The Liquid Waste Request for Service Form is issued by the Sacramento County Environmental Management Department, Environmental Compliance Division, to request services from its Liquid Waste (septic) program. A homeowner, contractor, consultant or other requesting party uses it to identify the site, the property owner and the party who will be billed. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the original PDF is published by the county at emd.saccounty.gov.
Last updated
What is Liquid Waste Request for Service Form – Sacramento County, CA?
The Liquid Waste Request for Service Form is the Sacramento County Environmental Management Department (EMD) form used to ask the Environmental Compliance Division for a Liquid Waste (septic) program service, and to identify the requesting party, the site and the party responsible for billing.
The top of the form is an Office Use Only block that the department completes. It lists the services the division handles, each with a code: Test Drill Review (PE 4240), Engineering Approval (PE 4241), Plot Plan Approval Letter (PE 4242), Consultation (PE 4265), Bank (PE 4243), Variance (PE 4245) and Septic to Sewer Waiver (PE 4244). The block also holds the department's receipt, fee and hours entries.
The part you complete covers the requesting party, the site information (property owner, cross street, subdivision, APN#, CBN# and LOT #), the responsible party for billing, how plot plans should be returned, the date and time requested for a test drill or site evaluation, and a billing acknowledgement with a signature.
The county's Waste Program Forms and Documents page lists this form among the Liquid Waste (Septic) Program forms, next to separate documents such as the Liquid Waste Permit Application Form and the Liquid Waste Site Map Template. This form is a request for service, not a permit application.
Who needs to file Liquid Waste Request for Service Form – Sacramento County, CA?
The requesting party files this form when it wants the Sacramento County Environmental Compliance Division to perform a Liquid Waste (septic) program service at a site. The form identifies the requesting party as a Homeowner, Contractor, Consultant or Other, with a line to say who.
- Property owners who are not the requesting party are listed under Site Information; if the site details match the requesting party, check Same as above.
- The billing party is the Requesting Party, the Property Owner, or someone else you name on the form.
- Business owners and authorized agents may sign the billing acknowledgement: it is signed by the property or business owner, or an authorized agent of the same.
The form does not state minimum qualifications or exclusions. Because it is a request for service rather than a permit application, check the county's Liquid Waste Permit Application Form if you need a permit.
When to file Liquid Waste Request for Service Form – Sacramento County, CA
Submit the form when you need the Liquid Waste program to perform a service at your site, such as a test drill or site evaluation, a plot plan approval, a consultation or a variance. The form prints no deadline and no processing time of its own.
If you ask for a test drill or site evaluation, the form asks for the date and time you request, so decide on them before you complete it. If you ask for plot plan approval, the form asks how you want the plans returned: call for pick-up, or mailed to an address you provide. Hourly charges accrue for site and project-specific work, so the request is the point at which the billing party is identified and the acknowledgement is signed.
How to fill out Liquid Waste Request for Service Form – Sacramento County, CA
Skip the Office Use Only block
Leave the top section, with the service codes, plan dates, fee and hours, to the Environmental Management Department.
Describe the scope of work
Use the SCOPE OF WORK area to describe the service or work you are requesting, if you are asking for a specific service.
Enter the requesting party
Under REQUESTING PARTY, enter your name, phone, address, city and ZIP code. Check Homeowner, Contractor, Consultant or Other and write who if you choose Other.
Complete the site information
Check Same as above if the site matches the requesting party. Otherwise enter the property owner's name, phone, address, city and ZIP code, plus the cross street, subdivision, APN#, CBN# and LOT #.
Identify the responsible party
Under RESPONSIBLE PARTY (BILLING), check Requesting Party or Property Owner. If someone else pays, specify their name, phone and mailing address.
State how plans are returned
For Plot Plan Approval, enter a phone number for Call for pick-up or the address for Mail Plans to.
Request a test drill date
For Test Drill / Site Evaluation, write the date and time you are requesting.
Sign the billing acknowledgement
The property or business owner, or an authorized agent, signs and prints a name under BILLING ACKNOWLEDGEMENT, accepting hourly charges for the department's site and project-specific work.
Review and download the PDF
Check every entry, then download or print the completed PDF from FillingPDF and send it as described under How to submit.
How to submit Liquid Waste Request for Service Form – Sacramento County, CA
The form does not name a submission channel. It prints the contact details of the Environmental Management Department, Environmental Compliance Division:
- Address: 11080 White Rock Rd. Ste 200, Rancho Cordova, CA 95670
- Telephone: (916) 875-8550
- Fax: (916) 875-8513
- Liquid Waste Inspection Line: (916) 875-1500
Contact the division to confirm which channel it accepts for your request before you send the form. If you request plot plan approval, give your return preference on the form: a telephone number for pick-up or a mailing address.
Hourly charges for site and project-specific work are billed to the person or business that signs the billing acknowledgement; the form prints an hourly rate, and the division can confirm the current amount. FillingPDF lets you fill out and download the PDF; submission follows the county's channels.
Common mistakes to avoid
- Writing in the Office Use Only block at the top, which the department completes (plan received, fee, service codes and hours).
- Leaving the Responsible Party (Billing) selection blank, or choosing "If other" without specifying the party's name, phone and mailing address.
- Requesting plot plan approval without saying how the plans should be returned: call for pick-up with a phone number, or a mailing address.
- Requesting a test drill or site evaluation without the date and time requested.
- Leaving the billing acknowledgement unsigned or the print name blank; the form is signed by the property or business owner, or an authorized agent.
- Signing the acknowledgement without understanding that all site and project-specific hourly charges, or fractions of an hour, are billed to you or your business.
- Omitting site identifiers such as APN#, LOT #, cross street or subdivision when the site differs from the requesting party's address.
Frequently asked questions
What is the Liquid Waste Request for Service Form?
It is the Sacramento County Environmental Management Department form used to request a Liquid Waste (septic) program service from the Environmental Compliance Division. It records the requesting party, the site, the billing party and a signed billing acknowledgement.
Is this form a Sacramento County business license?
No. This form requests a Liquid Waste (septic) program service from the Environmental Management Department; it is not a license application. The form does have a CBN# line under Site Information, but it asks only for that number and does not set out any licensing procedure.
Can I fill out the Liquid Waste Request for Service Form online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not send the form to the county; you deliver it through the department's channels.
Who signs the billing acknowledgement?
The property owner, the business owner, or an authorized agent of either signs and prints a name. By signing, they acknowledge that all site and project-specific hourly charges, billed per hour or fraction thereof, will be billed to them or their business.
Is there a charge for a liquid waste service request?
Yes. The form says hourly charges accrued by the department for site or project-specific work are billed to the signer. The amount is not repeated here; call (916) 875-8550 or check with the Environmental Compliance Division for the current rate.
Where do I send the Liquid Waste Request for Service Form?
The form names no channel but prints the division's address, 11080 White Rock Rd. Ste 200, Rancho Cordova, CA 95670, telephone (916) 875-8550 and fax (916) 875-8513. Confirm with the division which method it accepts before sending.
What does the form ask for if I need plot plan approval?
It asks how you want the plans returned: either call for pick-up, with a phone number, or mail to an address you write in. Complete only the option you want.
What should I enter for a test drill or site evaluation?
Write the date and time you are requesting in the Test Drill / Site Evaluation line. The form does not set deadlines; contact the division at (916) 875-8550 if you need to confirm availability.
Ready to fill out Liquid Waste Request for Service Form – Sacramento County, CA?
Fill out Liquid Waste Request for Service Form – Sacramento County, CA now