Application to change non-return to sewer percentage (H5)

Your Details

Customer reference number (10 digits)*:

Company Name*:

Premises Name:

Premises number and Street*:

Town/City*:

Postcode*:

Customer Name*:

Contact Number*:

Email Address*:

Why do you believe your current return to sewer percentage should change?*:

Where is the used water going?*:

E.g soakaway, septic tank or in to production

Total annual consumption:

Based on actual meter reads

Annual volume used in process:

No. of full-time employees*:

No. of part-time employees*:

Is there a canteen on the premises?*:

Yes
No

Please provide any evidence to support your claim:

E.g. production calculations / photographs

Additional documentation: