ASB Incident Diary
In order to decide whether we can take further action over your complaint we require more information.
We need to know how often it is occurring, at what time, how long it is happening and also how the problem affects you.
To do this we require you to complete written record sheets.You can download them from this page. We have provided them as a word document or a PDF.
If you download the word document you will be able to type the information into the document using your keypad.
If you download the PDF you will have to print it off and complete this by writing on it.
Once you have collated 14 continuous days worth of records please return the completed diary sheets to us.
If we do not receive the record sheets within 28 days of the email your complaint will be closed and no further investigation will be carried out.
We require a minimum of 14 days of records in order to be able to investigate your complaint.
- Incident Diary (PDF, 1 MB)(opens new window)
- Download word document of Incident Diary (Word doc, 236 KB)
Below is an example of how we would expect the record sheet to be completed.

You can return your diary record sheets by either posting them to us or bringing them into our office in Dereham.
Breckland District Council
Elizabeth House
Walpole Loke
Dereham
NR19 1EE
If you have any problems completing your record sheets or have any queries, please contact us, either via email or via Bobbie
Please allow at least 10 working days after submitting your record sheets before contacting us.