Form EHP-6 "Individual Onsite Wastewater System Installation Specifications" - Arkansas

What Is Form EHP-6?

This is a legal form that was released by the Arkansas Department of Health - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the Arkansas Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form EHP-6 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Health.

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Download Form EHP-6 "Individual Onsite Wastewater System Installation Specifications" - Arkansas

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Arkansas Department of Health
Receipt No.
Environmental Health Protection
Individual Onsite Wastewater System Installation Specifications
(Must be signed and returned to ADH Authorized Agent within five working days.)
TB = Trench Bottom Elevation
Name of Applicant
PE = Top of Pipe Elevation
Location of System
GE = Ground Elevation
FL = Flow Line Elevation (Top of Pipe Elev. + 4”)
Name of Installer
License #
TE = Tank Lid Elevation
Drawdown
Septic Tank Size
Gal
Dose Tank Size
Gal
Benchmark
Inches
Number and Length of
Type of System
at
ft
Lines
Pump Rest
sec
Orifice Head
Pump Run
min
sec
min
ft
Trench Media
Trench Width
Stub-out
FL
GE
Tank Inlet
FL
Dose Tank Inlet
FL
GE
TE
TE
GE
Tank Outlet
FL
GE
TE
Dose Tank Outlet
FL
GE
TE
Other
GE
D-box Inlet
FL
GE
D-box Outlet
FL
GE
PE
Devices
Line 1
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 2
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 3
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 4
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
EHP-6 (R 6/13)
Arkansas Department of Health
Receipt No.
Environmental Health Protection
Individual Onsite Wastewater System Installation Specifications
(Must be signed and returned to ADH Authorized Agent within five working days.)
TB = Trench Bottom Elevation
Name of Applicant
PE = Top of Pipe Elevation
Location of System
GE = Ground Elevation
FL = Flow Line Elevation (Top of Pipe Elev. + 4”)
Name of Installer
License #
TE = Tank Lid Elevation
Drawdown
Septic Tank Size
Gal
Dose Tank Size
Gal
Benchmark
Inches
Number and Length of
Type of System
at
ft
Lines
Pump Rest
sec
Orifice Head
Pump Run
min
sec
min
ft
Trench Media
Trench Width
Stub-out
FL
GE
Tank Inlet
FL
Dose Tank Inlet
FL
GE
TE
TE
GE
Tank Outlet
FL
GE
TE
Dose Tank Outlet
FL
GE
TE
Other
GE
D-box Inlet
FL
GE
D-box Outlet
FL
GE
PE
Devices
Line 1
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 2
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 3
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 4
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
EHP-6 (R 6/13)
Receipt No.
Line 5
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 6
Middle
Line Length
Beginning
End
TB
TB
TB
GE
GE
GE
Line 7
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 8
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 9
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Line 10
Line Length
Beginning
Middle
End
TB
TB
TB
GE
GE
GE
Environmental Health Specialist
Date
I have installed this system as designed and in compliance with all Rules and Regulations Pertaining to Onsite Wastewater Systems.
Installer Signature
License Number
Date
EHP-6 (R 6/13)
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