BRWC Septic Maintenance Cost Sharing Program

Blue Ridge Watershed Coalition Blue Ridge Watershed Coalition

Blue Ridge Watershed 501 (c) (3) EIN: 45-2105782 ID: 31474 PO Box 538 Harper’s Ferry WV 25425

Coalition

BRWC Septic Maintenance Cost Sharing Program

Application

Date: ______

Name ______

Mailing Address ______

______

Location of home if different: ______

Contact phone number: ______

Distance to nearest stream/water body (approximate) ______

Size of existing septic ______

(if known)

Date last pumped ______

(if known)

I understand once my application is accepted and my pumping receipt is turned in I (we) will be reimbursed 50% of the total pumping cost up to a maximum of $150.00. I (we) release the Blue Ridge Watershed Coalition from liability.

Homeowner Signature______Date______

Application Process:

After completing the application mail to: Blue Ridge Watershed Coalition,

Po Box 538

Harpers Ferry, WV 25425

Applications will be honored on a first come, first serve basis. You will be notified by phone.

Recipients will then schedule with a licensed septic pumping company to have their septic tank pumped. After the tank is pumped the homeowner will pay the initial cost up front. The original receipt marked as paid MUST BE submitted to the Blue Ridge Watershed Coalition (address above). Reimbursement may take a few weeks, as the WV DEP will have to release the funds to the BRWC for disbursement.

Thank you for participating in our program.

Please email the coalition at or call Ronda Lehman, BRWC Chair @ 304-261-8070 with any questions.

Web: www.blueridgewatershed.org/ Email: