2176 W. Treatment Plant Rd., St. George, Utah 84790
Phone: (435) 627-4266 Fax (435) 634-5846
Pretreatment Service Request
*Please allow up to 48-hours for review during regular business days, and up to 72-hours if submitting during weekends or holidays.
Date
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Month
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Day
Year
Date
Requesting Agency
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Ivins
Santa Clara
St. George
Washington
Business
Other
Other
Request Location Information:
Business Name
*
Type of Business
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date & Time Services are being requested:
*Note: Please select different dates for each choice below. (One choice per day.) Any requests with duplicate dates will be rejected. Once the request has been received a Pretreatment representative will reply via email with a confirmed date and time.
(1st choice) Earliest available: 8:30 a.m. Latest available: 4:00 p.m.
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Hour
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30
Minutes
AM
PM
AM/PM Option
(2nd choice) Earliest available: 8:30 a.m. Latest available: 4:00 p.m.
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Date
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Hour
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30
Minutes
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AM/PM Option
(3rd choice) Earliest available: 8:30 a.m. Latest available: 4:00 p.m.
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Year
Date
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Hour
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AM/PM Option
Contact Name
*
First Name
Last Name
Contact Title
*
Phone Number
*
-
Area Code
Phone Number
Contact Email Address
*
example@example.com
Requestor Information:
Name
*
First Name
Last Name
Requestor Title
*
Phone Number
*
-
Area Code
Phone Number
Requestor Email Address
*
example@example.com
Reason for Request
*
Dye Test *All kitchen fixtures need to be installed, in place and pressurized water available before the dye test can be performed. Any caps must be removed from the inlet tee of the interceptor in order to conduct the dye test as well as any bolts from the lids. At anytime during the dye test should one or more of the applicable fixtures (i.e. 3-compartment sink, mop sink, etc.) not pass, the dye test will need to be rescheduled. A rescheduled dye test may take up to 14 days depending on staff availability.
Grease Interceptor Inspection
Grease Trap Inspection
Sand/Oil Interceptor Inspection
Dental Facility Inspection
Food Truck Inspection *If requesting a Food Truck inspection please specify in the notes below if you would prefer to bring your truck/trailer to the SGRWRF for inspection, or would rather an inspector come to a designated location and provide the address for the location below.
Industrial Facility Inspection
Other
Other
Notes
*
Submit
Should be Empty: