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, 170 W. San Carlos Street, San José, CA 95113, phone (408) 945-3000.

TTO Certification Forms For Your SMR

We have TTO's MS Word or PDF
We Don't have TTO's MS Word or PDF
Organic Solvent Worksheet MS Word or PDF

Self Monitoring Report Forms

Self Monitoring Report (MS Word)
Self Monitoring Report (PDF)
Self Monitoring Report Quick Reference Guide (PDF)
Self Monitoring Report Fact Sheet (PDF)
Baseline Monitoring Report, due 90 days after first discharge at a new facility. (PDF)

Reasonable Control Measures Plan (RCMP)

Guidance Document and Forms (PDF)
Checklist and Implementation Schedule (Excel)

Mass Audit Study Protocol (MAS)

Program Description and Forms (PDF)
MAS Worksheets (Excel)

Flow Audit Study Worksheets (web page)

Plan Check Questionnaires (web page)

	Last Modified Date: 4/15/2009

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