09/01/19 Seller’s Initials: _____ _____ Buyer’s Initials: _____ _____ 1 of 2
ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL ESTATE
DISCLOSURE OF INFORMATION ON RESIDENTIAL SEWERAGE TREATMENT SYSTEMS
Property Address City State Zip
SELLER OF RESIDENTIAL REAL ESTATE: Complete this disclosure document if city, town, or municipality waste
treatment does not serve the property described herein.
mproperly treated or partially treated residential sewage poses significant risks to human health and to the
environment. Untreated or poorly treated water contains parasites, bacteria, and viruses that cause serious
disease. D.H.H Title 51, Subsection 707 states: “Individual sewerage systems shall be kept in service and in
serviceable condition sufficient to ensure compliance with this code and in order to avoid creating or contributing
to a nuisance or public health hazard.”
HEALTH HAZARDS AND DISEASES
Gastroenteritis – severe inflammation of the intestines that may cause severe vomiting and diarrhea leading to
Severe infection – result of contact with untreated water where there are cuts or abrasions on the skin.
Hepatitis – serious infection of the liver that can lead to long term illness.
residential sewerage treatment system that is not properly operated or maintained may also result in the pooling
of improperly treated water at the surface. Health risks also exist from mosquito infestations that may cause
West Nile Virus, Encephalitis, and other diseases. Improperly operating systems may be subject to fines and
penalties under Louisiana law.
1. Sewerage treatment is supplied by:
rivate Utility □ Onsite System □ None □ Not Known
2. If there is an onsite system, is it permitted by the Louisiana Department of Health (LDH)?
You can follow the link to contact your local Parish Health Unit for all of the information below.
3. List of Current Installers and Maintenance Providers: http://ldh.la.gov/index.cfm/newsroom/detail/2082
4. If there is an onsite system, it is:
eptic Tank w/field lines □ Aerobic Treatment Unit □ Septic tank w/Oxidation Pond □ Other
a. Is there more than one system on the property, e.g. guest house, outbuildings, barns, etc.?
□ Yes □ No □ Not Known
If yes, answer all questions for each system on a separate sheet of paper and attach to this addendum.
5. What is the approximate age of the system? □ Not Known