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Pretreatment Forms
Commercial businesses and industrial users who discharge wastewater to the sanitary sewer system in the jurisdiction of the San José-Santa Clara Regional Wastewater Facility may be required to complete these forms. If you have questions or need assistance, please contact a Source Control Inspector at (408) 945-3000.

Self Monitoring Report (SMR) Forms

Signatory Requirement Authorization Form
  • Certification Form for Assigning a Duly Authorized Representative: PDF

Toxic Organic Management Plan (TOMP) Forms

Wastewater Discharge Application Forms
  • Wastewater Discharge Permit Application: MS Word or PDF
  • Short Term (1 year) Wastewater Discharge Permit Application: PDF

Wastewater Discharge Application Forms should be submitted to Environmental Engineering at:
City of San José, Environmental Services
Watershed Protection - Environmental Engineering 
200 E. Santa Clara Street, 7th Floor
San José, CA 95113

Zero Discharge Certification Form
  • Zero Discharge Certification Form: MS Word or PDF