Fillable Confirmation of Permitted Activity Status: Proposed Domestic Wastewater (Ashburton District Council New Zealand)

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Confirmation of Permitted Activity Status: Proposed Domestic Wastewater (Ashburton District Council New Zealand)

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Wastewater Discharge
Declaration
(Inconjunction with form BAM 002)
BAM 002 - WD
VER. 2
Updated: May 17
Review: May 18
BAM002-WD Page 1 of 1
Confirmation of Permitted Activity Status: Proposed Domestic Wastewater Discharge
Please complete this statement for proposed domestic wastewater discharges that are
considered a permitted activity under Environment Canterbury’s Land and Water Regional
Plan (LWRP) Rule 5.8 and Rule 5.12 (Greywater).
By completing this statement you are confirming that this proposed system is designed in
accordance with the necessary standards and regulatory requirements.
Please contact Environment Canterbury regarding any questions on regional rule
requirements:
Environment Canterbury
(03) 353 9007 or 0800 324 636
ecinfo@ecan.govt.nz
www.ecan.govt.nz
Site Details
Site Address: _____________________________________________________
Legal Description: _________________________________________________
Property Owner: __________________________________________________
I, ___________________________________ of ___________________________________
hereby confirm that the attached domestic wastewater system for the above property has
been designed and will be installed in accordance with Section 5 and Section 6 of the New
Zealand Standard AS/NZS 1547:2012 – On-site Domestic Wastewater Management and will
comply with Environment Canterbury’s Land and Water Regional Plan (LWRP) Rule 5.8 and
Rule 5.12 (Greywater) as a permitted activity.
Signature of system designer:
Name: ____________________________
Signature: __________________________
Date: ____________________
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Confirmation of Permitted Activity Status: Proposed Domestic Wastewater (Ashburton District Council New Zealand)

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Completed 29 July 2020

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