Grass Valley, CA · Nevada County
Industrial Pretreatment Preliminary Survey
This survey collects business and wastewater information from Grass Valley businesses for the city’s wastewater pretreatment program.
What this form is
Grass Valley businesses complete this preliminary survey to provide information about their operations and wastewater before discharging to the city sewer system. It asks for business and owner details, water use, hazardous materials, floor drains, and pretreatment equipment. The signer certifies the information and agrees to specified wastewater-related responsibilities.
Who needs it
A business completing the survey should provide its business, wastewater, and pretreatment information and have an owner or designated agent sign it.
How to submit it
Return the completed survey to City of Grass Valley WWTP, 125 E Main Street, Grass Valley, CA 95945. For questions, contact the Public Works Water & Wastewater Division at (530) 274-4370.
About notarization
This document is signed without a notary; the signer just signs and dates it on the form.
How to submit this form
- 1
Download The Survey
Download the Industrial Pretreatment Preliminary Survey.
- 2
Complete The Survey
Enter the requested business, ownership, operations, and wastewater information.
- 3
Review And Sign
Certify the information and have the business owner or designated agent sign and date the form.
- 4
Return The Survey
Return the completed survey to City of Grass Valley WWTP at 125 E Main Street, Grass Valley, CA 95945.
Frequently asked questions
- What information does the Industrial Pretreatment Preliminary Survey request?
- It requests business and owner details, operating information, water use, hazardous materials, floor drains, and wastewater pretreatment equipment.
- Who signs the survey?
- The signer certifies the information and must be an owner of the business or the owner’s designated agent.
- Do I need a notary for the Industrial Pretreatment Preliminary Survey?
- No. The document is signed and dated without a notary; it does not identify any notarized attachment or related step.
- How do I submit the Industrial Pretreatment Preliminary Survey?
- Return it to City of Grass Valley WWTP, 125 E Main Street, Grass Valley, CA 95945. Contact the Public Works Water & Wastewater Division with questions.
Need something notarized?
This Industrial Pretreatment Preliminary Survey doesn’t need a notary — but if you have another Grass Valley form that does, a commissioned online notary can help.