Resources for Local Health Departments
Tab/Accordion Items
- Groundwater Report Form (PDF)
- Inspection of Engineered Systems (PDF)
- Inspection of Wastewater Treatment Plant (PDF)
- LPP Inspection Report Form (PDF)
- LPP Monitoring Visit Guide (PDF)
- O&M Service Provider Checklists
- Pre-occupancy Report - Migrant Housing (XLS)
- Pump Tank Operation Permit Checklist
- Subsurface System Inspection Form (DOC)
- Subsurface Wastewater Monitoring Form (XLS)
- Tank Yard Inspection Form (PDF)
- North Carolina Distribution Encroachment Agreement for Dispersal Field Encroachments - 03/25/2024
- Operation Permit Inspection Checklist (DOC)
- Records Retention Schedule for Health Departments
- Request or Decline Revised AC (DOCX)
- Site Plan Worksheet (DOC)
- Site Sketch IP CA (DOC)
- Voluntary Relinquishment of Administrative Appeal Rights (DOCX)
- Flow Through Orifices (PDF)
- Friction Loss in Pipes (PDF)
- How to Abandon a Septic System (PDF)
- LPP Design Recommendations (PDF)
- Pipe Volumes (PDF)
- Pressure Manifold Design (1986 Paper) (PDF)
- Pressure Manifold Drawings (PDF)
- Septic Tank Effluent Pump (STEP) System Design (PDF)
- Sand Filter Design Calculations (PDF)
Templates for Applications, Forms and Worksheets
- Sample Maintenance and Inspection Agreement (PDF) - 06/10/25
- NSF 350 Reclassification Application (PDF)
- IP/CA Application (DOCX) - 08/22/24
- Improvement Permit (DOCX)
- Improvement Permit Denial (DOCX)
- Construction Authorization (DOCX)
- Intent to Revoke IP/CA (DOCX)
- Intent to Suspend IP/CA (DOCX)
- Operation Permit (DOCX)
- Intent to Revoke OP (DOCX)
- Intent to Suspend OP (DOCX)
- Existing System Approval Application (DOC)
- Existing System Approval Denial (DOCX) - 12/04/24
- Existing System Approval (DOCX) - 12/04/24
- Notice of Non-Compliance (DOCX)
- Notice of Violation (DOCX)
- Soil and Site Evaluation Worksheet (DOCX)
- Voluntary Relinquishment of Administrative Appeal Rights (DOCX) - 04/01/24
- Best Professional Judgement Form (PDF)
- Best Professional Judgement Form Fillable (PDF)
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