Fillable ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL (Louisiana Real Estate Commission)

Fill Online, Printable, Fillable, Blank ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL (Louisiana Real Estate Commission) Form

Use Fill to complete blank online LOUISIANA LOUISIANA REAL ESTATE COMMISSION (LREC) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL (Louisiana Real Estate Commission)

On average this form takes 11 minutes to complete

The ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL (Louisiana Real Estate Commission) form is 2 pages long and contains:

  • 0 signatures
  • 48 check-boxes
  • 22 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your LREC forms online.

Louisiana Real Estate Commission (LREC) aim to regulate real estate affairs in the state of Louisiana. LREC help protect the public interest during activites including real estate transactions.

BROWSE LOUISIANA LOUISIANA REAL ESTATE COMMISSION (LREC) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
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.
I
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
dehydration.
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.
A
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:
□ P
rivate Utility □ Onsite System □ None □ Not Known
2. If there is an onsite system, is it permitted by the Louisiana Department of Health (LDH)?
□ Yes
□ N
o
□ N
ot Known
You can follow the link to contact your local Parish Health Unit for all of the information below.
http://ldh.la.gov/index.cfm/page/394
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:
□ S
eptic Tank w/field lines □ Aerobic Treatment Unit □ Septic tank w/Oxidation Pond □ Other
□ N
ot Known
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
09/01/19 Seller’s Initials: _____ _____ Buyer’s Initials: _____ _____ 2 of 2
a. The original permit was issued by on (date). □ Not Known
(Typically, a non-permitted system of any type is illegal, regardless of age or type.)
b. The system was last inspected by on (date). □ Not Known
c. Is an inspection report attached? □ Yes □ No
d. Has the health department inspected the system? □ Yes □ No □ Not Known
e. If yes, on what date was the inspection? ______________ (date)
6. The system was last pumped out when? _______________ (date)
7. Is the system an Aerobic Treatment Unit? □ Yes □ No □ Not Known
a. If yes, name the manufacturer. __________________________________________
(The name of the manufacturer may be located on the data plate on the tank, compressor, or control box.)
b. If yes, do you have an ongoing maintenance agreement with a licensed maintenance provider?
□ Yes □ No □ Not Known
(D.H.H. Title 51, Appendix A, Section A:6, 12 requires that perpetual maintenance be provided on Individual
Mechanical Sewerage Treatment Plants.)
8. What type of discharge is used?
□ Surface Drainage □ Drain-Field □ Spray Irrigation □ Artificial Drain-Field □ Drip Disposal
□ Over Land Surface Flow □ Below Ground Pipe to Ditch or Stream □ Not Known
(D.H.H. Title 51, Subsection 717 prohibits the discharge of the effluent from septic tanks into street gutters, surface
ditches or streams.)
9. If the discharge is from over land flow or from a pipe, where does it drain?
10. What type of tank is used?
□ Metal □ Concrete □ Fiberglass □ Other □ Not Known
11. Does the system have a compressor/aerator? □ Yes □ No □ Not Known
a. If yes, where is it located?
b. If yes, is it in working order? □ Yes □ No □ Not Known
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ADDENDUM to PROPERTY DISCLOSURE DOCUMENT FOR RESIDENTIAL REAL (Louisiana Real Estate Commission)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 20 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document