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A Sewage Management Program is a necessary component of every successful decentralized wastewater treatment system. Such programs are as important as site testing, design, material quality, and construction of the system. In order to be effective the system users must be included as part of the program, because they are part of the system. The purpose of this paper is to discuss the common elements of an effective sewage management program for onsite systems. For too long, decentralized systems were believed to be either temporary or maintenance free. As such, elected officials often have avoided regulating maintenance and ongoing operation. As the number of decentralized and onsite systems continue to increase so does the need for a mechanism to assure the long-term successful operation of these systems.