Re-approval of an onsite
wastewater treatment system
Certificate of Approval
Application Form
INSTRUCTIONS
(1) READ THE LATEST VERSION OF EPA PUBLICATION 935 “GUIDANCE ON APPLYING FOR A CERTIFICATE OF
APPROVAL FOR AN ONSITE WASTEWATER TREATMENT SYSTEM” – AVAILABLE FROM THE EPA WEBSITE AT
www.epa.vic.gov.au/environment/water/onsite_wastewater
(2) CONTACT EPA 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) WHERE INFORMATION THAT IS REQUESTED IS CITED AS ‘NOT APPLICABLE’, A STATEMENT EXPLAINING WHY
THE ITEM IS NOT APPLICABLE MUST ACCOMPANY THIS APPLICATION.
(4) ATTACH ALL WRITTEN AND ELECTRONIC (ON CD) INFORMATION DETAILED IN CHECKLIST SECTION 8.0
(5) POST THE COMPLETED APPLICATION FORM AND ALL ATTACHMENTS TO THE ONSITE WASTEWATER
PROGRAM MANAGER (ADDRESS ON THE LAST PAGE OF THIS FORM).
1.0
MANUFACTURER or IMPORTER’S DETAILS
1.1
Full Name of Company
1.2
Registered business name
1.3
Australian Company No. (ACN)
1.4
Australian Business No. (ABN)
1.5
Address of Registered or
Principal Office
1.6
Postal address
1.7
Name and address of Victorian
agent if different from above
1.8
Name of Contact Person
1.9
Contact details
Phone: ………………………………………………………...
Mobile: …………………………………………………………
Fax: ………………………………………………………….…
Email: ………………………………………………………....
Website: …………………………………………………………
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Re-approval of an onsite wastewater treatment system – application form
2.0
ON-SITE WASTE WATER MANAGEMENT SYSTEM DETAILS
2.1
Name and Model Number(s) of
the system
2.2
EPA Certificate of Approval
number
CA
2.3
Wastewater source
(circle 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
2.4
State the maximum hydraulic
load of each model (L/day)
2.5
State the maximum organic load
of each model (g /day BOD5)
2.6
State the peak flow rate (L/hr) for
commercial-scale systems
2.7
State the maximum expected
Nitrate concentration in the
effluent in mg/L (optional)
2.8
State the maximum expected
Total Phosphorus (TP)
concentration in the effluent in
mg/L (optional)
2.9
Treatment types (Circle ALL that
apply)
Primary treatment
Secondary treatment
Disinfection
2
Anaerobic Septic tank
Aerobic Biological Filter (Wet composting / Vermiculture)
Dry composting
Aerated Wastewater Treatment System (AWTS)
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
Other:
Re-approval of an onsite wastewater treatment system – application form
3.0
3.1
EFFLUENT END USE
Identify the end uses for the
treated water, or residual liquid
from a dry compost toilet.
(circle ALL options)
Not Applicable (no effluent)
Infiltration/soil absorption trench
Evapo-transpiration bed/trench
Mound
Subsurface irrigation
Surface irrigation (greywater only)
Toilet flushing (greywater only)
Cold water use in the washing machine (greywater only)
3.2
Identify the end use or
deposition of the sludge or
composted biosolids
Tankered off-site to a sewage treatment plant
Discharged to sewer
Composted and buried on-site
(circle ALL options)
Composted and taken off-site
Not applicable (no residual sludge / compost does not need to be
extracted)
Other:
4.0
4.1
ENERGY CONSUMPTION AND MAINTENANCE
List 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.
Electrical
component
(brand, model &
type)
Energy rating in
Watts of each
component
Typical daily hours of
operation for a 4-person
house
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)
4.2
5.0
5.1
State 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
ACCREDITATION BY JURISDICTIONS IN OTHER STATES
List other states or territories
where you have and/or will apply
for accreditation in the next six
months.
Include Certificate numbers and
dates (where applicable).
