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Surcharge Forms

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Industrial Waste Facility Online Reporting System (IWFORS): 

IWFORS streamlines the surcharge filing process by guiding you through each step and automating calculations. You will save time and reduce errors by using IWFORS to electronically prepare and submit your surcharge statement package. Visit our website at https://www.lacsd.org/IWFORS to learn more about registering for an account.  A printed version of the surcharge statement will no longer be mailed. Please use IWFORS or the forms below. 

Surcharge Forms by Fiscal Year: 

Surcharge Forms and Surcharge Sample Result Outlier Calculator require use of Microsoft Excel. Refer to Microsoft Excel (PC or Mac) to obtain the latest version of Microsoft Excel.

Surcharge Form Instructions:

In lieu of mailing by postal service, submission of Surcharge Statement Packages and all back-up may be emailed to surchargeinfo@lacsd.org.

Summary of Surcharge Program

For more information on the Sanitation Districts' surcharge program, contact the Surcharge Processing Group at (562) 908-4288, extension 2600 or by email at surchargeinfo@lacsd.org.

Please note that the electronic versions of the tables in Microsoft EXCEL are offered for your convenience only. The Sanitation Districts do not guarantee the accuracy of calculations performed using the electronic tables. Carefully review your surcharge statement before submission to ensure accuracy. Inaccurate surcharge filings may be subject to penalties and/or interest fees.

The following tables are located within the file for the current fiscal year in the folder above.

  • Table 1 - Multiple Discharge Outlet Summary
  • Table 2A - Water Usage Verification Table
  • Table 2B - Adjusted Meter Water Supply
  • Table 3 - Chemical Oxygen Demand & Suspended Solids Summary

Use the appropriate Table below based on your method of flow volume determination:

  • Table 3 - Metered Water Supply
  • Table 3 - Adjusted Metered Water Supply
  • Table 3A - Direct Determination (sampling frequency of bimonthly or less)
  • Table 3B - Direct Determination (weekly sampling frequency)
  • Table 3C - Direct Determination (biweekly sampling frequency)
  • Table 3D - Direct Determination (daily sampling frequency)