Name :
Organisation (if any):
Postal address :
Email address :
Contact telephone number:
NB. The information you have supplied will be held for reference. Personal details are not be passed on to any other organization.
Site name :
Grid reference :
SE SD Easting Northing
Description of Site Location (please describe where the site is located in relation to permanent or mapped features, such as buildings, boundaries, hills or water courses):
Land use/ Vegetation (please describe the prevailing land use and vegetation cover on and around the site) :
Ownership (please give details of who owns the site and/ or who can provide access, if known):
Does this report relate to a site or an object :
Please choose one Object Site
Summary (please summarize your new information in a few words) :
Detail (please give the detail of your new information, including a description of any techniques you have employed to collect information and any sources that you have consulted (such as aerial photographs, historical maps) :
Date (please give the date the site was last visited or found, e.g. dd/mm/yyyy) :
Is further information available?:
No Yes
Please comment on the condition of the site and, if applicable, let us know of any particular threats to its survival:
© West Yorkshire Joint Services 2006
