Follow the steps to complete the Request For Discharge Authorization form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the Owner’s Information section. Enter your name, septic permit number, site address, parcel number, and mailing address, including city and zip code.
3. Complete the Applicant section with your name, phone number, title, firm name, mailing address, city, and zip code.
4. If there is a different contact person or agent from the applicant, fill out the Contact Person/Agent section with their name, phone number, title, firm name, mailing address, city, and zip code.
5. In the Conformance with Information Submitted in Notice of Intent to Discharge section, check one box that reflects the state of your site plan: either that the original site plan accurately reflects the final location or that a revised site plan is attached.
6. In the Additional required information submitted to Department for Alternative System section, list all required information such as the final list of equipment, components, and materials, final operation and maintenance manual, engineer’s certificate of completion, and service contract. Ensure to mention the contractor’s name and license number.
7. For the Septic Tank Water Tightness section, provide the manufacturer and model name/number of the septic tank, indicate if a certificate of conformance is supplied, the tank's capacity, and whether the water tightness test passed.
8. Attach a map to your property by indicating if one is included with your submission.
9. In the Certification section, the applicant must read and understand the conditions listed. By signing, they certify that the information provided is accurate and comply with legal requirements.
10. Once all sections have been completed and reviewed, save the changes, and you may download, print, or share the form as needed.

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