• Inspection Title

  • Document ID

  • Client / Site

  • Location
  • Conducted on

  • Prepared by

Property Inspected

  • Street/Road Number

  • Street/Road

  • Property Name

  • Locality

  • Lot/Sec/DP

  • Assessment Number

  • Property Usage

  • No of Bedrooms

  • Property Area (m2/ha/acre)

  • Property Locale


  • Owners Name

  • Postal Address

  • Town

  • Postcode

  • Occupiers Name (if different to above)

OSSM Details

  • Type of OSSM

  • Other Details

  • Year Installed

  • Date of Last Inspection

Site Safety Inspection Checklist

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

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

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

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

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

  • No odours can be detected - 4 points

Disposal Area

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

  • 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

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

  • Arrangements for stormwater diversion in place - 3 points

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

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

  • Distance (m/km)

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

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

  • Describe the water course

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

  • Describe the water course

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

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

Septic Tank Safety Checklist

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

  • Does the Tank have a baffle - 3 points

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

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

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

  • The Septic Tank does not need pumping - 6 points

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

Aerated Waste Treatment System

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

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

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

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

  • Number of Sprinklers

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

  • Date of Last Service (if known)

OSSM Assessment

  • Total Score

  • 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

  • Further action required on the following items

Inspection Details

  • Site Photograph

  • Site Drawing

  • Date and Time of Inspection

  • Council Inspection Officers Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.