SB 205 Business License Stormwater Compliance Form

2. Before you begin, please keep in mind that you MUST create a different submission of this form for each location of your business within the City of Watsonville.
4. 1. Business Name*
6. 2. Address*
   What is the physical location or address of this business?
8. City
9. State
10. Zip Code
12. 3. What are the primary Standard Industrial Classification (SIC) codes for this business location?*

    Look up your SIC codes below and list them here. Use the two fields to the right to provide additional SIC codes if necessary.

13. SIC code 2
14. SIC code 3
16. Look up your SIC codes here
    OSHA website

    Search by keyword(s). For example: metal recycling. Alternatively, ask your insurance broker for your SIC code(s).
18. 4. Do any of the Primary SIC Codes from question #3 above match any of the regulated SIC codes listed on the Water Board website listed below?*

    1. Yes
    2. No
20. Check SIC Codes on this website
    Water Board Website
22. 5. If you selected NO in question #4, skip to the bottom of this form, sign, and submit the form. Then, submit your business license application. Nothing more for SB205 is required of you at this time.
24. 6. If you selected YES in question #4, has your business already obtained an Industrial NPDES Permit?

    1. Yes
    2. No
26. 7. If you selected YES in question #6 you are in compliance with SB205. Provide the following information regarding the existing Industrial NPDES permit, scroll to the bottom of this page, and submit this form. Be sure to also submit your business license renewal.
28. WDID#
29. WDID Application#
30. NONA ID#
31. NEC ID#
33. 8. If you selected NO in question #6 you need to enroll under the Stormwater Industrial General Permit (IGP) and provide the City with your permit numbers as described in question #7 above.)
    Sign and submit this SB205 Compliance Form AS WELL AS your business license form. Start the process of obtaining the Industrial General Permit by contacting the State or Regional Water Board at the information listed below.
35. Declaration*

    By checking the "I agree" box below, I agree and acknowledge that 1) my application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, I authorize my electronic signature to be valid and binding upon me to the same force and effect as a handwritten signature, and 3) I may still be required to provide a traditional signature at a later date. 4) I declare under penalty of perjury under the laws of California that the above information is true and correct to the best of my knowledge.

    1. I agree.
37. Electronic Signature*
39. State Water Board Contact

    Website: Waterboards.ca.gov/water_issues/programs/stormwater/industrial.html

    Email: stormwater@waterboards.ca.gov

    Phone: 1-866-563-3107

    
    

40. Region 3 Central Coast Regional Water Board - San Luis Obispo Office Contact

    Website: waterboards.ca.gov/centralcoast

    Email: r3_stormwater@waterboards.ca.gov

    Phone: 1805-549-3147

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field