Is there an operational dam on your property?* Yes No Unsure (please provide further comment) Unsure (please provide further comment)* Please mark on map the location of dam/s Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB. 4.1. If yes, do you still use the dam and how often* Daily Weekly Monthly Annually No longer in use Never used Date /year of last known use* 4.2. If yes, what purposes is the dam used for? (please tick all that apply and identify the primary use)* Domestic Drinking water Stock watering (i.e. troughs or dams) Horticulture (i.e. crops, orchards, market gardens) Other (i.e. bushfire readiness or specify) Other (i.e. bushfire readiness or specify)?* 4.2.1. If use is domestic, how is the dam water used for domestic purposes (please tick)* Drinking Cooking or kitchen Showering Washing machine/clothes Flushing toilets Garden watering Other use not listed (swimming, pets or please specify) Other use not listed (swimming, pets or please specify)* 5. Do you access or use the waterways (i.e. creeks or rivers) on your property?* Yes No Unsure (any other known details) Unsure (any other known details)* Please mark on map the location of waterways Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB. 5.1. If yes, how often do you use the waterways?* Daily Weekly Monthly Annually No longer in use Never used Date /year of last known use* 5.2. If yes, what is the use of the waterways? (please tick all that apply and identify the primary use)* Domestic Drinking water Stock watering (i.e. troughs or dams) Horticulture (i.e. crops, orchards, market gardens) Other (i.e. bushfire readiness, recreational fishing or specify?) Other (i.e. bushfire readiness, recreational fishing or specify)?* 5.2.1. If yes, to using the waterway for domestic purposes, please tick how it is used* Drinking Cooking or kitchen Showering Washing machine/clothes Flushing toilets Garden watering Other use not listed (swimming, pets or please specify) Other use not listed (swimming, pets or please specify)* Any additional comments about your water usageNameThis field is for validation purposes and should be left unchanged.
