In the Municipality of Penn Hills, the Dye Test Form serves an essential role in the maintenance of public health and safety by ensuring that properties are free of improper storm water connections to the sanitary sewer system. As administered by the Code Enforcement Department, this certification process is mandated under the provisions of Ordinance 2497, often as a prerequisite for obtaining an occupancy permit. With a nominal application fee of $20.00, payable to the Municipality of Penn Hills, this procedure underscores the local government's commitment to environmental stewardship and infrastructure integrity. The form requires detailed information including the property location, current owner details, and the testing firm's data, followed by the test results which categorically state whether downspouts or driveway drains are improperly connected. Furthermore, it documents the remediation actions taken if a violation is found, culminating in a certification that either confirms compliance or outlines necessary corrections. For any inquiries, the Department of Code Enforcement provides contact details, emphasizing the ordinance's role in safeguarding the community’s wellbeing by preventing the contamination of the sanitary sewer system.
| Question | Answer |
|---|---|
| Form Name | Dye Test Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | penn hills test form, hills dye form, hills dye test form, dye test penn create |
DYE TEST FORM
MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT DEPARTMENT
12245 FRANKSTOWN ROAD
PENN HILLS , PA 15235
OFFICE #
This form is for purposes of certifying that a property is free of storm water connections to the sanitary sewer. This certification may, under the provisions of Ordinance 2497, be required prior to the approval of an occupancy permit.
Currently, the application fee is $20.00, payable to the Municipality of Penn Hills.
For more information, contact the Department of Code Enforcement at (412)
Note: Please Print or Type This Application |
Date: |
APROPERTY LOCATION :
B Lot & Block No. |
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Fee: $20.00 |
Receipt No. |
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CCURRENT OWNER:
DOWNER'S ADDRESS:
EOWNER'S TELEPHONE NUMBER
FTESTING FIRM NAME:
GTESTING FIRM ADDRESS:
HTESTING FIRM AGENT:
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TEST RESULT(S): |
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Number of Downspouts: |
Positive |
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Negative |
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Driveway Drain: |
Positive |
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Negative |
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Other (Explain): |
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DATE OF TEST(S): |
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KDATE OF REMOVAL/CORRECTION
LTYPE OF REMEDIAL ACTION:
Drained to Surface |
Drained to Municipal Storm Sewer |
Drained to Sump |
Repair/Replaced Lateral |
Other (Explain) |
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MCERTIFICATION:
I hereby certify that this property has been tested for storm water infiltration to the sanitary sewage system under the terms of Ordinance 2080 and that no violation exists.
Name:Signature:
THE DOCUMENT OF CERTIFICATION
MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT OFFICER SIGNATURE