Windsor, VA · Isle of Wight County
Septic Pump-Out Program Compliance Form
Property owners or responsible parties use this form to report septic system and pump-out information to the Town of Windsor.
What this form is
The Town of Windsor uses this form to collect information about a property's on-site septic system and its most recent pump-out. The form asks for owner and property details, septic system counts, pump-out dates, and information about an effluent filter. Attach a pump-out receipt or other acceptable documentation, and, if applicable, a contractor receipt for an installed filter.
Who needs it
Property owners or responsible parties completing the Town of Windsor's Septic Pump-Out Program compliance process should submit this form.
How to submit it
Return the completed form to the Town of Windsor, C/O Planning and Zoning Administrator, PO Box 307, Windsor, Virginia 23487.
About notarization
This form is signed and dated without a notary; attach a pump-out receipt or other acceptable documentation, and a contractor receipt for an installed filter if applicable.
How to submit this form
- 1
Download The Form
Download the Town of Windsor Septic Pump-Out Program Compliance Form.
- 2
Complete The Form
Provide the property owner and property details, answer the septic system questions, and enter the most recent pump-out date.
- 3
Gather Attachments
Attach pump-out documentation; if an effluent filter was installed, include the contractor receipt showing its installation date.
- 4
Sign And Date
Sign and date the form as the property owner or responsible party.
- 5
Return It To The Town
Send the form to the Planning and Zoning Administrator at PO Box 307, Windsor, Virginia 23487.
Frequently asked questions
- Who should complete the septic pump-out compliance form?
- The property owner or responsible party should complete it with property and septic system details, including the most recent pump-out date.
- What attachments does the form request?
- Attach a pump-out receipt or other acceptable documentation from the sewage handler. If an effluent filter was installed, provide the contractor's receipt showing its installation date.
- Do I need a notary for this septic pump-out form?
- No. The form calls for the property owner or responsible party to sign and date it; it does not specify a notarized or sworn attachment.
- How do I submit the septic pump-out compliance form?
- Return it to the Town of Windsor, C/O Planning and Zoning Administrator, PO Box 307, Windsor, Virginia 23487.