Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Owner Details

  • Servicing agreement provided for quarterly inspections

  • Audible and visual alarm working and located within the dwelling

  • Roof water diverted away from surface irrigation area

  • Installed as per the approved plan


  • Chambers are full and holding water

  • Growth media is in position

  • Blowers/aerator and alarms are functional

  • Chlorine dispenser is full and in position

  • Fittings and protective covers are secure

  • 1.8m from surface irrigation disposal area

  • 1.2m from boundary or building

  • 6m from a bore, well, dam or water course

Irrigation Area

  • 250m2 required for disposal area, minimum of 150m2 for irrigation unless a reduced disposal area is approved


  • Disposal area is not spread over more than two sperate areas

  • Irrigation pump functional

  • No garden hose fittings connected to the system or UPVC pipes and fittings

  • Irrigation system permanently fixed

  • Flat or gently sloping site - 1.8m from boundaries with open fencing, buildings, and paved surfaces, 3m from a swimming pool

  • Sloping site - 1.8m from boundaries with open fencing & paved surfaces, 3m upslope from buildings & lower cut face/bench, 6m upslope and 3m downslope of a swimming pool

  • 30m from a bore, dam, or water course available for human or animal consumption

  • At least two warning signs erected in the irrigation area

  • 100mm of soil is placed over the disposal area and 50mm of mulch on top

  • No fruit trees/food crop planted in the irrigation area

  • Landscaping in the disposal area completed

Sub-strata Drippers

  • 0.5m from open fenced boundaries, closed fencing, buildings, ATU's and paved surfaces

  • 2m from a swimming pool

  • 3m from sub-soil/open drains

  • 10m from garden bores and 30m from potable bores

Sub-surface Drippers

  • 0.5m from open fenced boundaries, closed fencing, buildings, ATU's, swimming pools and paved surfaces

  • 10m from garden bores and 30m from potable bores

  • 3m from sub-soil/open drains


  • Other

  • Officer name and signature

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