कार्यालय नगर पालिका निगम / पालिका / पालिका

ULB C
E-Mail: ____________________________________
Division
ULB Code
2011 census Population

Is the septic
Type of Septic Tank
tank
(Residential/
Sr. No. Ward Number Address with pincode connected to
Institutional/
soak pit?
Commercial/ CT/PT)
(Yes/No)
नगर पालिका निगम / पालिका / पालिका परिषद ________________ (म.प्र.)
ULB Code :
__________________________ Tel.__________________________________
Dist.
ULB name
Total HouseHolds

Date of next de-

Is the septic tank compliant to IS 2470
sludging
Date of last De- Date of last (Indian standard code of practice for
(3 years from
sludging? Inspection installation of septic tanks and
date of last de-
soakpits)?
sludging)
___________

Please capture longitude

Please capture latitude of the
of the Septic Tank (from
Septic Tank (from Google Map)
Google Map)