Republic, WA · Ferry County
Lagoon Dump Form
The Lagoon Dump Form records company and contact details, dump date and gallons, and signatures for a lagoon dump billed by the City of Republic.
What this form is
This form records details of a lagoon dump for City of Republic billing. It asks for the company name, contact, mailing address, phone number, date, gallons dumped, and signatures for a representative and the City. The form states a charge of $175 per 1,000 gallons, with a $175 minimum, plus a 10% utility tax on the total due.
Who needs it
A company or representative documenting a lagoon dump billed by the City of Republic needs this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the form provides company representative and City signatures, and the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Lagoon Dump Form from this page.
- 2
Complete The Form
Enter the company and contact details, dump date, gallons dumped, and the requested signatures.
- 3
Review The Form
Check the completed details and signatures. The form lists no required attachments.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Lagoon Dump Form request?
- It requests the company name, contact, mailing address, phone number, dump date, gallons dumped, and signatures for a representative and the City.
- Do I need a notary for the Lagoon Dump Form?
- No. This form is signed without a notary; it provides spaces for company representative and City signatures, and the signer just signs and dates it.
- How do I submit the Lagoon Dump Form?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Lagoon Dump Form doesn’t need a notary — but if you have another Republic form that does, a commissioned online notary can help.