FORM SSA/PDC/3

SEWERAGE SERVICES ACT 1993

SEWERAGE SYSTEMS AND SEPTIC TANKS
CERTIFICATE OF STRUCTURAL PLANS & DESIGN CALCULATION
(for endorsement on plans to be lodged with the Director General)
Date: __________________ 20 ____
To: The Director General of Sewerage Services
I hereby certify that the details in the structural plans and design calculations viz:

On Lot/s: ___________________________________________________________________
Section: ____________________________________________________________________
Jalan: ______________________________________________________________________
for (Name of owner): _________________________________________________________

I hereby certify that these works have been design by me in accordance with sound
engineering practice and are in accordance to the Guidelines For Developers, the MS1228
Codes of Practice for Design and Installation of Sewerage System, and other regulatory
agencies requirements and that I take full responsibility for the design and performance of the
same.

Signature of Qualified Person

Name of Qualified Person:
Discipline: Civil Engineer
Address:
I.C.No.:
Registration No:
Class:

FOR OFFICIAL USE ONLY

Date Received: ______________________ Checked By:_______________________

Ref.No._____________________________