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: ___________________ 20____
I/we (the undersigned) ____________________________________________________________
hereby apply to undertake the following sewerage works:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
and submit the following particulars:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
As required by the 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.:

Declaration for Sewerage Works Design Approval

SSD Regional Office: ________________________

Date:______________

File No.

: ________________________________________________________

Project Title

: _____________________________________________________________

__________________________________________________
__________________________________________________
License Land Surveyor

: __________________________________________________

Address

: ______________________________________________
________________________________________
________________________________________

Telephone/Fax

: ________________________________________

Lot No/PT

: _____________________________________

Mukim/Village/Town

: _____________________________________

District

: _____________________________________

State

: _____________________________________

Land Title No

: ________________________________________

Area of STPs/NPS

: __________________________sq meter.

Land Status of STP

: __________State Land/ Alienated Land/ Reserved Land

Developer

: _____________________________________________________

Consultant

: _____________________________________________________

Proposed Treatment System : _____________________________________________________

Development Type

: ________________________________________________

Population Equivalent (PE) : ______________________________________

Catchment

: ______________________________________
STP

NPS

N/W

IST

Declaration by Qualified Person

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 Malaysia Sewerage Industry Guidelines and the MS1228 Codes of
Practice for Design and Installation of Sewerage Systems and I accept full responsibility accordingly

Date: ....

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

Declaration by Qualified Person

I hereby certify that the details in the plans and design calculations are in accordance with the Sewerage System
and Septic Tanks (Planning, Design and Construction) Regulation 1996 and with MS 1228 Code of Practice
fro 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:Civil Engineer
I.C.No.:
Address:

Telephone No.:
Telefax No.:
Qualifications and Registration particulars:

FOR OFFICIAL USE ONLY

Date received: __________________________
Date Replied: __________________________

Checked By: __________________________

Ref. No:

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 p lan 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 sect

8)

Detailed plans of proposed septic tanks (where applicable).

9)

Specifications of materials, equipment and plant.

10)

Detailed calculations for the components of the sewerage system.

11)

Detai led 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)

Sta ndard of final effluent to be achieved (where applicable).

15)

Details of security, screening and access arrangements to plants (where applicable).

ions of pumping stations (where applicable).