Lynnwood, WA · Snohomish County
Limited Discharge Authorization Supplemental Application
Industrial users complete this supplemental application to request authorization to discharge industrially contaminated groundwater to the Lynnwood sewer system.
What this form is
This application requests authorization to discharge industrially contaminated groundwater to the City of Lynnwood sewer system and sets out discharge limits, monitoring requirements, and permit conditions. It asks for company and facility details, a signature agreeing to comply with permit conditions, and drawings showing the dewatering site, holding tank, and discharge location; the process note also calls for a site plan showing discharge details.
Who needs it
Industrial users seeking authorization to discharge industrially contaminated groundwater to the City of Lynnwood sewer system need this application.
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 applicant’s representative signs and dates the form, and no notarized attachment is identified.
How to submit this form
- 1
Download The Application
Download the Limited Discharge Authorization Supplemental Application PDF.
- 2
Complete The Application
Enter the company and facility details, then have the applicant’s representative sign and date the form.
- 3
Gather The Drawings
Include drawings showing the dewatering site, holding tank, and discharge location; follow the electronic submittal requirements referenced in the form.
- 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 is the Limited Discharge Authorization Supplemental Application?
- It is an application for industrial users seeking authorization to discharge industrially contaminated groundwater to the City of Lynnwood sewer system.
- What information and attachments does the application request?
- It asks for company and facility information and a signature agreeing to comply with permit conditions. The document also calls for drawings showing the dewatering site, holding tank, and discharge location.
- Do I need a notary for the Limited Discharge Authorization Supplemental Application?
- No. The applicant’s representative signs and dates the form; the document does not identify a notarized attachment.
- How do I submit the Limited Discharge Authorization Supplemental Application?
- The document does not specify a submission method. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Limited Discharge Authorization Supplemental Application doesn’t need a notary — but if you have another Lynnwood form that does, a commissioned online notary can help.