Vancouver, WA · Clark County
Industrial Information Form
Businesses complete this form to provide the City of Vancouver with information about facility wastewater, floor drains, chemical storage, and vehicle maintenance.
What this form is
The Industrial Information Form collects business and facility contact details and information about sewer connections, wastewater discharges, floor drains, chemical or petroleum storage, and onsite vehicle maintenance or washing. Businesses complete it to report facility activities to the city’s Industrial Pretreatment Program. The form includes a certification statement and spaces for a signature, date, printed name, and title.
Who needs it
A business or facility providing information about its sewer connections, wastewater, drains, chemical storage, or onsite vehicle activities should complete this form.
How to submit it
Fax the signed form to 360-487-7139 or mail it to PO Box 1995, Vancouver, WA 98668. Contact the Industrial Pretreatment Program at 360-487-7130 with questions about completing it.
About notarization
This document is signed without a notary; the signer signs and dates the certification, and any extra sheet about stored materials is not identified as requiring notarization.
How to submit this form
- 1
Download The Form
Download the Industrial Information Form.
- 2
Complete Business Details
Enter the business name, facility and mailing addresses, contact information, and a brief description of the business and wastewater-producing activities.
- 3
Answer Facility Questions
Answer each question about sewer connections, non-domestic wastewater, floor drains, chemical or petroleum storage, and vehicle maintenance or washing.
- 4
Add Materials Details
If the facility stores chemicals or petroleum products in containers larger than five gallons, provide the requested information and use an extra sheet if needed.
- 5
Sign And Submit
Sign and date the certification, then fax the form to 360-487-7139 or mail it to PO Box 1995, Vancouver, WA 98668.
Frequently asked questions
- Do I need a notary for the Industrial Information Form?
- No. The document has a certification statement and requires a signature and date, but it does not require notarization. An extra sheet about stored materials is not identified as needing a notary.
- How do I submit the Industrial Information Form?
- Fax the signed form to 360-487-7139 or mail it to PO Box 1995, Vancouver, WA 98668. The form lists the Industrial Pretreatment Program at 360-487-7130 for questions.
- What information does the form ask for?
- It asks for business and contact details, sewer connection and wastewater information, whether the facility has floor drains, chemical or petroleum storage details, and information about onsite vehicle maintenance or washing.
- Who completes the Industrial Information Form?
- A business or facility completes it to provide the city with information about its operations, sewer use, wastewater discharges, drains, stored materials, and vehicle-related activities.