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.