On-site Sewage Management Inspection

• Type of inspection

  Select Approval to Operate Approval to Install - Final Approval to Install - Inspection Complaint

  • Approval to Operate
  • Approval to Install - Final
  • Approval to Install - Inspection
  • Complaint
• Location
  Address

• Licence No.

• Applicant Name

• Applicant Phone Number

• Applicant email

• Conducted on

  Date

• Environmental Health Officer

Inspection details

• Time at beginning of inspection

  Date

• Number of bedrooms

• Number of residents

• Soil type

  Select Sand and gravel Sandy loam Loam Clay loam Light clay Medium/Heavy Clay

  • Sand and gravel
  • Sandy loam
  • Loam
  • Clay loam
  • Light clay
  • Medium/Heavy Clay

• Inspection to be invoiced

  Yes

  No

  N/A

• System type

  AWTS

  Septic tank with land disposal

  Biological filtering system

  Pump-out

• Disposal area

  Select Absorption trench Evapotranspiration bed Wisconsin mound Spray Irrigation Sub-surface irrigation Pump-out

  • Absorption trench
  • Evapotranspiration bed
  • Wisconsin mound
  • Spray Irrigation
  • Sub-surface irrigation
  • Pump-out

Performance standards

• Does the system prevent the spread of disease by micro-organisms? (1)

  Yes

  No

  N/A

• Does the system prevent the spread of foul odours? (2)

  Yes

  No

  N/A

• Does the system prevent the contamination of water? (3)

  Yes

  No

  N/A

• Does the system prevent the degradation of soil and vegetation? (4)

  Yes

  No

  N/A

• Does the system discourage insects and vermin? (5)

  Yes

  No

  N/A

• Does the system ensure that persons do not come I to contact with untreated sewage or effluent (whether treat or not) in their ordinary activities on the premises concerned? (6)

  Yes

  No

  N/A

• Does the system minimise any adverse impacts on the amenity of the premises and surrounding lands? (7)

  Yes

  No

  N/A

• Does the systems provide for he re-use of resources (including nutrients, organic matter and water? (8)

  Yes

  No

  N/A

Buffer distances

• Is the effluent disposal area greater than 100 m to permanent surface waters? (9)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 250 m to domestic groundwater? (10)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 40 m to other waters (eg intermittent waterways, dams)? (11)

  Yes

  No

  N/A

Spray irrigation

• Is the effluent disposal area greater than 6 m up/3m down to driveways & property boundaries? (12)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 15 m to dwellings? (13)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 3 m to paths and walkways? (14)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 6 m to swimming pools? (15)

  Yes

  No

  N/A

Subsurface & trickle irrigation

• Is the effluent disposal area greater than 6 m up/ 3 m down to pools, property boundaries, driveways & buildings? (16)

  Yes

  No

  N/A

Absorption disposal methods

• Is the effluent disposal area greater than 12 m up/6m down to the property boundary? (17)

  Yes

  No

  N/A

• Is the effluent disposal area greater than 6 m up/ 3 m down to pools, driveways and buildings? (18)

  Yes

  No

  N/A

Tanks

• Is the lid, manhole and inspection openings undamaged and in place? (19)

  Yes

  No

  N/A

• Is the tank accessible? (20)

  Yes

  No

  N/A

• Is the tank undamaged? (21)

  Yes

  No

  N/A

• Does the tank need a pump-out? (22)

  Yes

  No

  N/A

AWTS & Irrigation area

• Have service reports been sent to Council? (23)

  Yes

  No

  N/A

• Is the irrigation line buried? (24)

  Yes

  No

  N/A

• Is there sufficient irrigation area? (25)

  Yes

  No

  N/A

• Is the system operational at the time of inspection? (27)<br>Eg - chlorine tablets, UV lamp

  Yes

  No

  N/A

• Are irrigation warning signs present? (28)

  Yes

  No

  N/A

• Is effluent being evenly distributed? (29)

  Yes

  No

  N/A

• Are garden hoses and fittings being used for irrigation? (30)

  Yes

  No

  N/A

Septic tanks, biological systems: Absorption trenches, evapotranspiration beds and mounds

• If there is a grease trap, is it satisfactory? (31)

  Yes

  No

  N/A

• Is greywater being disposed of satisfactorily? (32)

  Yes

  No

  N/A

• Is the disposal area showing signs of stress? (33)

  Yes

  No

  N/A

• Is the disposal area failing? (34)

  Yes

  No

  N/A

Pump-out

• Is there a pump-out contract? (35)

  Yes

  No

  N/A

• Is there a draw line with a cam lock? (36)

  Yes

  No

  N/A

• Does the operator have pump-out receipts? (37)

  Yes

  No

  N/A

• Is greywater being disposed of satisfactorily? (38)

  Yes

  No

  N/A

Comments

• Comments

• Inspection result

  Select 5 year approval 3 year approval 1 year approval Letter Local Government Order POEO Notice Works satisfactory - proceed

  • 5 year approval
  • 3 year approval
  • 1 year approval
  • Letter
  • Local Government Order
  • POEO Notice
  • Works satisfactory - proceed

• Time at end of inspection

  Date