Strasburg, PA · Lancaster County
Wastewater Discharge Questionnaire
This questionnaire collects business and facility information about wastewater discharges for businesses completing it for the Strasburg Borough Authority.
What this form is
The questionnaire gathers business contact details and information about facility services, drains, water flow, chemicals, wastewater analysis, and pretreatment. Businesses complete the sections and certify that the information is true, accurate, and complete; if the discharge was analyzed, the form asks for the most recent results to be attached. The document does not state when the Authority requires submission.
Who needs it
A business completing a wastewater discharge survey for a facility served by the Strasburg Borough Authority should provide the requested facility and wastewater information.
How to submit it
Return the completed survey to Strasburg Borough Authority, 145 Precision Avenue, Strasburg, PA 17579, or email it to [email protected].
About notarization
This document is signed and dated without a notary; the signer certifies the information under penalties for unsworn falsification, and no notarized attachment is specified.
How to submit this form
- 1
Download The Questionnaire
Download the Wastewater Discharge Questionnaire PDF.
- 2
Complete The Sections
Enter the business and contact information, answer the facility and wastewater questions, and complete the certification.
- 3
Gather Any Analysis Results
If the wastewater discharge has been analyzed for contaminants, attach a copy of the most recent results.
- 4
Submit To The Authority
Return the completed survey to the Strasburg Borough Authority by mail or email using the contact details on the form.
Frequently asked questions
- What information does the Wastewater Discharge Questionnaire request?
- It asks for business and contact details, facility services, drains, seasonal operations, water flow, chemicals and raw materials, wastewater analysis, and pretreatment information.
- Do I need a notary for the Wastewater Discharge Questionnaire?
- No. Sign and date the certification without a notary. It certifies the information under penalties for unsworn falsification; the form does not specify a notarized attachment.
- How do I submit the Wastewater Discharge Questionnaire?
- Return it to Strasburg Borough Authority at 145 Precision Avenue, Strasburg, PA 17579, or email it to [email protected].
- Do I need to attach wastewater analysis results?
- If the facility's wastewater discharge to the sewer system has been analyzed for contaminants, the questionnaire asks you to attach a copy of the most recent results.