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Pretreatment Forms
Wastewater Discharger 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.

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 the Senior Environmental Inspector at:

City of San José, Environmental Services
Watershed Protection Division
200 E. Santa Clara Street, 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    

TTO Certification Forms For Your SMR
  • If you DON'T have TTO's:
  • If you DO have TTO's:

Self Monitoring Report Forms

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