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Get CA Industrial Wastewater Permit Application

INDUSTRIAL WASTEWATER PERMIT APPLICATION (SHORT FORM – DENTAL OFFICE OR CLINIC) Inspection District No: ______________ IU No.: _________________________ Permit No.: ______________________ Forwarded to: SIU LIU Instructions for completing the permit application are located on Pages 4 and 5. For additional assistance please call (323) 342-6200. Section 1. FILING STATUS (Check One) A. New or Proposed Point of Discharge to Sewer B. Existing, but Un-permitted Point of Discharge to Sewer C. New O.

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