• Class I Industrial User Survey

    All industrial dischargers of nondomestic wastewater are required to complete the Industrial User Survey under Section 13.08.150 of the Sewer Use Ordinance.

    Completion of the permit application and survey will assist the Environmental Compliance Program in determining if a permit is required for your type of business.

  • Section 1.

    Reason for Applying
  • Reason for Applying*

  • Section 2

    Company Information
  • Type of Ownership*
  •  -
  • Billing Address is the SAME as the:
  • Property Owner Mailing Address is the SAME as the:
  •  :
    Until
     :
  • Days Per Week*
  • When Did Operation Begin?*
     - -
  • Has there been any construction since the beginning of operations that has modified or replaced the process or production of equipment that caused the discharge of pollutants?*

  • Section 3

    Facility
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  • Source of water supply*
  • Does the facility discharge STORM WATER to the City of San Luis Obispo sewer system?*

  • Section 4

    Operation(s)

  • Section 5

    Wastewater Information
  • Water conditioning unit(s) (softener or demineralizer) used on site?*
  • Conditioning unit regenerated on site?*

  • Section 6

    Spill Prevention
  • Do you have chemical storage containers, bins, or ponds at your facility?*
  • If yes, could an accidental spill lead to a discharge to: (check all that apply):*

  • Do you have floor drains in your manufacturing or chemical storage area*
  • Do you have an accidental spill prevention plan (ASPP) to prevent spills of chemicals or slug discharges from entering the Control Authority’s collection systems?*
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  • Section 7

    Certification

  • I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based upon my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and/or imprisonment for knowing violations.

  • Date*
     - -
  • Should be Empty: