Industrial Waste Forms

  1. Discharge Permit Application
  2. Flow Monitoring
  3. Combustible Gas Monitoring
  4. Policies
  5. Zero Discharge Forms
  6. Chloride
  7. Baseline Monitoring Reports
  8. Liquid Waste Disposal
  9. Connection Fee Form
  10. Supplemental Monitoring Data (Optional)
  11. Additional Forms
  12. Surcharge Forms

DISCHARGE PERMIT APPLICATION

  • Information and Instructions for Obtaining an Industrial Wastewater Discharge Permit [PDF]
  • Permit Application Form [PDF] [DOC]
  • Form A: Applicant Questionaire [PDF] [DOC]
  • Form B: Calculation of Industrial Wastewater Discharge Flow Rate [PDF] [XLS]
  • Form C: Tank Schedule and Spill Containment Calculations [PDF] [DOC]
  • Form D: Checklist for an Industrial Wastewater Discharge Permit Submittal [PDF] [DOC]

FLOW MONITORING

  • Flow Measurement Requirements [PDF] [DOC]
  • Flow Monitoring System Maintenance Records [PDF] [DOC]
  • Flow Monitoring System Calibration Check Record [PDF] [DOC]
  • Flow Monitoring System Certification of Calibration Check [PDF] [DOC]

COMBUSTIBLE GAS MONITORING

  • Combustible Gas Monitoring System Maintenance Record [PDF] [DOC]
  • Combustible Gas Detection Meter Calibration Check Record [PDF] [DOC]

POLICIES

  • Slug Discharge Notification Form [PDF] [DOC]
  • Toxic Organic Management Plan [PDF] [DOC]
  • Total Toxic Organics Attachment 4 [PDF] [DOC]
  • Dry Cleaners Certification 1 [PDF] [DOC]
  • Dry Cleaners Certification 2 [PDF] [DOC]

ZERO DISCHARGE FORMS (Perchloroethylene Dry Cleaner Zero Discharge Certification for Separator Wastewater)

  • Certification Form to be returned to the Districts [PDF]
  • Certification Form to be retained by Permittee [PDF]

CHLORIDE

  • Industrial Chloride Reduction Guidance Document [PDF] [DOC]
  • Chloride Reduction Workplan [PDF] [DOC]

BASELINE MONITORING REPORTS

  • Electroplating (413) and Metal Finishing (433) [PDF] [DOC]
  • Pharmaceutical Manufacturing Category [PDF] [DOC]
  • Centralized Waste Treatment [PDF] [DOC]
  • Transportation Equipment Cleaning [PDF] [DOC]

LIQUID WASTE DISPOSAL

  • Liquid Waste Disposal Station Permit Application Form (front and back pages) [PDF]
  • Liquid Waste Disposal Fee Deposit Form [PDF]
  • Debit Authorization Form Liquid Waste [PDF]
  • Uniform Sewage Manifest Form and Completed Sample [PDF]

ADDITIONAL FORMS

  • Wastestream and Production Information [PDF] [DOC]