In this section
= Required Fields

Online Form - Application to Construct or Install an Apparatus for the Treatment of Sewage

Health (Miscellaneous Provisions) Act 1911

Health (Treatment of Sewage and Disposal of Effluent and Liquid Waste) Regulations 1974 

PLEASE BE ADVISED THIS FORM IS ONLY FOR APPLICATIONS TO THE TOWN OF PORT HEDLAND, NOT THE EXECUTIVE DIRECTOR OF PUBLIC HEALTH. 

Location of System


Owner / Applicant Details


Premises Details

Please select the type of premises


Residential Premises

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOUR APPLICATION IS FOR A RESIDENTIAL PREMISES

Is this an ancillary accommodation?
Is there a Spa(s) on the premises?

Non-Residential Premises

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOUR APPLICATION IS FOR A NON-RESIDENTIAL PREMISES


Treatment System Details

Please indicate the type of treatment system you are applying for





Standard Septic Tanks to Leach Drains or Evaporation Ponds

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOU ARE APPLYING FOR STANDARD SEPTIC TANKS TO LEACH DRAINS OR EVAPORATION PONDS

Is it an alternating system?


Aerobic Treatment Unit

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOU ARE APPLYING FOR AN AEROBIC TREATMENT UNIT

IF LEACH DRAINS ARE USED FOR DISPOSAL, PLEASE COMPLETE THE POINTS ON LEACH DETAILS IN THE PREVIOUS SECTION ON "STANDARD SEPTIC TANKS TO LEACH DRAINS OR EVAPORATION PONDS"

Please select the disposal method



Wastewater Treatment Plants

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOU ARE APPLYING FOR WASTEWATER TREATMENT PLANTS

Please indicate the disposal method



Grey Water Reuse System

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOU ARE APPLYING FOR A GREY WATER REUSE SYSTEM

IF LEACH DRAINS ARE USED FOR DISPOSAL, PLEASE COMPLETE THE POINTS ON LEACH DETAILS IN THE PREVIOUS SECTION ON "STANDARD SEPTIC TANKS TO LEACH DRAINS OR EVAPORATION PONDS"

Please indicate the disposal method



Alternative Wastewater Treatment Systems

PLEASE ONLY COMPLETE THIS SECTION OF THE FORM IF YOU ARE APPLYING FOR AN ALTERNATIVE WASTEWATER TREATMENT SYSTEM


Information for Government Sewerage Policy Compliance Assessment

Are there any existing on-site effluent disposal systems on the lot?

System and Site Layout Plans

Unless the following are provided according to the requirements specified, the application will be returned to the applicant for resubmission


Declaration

I hereby apply as the owner, or the person authorised to act on behalf of the owner, for approval to construct or install the apparatus as referred to above. I have completed Section 1-6 of this application form and provided plans that meet the requirements detailed in Section 7.