September 2, 2022
NOTICE OF REVISION TO FORM #3850-FM-BCW0290
APPLICATION FOR AN ON-LOT SEWAGE SYSTEM PERMIT
Please note the Department significantly revised the Application for an On-lot Sewage System Permit (#3850-FM-BCW0290). The major changes are as follows:
1. The DEP is no longer providing tablets of permit applications and they will not be available in quadruplicate paper format. The form is only being provided electronically through the Department’s eLibrary and can be found at the following link: (Application for an On-lot Sewage System Permit) . The form can be filled out electronically for your convenience by typing in the boxes provided in the Word version, or you can print hard copies to be filled out by hand from either the Word or Adobe pdf versions. The eLibrary is the only place the latest version of this form will be available, so please copy this link to wherever you need to access it and obtain your permit applications only through the link.
If you still have tablet copies of the paper application, you may continue using them until they are gone.
2. The previous Department supplied forms had unique application numbers. The revised form does not have an assigned application number, the number will now be assigned by the local agency Sewage Enforcement Officer (SEO). The instructions provided with the application form explain how to generate this unique number.
3. Please inform your local agency or municipality of this major change. The local agency/municipality shall maintain a list of all application numbers issued in their jurisdiction and the list must be submitted to the Department with the annual report.
4. The following items have been added to the form:
a. A checkbox for a Well Isolation Distance Exemption.
b. A checkbox for No Planning Required.
c. A checkbox for Limitations in Effect along with a field for the type of limitation.
d. A checkbox for Soil Morphological Evaluation.
e. A checkbox for Additional Hydrologic Testing with subsections.
f. A checkbox for Revoked Permit along with a field for the date and reason.
g. A checkbox for Equalization Tank along with a field for the gallons.
h. A checkbox for Free Access (IRSIS only) filter.
i. A requirement to attach an On-lot Sewage System Design Report which is a report containing a detailed description of the selected system design.
j. An SEO signature block attesting to final inspection criteria.
5. The instructions were bolstered to aid in the completion of the application and do not have to be submitted with the form.
If you have any questions or concerns, please contact RAfirstname.lastname@example.org .
Bureau of Clean Water