Forms - Clairton Municipal Authority

Forms

	Medical Emergency Certification	Download Medical Emergency Certification Form (PDF)

	Dye Test Certification Instructions Effective August 1, 2012, all properties being serviced by the Clairton Municipal Authority must pass a routine DYE TEST in order to be sold. A dye test is required on a sale of property. The plumber’s fee is $200.00. The dye test application fee is $25.00. The no-lien letter fee is $15.00. Send one check totaling $240.00 to: The Clairton Municipal Authority 1 North State Street Clairton, PA 15025 Once The Clairton Municipal Authority has received payment, contact one of plumbers listed on the Authorized Plumbers List to schedule a dye test. Once the property has successfully passed the dye test, the Sewer Certification Letters will be issued to whomever paid for them. If the property does not pass the dye test, the owner must perform the necessary corrections as instructed by the authorized plumber. Once the corrections are made, the owner must recall the plumber and reschedule another test (at no additional cost). If the property successfully passes the recheck, then the Sewer Certification Letters letters will be issued and mailed.	Download Dye Test Certification Instructions and Authorized Plumbers List (PDF) and the Certificate of Compliance Request Form (PDF)

	Capacity Tap Fees In order to tap into the Clairton Municipal Authority sewer system, you must have approval from from the community within which you are building. Capacity / Tap Fee is $809.00 per EDU. Provide the Clairton Municipal Authority with the completed approval letter and mail a check for $809.00 for each tap requested to: Clairton Municipal Authority 1 North State Street Clairton, PA 15025 Once the approval letter and check are received, we will fax, mail, or email (whichever you prefer) the receipts back to the builder and the builder can take that information back to the appropriate Community for final approval.	Download Capacity Tap Fee Form for Approval (PDF)

	Insurance Claims In certain instances, the Clairton Municipal Authority may be able to help property owners clean up their residences from sewage backups due to main line surcharging. To be considered for this service, please fill out the Insurance Claim Form and submit it to The Clairton Municipal Authority.	Download Insurance Claim Form (PDF)

	Right to Know Request Written / Verbal Requests - Upon receipt of a request for records, the open records officer must note the date of receipt on the written request. Compute the date on which the 5-day period under Section 901 will expire and make such notation on the written request. The open records officer shall be expected to maintain an electronic or paper copy of the written request, including all documents submitted with the request until the request has been fulfilled. If the request for information is denied, the written request shall be maintained for 30 days, or if an appeal is filed, until a determination is issued under Section 1101(b) or the appeal is deemed denied. If the record requires a time extension, the open records officer shall send written notice within 5 days to the requestor outlining the reason for the delay and a reasonable date as to when records will be available.	Download Right to Know Request Form (PDF)
	Record Request Denials / Appeals - If a record is to be deemed denied, a written explanation will include: A description of the record requested Specific reasons for denial Contact information for open records officer Date of response Procedure to appeal denial of this access under this Act If a request has been deemed denied, the requestor may file his appeal within 15 days of the date of the written letter of denial. The requestor must submit their appeal to the Office of Open Records. The Office of Open Records will have 30 days to review and make a decision on the appeal.	Commonwealth of Pennsylvania Office of Open Records Commonwealth Keystone Bldg 400 North Street, Plaza Level Harrisburg, PA 17120-0225 717-346-9903
	Open Records Fees Photo copy (single sided on 8.5”X11” page) Certified Copy Specialized documents (For example, but not limited to blue prints, color copies and non-standard sized documents) Facsimilie/Other Media Postage Fees	$0.25 per page $5.00 per record Actual Cost Actual Cost Actual Cost

	Act 44 Disclosures For entities providing professional services to the Clairton Municipal Authority's Pension System Chapter 7-A of Act 44 of 2009 mandates the annual disclosure of certain information by every entity (hereinafter "Contractor") which is a party to a professional services contract with the Clairton Municipal Authority’s pension fund. The Clairton Municipal Authority has determined that the Act 44 disclosure requirements apply to Contractor’s who receive payment of any kind from the Clairton Municipal Authority pension fund. The disclosure form provides certain information in regard to any financial relationships that may exist between the Contractors providing service to the pension fund and the appointed officials of the Authority and whether such a relationship could be a conflict of interest.	Download and View Act 44 Disclosure Forms US Asset Management (PDF) Law Offices of Randall R. Rhoades, Esquire (PDF) Dunbar, Bender & Zapf, Inc. (PDF) M&T Bank a/k/a Wilmington Trust (PDF)