APPLICATION TO RENEW A PRODUCT APPROVAL OF AN ON-SITE WASTEWATER SYSTEM
Regulation 93, Public and Environmental Health Regulations
This application form is for the following types of wastewater system products:- Septic tanks
- Aerated wastewater treatment systems
- Ancillary products
- Other biological wastewater treatment systems, such as trickling filters, rotating biological contactors etc.
- Filtration systems
- Greywater systems
- Composting toilets
- Other blackwater / toilet waste systems
- Yellow water (urine separation and/or treatment) systems
- Alternative technologies, UV, ozone etc.
INSTRUCTIONS
(1)READ THE LATEST VERSION OF THE CODE OF PRACTICE FOR ON-SITE WASTEWATER MANAGMENT – AVAILABLE FROM DoH WEBSITE AT > Wastewater Management
(2)CONTACT DoH TO ENSURE YOU HAVE THE LATEST APPLICATION FORM AND TO GET ADVICE
(3)FILL OUT THE APPLICATION FORM AND ENSURE THAT ALL DETAILS ARE ACCURATE AND COMPLETE
(4)All drawings or specifications are to conform to the general standard of drawing practice included in AS 1100 and be prepared by an appropriately qualified engineer or other qualified person with knowledge and experience in wastewater management and design
(5)Any claims or statements made by the supplier or designer must be backed up by appropriate supporting documentation and/or expert opinion(s)
(6)Do not include information which is not relevant to the system for which approval is being sought as this will only delay the accreditation process
(7)All commercial in confidence material must be clearly identified
(8)Industry standard terminology and symbols must be used in the application documentation
(9)For systems tested outside Australia a copy of the international test results and reports are to be submitted along with information specified in this application form
(10)ATTACH ALL WRITTEN AND ELECTRONIC (ON CD OR USB) INFORMATION DETAILED IN CHECKLIST SECTION 7
(11)Where information that is requested in the application form is cited as ‘not applicable’, include a page referencing the item and a statement explaining why it is not applicable
(12)PAY THE APPLICATION FEE AND LODGE THE APPLICATION AS DETAILED IN SECTION 8 AND ENVIRONMENTAL HEALTH FACT SHEET No. 508
(13)Applications will not be assessed until DoH receives receipt of fee payment from the Receiver of Territory Monies
(14)Approvals are issued for a period of 5 years unless otherwise specified by DoH
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT
For assistance with completing this application form, phone the DoH Environmental Health Branch on
(08) 8922 7152 and refer to Environmental Health Fact Sheet 508: Prescribed fees for wastewater approvals, for fee, payment and lodgement details.
NOTE: Information contained in the completed application form may be shared with interstate
on-site wastewater regulators for the purpose of peer review and national consistency.
1.1Applicant name (full name of individual or company)
1.2Registered business name
1.3Australian Company No. (ACN)
1.4Australian Business No. (ABN)
1.5Address of Registered or Principal Office
1.6Postal address
1.7Name and address of NT
agent(s) if different from above
1.8Name of contact person
1.9Contact details / Phone: ......
Mobile: ......
Fax: ......
Email: ......
Website: ......
2.0ON-SITE WASTEWATER SYSTEM DETAILS
2.1Name Model No. of the system (provide all model numbers if application is for multiple systems designed on a base system)
2.2Wastewater source(select ONE only)
☐All wastewater (blackwater and greywater)
☐All wastewater (excluding urine)
☐Greywater including kitchen wastewater
☐Greywater (no kitchen wastewater) / ☐Blackwater (toilet water including urine)
☐Blackwater (toilet water without urine)
☐Faeces and urine only
☐Faeces only
2.3Maximum hydraulic load of each model (L/day)
2.4Maximum number of equivalent persons for residential installations(EP)
2.5Maximum organic load of each model (g/day BOD5)
2.6Treatment types(select all that apply)
Primary treatment / Secondary treatment / Disinfection
☐Anaerobic Septic Tank
☐Aerobic Biological Filter (Wet composting / Vermiculture)
☐Dry composting Toilet
☐Greywater Diversion Device (GDD)
☐Other: / ☐Sewage Ejection Pump Station
☐Aerated Wastewater Treatment System (AWTS)
☐Greywater Treatment System (GTS)
☐Aerobic Biological Filter (Wet composting / Vermiculture)
☐Electro-flocculation
☐Membrane Filtration
☐Ozonation
☐Reedbed
☐Sand Filter
☐Trickling Filter / Packed Bed Reactor
☐Other: / ☐Chlorine / Bromine
☐Ultra-Violet Light
☐Ozonation
☐Heat
☐Other:
3.0EFFLUENT END USE
3.1Identify the end uses for the treated water, or residual liquid from a dry composting toilet.
(select ALL options) / ☐Not Applicable (no effluent)
☐Infiltration/soil absorption trench
☐Evapo-transpiration bed/trench
☐Mound
☐Subsurface irrigation
☐Surface irrigation
☐Toilet flushing
3.2Identify the end use or deposition of the sludge or composted biosolids(select ALL options)
☐Tankered off-site to a sewage treatment plant
☐Discharged to sewer
☐Composted and buried on-site / ☐Composted and taken off-site
☐Not applicable (no residual sludge / compost does not need to be extracted)
☐Other:
4.0ENERGY CONSUMPTION AND MAINTENANCE
4.1List the brand, model and type of each electrical component of the system, including any fans, aerator pumps and the irrigation pump for secondary treated effluent.
Attach additional sheet if required.
(This information will be used to calculate an approximate yearly energy usage in kWh/year and running cost in dollars) / Electrical component
(brand, model & type) / Energy rating in Watts of each component / Typical daily hours of operation for a
3 bedroom house
4.2State the maintenance or servicing intervals as required in the Manual / Maintenance / Service is required every ……….. months.
The regime is detailed on page ….. of the ………….. Manual
5.0ACCREDITATION BY JURISDICTIONS IN OTHER STATES
5.1List other states or territories where you have and/or will apply for approval/accreditation in the next six months. Include Certificate numbers and dates (where applicable)
6.0SYSTEM AND END-PRODUCT QUALITY ASSURANCE PROTOCOLS
6.1Select all the quality assurance programs used to assess:
- the performance of the treatment system,
- the structural integrity of the components of the system, or
- the quality of the water or compost end product.
☐AS 1546:1 2008 Onsite domestic wastewater treatment units – Septic tanks
☐AS 1546:2 2008 Onsite domestic wastewater treatment units – Waterless composting toilets
☐AS 1546:3 2008 Onsite domestic wastewater treatment units – Aerated wastewater treatment systems
☐NSW Health Domestic Greywater Treatment Systems Accreditation Guidelines (February 2005) (as amended)
☐An international standard.
7.0CHECKLIST OF REQUIRED DOCUMENTS
All the following items must be collated in one bound paper copy plus as individual documents on a CD or memory select and posted with the completed application form. Note if the requested details have not changed since the previous approval and have been previously provided then note in the submission.
Documents Required
Item No. / Type the reference number of the item in the attached document or type ‘not applicable’
7.1Table of contents of the documentation accompanying this form.
7.2Covering letter and overview of the system describing any special features and recommended land application system.
7.3Detailed description of the treatment train and processes including a description of the equipment and process that returns sludge from the secondary chamber to the primary chamber (a manually operated sludge return system is not acceptable).
7.4Detailed description of any alarm system associated with the system
7.5Manufacturer’s membrane specification sheets
7.6Manufacturer’s specification sheets for all electrical components
7.7Manufacturer’s specification sheets for the UV unit including the wavelength range, maximum flow rate per minute, lamp intensity, lamp life and any transmissivity monitoring.
7.8Engineering drawings in plan view and cross-sectional view of the tanks, internal components, effluent storage container and pipe work of all models.
7.9Schematic diagram of the system in plan form and cross-sectional view of the tanks, chambers, components, sludge return mechanism and pipe work of all models including the flow path of the wastewater (A4 size in PDF format).
7.10A series of photographs of a treatment system of the same type showing detail of installation processes and typical post installation setting.
7.11Description of any nutrient reduction equipment or mechanism, an explanation of its processes and justification of its long-term capability.
7.12Quality Assurance (QA) Certificate of the applicant’s company to StandardsMark QA program or equivalent (i.e. ISO9000, ISO type 5).
7.13Certificate of Accreditation by JAS-ANZ of the company (third party Conformity Assessment Body) conducting and reporting on the tests
7.14Product Certificate(s) issued by a JAS-ANZ accredited company in accordance with:
- AS/NZS 1546.1 (2008) Cert No.
- AS/NZS 1546.2 (2008) Cert No.
- AS/NZS 1546.3 (2008) Cert No.
- NSW Health Greywater System Accreditation Guidelines (2005) Cert No.
7.15Product Certification Report issued by a JAS-ANZ accredited company in
accordance with: AS/NZS 1546.1 (2008) Report No. …………
AS/NZS 1546.2 (2008) Report No. …………
AS/NZS 1546.3 (2008) Report No. …………
NSW Health Greywater System Accreditation Guidelines (2005)……
7.16Certificates of Approval from other Australian States and Territories
7.17Warranty of service life
7.18Owner’s Manual (in PDF format))
7.19Installation Manual (including site installation plan)
7.20Operation and Maintenance Manual
7.21Sample service agreement
7.22Sample inspection / maintenance record sheet
8.0APPLICATION FEE TO RENEW APRODUCT APPROVAL
8.1The fee and payment options for the ‘Application to renew product approval’ are detailed in Environmental Health Fact Sheet 508: Prescribed fees for wastewater approvals.
9.0CERTIFICATION THAT ALL OF THE INFORMATION SUPPLIED IS ACCURATE AND COMPLETE
9.1Full name of applicant
9.2Position in company
9.3Company address
9.4Phone number
9.5I certify that the information contained in this application, (including attachments) is accurate and complete / Signature:
Date:
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