"Transfer of Ownership Inspection Waiver Application" - New Mexico

Transfer of Ownership Inspection Waiver Application is a legal document that was released by the New Mexico Environment Department - a government authority operating within New Mexico.

Form Details:

  • Released on March 21, 2016;
  • The latest edition currently provided by the New Mexico Environment Department;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Environment Department.

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Download "Transfer of Ownership Inspection Waiver Application" - New Mexico

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NEW MEXICO
ENVIRONMENT DEPARTMENT
2540 Camino Edward Ortiz
Santa Fe, NM 87507
Phone (505) 827-1840 Fax (505) 827-1839
RYAN FLYNN
SUSANA MARTINEZ
www.env.nm.gov
Cabinet Secretary
Governor
BUTCH TONGATE
JOHN A. SANCHEZ
Deputy Secretary
Lieutenant Governor
OPTIONAL: Division Director or Bureau Chief (use one line)
TRANSFER OF OWNERSHIP INSPECTION WAIVER APPLICATION
For use when an inspection has been performed on a permitted or registered liquid waste system within the last 180
days, or a system that has been inspected, but has been unoccupied for up to one year since the inspection.
GENERAL (To be completed by Owner, General Building Contractor or Authorized Representative):
*Owner________________________________________________________Phone _________________________
*Mailing Address ________________________________ City ______________ State ________ Zip___________
*Site Address ________________________________________________ Lot Size _________________________
Property: Township __________________ Range __________________ Section _____________________
Subdivision ___________________________ Unit No. _________ Block No. _________ Lot No. _____________
*Liquid Waste Permit # __________________________ Uniform Property Code ___________________________
Date of Last Inspection/Inspector Name
Reason the system has not been in use, if applicable
Liquid Waste Contractor name __________________________________________ Date ___________________
(Print) CID License Number__________________________
*Applicant Signature __________________________________________________________________________
This waiver shall not be construed as a warranty that the system will function properly. Because of the numerous
factors (usage, soil characteristics, previous failures, etc.) which may effect the proper operation of a liquid waste
system, NMED disclaims any warranty, either expressed or implied, arising from the inspection and evaluation of
the wastewater system or this inspection waiver. This waiver is invalid if any modifications have been made to the
liquid waste system since the original inspection, including changes in the design flow.
The NEW MEXICO STATE ENVIRONMENT DEPARTMENT may verify the above information.
NMED Review: _______ Accepted _______ Not Accepted
Date of initial inspection: ___________________________________________
This waiver is valid for: ___180 days from initial inspection, or ___1 year from initial inspection
Reviewed by: _________________________________________________ Date __________________________
3/21/16 mb
NEW MEXICO
ENVIRONMENT DEPARTMENT
2540 Camino Edward Ortiz
Santa Fe, NM 87507
Phone (505) 827-1840 Fax (505) 827-1839
RYAN FLYNN
SUSANA MARTINEZ
www.env.nm.gov
Cabinet Secretary
Governor
BUTCH TONGATE
JOHN A. SANCHEZ
Deputy Secretary
Lieutenant Governor
OPTIONAL: Division Director or Bureau Chief (use one line)
TRANSFER OF OWNERSHIP INSPECTION WAIVER APPLICATION
For use when an inspection has been performed on a permitted or registered liquid waste system within the last 180
days, or a system that has been inspected, but has been unoccupied for up to one year since the inspection.
GENERAL (To be completed by Owner, General Building Contractor or Authorized Representative):
*Owner________________________________________________________Phone _________________________
*Mailing Address ________________________________ City ______________ State ________ Zip___________
*Site Address ________________________________________________ Lot Size _________________________
Property: Township __________________ Range __________________ Section _____________________
Subdivision ___________________________ Unit No. _________ Block No. _________ Lot No. _____________
*Liquid Waste Permit # __________________________ Uniform Property Code ___________________________
Date of Last Inspection/Inspector Name
Reason the system has not been in use, if applicable
Liquid Waste Contractor name __________________________________________ Date ___________________
(Print) CID License Number__________________________
*Applicant Signature __________________________________________________________________________
This waiver shall not be construed as a warranty that the system will function properly. Because of the numerous
factors (usage, soil characteristics, previous failures, etc.) which may effect the proper operation of a liquid waste
system, NMED disclaims any warranty, either expressed or implied, arising from the inspection and evaluation of
the wastewater system or this inspection waiver. This waiver is invalid if any modifications have been made to the
liquid waste system since the original inspection, including changes in the design flow.
The NEW MEXICO STATE ENVIRONMENT DEPARTMENT may verify the above information.
NMED Review: _______ Accepted _______ Not Accepted
Date of initial inspection: ___________________________________________
This waiver is valid for: ___180 days from initial inspection, or ___1 year from initial inspection
Reviewed by: _________________________________________________ Date __________________________
3/21/16 mb