Complete Sanitary Forms List

Maintenance Reporting Forms

• Option 1 - Septic Tank Maintenance Form (PDF)
• Option 2 - Evaluation Report From (PDF)
• Holding Tank Report Form (PDF)
• Supplemental Treatment Device Report Form (PDF)

Permit Application / Review Forms

• State Sanitary Permit Application - (R 03/21) (PDF)
• Application for Holding Tank Review For Private or Public Facilities with a Design Wastewater Flow of 3000 GPD or less (PDF)
• County Sanitary Permit Application - for county permits only (PDF)

Non-Recordable Document Forms

Single Component - POWTS Service Frequency Greater than 12 Month Intervals
No recording fee necessary

• Septic Tank Maintenance Agreement (PDF)
• Holding Tank Service Contract (PDF) - no fee necessary

Recordable Document Forms

Single Component - POWTS Service Frequency Less than 12 Month Intervals
Recording fee: $30 per document

• Holding Tank Agreement (PDF)
• Notice of Use of a Holding Tank in Lieu of a POWTS with a Dispersal Cell (PDF)
• Notice of a Per Capita Sizing of a POWTS (PDF)
• Notice of a POWTS Serving More than 1 Building (PDF) - for systems currently serving a building
• Notice of a POWTS Serving More than 1 Building (PDF) - used for installation of all POWTS components
• Pretreatment Unit Maintenance Agreement (PDF)

Multi-Component Recordable Document Forms

Recording fee: $30 per document

• Septic Tank / Pretreatment Unit / Combined Form (PDF)
• Septic Tank / Pretreatment Unit / Supplemental Treatment Device (e.g. Ultraviolet Light) / Combined Form (PDF)

Additional County Forms

• Existing POWTS Evaluation Report Form (PDF)
• Addendum to POWTS Management Plan (PDF)
• Application for Soil Test Review (PDF) - for land divisions

All the documents on this web page are saved in Portable Document Format (PDF). We recommend you download Adobe Reader, a free software that lets you view and print PDF files.