FORM SSD / PDC / 2 SEWERAGE SERVICES ACT 1993 SEWERAGE SYSTEMS AND SEPTIC TANKS (PLANNING, DESIGN AND

CONSTRUCTION) REGULATIONS 1996 (Regulation 7) APPLICATION FOR APPROVAL OF SEWERAGE WORKS Date :

I / We (the undersigned) hereby apply to undertake the following sewerage works:

and submit the following particulars (see reverse of form):

As required by Federal Government, all land sites for sewerage shall be reserved. Therefore, I / We as the owner of the sewerage land sites, hereby agree to surrender the above sewerage land site to the State Authority under Section 195 of the National Land Code 1965 to enable it to be vested to the Federal Government.

Signature of Owner Name of Owner (in block letters) I.C No Address : : :

Telephone No Fax No

: :

BORANG PDC 2

DECLARATION FOR SEWERAGE WORKS DESIGN APPROVAL

SSD Regional Office File No. Project Title

: : :

Date :

License Land Surveyor : Address :

Telephone / Fax Lot No. / PT

: :

Mukim / Village / Town : District State Land Title No. Area of STPs / NPS Land Status of STP Developer Consultant Proposed Treatment System Development Type Population Equivalent (PE) Catchment : : : : : : : : : : : STP NPS Declaration by Engineer I hereby certify that all written information provided in this declaration and the attachment document are completed, true and correct and are in accordance to the 'Guidelines for Developers' and the MS1228 Codes of Practice for Design and Installation of Sewerage System and I accept full responsibility accordingly. N/W IST sq meter. State Land / Alienated Land / Reserved Land

Date : Qualified Person by Lead Consultant Name : Discipline : Civil Engineer

BORANG PDC 2

Declaration by Qualified Person I hereby certify that the details in the plans and design calculation are in accordance with the Sewerage System and Septic Tanks (Planning, Design and Construction) Regulations 1996 and with MS1228

"Code of Practice for Design and Installation of Sewerage System" and I accept full responsibility accordingly.

Signature of Qualified Person (by Lead Consultant)

Name of Qualified Person (in block letters) Discipline I.C No. Address

: : Civil Engineer : :

Telephone No Fax No

: :

Qualifications and Registration particulars:

FOR OFFICE USE ONLY Date received Date replied : : Checked By : Ref. No. :

BORANG PDC 2

PARTICULARS The following particulars are to be submitted with each application for sewerage works approval : 1) Sewerage Planning Approval letter issued by the Sewerage Services Department.

2) A site layout plan as approved. 3) A location plan of the sewerage works. 4) Plans and longitudinal sections of proposed sewers. 5) Detailed plans and sections of sewage treatment works (where applicable). 6) Detailed plans and sections of sewer appurtenances. 7) Detailed plans and sections of pumping stations (where applicable). 8) Detailed plans of proposed septic tanks (where applicable). 9) Specifications of materials, equipment and plant. 10) Detalied calculations of the components of the sewerage system. 11) Detalied calculations of the treatment process and hydraulic design (where applicable). 12) Details of phasing of development and numbers of properties served. 13) Details of population equivalent to be served by the proposed sewerage works. 14) Standard of final effluent to be achieved (where applicable). 15) Details of security, screening and access arrangement to plants (where applicable).

BORANG PDC 2