Nuisance Log Sheet Example Only
NUISANCE RECORD SHEETS Reference: Contact Officer:
Please return the completed log sheets in the envelope provided within two weeks of the first Incident.
Date / Time Noise Starts / Time Noise Finishes / Description of Noise(where does it originate, what is source eg radio, car repairs etc) / Room Affected
(e.g. bedroom) / How Does the Noise Affect You?
(e.g. loss of sleep) / Level of noise
(e.g 1 means you can hear it but not when the tele etc is on, 5 is you can hear it significantly over background noise ie the tele and 10 it is so loud you cannot hear anything but this noise)
01/01/2016 / 02:00 / 04:00 / Loud music assume from a stereo – can hear clearly the lyrics and feel the vibration of the bass / All house – loudest in child’s bedroom / Neither myself or my child are able to sleep, we are woken as soon as the music started / 8
NUISANCE RECORD SHEETS Reference: Contact Officer:
Date / Time Noise Starts / Time Noise Finishes / Description of Noise(where does it originate, what is source eg radio, car repairs etc) / Room Affected
(e.g. bedroom) / How Does the Noise Affect You?
(e.g. loss of sleep) / Level of noise
(e.g 1 means you can hear it but not when the tele etc is on, 5 is you can hear it significantly over background noise ie the tele and 10 it is so loud you cannot hear anything but this noise)
Date / Time Noise Starts / Time Noise Finishes / Description of Noise
(where does it originate, what is source eg radio, car repairs etc) / Room Affected
(e.g. bedroom) / How Does the Noise Affect You?
(e.g. loss of sleep) / Level of noise
(e.g 1 means you can hear it but not when the tele etc is on, 5 is you can hear it significantly over background noise ie the tele and 10 it is so loud you cannot hear anything but this noise)