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Official government websites use .gov

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A lock lock or https:// means you've safely connected to the .gov website. Only share sensitive information on official, secure websites.

Wastewater discharge self-monitoring forms

Download KCIW self-monitoring forms in either Microsoft Word or Acrobat PDF format.

Self-monitoring form Microsoft Word Format Adobe PDF format
Monthly  (25KB) 
 (59KB) 
Monthly - food processors only  (104KB)
 (35KB) 
Quarterly  (48KB) 
 (76KB) 
Quarterly - breweries only  (50KB) 
 (191KB)
Semiannual  (32KB) 
 (52KB) 
Annual  (22KB) 
 (36KB) 
Annual - groundwater remediation only  (23KB) 
 (36KB) 
 Revised Data  (146KB)
 (399KB)

Signature and submittal

King County Industrial Waste forms must be signed by an authorized representative before submittal.

Please scan your signed forms and send them by email  info.kciw@kingcounty.gov.

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