Water and Sewer Apps

Sewage Collection System Inspection Form

Use this Sewage Collection System Inspection Form, based on the qualifications of the Environmental Protection Agency (EPA) Regulation 9. Gather accurate and up-to-date information on your local sewage collection systems for capacity assurance and control and to inform infrastructural renewal and capital improvements. This form is 100% customizable to suit your local regulation and assessment requirements and will work in both on and offline environments.

Sewage Collection System Inspection Form iPhone, iPad Sewage Collection System Inspection Form Android Sewage Collection System Inspection Form Web, Desktop
Sewage Collection System Inspection Form

General Information

Inspection Date

Utility Name

Address

Contact Person

Phone

Email

Inspector

Inspector Name

Agency/Contractor

Utility personnel who accompanied inspectors

Name

Title

System Overview

Population

Service Area

Service Area Description

Number of Service Connections

Residential

Commercial

Industrial

Total

Combined Sewers

Name and NPDES permit number for WWTP(s) owned or operated by the collection system utility

Name and NPDES permit number for WWTP(s) that receive flow from the collection system utility

Names of upstream collection systems sending flow to the collection system utility

Names of downstream collection systems receiving flow from the collection system utility

Do any interagency agreements exit with upstream collection systems?

Does the utility maintain the legal authority to limit flow from upstream satellite collection systems?

System Inventory

Miles of gravity main

Miles of force main

Miles of Laterals

Number of maintenance access structures

Number of pump stations

Number of siphons

Utility responsibility for laterals

Size Distribution of Collection System

6 inches or less

Gravity Sewer

Force Mains

8 inches

Gravity Sewer

Force Mains

9 - 18 inches

Gravity Sewer

Force Mains

19 - 36 inches

Gravity Sewer

Force Mains

> 36 inches

Gravity Sewer

Force Mains

System Flow Characteristics

Collection System

Average Daily Dry Weather Flow (MGD)

Peak Daily Wet Weather Flow (MGD)

Peak Instantaneous Wet Weather Flow (MGD)

Location of flow monitor(s) from which above information obtained

Period over which flow was monitored

Agency conducting the flow monitoring