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Environmental Protection and Sustainability
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 Well and Septic Forms

The following forms are for property owners, developers and any applicant needing well or septic assistance. All forms are in PDF format and open to a new window.

  • Soil Percolation Test Application
    (Appendix A-1) - Use this form when applying for approval to perform percolation testing of soils to evaluate a property for subdivision of land or development using on-site sewage disposal systems.
  • Perc Application Checklist
    (Appendix A-2) - This reference sheet provides a brief description of what information is required to process an application for a percolation test in Baltimore County.  More detailed information about Percolation Testing is available in the Ground Water Management Policy Manual
  • Justification for Variance to the Master Water and Sewerage Plan
    (Appendix A-3) - Any applicant may request to install a private well and/or septic system to serve a property that is within an existing or planned public water and sewer service area.
  • Interim Agreement
    (Appendix A-4)  - Request permission to install a private well and/or septic system to serve a property that is within a planned public water and sewer service area in Baltimore County, but has obtained a Justification for Variance to the Master Water and Sewer Plan indicating that the property does not have reasonable access to existing public utilities.
  • Agreement for Ongoing Maintenance of a Sewage Disposal System)
    (Appendix A-5) - This form is to be used where Baltimore County EPS is requiring a perpetual service agreement be maintained for use of an approved on-site sewage disposal system.
  • Agreement and Easement for Installation of an Innovative and Alternative On-Site Sewage Disposal System
    (Appendix A-7)  - This form is to be used where Baltimore County EPS and Maryland Department of the Environment is approving the use of an “Innovative” sewage disposal technology as defined in COBAR 01.03.01.02 B.
  • Water Usage Letter
    (Appendix A-8)  - This form is to be used by any applicant who is seeking approval to construct or expand any non-residential facility to be served by a well and/or septic system. The intent of the usage letter is to help establish the optimal design of the septic system to accommodate the average and peak flow generated by the facility.
  • Holding Tank Agreement
    (Appendix A-9) - This form is to be used when requesting approval to utilize a holding tank for the disposal of domestic wastewater in Baltimore County.
  • Property Owners Request to Use a Lesser Design of a Sewage Disposal System Repair
    (Appendix A-10) - Property owner who wishes to request a variance to the design recommended by EPS for repair of a given septic system.
  • OSDS Repairs in Problem Soil Areas
    (Appendix A-11)  - GWM to inform property owners of instances where the soils and/or property constraints preclude a septic repair that would meets minimum State and County requirements.
  • Well Siting Agreement
    (Appendix A-12) - Developers of a major subdivisions to be served by individual well water supplies.
  • Well Location Sheet
    (Appendix A-13) - GWM to document the approval of well locations to serve for domestic purposes.
  • Water Well Yield Test Report
    (Appendix A-14)  - This form is to be used by licensed well drillers and pump installers to document yield test data for domestic water wells.
  • Water Well Fracturing Report
    (Appendix A-15) - This form is to be used by licensed well drillers for wells that have been hydrofractured.
  • Geothermal Well Report
    (Appendix A-16) - This form is to be used by licensed well drillers for wells to be used as part of a geothermal heat pump system.
  • General Requirements for Hydrogeologic Studies
    (Appendix A-17) - This form is to be used by applicants proposing a major subdivision of land (4 lots or more) or any non-residential development in Baltimore County.
  • Request to Install a UV Disinfection System
    (Appendix A-18) - This form is to be used by property owners seeking to obtain a variance from bacteriological requirements for domestic well water supplies by installation of a ultra-violet (UV) disinfection device.
  • Waiver of Chemical Quality Prior to Conveyance
    (Appendix A-19) - This form is to be used for property transfers in which the Buyer agrees to purchase an improved property without a well meeting the water quality requirements. According to Baltimore County Code, this waiver form must be submitted to the Baltimore County Department of Environmental Protection and Sustainability at least 6 days prior to settlement.
  • Waiver of Yield Requirement for Improved Property
    (Appendix A-20) - This form is to be used for property transfers in which the Buyer agrees to purchase an improved property without a well meeting the minimum yield test requirements. According to Baltimore County Code, this waiver form must be submitted to the Baltimore County Department of Environmental Protection and Sustainability at least 6 days prior to settlement.
  • Waiver of Yield Requirement for Unimproved Property
    (Appendix A-21) - This form is to be used for property transfers in which the Buyer agrees to purchase an unimproved property without a well meeting the minimum yield test requirements. According to Baltimore County Code, this waiver form must be submitted to the Baltimore County Department of Environmental Protection and Sustainability at least 6 days prior to settlement.
  • Concept Plan Review Checklist
    (Appendix A-22) - GWM to review Concept Plan submittals for major subdivisions and commercial development. This checklist provides a basic summary of GWM requirements for all new development.
  • Environmental Sanitary Survey Form
    (Appendix A-23)  - GWM to document individual property inspections for well and septic system deficiencies during community-wide surveys for possible public water and sewer extensions.
  • Ground Water Management Notification Letter
    (Appendix A-24) - Underground Storage Tank (UST) contractors to confirm their responsibility to notify GWM at least 3 days prior to performing UST removals.
  • Tank Closure Inspection Report
    (Appendix A-25) - This form is to be used by GWM to document residential UST removal inspections.
  • Scavenger Inspection and Permit
    (Appendix A-26) - This form is to be used by GWM to record inspection and permit approval for septage waste haulers in Baltimore County.

Revised January 5, 2012

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