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Re-approval of an onsite wastewater treatment system – application form
6.0
6.1
SYSTEM AND END-PRODUCT QUALITY ASSURANCE PROTOCOLS
Circle 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 1547:2012 Onsite domestic wastewater management
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
EPA Victoria Publication 760 Guidelines for Aerated Wastewater
Treatment Systems (as amended)
NSW Health Domestic Greywater Treatment Systems Accreditation
Guidelines (February 2005) (as amended)
7 .0
CHECKLIST OF REQUIRED DOCUMENTS
All the following items must be collated in one bound paper copy plus as individual documents on a CD
or memory stick and posted with the completed application form
Documents Required
Item No.
4
7.1
Table of contents of the documents accompanying this application form.
7.2
A list of all installations including:
Type the reference number
of the item in the attached
document or type ‘not
applicable’
1. property owner’s first name and surname
1.
2. address of installation
2.
3. name of local council
3.
4. property owner’s phone number(s)
4.
5. whether the system is used full-time or part-time (where known)
5.
6. greywater used for toilet flushing or cold water supply to the clothes washing
machine
6.
7. date of installation
7.
8. date of last service
8.
9. date that the system was last desludged
9.
10. name and contact details of each service technician.
10.
7.3
Name of the NATA-registered laboratory with which a contract has been
set up to pay for the influent and effluent sampling and analysis, and the
name and phone number of the contact person.
7.4
Name and phone number of the contact person at the NATA-registered
laboratory which will undertake the influent and effluent sampling and
analysis
7.5
Detailed description of the influent and effluent water quality sampling point
or mechanism and a diagram of their locations.
Re-approval of an onsite wastewater treatment system – application form
7.6
Confirmation that the influent and effluent sampling point diagram and
procedures have been received and understood by the lab sampling staff.
7.7
Certificate of Accreditation plus Scope of Accreditation issued by NATA for
the laboratory conducting the biological testing (eg E.coli, salmonella)
7.8
Certificate of Accreditation plus Scope of Accreditation issued by NATA for
the laboratory conducting the chemical testing (eg BOD, TSS, nutrients)
7.9
Engineering laboratory report issued by the NATA-registered engineering
laboratory in accordance with AS/NZS 1546.1 (2008).
7.10 Quality Assurance (QA) Certificate of the applicant’s company to
StandardsMark QA program or equivalent (i.e. ISO9000, ISO type 5)
7.11 Product 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. .......
7.12 Product 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)………
7.13 Certificates of Approval from other Australian States and Territories
7.14 Updated detailed description of the treatment train and processes for each
model including a description of the equipment and process that returns
sludge from the secondary chamber to the primary chamber (a manuallyoperated sludge return mechanism is not acceptable).
7.15 Detailed description of the alarm system
7.16 Manufacturer’s specification sheet for each electrical component
7.17 Manufacturer’s membrane specification sheets
7.18 Manufacturer’s specification sheets for the UV unit including the
wavelength range, maximum flow rate per minute, lamp intensity and any
transmissivity monitoring
7.19 Description of any nutrient reduction equipment or mechanism, an
explanation of its operation and justification of its long-term capability.
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Re-approval of an onsite wastewater treatment system – application form
7.20 Updated schematic diagram of the system in plan 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 on CD for EPA website)
7.21 Photograph of installed treatment system (PDF for EPA website) (optional)
7.22 Warranty of service life
7.23 Updated Owner’s Manual (in PDF format on CD for the EPA website)
7.24 Risk assessment and trouble-shooting advice (eg. AS/NZS4360 based)
7.25 Updated Installation Manual (including site installation plan)
7.26 Updated Operation and Maintenance Manual
7.27 Sample service agreement
7.28 Sample inspection / maintenance record sheet
Commercial-scale systems (2000L to 5000L/day) design justification in
accordance with latest version of Pub. 500 Small Wastewater Treatment
Systems
7.29 Calculations to justify the minimum operating capacity (volume) of the
primary treatment tank, relative to the claimed maximum hydraulic (see
2.4) and organic (BOD5) (see 2.5) design loadings. The calculations must
demonstrate the provision of adequate sludge storage (not less than
2m3/kg BOD.day).
