Tolleson, AZ · Maricopa County
Wastewater Discharge Survey
Businesses complete and submit this survey to request wastewater discharge to the City of Tolleson or provide information for an initial permit application or renewal.
What this form is
The survey collects business and facility details, expected water use and wastewater discharge, disposal methods, pretreatment systems, floor drains, and information about hazardous products. The City of Tolleson Pretreatment Department reviews the completed questionnaire to determine whether additional information or forms are required. The form includes a certification that the information is true, accurate, and complete to the signer’s knowledge.
Who needs it
Businesses requesting to discharge wastewater to the City of Tolleson, applying for an initial permit, or renewing a permit should complete the survey.
How to submit it
Mail the completed and signed questionnaire to the City of Tolleson Pretreatment Section, Jim Lunsford, 9501 Pima, Tolleson, AZ 85353. Send an electronic copy to [email protected].
About notarization
This document is signed and dated without a notary; the signer certifies the information and any attachments, but the document does not require a notarized attachment.
How to submit this form
- 1
Download The Survey
Download the Wastewater Discharge Survey PDF.
- 2
Complete The Survey
Print or type responses to the questions about your business, facility, water use, wastewater, and pretreatment.
- 3
Sign And Date
Have the signing official certify the information, then sign and date the questionnaire.
- 4
Send It To The City
Mail the completed survey to the Pretreatment Section at the address on the form and email an electronic copy to the listed address.
Frequently asked questions
- Do I need a notary for the Wastewater Discharge Survey?
- No. Sign and date the survey and certify that its information is true, accurate, and complete to your knowledge. The document does not require a notarized attachment.
- How do I submit the Wastewater Discharge Survey?
- Mail the completed and signed survey to the City of Tolleson Pretreatment Section, Jim Lunsford, at 9501 Pima, Tolleson, AZ 85353, and send an electronic copy to [email protected].
- What information does the survey ask for?
- It asks for business and facility details, water use and wastewater discharge estimates, disposal methods, pretreatment systems, floor drains, hazardous products, and a responsible contact.
Need something notarized?
This Wastewater Discharge Survey doesn’t need a notary — but if you have another Tolleson form that does, a commissioned online notary can help.