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Type years and months
Provide a brief description of the manufacturing, production, or service activity(ies) your firm engages in:
If your facility employs or will be employing processes in any of the industrial categories or business activities listed below, place a checkmark beside the category of business activity. For more information on each business activity and corresponding CFR, please see the Code of Federal Regulations, Title 40 here.
Provide a schematic diagram showing the floor plan of the manufacturing area. Include all of the wastewater drains and any equipment from which wastewater is discharged. Identify point of discharge to the City sanitary sewer system. Indicate the location of any wastewater pretreatment equipment, raw material storage, chemical storage, storm drains, and/or hazardous waste storage. Include attachments as necessary.
If YES, attach copy of plan to application.
Enter the name and title of the person signing the appliation, along with their mailing address, phone number, and email address. The person signing the application must meet the signatory criteria as specified in Watsonville municipal Code 6-3.100 (d).
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 4) I certify under penalty of the law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to ensure that qualified personnel properly gathering and evaluate the information submitted. Based on 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 fines and imprisonment for knowing violations.
This field is not part of the form submission.
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