Subsurface Wastewater Forms
Please Note: The Subsurface Wastewater Unit no longer provides CAD versions of our forms.
List of Forms Available for Download
Forms are listed alphabetically by title or primary purpose. Click here to view a list of forms organized by document type (PDF, MS Word, etc.).
- Affidavit of Site Preparation - HHE-238B: Download - MS Word
- Certificate of Approvals - HHE-239: Download - PDF
- Engineered System Application - HHE-220: Download - PDF
- Holding Tank Application - HHE-233: Download - MS Word
- Holding Tank Deed Covenant - HHE-300: Download - PDF
- Inspection Checklist for LPIs: Download - PDF
- Internal Plumbing Permit Application - HHE-211: Download PDF Electronic Form – Standard (Complete by Hand)
- Local Plumbing Inspector (LPI) Appointment - HHE-FL5: Download - PDF
- Minimum Lot Size Law Waiver Application - HHE-236: Download - MS Word
- New Vendor & Vendor Update: Download - PDF
- Notice of Intent to Install a SSWW Disposal System...Expanded Structure - HHE-234: Download - MS Word
- Notice of Permit: Download - MS Word
- Personal Reference for Site Evaluator Exam - HHE-217: Download - MS Word
- Pre-Treatment Maintenance Agreement - HHE-300A: Download - PDF
- Product Registration - HHE-221: Download - PDF
- Single Replacement Tank Only - HHE-200A: Download - PDF
- SSWW Disposal System Application - HHE-200, Page 1: Download - PDF
- SSWW Disposal System Application - HHE-200, Page 2: Download - PDF
- SSWW Disposal System Application - HHE-200, Page 2 (extra soil logs): Download - PDF
- SSWW Disposal System Application - HHE-200, Page 2 (no grid): Download - PDF
- SSWW Disposal System Application - HHE-200, Page 3: Download - PDF
- SSWW Disposal System Application - HHE-200, Page 3 (no grid): Download - PDF
- Statement of Compliance for Engineered Systems - HHE-220A: Download - PDF
- Statement of Rule Compliance - HHE-238A: Download - MS Word
- Variance Request Form - HHE-204: Download - PDF
- Voluntary Septic System Inspection: Download - MS Excel
- Water Use Records Percentile Calculator Spreadsheet: Download - MS Excel
‘Fillable’ PDF Forms
Some of the forms on this page can be printed and completed by hand or filled-in using your computer (specific PDFs only).
- To ensure all functions operate properly, the forms should be opened and completed using Adobe® Reader. Click here to download and install the application. This is a safe and free download from Adobe®.
- IMPORTANT: If using the ‘fillable PDF’ option, do not attempt to complete these forms in a web browser such as Chrome or Edge, as some functions may not be available.
To use PDF forms on your computer, simply follow these easy steps:
- Download the form and save it to your computer, either on your desktop or in a folder you can easily access.
- Open the blank form at its location on your computer using the PDF Reader.
- ‘Save As’, re-naming the form using pertinent information that will help identify the document in the future (e.g., permit number, issue date, client name/address, etc.).
- Using your computer keyboard, fill-in all applicable fields; use the TAB key to navigate through the document.
- Click ‘Save’.
You may return to the form at a later time to revise and/or complete your work. Be sure to 'Save' subsequent additions/revisions. - Print for signature and/or mailing, or attach to an email for electronic submittal.
For assistance, please contact the Subsurface Wastewater Team: Email or phone (207) 287-2070.
Updated 5/24/2024