Septic System Complaint/Report Form | Wake County Government

Wake County’s Wastewater Program is responsible for all permitting and inspecting activities that require a septic system for wastewater disposal.

Please use this form to report any septic system issues you maybe experiencing such as odor, surfacing wastewater, wastewater backups, wastewater flow to other properties, etc.

Click here to see if you might qualify for financial assistance to correct this problem.

Report anonymously?

Name

(Leave blank to remain anonymous.)

Site/Property Address*

Are you the (check all that apply):*

Property ownerComplainantContractor

Email*

Phone*

Applicant Address*

Site/Property Address (if different from applicant address)

(If you don't know the address, please describe the area as best you can.)

What type of property?*

What septic system failures have you observed at the property listed above?*

Other system failures

Details

Type of Business*

Number of Employees per Shift

Number of Shifts per Day

Number of Days per Week of Operation

Start Date (When did the system start to fail?)*

Date

How frequent is this problem? (after rain, every day, only in spring, etc.)*

Have you reported this system failure previously? If so, when?*

What type of water?*

Rental Property?

Dogs?

Part of Real Estate Transaction?

Attach a Certified Septic Inspection Report*

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Number of Bedrooms

Other Rooms with Closets

Number of Units

Number of Bedrooms in Units

Basement?

Damaged?

Has your tank been pumped recently? (less than 6 months)

Waste Water Strength

Garbage Disposal? (Garbage disposals are no longer permitted for use.)

*

I certify that all of the statements made on this form and on any attached documents are true, complete and correct to the best of my knowledge and belief and are made in good faith. I acknowledge that checking this box and electronically submitting the complaint form to Wake County Environmental Services functions as my certification to the statements above.

*

I certify that all of the statements made in this application and on any attached documents are true, complete and correct to the best of my knowledge and belief and are made in good faith. I understand that false information may be grounds for rejection of this application or revocation of any permits issued based on this information. Authorized Environmental Services representatives are granted right of entry to make evaluations or inspections and to release information upon public request. I acknowledge that checking this box and electronically submitting the completed repair application to Wake County Environmental Services functions as my certification to the statement above.

Signature of Owner or Authorized Agent*

Type in name above if completing form by email.

Today's Date*

Date

This report is based in part on information provided by the homeowner or his/her representative in the application submitted for this permit. The Environmental Health Specialist is not responsible for false or misleading information contained in the application. The Environmental Health Specialist is also not responsible for concealed conditions on the property or for statements in this report that may have resulted from false or misleading statements provided to him in the application. Neither Wake County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily in the future or that the water supply will remain potable.

Call 811 before digging!

Please call 811 to contact NC No Cuts to locate all underground utilities.

Please verify that you are human*