7.30 Calculations to justify the minimum operating capacity (volume) of the
secondary treatment tank(s), relative to the claimed maximum hydraulic
(see 2.4) and organic (BOD5) (see 2.5) design loadings.
7.31 Calculations to justify the maximum daily organic (BOD 5) loading of each
fixed media process.
7.32 Calculations to justify the maximum operational capacity (volume) for
aerobic biological chambers for aeration, submerged fixed media or
activated sludge processes, relative to the maximum daily BOD and
hydraulic loadings. [A maximum BOD5 reduction of 30% can be allowed
only if primary settling tanks with excess sludge storage capacity are
provided (see 7.29 above).]
7.33 Calculations to justify the storage capacity of each treated effluent clarifier.
7.34 Calculations to justify the storage capacity of the chlorine contact chamber
or any other treated effluent disinfection chamber or tank.
7.35 Calculations to justify the maximum desludging interval based on the
maximum hydraulic and organic design loadings (BOD5) of the system.
7.36 Calculations that demonstrate the ability of the primary tank to provide at
least 24 hrs emergency storage i.e. to store raw sewage above the alarm
activation level and below the outlet pipe (not relevant for tanks with pump
wells).
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Re-approval of an onsite wastewater treatment system – application form
7.37 Method of oxygen injection and details of proven scientific test data to
determine operational dissolved oxygen concentrations at the bottom of the
aeration, activated sludge or bioreactor (submerged fixed media
processes) aerobic chamber.
7.38 Method and frequency of automatic clarified sludge return (a manuallyoperated sludge return mechanism is not acceptable).
7.39 Details of automatic standby pumping equipment, standby aeration
equipment and method of deployment in the event of primary equipment
failure.
7.40 Above- and in-ground tanks: in the absence of a suitable Australian
Standard certification of any tank structure, the STP manufacturer must
provide computations from a certified structural engineer to demonstrate
that the tank structures are suitable for the respective application.
8.0 CERTIFICATION THAT ALL OF THE INFORMATION SUPPLIED IS
ACCURATE AND COMPLETE
8.1
Full name of applicant:
8.2
Position in company:
8.3
Company address:
8.4
Phone number:
8.5
I certify that the information
contained in this application,
(including attachments) is
accurate and complete
Signature:
Date:
INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT
For assistance with completing this application form phone the EPA Onsite Wastewater Program Manager on
1300 EPA VIC (1300 372 842)
POST THE COMPLETED APPLICATION FORM AND ALL THE REQUIRED WRITTEN AND ELECTRONIC
DOCUMENTS (IN HARDCOPY AND ON CD OR MEMORY STICK) LISTED IN THE CHECKLIST TO:
Onsite Wastewater Program Manager
EPA Victoria
GPO Box 4395
Melbourne VIC 3001
NOTE: Information contained in the completed application form may be shared with interstate
onsite wastewater regulators for the purpose of peer review and national consistency.
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Re-approval of an onsite wastewater treatment system – application form
Guidelines and information to assist in submitting a complete application:
8
(i)
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.
(ii)
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 waste water management and design.
(iii)
Any claims or statements made by the supplier or designer must be backed up by appropriate supporting
documentation and/or expert opinion(s).
(iv)
Do not include information which is not relevant to the system for which accreditation is being sought as
this will only delay the accreditation process.
(v)
All commercial in confidence material must be clearly identified.
(vi)
Industry standard terminology and symbols must be used in the application documentation.
(vii)
A table of contents must form part of the application documentation and is to include the items contained
in the checklist with corresponding page numbers showing where the relevant information can be found.
www.epa.vic.gov.au T: 1300 EPA VIC F: 03 9695 2610