A sewage treatment apparatus comprising a separation membrane module comprising a plurality of separation membrane elements and a housing containing the separation membrane elements, each separation membrane element comprising a separation membrane comprising a porous substrate and a porous resin layer on at least one surface of the porous substrate, the porous resin layer comprising a resin, part of the resin permeating into the porous substrate to form a composite layer, wherein the porous resin layer has an average pore size in the range of 0.01 to 0.2 μm and a standard variation of the pore size of 0.1 μm or less at the surface, the separation membrane module being immersible into sewage to be treated in use.