Wastewater Discharger Forms
Commercial businesses and industrial users who discharge wastewater to the sanitary sewer system in the jurisdiction of the San Jose/Santa Clara Water Pollution Control Plant may be required to complete these forms. If you have questions or need assistance, please contact a Source Control Inspector at (408) 945-3000.
Wastewater Discharge Application Forms
- Wastewater Discharge Permit Application MS
Word or PDF
- Short Term (1 year) Wastewater Discharge Permit Application MS
Word or PDF
Wastewater Discharge Application Forms should be submitted to the Senior Environmental
Inspector:
Environmental Services, Watershed Protection Division
200 E. Santa Clara St. 7th Floor
San José, CA 95113
(408) 793-5300 or (408) 945-3000
Zero Discharge Certification Forms
- Zero Discharge Certification Form MS Word or PDF
- Zero Discharge Certification Form – No Categorical Discharge MS Word or PDF
TTO Certification Forms For Your SMR
If you DON'T have TTO's:
If you DO have TTO's:
Self Monitoring Report Forms
Self Monitoring Report MS Word or PDF
How to Fill Out a Self Monitoring Report (PDF)
Self Monitoring Report Fact Sheet (PDF)
Baseline Monitoring Report, due 90 days after first discharge at a new facility. MS Word or PDF
Reasonable Control Measures Plan (RCMP)
Mass Audit Study Protocol (MAS)
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