OSSM System Inspection Report

• Inspection Title

• Document ID

• Client / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

Property Inspected

• Street/Road Number

• Street/Road

• Property Name

• Locality

  Cootamundra

  Stockinbingal

  Wallendbeen

• Lot/Sec/DP

• Assessment Number

• Property Usage

  Residential

  Non-Residential

• No of Bedrooms

• Property Area (m2/ha/acre)

• Property Locale

  Rural Property

  Urban Property

Owner/Occupier

• Owners Name

• Postal Address

• Town

• Postcode

• Occupiers Name (if different to above)

OSSM Details

• Type of OSSM

  Aerated Waste Treatment System

  Septic Tank

  Other

• Other Details

• Year Installed

• Date of Last Inspection

  Date

Site Safety Inspection Checklist

• Is the system suitable for the proposed use - 6 points

  Yes

  No

• Is the system located outside of an Environmentally Sensitive Area - 8 points

  Yes

  No

• There are no negative impacts on neighbouring properties - 6 points

  Yes

  No

• Is the area of land suitable for the system in use - 4 points

  Yes

  No

• There is no evidence of effluent at ground level - 8 points

  Yes

  No

• No odours can be detected - 4 points

  Yes

  No

Disposal Area

• Does the Absorption trench follow the contours of the land - 3 points

  Yes

  No

• Length/size of the Absorption trench (m)

• Is the length/size of the absorption trench appropriate for the systems occupancy rate (see Note 1) - 4 points

  Yes

  No

• Is the Disposal area further than 6m of the nearest property boundary - 8 points

  Yes

  No

• Arrangements for stormwater diversion in place - 3 points

  Yes

  No

• Are vehicles, stock and people excluded from the disposal area (proximity to Human activity) - 1 or 5 points

  Yes

  No (1)

  No (5)

• Disposal area is NOT within 250m of a downhill bore or water supply - 8 points

  Yes

  No

• Distance (m/km)

• Are there physical barriers (man made) between the disposal area and the water course - 2 points

  Yes

  No

• Is the disposal area further than 30m from the nearest water course (m) - 8 points

  Yes

  No

• Describe the water course

• The disposal area is not within 100m of the nearest downhill water course (m) - 5 points

  Yes

  No

• Describe the water course

• Is there NO potential for contamination of water course or water supply - 8 points

  Yes

  No

• Are all edible plants, fruit trees etc. excluded from the disposal area - 6 points

  Yes

  No

Septic Tank Safety Checklist

• Is the Tank lid/riser a minimum of 100mm above ground level - 2 points

  Yes

  No

• Does the Tank have a baffle - 3 points

  Yes

  No

• Is the Tank-lid and inspection points intact, tank accessible and is it insect proof - 6 points

  Yes

  No

• Are all pumps or float switches working (pump-out - collection wells) - 7 points

  Yes

  No

• Does the Tank have a "T" inlet - 3 points

  Yes

  No

• The Septic Tank does not need pumping - 6 points

  Yes

  No

• The Septic Tank is in a healthy condition (appears to be working adequately) - 5 points

  Yes

  No

Aerated Waste Treatment System

• Is the effluent irrigation system UNABLE to be connected to any standard water fittings - 8 points

  Yes

  No

  N/A

• Is there at least one well made readable "RECYCLED OR RECLAIMED WATER - DO NOT DRINK" warning sign - 5 points

  Yes

  No

  N/A

• Are the distribution lines buried at least 100mm below surface - 3 points

  Yes

  No

  N/A

• Are the sprinklers the correct type and operating adequately - 5 points

  Yes

  No

  N/A

• Number of Sprinklers

• Is the system being serviced by an accredited technician - 8 points

  Yes

  No

  N/A

• Date of Last Service (if known)

  Date

OSSM Assessment

• Total Score

  157 to 153 points

  152 to 150 points

  149 to 137 points

  136 or less points

• Risk Assessment = Low (1-4)

• Risk Assessment = Medium (5-7 AWTS)

• Risk Assessment = High (8+ AWTS)

• Risk Assessment = High (8+ AWTS)

• More than 20 points means that the OSSM will require a follow-up inspection before the

  Date

• Further action required on the following items

Inspection Details

• Site Photograph

  Media

• Site Drawing

  Drawing

• Date and Time of Inspection

  Date

• Council Inspection Officers Signature

  Sign