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WSCS - Flow Rate Capacity Request Form

The Capacity Management group will send you a letter with the results of the sewer capacity analysis within 2 weeks. NOTE: THE LETTER IS NOT AN WSCS PERMIT TO DISCHARGE. To obtain the permit, please submit the capacity letter to WSCS. If you do not receive the capacity analysis letter within 2 weeks or if you have any questions about filling out the form, please contact:

Ligaya Kohagura at (916) 876-6045 or Kim Dao at (916) 876-6061.

Please fill in the appropriate information in the fields below and submit your request by clicking the SUBMIT button below. We will confirm receipt of your request and ask for additional information if needed. NOTE: Asterisks (*) indicate required fields. Omitting required information will delay the processing of your request.

1. Requester Information

*
Company Name:
 
Company Type:
Example: dry cleaners, bakery, car wash, restaurant, fast food, etc. . .
*
Company Address 1:
 
Company Address 2:
*
City:
*
State:
*
Zip:

Contact Person

*
First Name:
*
Last Name:
*
Phone:
() - ext:
 
Fax:
() -
*
Email Address:

Contact's Mailing Address (if different from above)

 
Company Name:
 
Company Address 1:
 
Company Address 2:
 
City:
 
State:
 
Zip:

WSCS Contact Information

 
WSCS Contact's Name:

2. Discharge Information

Sewer Discharge Location Information

*
Address/Location of Discharge:
*
Cross Streets:
 
9-Digit Discharge Manhole #:
 
APN # (if applicable):
*
Discharge Type:
A permanent discharge is one that occurs for longer than 1 year.
A temporary discharge is one that occurs one time or for less than 1 year.

Please complete the appropriate section below:

**fields required per Discharge Type selection

REQUEST FOR A PERMANENT
DISCHARGE PERMIT
**Type of Discharge:
**Typical Discharge Hours:
From:
To:
**Maximum Discharge Rate Requested:
gallons per minute
Average Discharge Rate:
gallons per minute
REQUEST FOR A TEMPORARY
DISCHARGE PERMIT
**Type of Discharge:
**Typical Discharge Hours:
From:
To:
**Maximum Discharge Rate Requested:
gallons per minute
**Total Discharge Volume Requested:
gallons
Approximate Discharge Begin Date:
Approximate Discharge End Date:
**One Time Discharge?
*
Reason/Type of Discharge:
 
Additional Comments (optional):
 
 

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